Sitting of 10 June 1988

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

Women's Health
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Peter Lloyd.]
9.36 am
The Parliamentary Under-Secretary of State for Health and Social Security (Mrs. Edwina Currie): This is, I believe, the first debate on women's health called in Government time for a long while, and I believe that it shows how far we have come on this important topic. In a moment I shall outline some of the major improvements that we have seen in the last year or so, and some aspects on which I want to take matters forward.
Women have been receiving advice on their health and welfare for a long time. Here is the columnist of Home Companion magazine of 12 November 1898, writing in answer to two correspondents:
"In your trouble, 'AM', you have my sympathy, and though I can hardly tell you how to become as thin and wan as a willow, I can at least tell you how you can reduce your form to graceful proportions. Take plenty of vigorous exercise and I advise you especially to try bicycling … And here comes 'Dorothy' who wants to know how she can grow stout. Laugh, and grow fat, 'Dorothy'. A good laugh promotes digestion and tends to lengthen life." All good advice!
Modern problems have also been around for a long time. This is "Meg", writing to Woman's Weekly in June 1918—the date is significant:
"I should very much like to have your opinion on the modern woman's craze for smoking. One hears so much for and against the habit. A few years ago when I was in Paris, I asked a Frenchman if he admired a woman who smoked. He replied: 'Well, I should not like my wife to smoke, and would not allow her to."
The answer would not satisfy us today:
"I don't approve of men taking this kind of tone, as if their wives were small children; but at the same time, I think Meg's words are worth attention from another point of view. Tobacco is getting very short and we are told it will have to be rationed. Think of what that will mean to our soldiers and sailors. Girls, every packet of cigarettes you buy to smoke yourselves leaves a packet less for our fighting men!"
But yesterday's agony aunts had a different attitude on other subjects. Here is one letter, coyly signed "Wavelet", on the problems of cycling, in Home Chat magazine of April 1897:
"On a recent cycle ride, I was overtaken by another cyclist who told me one of my tyres was soft, and offered to blow it up for me. I accepted his offer. Since then, when we meet, he bows. Yesterday, I had a note asking me to take a ride with him on Sunday week. He appears to be a gentleman, but I don't know what to do with regard to this request."
The answer was very firm:
"Give the letter to your parents, who will no doubt so deal with it that this very impertinent young man will not take such a liberty again."
The obvious question to ask is why women's health? Why not health in general? Is it not somewhat artificial to separate out "women's health", along with "women's
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issues", "women's rights" and other, as Private Eye would put it, "loony feminist nonsense"? I am no feminist. When I was asked to take on responsibility for women's health in 1986 I wondered whether, apart from maternity, there were indeed any separate issues. There are two answers: we should look at women's health because it is completely different from men's health at almost every stage in our lives, and because many aspects of women's health and women's role in the health of their families have perhaps received far less attention in the past then they merited, not just from men but also from the women.
The differences start from the first day. More boy babies are born, but relatively more girls survive: we do not know why. Women outnumber men in every age group after middle age and the imbalance slowly increases throughout later life, until women form two thirds of the age group above 75. Thus, illnesses that increase with age affect far more women than men, and women account for the majority of in-patients in the National Health Service—that does not apply to acute care only. Women outnumber men in most age groups in diagnoses of mental illness in England; for every three men admitted to NHS mental illness hospitals and units in 1986 there were four women. Even if elderly people—75 and above—are excluded, the ratio is two men to three women. In fact, admission rates for women outnumber those for men in most of the main diagnostic groups in mental illness. The main exceptions are schizophrenia, and drug and alcohol-related mental illness—although for the latter two, women are beginning to catch up.
Women's health is different. Women tend to suffer from different ailments, and not just the obvious ones associated with reproduction. Among the preventable diseases, our main killer in this country is heart disease. It is mostly men, however, who die of heart disease. Women in middle age are on the whole far less affected than men by diseases of the cardiovascular system, unless, of course they are foolish enough to be smoking while on the pill, when their risk of a heart attack rises 10 times. In middle age, women are more likely to be victims of cancer, particularly breast cancer. It follows therefore, that health campaigns for women that may help to improve their chances of reaching a healthy and happy old age are significantly different from those for men.
Let us consider some issues of concern to women. The major killer of women before their time in the United Kingdom is breast cancer. About 250,000 women every year in the United Kingdom get a breast lump—90 per cent. are benign but 24,000 are cancer and 15,000 women die each year from this disease. That is more than seven times as many as from cervical cancer, which is probably the better known disease. The survival rate is improving. Sixty four per cent.—nearly two thirds—survive longer than five years now following first diagnosis of breast cancer, and there should be a real improvement in survival in the next decade. Although much research is under way, there is no clear causal link between breast cancer and environment or lifestyle. Therefore, apart from women with a family history of the disease, who can be warned to be especially vigilant, there is as yet no good advice we can give women on how to avoid it. That is one reason why we have developed the breast cancer screening programme. If we cannot avoid the disease—primary prevention—then the next best is to find it as early as possible and treat it while still curable—secondary prevention.

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Many hon. Members will know that the NHS is setting up a national breast cancer screening service over the three years to 1990. The programme traces its origins to a working group that was set up in July 1985 on behalf of United Kingdom Health Ministers. The group was chaired by Professor Sir Patrick Forrest from Edinburgh. In February 1987, the then Secretary of State, my right hon. Friend the Member for Sutton Coldfield (Mr. Fowler), announced the Government's acceptance of the proposals in the Forrest group's report.
The Forrest report concluded that screening women aged 50 to 64 by mammography every three years should eventually reduce the deaths from breast cancer by at least one third. That is several thousand women. The NHS breast cancer screening service will do what he recommended, and provide a computerised call and recall system to screen women in the age group 50 to 64 by mammography with screening for women of 65 and over if requested.
We are often asked, why not younger women? As a younger woman I assure the House that, if there was any evidence that screening would help, that would have been taken in to account, but there is insufficient evidence to show that mass screening for younger women is effective in significantly reducing mortality, and more research is under way. Younger women at special risk—for example if there is a family history of breast cancer—may be offered mammography if referred by their general practitioner. Hon. Members may already know that 88 per cent. of all deaths from this cancer occur in the over-50s and its incidence in young women is far less common.
I am glad to report that the programme is making excellent progress. Each of the 14 English regional health authorities was asked to set up its first screening centre by the end of March 1988. In fact, 17 centres have now been set up—of which four will provide training for staff from the whole programme—and nearly all have now started screening. This afternoon, I shall he visiting the London training centre at King's college hospital and the first inner London screening unit at Camberwell.
By 1990, we expect to have about 100 centres nationwide, each covering a population of about half a million people. Mobile caravans will be used for screening in some areas. We hope to announce all the details about the remaining centres before the recess. The programme must be developed relatively slowly because of the need to train staff and to provide back-up facilities for diagnosis, treatment, counselling and after-care. The initial response has been excellent—in some places over 80 per cent. of the first women responded to their screening invitation. That is very encouraging.
Between 1987–88, the last financial year, and 1989–90, on current plans, nearly £55 million will have been provided to set up and run the screening centres including staff training, development of computer software, health education and counselling and support for patients. A service on the same lines is being developed in Scotland, Wales and Northern Ireland. This will be the first nationwide comprehensive breast cancer screening service in the world. We are well ahead of all our partners in the European Community and there are no comparable programmes in nations such as the United States, which spends far more on health than we do. Our system will save many lives and we should be proud of what we are doing and aware of the massive investment which demonstrates the Government's commitment.
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We have taken a similar approach to cervical cancer. It is far less common than breast cancer, with about one seventh the number of deaths per year. In 1986, 2,004 women died of cervical cancer in England and Wales. It has been linked in research to smoking and to the number of sexual partners. The significant factor, however, is that this cancer has a relatively long detectable pre-cancerous stage, during which the condition is 100 per cent. curable. Cervical cancer was one of the first cancers for which that was true. We believe that the cancer screening programme that we are implementing should save most of those 2,004 lives. All district health authorities in England have implemented computerised call and recall systems That has been an enormous task. It has meant providing 750 visual display unit terminals; making an investment of £10 million in information technology and computerising 35 million records. The result of that may mean that we shall have a completely computerised system to assist us in all sorts of preventable screening work in future, which, of course, will also cover men.
As a result of the effort, all DHAs are now able to call women who have never been screened before, as well as recalling women who have previously had smear tests; and within five years the system will have invited all women in the age range 20 to 64 who are registered with a GP—all those we can reach, which is around 13 million women. Programmes for cervical cancer screening on similar lines are being implemented in Scotland, Wales and Northern Ireland.
A mass screening programme of a kind has existed since 1966. Its value is shown in the fact that deaths from cervical cancer have fallen by 14 per cent. in the 10 years to 1986, the year for which we have the latest figures. Without the existing system, we believe that deaths would have been much higher and could have risen. The efforts of the Government will ensure much more systematic screening and this should further increase the effectiveness of the services against cancer. Again, Britain is well ahead of the rest of the European Community on this programme and—apart from Scandinavia—is the first major country in the world to implement such a nationwide programme.
We should not underestimate the huge scale of the effort required to detect cervical cancer. Last year, about 4 million smears were done. Many of these were repeats or were done outside the screening programme. About 150,000 were abnormal, but again many were repeats. Most of the abnormal ones showed up non-cancerous infections of varying degrees of severity. Therefore, we are picking up many gynaecological conditions through this system. About 4,000 new cases of cervical cancer are reported each year, many of which do not come through the screening service at all. As I have said there are about 2,000 deaths each year, mostly among older women. It follows that the incidence of this cancer is tiny—a handful of cases in each district health authority each year.
It is important that health care professionals, especially doctors, are aware of these data so that they can reassure women with abnormal smears that the odds are that the condition is not cancer, and whatever it is, it is likely to be treatable. This programme is intended not to alarm people: but to reassure them.
There is one point to make about all our cancer screening programmes. All this money and effort will be wasted if we women do not use the systems properly. There is no need to approach one's doctor or hospital for a test

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unless there are symptoms. Everyone will be called in time, and we hope that everyone will respond. If there are symptoms—a breast lump, or a discharge, or anything unusual—the woman should see her doctor at once. She does not need to wait.
Incidentally, it is up to us as patients to ensure that the computer knows where to find us. Now that we have computerised every register in Britain, we are coming up against the problem that some of the registers are inaccurate to an unacceptable degree. If we move house, we should ensure that, along with the post office and the gas board, the doctor knows our new address. In these ways we will have a cost-effective and confident service and save lives.
I should like to deal with one or two matters on the cervical cancer programme about which women have written to me. I have no doubt that the hon. Ladies in the House will raise these points, so perhaps I can take the opportunity now to deal with them. Many women want to know why we do not reduce the recommended time interval between smear tests from five years to three years. The guidance that we issued in January says:
"recall should be at least every five years".
Most deaths occur in women who have never had a smear test. We know that a five-year screening programme can reduce deaths among women screened by an estimated 84 per cent.
For this reason, we believe that increasing the proportion of women being screened at all should take precedence over increasing the frequency of screening. In terms of saving lives, we are trying to get from a very low figure to 84 per cent.—and we are not there yet. That accords with advice given to us by Professor Jocelyn Chamberlain and her team at the DHSS cancer screening evaluation unit, which is based at the Royal Marsden hospital in Sutton.
We are not pressing health authorities to recall women more frequently than at five-year intervals, but we will not hinder them from doing so. I know that some district health authorities have decided to recall after three years. Before DHAs move from five-year screening to three-year screening I would expect them to have satisfied themselves on two points. First, they should be getting a high response from the women in the eligible age range, but particularly from older women who have never been screened before. Secondly, they should be able to run the system smoothly without laboratory backlogs or delays in diagnosis and treatment. We monitor laboratory backlogs very closely.
I see that my hon. Friend the Member for Winchester (Mr. Browne) is in the Chamber, and no doubt he will tell us about one or two laboratory backlogs in his area. As I say, we monitor the backlogs very closely and have been pressing districts to take action where there is a persistent problem. Three quarters of district health authorities do not have any backlog to report.
If we did not insist on these rules, there is a risk that we would overload the laboratories. The same, keen women would come in to be tested repeatedly and we would miss many of the women most at risk and might waste everybody's time and money.
There are other cancers which affect women. The most worrying of these is lung cancer which is rapidly rising. Since 1979, the death rate from lung cancer among men in the United Kingdom has dropped by 6 per cent. but
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among women it has risen by 27 per cent., and that is causing considerable alarm. Lung cancer is the second largest cancer killer of women in this country and accounted for 11,000 dead women last year. It looks set to overtake the major cancer killer—breast cancer. The survival rate over five years of women with lung cancer is very poor—betwen 3 and 13 per cent. according to age.
Cigarettes offer women more than the long-term worries about cancer. They interfere with hormone levels in both men and women, and on average lead to the menopause five years earlier. Nobody believes me about that but that is what the research shows. Smoking is regarded as having a role in the increased incidence of osteoporosis. I have mentioned the well-documented link between cervical cancer and smoking. A recent study in the United States of America has suggested that just a few cigarettes a day doubles our risk of heart problems. Worst of all we know that, among pregnant women who smoke, the risk of perinatal mortality is 28 per cent. higher than for a non-smoker. It is also associated with a significant reduction in birth weight by as much as half a pound. The effect of smoking on the baby can be both rapid and devastating.
I suppose that many women believe that smoking keeps them slim, but there are sensible ways to keep one's weight at a healthy level without taking up a habit that stands a good chance of doing irreparable damage to one's health and the health of one's baby. Some people say they smoke to deal with stress, but there are healthy options to deal with stress and most people, including most doctors, have found other ways.
For all these reasons we are very concerned about patterns of smoking behaviour among girls and young women. Smoking has been falling in older women in recent years, but that had not been happening among women under the age of 25. Among secondary schoolchildren in England and Wales, who fortunately still smoke far less than their parents, girl smokers outnumber boys by nearly two to one. As I said in a debate on 23 October, we commissioned research on this to try to find what influences the behaviour of girls in this way. Preliminary results suggest that girls are influenced in a different way from boys.
I have asked the Health Education Council to look at a sustained programme of health education aimed at young people. We have accepted the Froggatt report which recommended:
"It is essential that more smokers are encouraged to stop smoking and that non-smokers are strongly discouraged from starting".
We are now considering how best to take that forward. I am pleased to see that the Royal College of Nursing, the largest trade union in the National Health Service, representing about 250,000 women, recently adopted a no smoking policy, as has the Royal College of Midwives and the Health Visitors' Association, both of which have a preponderance of women members. In the DHSS, where we employ about 100,000 people, the majority of them female, I understand that no smoking policy guidelines will soon be issued to local social security offices with the support of the trade unions. We look to see considerable progress there to help all our excellent staff work in a smoke-free atmosphere.
In ways like these we shall continue to do what we can to promote health education and disease prevention campaigns such as those for women's cancer. We watch with interest developments for screening for other

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conditions such as ovarian cancer, although we are nowhere near a sound, accurate system that we could use nationwide.
Similarly, we are keen to encourage the development of laboratory tests which are less demanding of scarce staff than the current smear test reading method. However, as my right hon. Friend the Minister of Health said in the Adjournment debate on the organisation Quest for a Test for Cancer on 13 May, any new test we adopt must be cheap, effective, fast, accurate and robust. By robust we mean that it should be capable of being performed in different types of laboratories and by operators with varied levels of skills. I am hopeful that some automated system will come in before too long. I was impressed that a recent meeting of our scientific advisers had 13 such proposals to consider, some of which looked promising.
It might be helpful if I say a word about the growing involvement of the private sector in screening programmes, which we welcome. For a long time preventive medicine was the poor relation in the NHS and we have much catching up to do. The private and non profit-making sectors stepped in to fill the gap and have developed their schemes to the benefit of their millions of members. I understand that more than 150 clinics of various kinds are now in operation. There are two main points I would make to them and their customers.
First, it is not enough to offer simply a testing service. Proper arrangements should be made for laboratory services and to notify the woman's GP that she has been tested and of the results, subject to her consent. That is intended to avoid unnecessary repetition of tests especially as the National Health Service gets it own screening services up and running. Further sensible arrangements should be made for the care, counselling and treatment of women and they should be explained to the customer when she first comes. This also applies to occupational health screening, such as the splendid system that I saw at the Post Office last week, which uses the services, where required, of AMI International and thus relieves the National Health Service of the burden entirely.
Secondly, those setting up such screening systems should be well aware of the good medical reasons why we do not screen younger women for breast cancer. In women under 35, for example, the condition is rare, but benign lumps and cysts are very common. The mammogram used under these circumstances is likely to pick up a high level of false positives, leading to unnecessary anguish until the all-clear is obtained and, worse, possibly to unnecessary treatment. Mr. Ian Fentiman of the Imperial Cancer Research Fund unit at Guy's hospital has expressed his concern about that matter, and I share it. I hope that the reputable companies involved will take note.
We are pleased that the private sector is taking steps to provide a quality assurance scheme supported by a system of registration, inspection and approval. We shall watch that development with interest.
There is no doubt about the growing interest in women's health inside the House and among the population at large. This has led my Department to respond by organising a full-day conference on the subject on 22 June. The many subjects covered will include the cancers that I have mentioned, but the afternoon session will look at conditions which do not kill, but from which millions of women suffer, often silently, such as mental illness—in which women outnumber men—the menopause—problems associated with which were regarded
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until quite recently as either imaginary or untreatable—and osteoporosis, the thinning of the bones, which is increasingly filling accident and emergency departments and orthopaedic beds. There will be a session on puerperal psychosis, which is an appalling mental illness that affects some women after childbirth and can vanish as quickly as it came, leaving havoc in its wake in the woman's family. The conference is designed to have learned speakers sharing the latest information with lay people, including representatives of more than 50 women's organisations, and press representatives who write on women's issues and health. Many hon. Members and Members of the other place have accepted invitations to attend.
Since some important new issues will be covered on that day, it will be apparent that the Government want to move the discussion on. We have put our efforts against cancer on a sound footing, but now we must turn our attention elsewhere. Osteoporosis, for example, is a condition which probably affects one woman in four, and is clearly linked to falls in hormone levels after the menopause.
Ms. Harriet Harman: Is the Minister aware that, because of cuts in the district health authority's budget, a consultant in Sheffield has taken out a bank overdraft to keep his unit, which conducts care and research into osteoporosis, going? I welcome the Minister's concern about this issue, but will she ensure that he is given money to run the unit and so that he can pay off his overdraft?
Mrs. Currie: The hon. Lady should beware of challenging me on such topics. I had a healthy supper with the extremely eminent physician concerned on Tuesday night. We discussed some of the circumstances surrounding his work. The press has been less aware of the fact that he receives £700,000 for his research from the Medical Research Council. It was suggested that he might like to discuss what he will want to do in the future with the regional health authority, the district health authority and the Medical Research Council. I believe that that is now happening. The reason why I had supper with him was that I have invited him to be one of the speakers at the conference. The work being done on osteoporosis in units such as the MRC-funded one in Sheffield is important, and I have conveyed that interest to the health authorities concerned. I hope that that answers the hon. Lady's question.
Osteoporosis is 10 times commoner among women than men, and among older women it often shows itself as dowager's hump. Women can lose as much as 6 inches in height a year as spinal bones collapse. One realises when looking around our towns and villages, how many women suffer from that painful and disabling condition. I see that my hon. Friend the Member for Billericay (Mrs. Gorman) is in her place primed to give the answer. She is aware of the close interest that my Department is taking in the work of the Amarant trust, which she chairs, and which advocates hormone replacement therapy. My hon. Friend will, I know, understand our caution about any treatment which involves drug therapy over a long period. hope that she will also feel able to support and advocate those preventive measures, which are emerging from research, as the best advice to women, particularly before they reach menopause: do not smoke and stay physically active so that the bone mass is maintained. There is evidence that bone mass is significantly greater among women who take

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regular exercise than among those who do not. Even for post-menopausal women, exercise can slow down the rate of loss, or even reverse it somewhat. So, I am afraid that it is on with the tracksuits girls, and leave those fags at home, and I invite all hon. Members to join me. Incidentally, HRT, where appropriate, is available on the National Health Service. Patients are not obliged to seek private treatment.
Among the other organisations that are interested and involved, we help the National Osteoporosis Society, the Women's Aid Federation,—the battered wives organisation—and Maternity Alliance. We grant-aid the Widows Advisory Trust, the Miscarriage Association and many other organisations. Our male colleagues would be surprised if they saw a list of the wide range of groups concerned with women's health that we support.
The other main chunk of work carried out for women, which has experienced important developments lately, is maternity care. As it will not be one of the subjects discussed at the women's conference, I shall spend a few moments considering it. Since 1981, following the Social Services Select Committee report on perinatal mortality, vigorous efforts have been made to improve services. We set up the maternity services advisory committee, which published three reports under the title "Maternity Care in Action". The first, in 1982, was entitled "Antenatal Care", the second, in 1984, was entitled "Care during Childbirth", and the third, in 1985, was entitled "Postnatal and Neonatal Care". Those reports are a comprehensive guide to good practice and a plan for action for health authorities.
The resulting improvements in perinatal mortality are well-known. Between 1979 and 1987, the death rate among babies in the first month after birth dropped from 14·6 per 1,000 live births to 8·9 per 1,000 live births. It is more revealing if we look at absolute numbers. In 1979, there were just over 600,000 births and nearly 5,000 stillbirths, whereas in 1987 there were 645,000 births—many more pregnancies went to full term—and only 3,200 stillbirths. Far more babies are being born alive. We had therefore about 40,000 more babies to care for last year than in 1979.
Similarly, the chances of survival of tiny, low-birthweight babies have improved dramatically. In 1976, there were 38,000 births below 2·5 kg—about 5·5 lb—of whom 84 per cent. survived. In 1987, there were over 45,000 births below 2·5 kg, of whom 92 per cent. survived. Many thousands more tiny babies now survive every year. The amount of care needed to achieve that success is enormous. The object of the exercise is a healthy baby and a contented mother and family.
Over a 10-year period—indeed, a 20-year period—some matters have not improved. In 1976, the number of low-birthweight babies born alive represented about 6·5 per cent. of the total. In 1986, it was 6·8 per cent. The figure has been about 7 per cent. for over 20 years. The failure of the these statistics to change is a matter of considerable concern. Low-birthweight babies are far more likely to be sick babies in the future. They have a far higher death rate in the first few months of life, when they seem especially prone to infections.
In some parts of the country, such as Leeds, which I visited last year, the proportion of low-birthweight babies is over 9 per cent., yet in Scandinavia it is 3 per cent. In
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Scandinavia, a higher proportion of babies go to full term and are born at full weight. We do not know why our figures are so high, except that perhaps there is a link with smoking. A drop in the birthweight of the baby and increased perinatal mortality are directly linked to the number of cigarettes smoked. Therefore, heavy smoking is likely to produce a stronger effect.
We undertook a survey of health authority maternity care in 1985 following the MSAC reports, but we propose to write again to the district health authorities in England and ask how they are implementing MSAC. This time we shall particularly look at the antenatal care side and at the levels of care in the community. We are looking for responses within less than 12 months.
Mrs. Margaret Ewing: The hon. Lady referred to care within the community. Is she aware of the deep concern in rural parts of England, Wales and Scotland about the large number of general practitioner units that have been closed that offered very effective neonatal and maternity care to women, without their having to travel long distances to high-tech centres?
Mrs. Currie: Yes, I recognise that fact. When we receive responses to our new survey of antenatal care, we shall consider the extent to which we can provide out-patient care as close to home as possible, while at the same time enabling women to have access to the latest facilities in the services that are most appropriate to them. There may need to be more of a division between facilities. I shall refer later to isolated units.
Much of the improvement in baby mortality is well known. What is less well known is the sharp drop in the death rate of women in childbirth that has accompanied all these improvements. Forty years ago, when I was born, the number of births a year was roughly the same as it is now, but some 700 women died in or soon after childbirth. Even 10 years ago it was 74, a rate of 12 per 100,000 live births. Now it is seven per 100,000 live births, but, at 45 cases in the most recent year for which we have figures, it is still too many. Nevertheless, it shows a continued improvement.
We have given a lot of thought to this subject and we have done a lot of work on it. I attribute much of this welcome change and the drop in the death rate of babies and mothers to our efforts in maternity care. It has involved far more women giving birth in hospital. Most now follow the recommendation that births should take place in modern hospitals that provide a full range of services, including anaesthetics and a paediatrician on call. I recognise that, where they still exist, people say that they like small, isolated maternity units, but we are still advised to move away from delivering women in such units.
Such advice was included in a recent publication of the National Birthday Trust Fund. I believe that it is wise to continue to take that advice. Fewer women and fewer babies are dying. The results have convinced me. I am also convinced that it should be possible—that in fact it is essential—to provide modern maternity care in a way that is both professional and friendly. I say that firmly.
I referred to sick babies. When a child is ill, the presence in hospital of the mother or another close relative may be an essential element in the child's recovery. I agree firmly with the National Association for the Welfare of Children in Hospital on these matters. I hope to be able to issue new draft guidelines for consultation within the next four weeks which will update those issued in 1972. The hon.

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Member for Peckham (Ms. Harman) knows that that fulfils a promise that I made in Committee on the Health and Medicines Bill.
The last topic that I want to cover is still concerned with women and their babies. It is breast feeding. This week, we made an announcement that is of considerable significance. Since 1980, the proportion of women breast feeding has stood at around two thirds, but the most recent survey in 1985 showed that, while 85 per cent. of educated and social classes 1 and 2 women breast-feed their babies, only 45 per cent. of social class 5 do, which is rather the reverse of what I should have expected. In January, we published the latest report on infant feeding from the Committee on Medical Aspects of Food Policy, entitled "Present Day Practice in Infant Feeding: Third Report." It affirms:
"Breast feeding from a woman who is in good health and nutritional status provides a complete food which is unique to the species. There is no better nutrition for healthy infants both at term and during the early months of life."
The significance of that for us today is that there is plenty of medical evidence that natural feeding is better for both the baby and the mother. It returns her to normal far more quickly. It also helps to cement a very special bond between her and her baby, to their mutual advantage. I have to confess that it is also very nice, so we want to promote it.
I have therefore agreed to support a new initiative to promote breast feeding around the country by the National Childbirth Trust's breast feeding promotion group, the La Leche League and the Association of Breastfeeding Mothers. We will grant aid these bodies for a sustained campaign among health professionals and mothers. We expect to spend at least £100,000 over the next two years. In addition, the infant and diatetic foods association of the Food and Drink Federation, whose members make infant formulae, have agreed this week to provide an additional £30,000 this year, and possibly next year as well, to help with the printing and dissemination of suitable breast-feeding literature, posters and so on. I think that that is a remarkable gesture, and I congratulate and thank the association.
But the manufacturers have done more. They have agreed to phase out by the end of this year all free samples and subsidised supplies of baby milk to hospitals, thus closing an important loophole. The bottle and teat manufacturers have agreed to consult on ending their advertising to the general public along the same lines as the baby milk manufacturers. I accept with gratitude the good wishes of the hon. Member for Stoke-on-Trent, North (Ms. Walley), who is smiling. All these changes bring us into line with the World Health Organisation's requirements on marketing breast milk substitutes, promulgated in 1981 and strengthened in 1986. We shall be revising the relevant NHS circular. We intend to issue the new version in the autumn when the manufacturers issue a revised complementary marketing code—I hope in time for a major seminar on 18 October—which will launch the new breast-feeding promotion initiative.
Ms. Harman: Does the hon. Lady accept that one of the concerns of midwives is that the shortage of midwives, and the extra pressure in maternity units because of the cuts in maternity beds at a time when the number of births is increasing, means that midwives do not have the time to help mothers to establish breast feeding? We welcome the hon. Lady's interest and concern and we share her concern about the drop in the percentage of women who are breast
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feeding their children, but that makes it crucial for midwives to have enough time to help mothers to establish breast feeding. They feel, and I share their view, that they do not have enough time because of the growing crisis in maternity wards that has been caused by financial pressures.
Mrs. Currie: As the hon. Lady knows, because I have responded to these points on numerous occasions, the number of midwives is increasing. What is more important, the proportion of qualified staff has risen sharply. Therefore, I am content that the National Health Service and the professional side are devoting the appropriate level of resources to this subject. We must ensure that the health professionals realise how important and valuable it is to assist women.
However, the evidence suggests that much of the help, support and encouragement for breast feeding comes best from other women in the same neighbourhood and with the same accents who have been doing it and who are therefore conscious of the pleasure that it gives and of some of the difficulties—and how to overcome them. In that sense, I hope that the new campaign will be directed at both the professionals and, through the voluntary movement, at the women concerned.
We think that we can make considerable progress. Then we shall be able truly to say that we will be promoting breast feeding as best for both the baby and the mother. I cannot conceal my delight that we are making progress in this way on an entirely voluntary basis. It puts us well ahead of the rest of the European Community and most of the developed world.
We are most emphatically not complacent. There are still far too few women who never book their confinement and who first appear in an advanced stage of labour, often too late to save their baby. There are still too many women who die in childbirth. There are far too many women who have never had a cervical smear test, and I fear that there will be always some who refuse. There are too many doctors who dismiss women's menopausal symptoms. and too few of them advise their women patients on how to avoid thinning bones—osteoporosis—in the first place.
There are too many women, particularly among the young, who dismiss our warnings about smoking. Most of all, there are still far too many women who suffer in silence when they should be seeking help. Often they wait until it is too late. The House should firmly reject the notion that a responsible women cares for her family's health but neglects her own. Today's wife and mother knows that her family need her to be fit and well, as does her employer, if she is to meet the increasing demands that are now placed upon women in this country. Our health is in our hands. I hope that all generations of women will in future take a positive and informed interest in their own health.
The programmes that I have outlined make me feel very proud. I think that we in Britain are lucky to have these opportunities, and I commend the programmes to the House.
10.19 am
Ms. Jo Richardson: My hon. Friends and I are glad that the Government have chosen the subject of women's health for debate. I do not denigrate the value of Friday debates but in some ways wish that the debate could have been held in prime time during the week, when more hon. Members could have been here; I know that

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many hon. Members have to get away on Fridays. Nevertheless, I am glad to see that a representative number of hon. Members are present.
Doubtless the Under-Secretary of State for Health and Social Security will recall that we had a debate about cervical cancer screening during our recent proceedings on the Health and Medicines Bill. We now have the opportunity to consider all aspects of women's health and to identify and discuss some of the problems facing women, especially women who have little money and who are hampered in trying to live a healthy life. I am a little disappointed that in the catalogue that the Minister gave us, she took a rather blinkered view in some respects; she confined her remarks to the medical aspects of women's health without considering the social causes that often lead to women's ill health. Nevertheless, the fact that the Government have chosen women's health as the subject of this debate is an acknowledgement of the fact that they have begun to take it much more seriously. In that regard, I pay tribute to my hon. Friends the Members for Holborn and St. Pancras (Mr. Dobson) who did much as shadow Minister for Health and to my hon. Friend the Member for Peckham (Ms. Harman) who is doing much now to push the Minister to accept various schemes.
I begin by firmly dismissing the Minister's oft-expressed contention that many of the problems of women's health are women's own fault. The hon. Lady is very fond of expressing herself in lurid language. She has not done so today, but she would acknowledge that she frequently does. I wonder whether she realises just how hurtful that lurid language is to women struggling in an unjust society to maintain their families and to keep them together, to find and keep a job and to cope with bad working and housing conditions. For women who are home workers the last two often go together. There was an interesting article in last Sunday's edition of The Observer dealing with the problems, including health problems, facing home workers. I shall do no more than quote the remarks of a women whose case was cited in that article:
"I used to work a 90-hour week to get the money I needed to live. My daughters used to come in from school, eat and start sewing … We were absolutely desperate for money … I challenge anybody to check, sew and label a dozen sweaters at the rate they set and earn more than 66p an hour."
The Minister may think that that quotation is irrelevant to a debate about women's health. However, poverty is one of the conditions that take a toll on women's health. Judging by her speech, the hon. Lady does not even begin to understand that. I hope that she will not mind my reminding her that on 11 March 1985, before she was a Minister, she made a speech on unemployment and industrial policies. She advocated the employment of part-time women workers as opposed to male full-time workers, who she said had all the protection of employment legislation. She also said that full-time male workers
"will probably receive holidays and so on."—[Official Report, 11 March 1985; Vol. 75, c. 87.]
The implication is that women can work without the benefit of a yearly break that might help their health. The Government have removed what minimal protection women had and fulfilled the Minister's hopes as expressed in that speech by decreasing the rights of workers and the
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obligations of employers. They have increased the risks to women in terms of stress, which has a profound effect on their health.
I shall deal briefly with women's health in connection with work and I hope that my hon. Friends will discuss the matter at greater length. The 9·5 million women now in work account for 45 per cent. of the work force. At work women often cope with equipment designed specifically for men. They suffer from the same health problems at work as men but they are also subject to specific problems such as tendonitis and to the scandals of VDUs. Those are just two of the problems that predominantly affect women. When shopping, I have often noticed the problems faced by women at the check-out and I have discussed those problems with them. They often have to sit in an awkward position on a swivel stool handing goods from the basket on to the counter with one hand and using the other to check up the price. I have noticed that many of them rub their shoulders and complain of back ache. All such factors cause women stress and strain and bad health.
All too often women's work does not end at the factory gate or the door of the shop. Most women still have the sole or major responsibility for looking after the home and many are carers who care for the old, the sick and the young. In recent years many reports have highlighted the problems arising from those circumstances. It is to their credit that most trade unions—notably, the National Union of Public Employees—are taking up with employers issues such as stress and its effect on women's health.
The Minister for Health (Mr. Tony Newton): I have a genuine point, which is not a point of argument. I want to solicit further information. Unless my ears misled me, the hon. Lady referred to the "scandals of VDUs". I would like to know what she meant. As I understand it, a great deal of the clerical work that women used to do—for example that involving heavy filing cabinets—has been made infinitely easier by access to modern technology and the equipment that goes with it.
Ms. Richardson: I shall gladly elaborate. I agree that I used a shorthand phrase, perhaps I should have explained more fully what I meant by the scandals of VDUs. We accept that VDUs have decreased the work load and made the work easier than it was with the old filing and call and recall system. However, I am sure that it will not have escaped the attention of the Minister for Health that VDUs involve health hazards. I do not think that enough is done to ensure that employers take that into account.
The Ministers are looking puzzled. Sitting for too long in front of a VDU can affect health. There is a risk to a woman's reproductive capabilities. I am amazed that the Minister looks surprised to hear that fact, because it is common knowledge. Indeed, many unions and employers have a written agreement limiting the number of hours that someone can sit in front of a VDU, precisely because of that risk. That is what I meant by "scandal", but perhaps I should have said "hazard". It is certainly something that must be borne in mind.
Before the Minister's welcome interruption I was discussing problems at work. The Government have compounded the difficulties facing women through their attacks on maternity rights and parental leave. The

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Government preside over legislation designed specifically to encourage low wages and, in some cases, dangerous conditions, and to erode the rights of individuals.
Work should offer the opportunity of better health screening and education and should enhance women's lives. Instead, during the past nine years much gained in previous years has been eroded. On a number of recent occasions, and certainly at some length today, the Under-Secretary has berated women for smoking. She did not refer to drinking today, although she has referred to that and other habits on many occasions. I was stunned when I heard her attributing smoking to the desire of women to keep slim. It is a long time since I heard that one. Most of the women I know who smoke do so because they are under some stress. They do not necessarily want to smoke. I smoke, and I do so because I like—it but that is my problem. I certainly do not do it because of stress.
Many women smoke because of stress caused by poor housing or work or family problems. They smoke not to keep slim but because they are nervous and under stress, and smoking provides some form of release for them. I am a little surprised that the hon. Lady did not acknowledge that. Indeed, it is downright offensive to talk about women in the way that she did and to blame them for seeking relief from tensions that, in many ways, the Government have forced upon them. After all, the Government capitulate to the tobacco and alcohol businesses whenever there is a call for action against advertisements deliberately aimed at the young and at women. Blaming the victim is an obnoxious practice and is always an unproductive and futile exercise.
Does the hon. Lady really believe that women are less aware than men of health risks, or that they are more difficult to educate than men? Does she believe that they are simply more reckless or feckless than men about the lifestyle and health of themselves and their families? I hope that she does not believe that; I cannot believe that she does. However, that is the logical interpretation of some of her outbursts that sometimes, although I am sure she does not mean them to be so, sound almost sexist—until, that is, we place them in the context of the rest of the Government's policies.
The Secretary of State for Social Services presides over a social security system founded on the Victorian values of the deserving and the undeserving poor, while the hon. Lady wants to found the Health Service on the values of the deserving and the undeserving sick. Unlike Conservative Members, the Opposition want all women to have the best available health case and health opportunities, regardless of ability to pay.
The hon. Lady proudly mentioned the role of the private sector in breast cancer screening. I accept that it has a role, but I should prefer all such screening to be carried out within the NHS. A letter dated 4 January 1988 from the London hospital Whitechapel, addressed to one of my constituents, has caused me some surprise. It refers to the first stage of an ovarian cancer screening project in which my constituent had participated. It said that the project had yielded valuable and exciting results that would shortly be published in The Lancet. It said that it would dramatically improve the outlook for the 4,000 women a year who died from ovarian cancer.
To my amazement, the letter's writer said:
"There are two ways in particular that early participants in the project such as yourself can ensure its continuation: (1) By helping us to raise sufficient money to complete the project by selling tickets for our 1988 raffle."
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It is amazing that a woman who has taken part in a project to help her health and that of other women should be asked to buy a raffle ticket so that other women can also participate. Is that private health care, semi-private health care, supported health care or sponsored health care? We should fund such projects properly and not depend upon people buying raffle tickets.
The Government must fully provide properly resourced services that genuinely promote health, as well as meeting the needs of women when they are sick. Promoting good health means challenging the causes of ill health, such as poor diet, poor housing and homelessness. What about the hundreds and thousands of women currently living in bed-and-breakfast accommodation? That is hardly a healthy life. They are expected to care for their families in one room and they have to leave the accommodation and stay out all day. I do not know how they can be expected to provide a healthy diet in such circumstances. The Government do very little to help those problems. Other causes of ill health are unemployment, unsafe and stressful working conditions in the workplace and at home, the dual load of unemployment and caring responsibilities and poverty and powerlessness.
Every health study has shown that poverty is one of the most important factors influencing life and health chances, so we should not increase the poverty of those who are already the poorest in our society. The Government's record is second to that of no Government this century, as is shown by the first increase on the infant mortality rate since 1970. An article in The Health Services Journal headed:
"Why are our babies dying?"
states:
"A rise in the infant death rate in England and Wales—the first since 1970—is causing concern among community service managers and staff. The most recent figures from the Office of Population Censuses and Surveys (OPCS) show that the number of deaths of children under the age of one, internationally accepted as an important indicator of health and social conditions, rose from 9·4 per 1,000 births to 9·6, an increase from 6,141 deaths in 1985 to 6,313 in 1986 … but initial response from health professionals suggests that social deprivation, not gaps in medical services, is the underlying cause."
Mrs. Currie: The hon. Lady should know that we shall shortly have to hand more recent figures that show that mortality rates have dropped again. They have dropped below what the trend line would have been. That is precisely why I am now so concerned about smoking behaviour in young women. They are the only group whose smoking behaviour is increasing. As I demonstrated, the effect on the baby is immediate and devastating. It helps to cause perinatal mortality and reduce the chances of babies who are born alive.
Ms. Richardson: Again, the hon. Lady has blamed young women who smoke. Smoking may be a contributory factor, but she has not answered the point, which was that health professionals believe that
"social deprivation, not gaps in medical services, is the underlying cause"
of the increase in that period. I am still amazed that the hon. Lady has not taken that fact into account.
During Prime Minister's Question Time yesterday, there were references to a report from the Low Pay Unit and the Child Poverty Action Group. It showed that between 1979 and 1985—I acknowledge that it was three years ago—the number of people below pension age living

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on or below the poverty line rose from 2·9 million to 6·54 million, a rise of 120 per cent. It is no good the Government saying as they tried to do yesterday, that it is an old report and that things have got better since then. I promise the hon. Lady that things have not got better since then. The figures have not dropped—in fact, they will get worse. With the poll tax, more people will drop into the poverty trap.
The hon. Lady referred with pride to working with the Maternity Alliance and other organisations. I am glad that she acknowledges their worth. Four years ago, the Maternity Alliance produced a report called "Poverty in Pregnancy". The report looked in detail at the basic requirements for a healthy, nutritional diet for pregnant women. It concluded that pregnant women whose income came from benefits and those in very low wage families had incomes which were clearly insufficient to buy an adequate diet which would ensure their own and their babies' future good health. It estimated that benefits needed to be increased by at least one third, that the maternity grant needed to be restored to its original value, which at that time would have been £125, and that the seriously inadequate welfare foods policy needed radical improvement.
We have certainly had radical change since then, but we have not had radical improvement. The social security review has cut benefits and removed one of the most vulnerable groups—the under-16s—from any benefit. At one time, the maternity grant, albeit at a low level, was universal. It is now available only to those who are on benefit. Free school meals have gone, and welfare foods have been cut.
Does the Under-Secretary really believe that such actions—and by her own Department, too—are the right way to ensure that women have a good start for themselves and their families and have a healthy life?
The feminisation of poverty is not a new phenomenom. The hon. Lady quoted some women's journals from perhaps 100 years ago. At the beginning of the century, 60 per cent. of all Poor Law recipients were women. In 1988, 60 per cent. of all income support recipients are women. It is truly staggering that things have not changed over 88 years. Three quarters of the low paid are women. Yesterday's copy of The Independent contained a whole page of little bits on regional trends that were recently published by the Government. The article is headed:
"Women's pay still lags behind"
An extract states:
"Progress towards equal pay appears extremely slow. Women's pay still lags far behind men in every part of the country, irrespective of prosperity.
The highest-paid women are in the South-east, where average weekly earnings are £167·60p, is well short of the earnings of the worst-paid men, who are in Northern Ireland and take home an average of £190·40p.
Women in manual jobs fare worst of all, averaging only £115·30 a week—£70 less than their male counterparts. Although these are full-time jobs, more than half the women so employed in East Anglia and Northern Ireland earn less than £100."
All those factors are relevant to our discussion about women's health. Thousands of women actually have to earn their poverty by working in the NHS and related local authority community services and subsequently get as a bonus ill health and a lack of opportunity to choose a
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healthier lifestyle. I refer to nurses, therapists, administrators, technical workers, caterers, cleaners, laundry workers, home helps, day care and respite care workers, and, of course, the millions of unpaid carers at home, who are often isolated and unsupported in caring for their loved ones and who had to fight the Government through the European courts for financial recognition. All such people are low paid and below the threshold laid down by the Council of Europe.
We have just received an important report from the Policy Studies Institute on doctors and their careers. That report was commissioned by the DHSS. [Interruption.] The Under-Secretary points to herself. It was commissioned by her. I hope that she is interested in the results. So far, I have managed to read only the shortened version, as the longer one rather defeated me in the time available.
The pattern of discrimination and career prospects for women doctors mirrors the picture that we see everywhere. If there is a hierarchy, women are in powerless positions. If there is a grading structure, women are at the bottom of it. If there are pay differentials, women are on the lowest rates. The description of the effects on women doctors of working in the Health Service hold true of women in all professions and all women working in health and community services. The report states:
"Exhausting and stressful hours of work"—
Perhaps hon. Ladies will include the House of Commons in this—
"disrupted or non-existent family and social life, endless exams, the repeated scramble for short-term jobs that involve moving around the country, inflexible career structures and the increasing importance of patronage from powerful, and usually, male senior doctors, all conspire against women."
With the addition of a few substitute words, we could adapt that paragraph to refer to the House of Commons. However, that is a quote about women doctors, though it applies across the board in most professions. Yet, as we know, access to a woman doctor is now one of the most frequent requests that women voice with regard to their own health needs. Information on the availability of a woman GP is one of the most frequent responses made by a family practitioner committee, yet the Government's White Paper, "Promoting Better Health- will threaten the availability of women GPs and the services they offer. I do not know whether the Minister has seen the response of Women in Medicine. I assume that she has. It is a responsible organisation of women doctors and says that many of the proposals threaten the availability of women GPs and the services they offer.
"The White Paper does not recognise or reward those aspects of work, often done by women GPs, which cannot be easily measured, such as the many forms of counselling. Instead, its emphasis is on a few countable targets, eg immunisations and cervical smears. Indeed, women could well be employed specifically to work in these limited areas of practice. They would lose job satisfaction, be inaccessible for consultation on other matters, and their wide range of skills would be wasted.
Changes in the way doctors are paid would encourage GPs to have more patients on their books. This would mean less time could be spent with each individual. Women, for a variety of reasons, on average consult their doctors more often than men do, and with more complicated problems. They, therefore, would be the hardest hit. …
Proposed changes threaten to remove valuable allowances from doctors who work reduced hours."
I hope that the Minister will take those views into account.
Support among women throughout the country for well woman centres has grown enormously. The services are run by women for women. Health education and mutual

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aid are provided in a positive and supportive manner. Well woman centres adopt an approach which encompasses the whole person rather than a set of symptoms. The whole person in her environment and its impact on her health is considered. That includes income, access to child care and community care, employment or unemployment, housing conditions, diet and the availability of healthy food in local shops and the sufficiency of income to buy it. All of those matters can be discussed in a well women centre.
I know that the Minister is a avid fan of healthy food. We all are, or ought to be.
Mrs. Currie: Yes.
Mrs. Teresa Gorman: I like hamburgers.
Ms. Richardson: So do I, but we must remember that traditional healthy food such as wholemeal bread is more expensive than the white plastic bread which most families have to buy. When the Minister talks about healthy food, she sometimes ignores many women's poverty.
A friend of mine lived in Brixton until recently—she moved because she changed jobs. She is a vegetarian, and tells me that she found it extremely difficult to buy her kind of healthy food in Brixton. Wholemeal bread and yoghurt for example, were difficult to find in the supermarkets because they are too expensive for the people of Lambeth to buy.
I did not hear the programme, but I understand that the Minister was on the radio yesterday introducing a recipe book. I do not know whether she wrote it herself, but I understand that it costs £14, which is quite a lot.
Mrs. Currie: It is a book for caterers.
Ms Richardson: I suppose that we are not intended to see it.
Mrs. Currie: The hon. Lady may not be aware that the book of recipes that we launched yesterday is not really intended for the general public—it is a caterers' book. Caterers repeatedly request that we provide recipes that accord with the latest recommendations. We have done just that.
Ms. Richardson: Perhaps we can have one in the House of Commons. It sounds a good idea and I hope that caterers in hospitals, who the hon. Lady says have asked her to produce the book, will be able to afford the ingredients on their reduced funding. We should not simply say that people should buy healthy food—we must remember its cost.
The development of mobile and workplace health care and screening facilities are another development of women's own work and campaigning to improve the quality and quantity of health services. I pay tribute to the work of women in what may loosely be called the women's health movement and to the trade unions who have played an important role in persuading employers to make workplace screening available. It has often been a long and difficult task, as the campaign for workplace screening in the House shows. We are now to have it at last.
I trust that our next success will be workplace child care, out-of-school care and parental and family leave as of right. One day we may get this place into shape. An integrated approach to economic, social and health policies is essential if we are to promote good health and well-being for all women. That is what the Government and the hon. Lady are failing to do.
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One-day seminars and one-off conferences are utterly insufficient. I apologise to the Minister for being unable, for very good reasons, to come to her conference on Wednesday. I know that she was anxious to make her announcement. I do not believe that such conferences have the power to embark on the cross-departmental action that is needed. They are useful in their own way—I am not patronising them or putting them down—but I would have preferred it if the hon. Lady had called a cross-departmental conference to consider the medical aspects of women's health, and the social causes of their problems to see how we can bring the whole thing together.
Women are the majority of NHS consumers because of their own health and because of their caring responsibilities for others. A wide range of health care needs and problems are experienced exclusively by women, such as maternity needs, menopause, pre-menstrual syndrome, post-natal depression and problems arising from use of the contraceptive pill or the intra-uterine device. In spite of the catalogue that the Minister gave us in that respect, the Government's policies are robbing and short changing women.
The NHS collects no data on the ethnic origin of patients, so the extent to which it meets the needs of women from ethnic minorities is difficult to judge. We know, however, that research on conditions such as sickle cell anaemia and thalassaemia, which are life-threatening in some cases, has been given a low priority.
Similarly, we have been too slow to respond to the needs of women for whom English is not their first language. As we all know, communication between doctor, nurse and patient is essential to confidence and good care. The London borough of Hackney is an excellent example of good practice. Its multi-ethnic women's health project employs five part-time workers, speaking Turkish, Urdu, Gujerati and Bengali. That ensures two-way communication, not just to explain the procedures to patients, but to assist in an exchange and dialogue between health workers and patients.
The Government's policies have cynically and deliberately engineered a crisis in the Health Service so that they can introduce market forces and further privatisation into our health system. The impact on women's health of those policies has already been dramatic and detrimental. Hospital and bed closures have reduced gynaecology beds by 10 per cent. obstetric beds by 8 per cent. and GP maternity beds by 40 per cent. The lengthening waiting list, as a result of the loss of beds for children and elderly patients, means that women are providing even more care at home, losing work time and income and suffering even greater stress.
Last Friday a woman came to see me about her 78-year-old mother whose legs had finally given way so that she could no longer walk. The mother weighs 17 stone. She is confined to bed. She needs a bed from which there is a hoist so that she can pull herself up, and then her 78-year-old husband can help her on to the bed pan. That is a fairly familiar story. A nurse visits three times a day simply to help with those bodily functions. However, most of the caring is down to the 78-year-old husband and the daughter.
I spoke to the health visitor on Monday. She said, "It is a tragedy, Ms. Richardson, that we do not have more of these beds readily available." We must depend on people such as my constituent, the daughter, who not only has to do these extra duties, as well as trying to maintain a full

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time job to keep her own family, but who feels a terrible sense of guilt about her mother—guilt that, perhaps, she has not done enough. We too infrequently acknowledge the great debt which we owe carers in our society, who have saved the health and community services so much money.
Special care baby units have suffered an 8 per cent. cut. The crisis in community care is rapidly approaching a position of community neglect.
The cervical cancer screening programme on which the Under-Secretary has given a lot of information is, frankly, a shambles. I have written to the hon. Lady telling her that I have already received information on this matter. For example, I am told that in Winchester and Basingstoke the computer call and recall system that came into operation only on 1 April this year is already out of action and cannot be restored because of lack of resources. I am also informed that call and recall letters will not be sent out, regardless of the problems with the computer, because the laboratories cannot cope with the backlog of smears already awaiting inspection. The hon. Lady must know that this is a pattern that is occurring all over the country.
There are similar fears about the much-publicised initiatives on breast cancer screening. Experts in that sector have already said—as they have about cervical screening—that the age at which screening begins should be lower. Today the Minister tried to justify why that should not be so. However, on balance I prefer to agree with the experts. We must aim for three-yearly intervals between screenings rather than five yearly. As I have said, I hope that the Under-Secretary will also look carefully at the shortage of specially trained radiologists and surgeons. All those matters cast grave doubts on the quality of that service.
While such doubts and uncertainties remain, thousands of women will continue to die needlessly. Money—the one thing the Government never want to discuss in debates on the National Health Service—is the major answer: money for training, money for more staff, money for laboratories and clinics, and money for further and continuing research. I am sure that the hon. Lady did not intend to delude women into thinking that all is now well with the programmes for cervical and breast cancer screening, but she appeared to suggest that. That would be unfair. Many of the women whom the hon. Lady wants to see screened will not even be called for screening until 1992. Will she tell us how many women will not be called until 1992? I am sure that she does not know the answer. Perhaps it is incalculable.
Mrs. Currie: Perhaps the hon. Lady might do the sums for herself. I said to her that through the screening service we expected to make contact with about 13 million women in this country. We expect to call them in approximately equal tranches over a five-year period. I also said that anyone who has never been called for screening—I have made this point on many occasions—can come in at any time. We tell people that if they are symptomless, there is no need to worry. I am content with that. It would not be possible to call in 13 million in the next six weeks and screen them all at once.
Ms. Richardson: I do not think that the hon. Lady has answered the point. We can all do our calculations. She
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says that women can come forward at any time if they wish to do so. As the Minister herself has pointed out, women do not always think about the necessity of doing so. Sometimes they do not do so until, unfortunately, it is too late. However, if they did all come forward at the same time, the entire system would snarl up. It would not be possible to cope with all those women because there are not enough laboratory resources or staff to check the smears. Unless more resources are provided, there will be women who would not be called until 1992, and many of them may die in the meantime.
Similarly, family planning services that have contributed so greatly to women's improved health, and again were fought for by women and brought into the National Health Service by a Labour Government—I am proud to say—are being cut. The hon. Lady has said that she would be concerned if the family planning service disappeared or was substantially cut. At least, 25 districts have made cuts in their family planning services already, according to reports from community health councils and family planning regional offices. All the available evidence shows that more districts are planning cuts.
Any Government who were genuinely interested and concerned about this matter would urgently intervene to prevent the inevitable increase in unplanned pregnancies that will result from such policies. Ironically, they will also create long-term increased social and economic costs. It is a short-sighted and narrow approach which plagues every aspect of the Government's policies. The obsession with cash limits, charges and market forces distorts every section of the Government's White Paper on promoting better health. They end up by addressing the wrong agenda and issues and, therefore, come to the wrong conclusions.
The Minister should be chairing an interdepartmental committee covering employment, her Department, housing, the environment and transport. The committee should cover all Departments. It should examine broadly what contributes to bad health in women and in men. The hon. Lady is the appointed Minister for women's health, and we are all glad that the Government have acknowledged that there is a problem and have appointed a Minister to deal with it. That will not be done, however, within the blinkered confines of the Minister's Department. I hope that she and the Prime Minister will recognise the necessity for having an interdepartmental link so that we can examine the problem properly and sanely.
Ms. Joan Ruddock: I recommend to my hon. Friend a recent report entitled "Poverty in Lewisham". If the Minister were to chair a committee of the sort that my hon. Friend has suggested, she might find some links that are well illustrated in the report. In three of the wards in my constituency, one in four is unemployed—one in five of the young people is unemployed—and one of every two households is receiving supplementary benefit. My hon. Friend will not be surprised when I say that in two of those wards my constituents are 30 per cent. more likely to be dead before the age of 65 than are those who live elsewhere. In the other ward the figure is 54 per cent. Those figures illustrate that mortality rates are linked directly to poverty, unemployment, bad housing and all the ills that have been illustrated by my hon. Friend.
Ms. Richardson: My hon. Friend, in referring to the borough which she represents, has illustrated what could

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be done nationwide if the Minister took up my suggestion of an interdepartmental committee. I hope that she will tell us later whether she is intending to take it up.
Labour's agenda for women's health—it has been set out in one of the best documents that the Labour party has ever produced—has been set by women. It was founded on women's own experience and it built on the ideas and the health projects that women have developed for themselves. Together with our proposal for a ministry for women, the agenda will provide the powerful Government machinery that is needed to ensure that every Government Department is included—for example, the Departments of the Environment and Employment, the Ministry of Agriculture, Fisheries and Food, the Departments of Energy and Education and Science, the Treasury and the Department of Health and Social Security. All those Departments should be monitored. A women's ministry and a health Department under a Labour Government will jointly ensure that the social and economic causes of women's ill health are tackled on every front.
If ever there is justification for the concept of a women's ministry, it rests with the problems of women's health and the necessity for monitoring what is happening in every Department. There must be a central strategy for women's health, and that is what the Government do not have. We would ensure under a Labour Government that all women had the same opportunities to make genuine and realisable choices about their own health and the health of their families and communities. That includes private and community health care. We would work together in teams and in partnership to ensure that there is real choice and the best of health for all. That, in our view, is the way forward. That is the only real hope for the future that women have for themselves and for their families.
11.14 am
Mrs. Teresa Gorman: I congratulate my hon. Friend the Minister on being able to produce the amazing catalogue of measures that the Government are now taking to improve women's health care. She must accept our congratulations on being the Minister who has put the subject on the map. There is no doubt that she whizzes around like an Exocet missile, attacking all areas that might prejudice women and which concern women especially. She is not the only member of the Government, however, who takes a special interest in women's health and general lifestyle. We do not need a Minister to take that special responsibility because we have so many Ministers who take an interest in the subject.
I shall talk especially about mature women and their health care. It is a subject in which I have a special interest, not least because I am one of them. When we are cute little babies, everybody loves us. When we become older and become pregnant mums, everyone cares for us. Who cares for women when they become menopausal? Until recently, not many.
Ms. Harman: Not many men do.
Mrs. Gorman: Perhaps. Women in this age group were often embarrassed and felt guilty. In many instances the approach of others was to this effect, "Well, you are getting old and you must put up with the consequences, just as your mother and grannie did." When the event hit me, as it does every woman eventually if she lives long enough, and I started to experience horrible hot flushes
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and other symptoms, I went to find treatment. As my hon. Friend the Minister said in her opening remarks, it is true that women tend to put up with a great deal that a man would normally go to his doctor to complain about. I am one of those real women who usually do not put with things. Accordingly, I went to find help, but it was not easy.
I shall refer briefly to some of the awful things that can happen. There are awful hot flushes, which are embarrassing when one is in a room that is full of people. The woman might say "Oh, my God, it is hot in here." Everyone looks round and says, "It is not really. It is you." It is rather like saying to a crowd of strangers, "I am getting old."
My wrists and ankles began to hurt. My ankles became so painful that I could hardly get to the top of my house—incidentally, it has 70 steps. My wrists became so painful that I could not cut a slice of bread. I had to buy sliced bread. Incidentally, I could tell the hon. Member for Barking (Ms. Richardson) where she could buy good sliced wholemeal bread in Brixton. I drive through Brixton almost every other day and I know where it is possible to buy good wholemeal bread and yoghurt. I am fond of Greek yoghurt. It is possible to buy some good West Indian bread, which is really delicious. It is brown and moist and lasts for ages. I buy it regularly.
As I was saying, I could not cut a loaf of bread because my wrists were so painful. I was running a business and when I returned home at about 7 o'clock I was knocked out, as it were. I was tired, listless, dreary and irritable. Worst of all, I started forgetting things. This meant that I missed appointments. I began to think that if these were the symptoms of becoming old at the age of about 40, I would rather be dead. I felt that I could not face another 30 years of them.
I was fortunate. I am a biologist by training and so I know a little about these things. I went to King's College hospital, which has a menopausal clinic that is one of the most prominent in the world. It is a world leader I got myself on hormone replacement and it reconstructed me. I am a resurrected woman. I would have fallen to pieces had it not been for the treatment.
When I saw the facilities at King's I realised that the opportunity for women to discover the marvellous treatment that has helped me enormously was scant. There are only about a dozen such clinics in the country. I asked those at King's who had helped me how I could help them. They said that they wanted to raise money for a unit that they could make a national research and development centre, and I started getting a committee together to do this work. In the meantime I was elected to Parliament. That meant that everything came out in the open about me—hormones, the menopause and my age. I decided that I might as well go for broke. I wrote an article for a newspaper that was to this effect, "Yes, I am over 50. Yes, I am menopausal. Yes, I have hormone replacement therapy. Yes, it is terrific." The response was 10,000 letters from women saying that they thanked God that someone was talking about the subject. Some of the letters set out horrific stories of broken marriages and women driving their kids mad because they were so irritable. I realised that there was a desperate, crying need to provide help for women in this position.
Since I have come out, as it were, I have met an enormous number of women who are prepared to admit that they receive hormone replacement treatment. These

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include Dora Bryan, Dot of EastEnders, Diana Sheridan and many other famous women. I shall not give the House the whole list now. The gynaecologist to the Queen is a big supporter of it. He believes that it can help enormously and is on record as saying so.
My experience has helped to highlight one aspect of women's medicine which was perhaps hidden and secretive, and about which women felt bad. A third of women have these desperately awful symptoms, another third have them fairly badly and some do not have them. One is unfortunate if one's doctor is a woman who has not experienced these symptoms because she will not be sympathetic, nor, I am sad to say, will many general practitioners.
The Minister said that this treatment is available on the Health Service, but that does not mean that a woman will always find a doctor willing to grant it to her. If she does, he may not understand all the nuances. There are about 20 different varieties of hormone involved, like baked beans. She needs a specialist and if her doctor gives her a treatment which does not work or affects her badly, often there is nowhere to go to see a specialist. we need more menopause specialists.
We have 9 million menopausal women, many of whom are suffering symptoms, some of which they can see, such as flushing, but many which go on inside the body insidiously. Outside we may become wrinkly but inside we are growing crumbly. Our bones, arteries and memory are all being affected. There is now masses of evidence, as the Minister pointed out, linking the lack of female hormones which are lost at the menopause with osteoporosis. I am delighted at the support and help that she has given to the National Osteoporosis Society. I am working closely with it and between us we want to set up special places where women can go.
Unseen symptoms include arterial problems. Arteries and veins decay, leading to strokes, which are another aspect of the loss of female hormones. That is being studied at King's College hospital, which also has a unit studying the mental and psychological effects of the loss of hormones. Many women undoubtedly suffer from deep depression and sometimes their doctor gives them tranquillisers or pep pills, which cost a fortune and which the doctor continues to prescribe for donkey's years. They cause side effects. The Minister said that she was not keen on on-going drug treatments over many years. People get hooked on tranquillisers. That is not necessary if more research is done on this subject.
The Minister's answer to osteoporosis is to take more exercise. That may be good advice for those under 40, but there is not much one can do to increase one's bone mass when one is over 40, except perhaps the middle bits. I am assured that the end bits which snap off with wrist and hip fractures are not particularly affected. Incidentally, many people die of jogging.
Some people worry about the side effects of this hormone replacement treatment. Whenever I become enthusiastic about it, which I frequently do, the scare of cancer is raised. We must meet that anxiety and we can probably do more research on that. Many women who have come to our new clinic, which I have helped to open,
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are discovered to have other conditions when they come in for menopause symptoms. They can then be sent on for other treatments.
Originally, American women with this problem were given only oestrogen. I do not want to get too technical. That hormone causes the lining of the womb to build up and if one does not get rid of it, as one does naturally when one is younger in the form of a period, it can become cancerous. That was not realised early on, but now it has been discovered and women are given a balance of hormones, similarly to those produced when young, so that the lining of the womb is shed periodically. That is good news for the tampon makers. In that way, women do not risk cancer of the uterus. There is a possible link with breast cancer which is under investigation, but by having frequent checks for hormone replacement therapy, women are more likely to be screened and mammogrammed. I go every six months and have a mammogram there. As far as we know, there is no link between the treatment and cervical cancer.
About a third of all Health Service beds, for example in orthopaedic wards, are used by women with problems linked to the menopause. Heart attacks rocket in older women. They are practically unknown in young women because they produce hormones, but when that stops, the rate of heart attacks in women catches up with that in men. Therefore, many menopausal women, for example, with arterial problems or suffering from strokes, are in hospital care. There are 10 women for every man in institutions for the senile because the menopause has a profound effect on one's mental capacity. Women reach the point, sometimes quite young, when they cannot remember how to light the gas stove. That is hard to believe, but it is true. They forget how to do as simple a task as that. We all know about women arrested for shoplifting and blaming it on their age, and often that is to blame. American evidence shows a distinct link between Alzheimer's disease and the loss of hormones, as witnessed by the number of older women, compared with men, suffering from it. That is a further area for research.
In America, this treatment has been used almost since the last war. At least women know about it there, which British women do not. Perhaps a third of American women take this type of help, so it is not a newfangled idea just to keep women young, although there is nothing wrong with that. If we do not have to get old, why bother? The treatment will not make us live for ever. We will go on for our four score years and 10. I say that because many women are living well into their eighties. We are talking about the quality of life. Are we going to be little old ladies, stooped with osteoporosis, having lost five or six inches in our spine and unable to remember what we did two seconds ago, or are we to be in the fantastic condition of someone like the Queen Mother, who is healthy, articulate, intelligent, bright and active?
Mrs. Currie: I was wondering whether my hon. Friend was going to offer herself as an advertisement for the treatment.
Mrs. Gorman: Why not? This treatment is well worth supporting and investigating.
Mrs. Audrey Wise: The hon. Lady is making an interesting and valuable speech, but I am not clear

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whether she is also advocating that the Government should put more resources into this. If she is, will she be explicit about it?
Mrs. Gorman: I am just coming to that point.
In response to my experience I set up a new charity called the Amarant Trust to raise funds for King's college hospital medical school. It would like to set up a national centre to investigate all aspects of this treatment, to make it as effective as possible, and the various ways of administering the treatment. We certainly applied to the Minister for support and I hope that under section 64 she will consider giving us some help. We need about £2 million for the centre where we should like to retrain doctors because few understand the menopause. It is not a special discipline, but it ought to be. I hope that we will put it on the map, and that doctors in training will be given a special course.
I also hope that we shall persuade more GPs to make such treatment available on the National Health Service. However, I certainly do not exclude the possibility of private sector funds. I should like to see a centre in every town, to which mature women can go without embarrassment to talk to qualified nurses, chat about all their symptoms, be given screening and generally undergo a check-up in a friendly, happy atmosphere. While I hope very much that some of the funds will come from the private sector in co-operation with the Government, who cares where the money comes from so long as the project gets off the ground?
This is one of the most important aspects of medical care—preventive medicine at its best. As some doctors have pointed out, it keeps women out of the orthopaedic wards, the divorce courts and institutions for the senile—I hesitate to use the word "madhouses". Those institutions are unnecessarily filled with women who, if they received more attention, could be prevented from reaching such a condition. We could all end up in our eighties as active, healthy and alert as the Queen Mother.
I am happy that the Government are supporting that kind of preventive medicine, and I hope that they will give it more support.
11.30 am
Ms. Joan Walley: It is a great pleasure to be here this morning, with women Members on both sides of the House, taking part in such an important debate. There are few men present, but those who are here seem a bit embarrassed during part of the speech by the hon. Member for Billericay (Mrs. Gorman). I am particularly sorry that the Secretary of State is not present to hear us all speak.
Women's health is not important only to us. It is equally important to our partners, our families, our children and all the people we care for. We must get that point across. I, too, regret that the debate is not taking place in prime time, and that this is not a parliamentary occasion with the Benches packed with the male Members who are in the majority here. Nevertheless, I welcome the debate, and I should like to expand on what was said earlier by my hon. Friend the Member for Barking (Ms. Richardson). We are discussing not merely health but stress, poverty, work and, in particular, the environment—all the issues that promote good health, not just the way in which the National Health Service is used to treat ill health.
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The hon. Member for Billericay expressed regret that not enough doctors were prepared to specialise in women's issues. I particularly regret the closure five or six years ago of the South London hospital for women, which was one of the major training grounds for women. We are now beginning to experience the bad effects of that closure. Not many female consultants and medics specialise in the different kinds of women's health care, and that is reflected up and down the country. A report produced last week clearly showed that proportionately very few women make it to the top in medicine.
The Minister said that our health was in our hands. I take issue with that. Some of our health is indeed in our hands, but so many other aspects are in the Government's hands. My hon. Friend the Member for Preston (Mrs. Wise) asked where the money would come from to fund a clinic to help menopausal women, and perhaps to extend the provision to set up well woman clinics all over the country. I do not think that it is enough to say that we do not care where the money comes from. The Government should be providing a lead. An integral part of NHS funding should be the provision of well woman clinics, where women can simply walk in without fear or embarrassment. The reason for a visit may be a means of uncovering all kinds of other illnesses or conditions for which the woman could receive support. That would benefit not only her but her family and her employer.
A range of issues affect women as women. First, family planning services have been cut dramatically. Two thousand unwanted and regretted pregnancies have been occurring every year because clinics are closing down. Women who are no longer able to walk into a clinic and obtain advice have no choice but to go to the local GP, who is often very busy and often male. He may not even be fully trained in contraception, and is more than likely to prescribe the pill as a matter of course—which is the best thing that a doctor can do when he is busy and far too many people are coming to his surgery every morning. There is a clear need for much more direction from the NHS to provide family planning clinics.
Secondly, a woman is likely to have babies at some stage in her life, which brings us to the subject of maternity services. My constituency contains one of the largest maternity hospitals in the country. Recently, I met the midwives who work there, and heard at first hand that, although they have a very good centralised unit—one of the largest in the country—the shortages mean that it is being run on the basis of midwives' good will. There are not enough resources to enable them to provide the full and comprehensive service that they would like to provide.
I did indeed smile when the Minister mentioned her initiatives to encourage more women to breast-feed. But hard-pressed midwives will not be available to advise all the patients who come into the hospital. They cannot tell all the new mothers how important breast feeding is. Short staffing means that it is impossible to provide a continuous service, from the time when a woman first knows of her pregnancy until the time when she gives birth. As the mother of two children, I know that it makes a world of difference for the midwife to be there from the beginning, to be present at the birth and to visit the woman at home afterwards. That gives a new mother the best possible start.
Ms. Harman: Does my hon. Friend agree that solving the shortage of midwives is fairly and squarely the

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Government's responsibility? Pay is not the only problem. Midwives complain strongly of the inflexibility of their working hours and the lack of child-care facilities. The Government must take action on all those problems.
Ms. Walley: My hon. Friend has summed up the position admirably. When there are shortages of midwives and other nurses—as we have seen recently in the Birmingham children's hospital—staff must be recruited, but that can only be done if we change the basis of their working conditions, and perhaps enable some of the menopausal women about whom we have just heard to get back into our hospitals and the NHS. That also applies to younger women with children at school. All these issues are vitally important.
I am delighted to see that breast cancer screening services are being set up all over the country. Let me say as an aside, however, that if the Minister is so keen to introduce them and to enlist the help of all hon. Members on both sides of the House, it might have been helpful to receive an invitation to the opening of the one that serves my constituency. I received no such invitation, which is why I was outside with all the other people who are concerned about aspects of NHS funding.
I welcome the introduction of the breast screening services. In Staffordshire the take-up of those services has been beyond our wildest dreams. A 70 per cent. take-up was expected, but the actual take-up was 76 per cent. My main concern is to ensure that, when women have plucked up courage to go for cancer screening, it will be possible to get treatment, should they need it, without having to wait a long time. I am concerned that in the west midlands those women who are receiving radiotherapy treatment have to wait a long time for that treatment and as a result suffer great personal hardship.
Cervical cancer screening is incredibly important. Women are unnecessarily dying of that disease. The problems that have been experienced by my district health authority have had to be kept in the public eye. There has been a considerable delay in processing the results of the tests, but I understand that that problem is now more in hand than it was four months ago. That is probably only as a result of the initiatives that have been taken by local hon. Members, including my hon. Friend the Member for Newcastle-under-Lyme (Mrs. Golding).
I was horrified when one of my constituents came to me and said, "My wife has been prescribed some treatment as a result of cervical cancer, but why is it that there is no laser equipment within the North Staffordshire health authority to provide that treatment? My wife must go elsewhere." When I delved deeper into the matter, I discovered that there are some fortunate district health authorities that have laser technology equipment. In many cases, however, that equipment has been bought as a result of private contributions, fund raising or by individuals taking out an overdraft, as in the case of the Sheffield consultant. The marvellous advances that have been made in new technology should be used to treat everyone who needs help. In the debate about the National Health Service and funding, the Secretary of State must face up to the fact that one must take account of new technology. We should ensure that every district health authority has the necessary equipment for treatment.
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In common with my hon. Friend the Member for Barking, I am delighted that, after campaigning since 1982, we are to have cervical cancer screening in the House. That development only occurred because of the screening that was conducted in the House of Lords, the results of which were so alarming that we managed to finally swing the balance and acquire that service in this House.
The Ceramic and Allied Trades Union, the major union for pottery workers, the headquarters of which are in my area, passed a resolution at a recent conference that it should do everything possible to ensure that a well woman clinic was established in north Staffordshire. On a number of occasions, I have made inquiries of the district health authority about that, but it has said that it does not consider that such a clinic is necessary.
I am sure that CATU members will be delighted that they have the full support of women hon. Members for a well woman clinic. I am sure that even the Minister will exert some pressure to demonstrate the importance of such clinics. If we had such clinics I believe that there would be many more of the "reconstructed women" referred to earlier.
I share the disappointment that the provision of school meals has been cut and the fact that marvellous initiatives, such as the healthy eating initiative adopted by Staffordshire county council, are likely to be affected by competitive tendering and as a result of loss of income due to social security changes.
Last week, a dentist in my constituency told me that Stoke-on-Trent is a black spot for tooth decay. I am sure that those of us who are mothers have, from time to time, had a child screaming with toothache. We must take into account the cuts in the school dental service and the recent charges for dental treatment that have been introduced.
It is marvellous that women are living longer. Many women need community care, and in my constituency that care is not available. Local authorities are hard pressed to find sufficient money within the rate support grant for such care. I make no apology for referring to a constituency interest, Westcliffe hospital, an institution which houses a large number of elderly patients. In the past, I have been assured that, if it is closed down, alternative health provision will be made available. I have been informed that the switchboard of that hospital is likely to be closed down, which will create safety problems for the women in that hospital. With regard to mental health care, it is clear that, as a result of DHA cuts, replacement hospital facilities will not be available.
At the moment there is an important debate about the funding of the National Health Service, about which many of us are concerned. I wish that the Secretary of State had been present today so that he could tell us whether he had had much success in his discussions with the Chancellor of the Exchequer. It would be interesting to know the extent of tax cuts that are to be provided for those who take out private insurance at the cost of the services provided by the NHS. Yesterday, I met representatives of North Staffordshire health authority and they asked that I should make an earnest plea to the Government to reconsider the proposed changes to the RAWP formula. As a result of those changes, it will be almost impossible for my area to provide the services that are especially needed for women.
Health care is not in our hands only. It is affected by the money we earn, our housing, working conditions and the environment. Mention was made earlier of a conference on

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health care, and I believe that different Departments should be represented at that conference. Exercise and sport are important, but why does the Department of the Environment provide insufficient money for local authorities to provide swimming pools and other services to enable women to keep healthy? Why are creches not provided so that women can take part in sport regardless of young children?
Pollution also contributes to ill health. The Government have been dragging their feet on the introduction of lead-free petrol. There are only two garages in my constituency where one can buy such petrol. Three weeks ago I met representatives of The Society of Motor Manufacturers and Traders. Its report "Into the '90s" contained not one mention about lead poisoning, lead-free petrol and its effect on children and women. Why has the Department of the Environment not made strong representations on this matter?
Why has the Department of the Environment not intervened on playground safety? The tarmac and concrete used on those playgrounds is dangerous and causes many injuries to young children, with which we mothers must contend. Why is the Department not prepared to put safety first?
Will the Ministry of Agriculture, Fisheries and Food be invited to the conference? Will it be asked to look at ways in which food policies affect women? Will there be any change in the labelling of foods so that we know what certain foods contain and therefore whether to buy them—presuming that we can afford them?
What steps will the Ministry of Agriculture take to look at the way in which radiation from Chernobyl gets into the food chain? It has become clear in recent weeks that because of water nitrates the water supply in some parts of the country is not safe for young children and babies. Mothers have been supplied with bottled water because the nitrate levels are so high.
Will the Ministry of Defence be asked to make a contribution? RAF Swynnerton is near my constituency, and radioactive substances have been used in exercises. What effect does that have on children's health? I ask that in the wake of the scientific report published earlier this week about the incidence of leukaemia in areas close to Dounreay. What is the Department of Trade and Industry doing about unsafe goods on sale and about the baby walkers that we heard about this morning? Why are there not more prohibition orders on unsafe goods and why is the Department not looking at imports? The Department should be concerned with ballpoint pens whose precise measurement means that if a child swallows a pen top it is likely to choke. We must look at all the issues about product liability and consumer legislation.
Transport has already been covered. Many women cannot live a full life and their mental health is affected because they are confined to the home. Pensioners in Burslem in my constituency cannot get to the health clinic because the bus service stops at a certain hour at night. There are constant complaints from people about such things.
I should like the junior Minister to take on board a few points about women workers. I have had representations about the effects of maternity pay on contractual payments. Some time ago I said how important it was that new mothers should get the best possible start to motherhood. That includes the importance of maternity pay to assist mothers through this difficult although very
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exciting time. Constituents have told me that because of the way in which maternity pay is assessed, a woman worker sometimes receives perhaps two weeks' holiday pay on the same day, but she may get more than that. or she could end up with 60 per cent. of the amount to which she is entitled. In my constituency, women sometimes get £90 or £67, while other women in the same factory receive perhaps £110. That is wrong. Women need the maternity pay to which they are properly entitled.
One of the things that has saddened me over the last nine years is the reduction in the Health and Safety Executive's ability to enforce good, safe standards of health and safety in the workplace. One of the industrial diseases that is especially prevalent among women pottery workers in my constituency is tenosynovitis. I pay the greatest possible tribute to the wonderful work of women pottery workers. Government Departments need to do more research into this important industrial disease. Why have we not had legislation about ways in which people move and carry things in the workplace? Those issues are important.
I hope that some of the many valuable contributions by hon. Members today will not be lost. This debate will not be left after today because we shall press these matters and bring them to the attention of the public at every possible opportunity.
11.53 am
Miss Janet Fookes: I welcome the decision of the Government to allocate to one Minister special responsibilities for women's health. It is quite clear from the debate and from what we know from experience that the topic certainly needs to be spotlighted because it tends to be underestimated and overlooked.
The debate has ranged so widely over the possibilities that might come before the Minister that there is a danger of diluting her activities and those of her Department. It would be wiser if some of the matters discussed could be allocated to the Departments in which they more properly lie and if we could have somebody in each Department to look at matters from the woman's point of view. That might be a more practical way of following up some of the points that have been made.
I should like to turn to those elements that are clearly the responsibility of the Department of Health and Social Security. I warmly welcome the emphasis that is now being placed on preventive medicine. It is not before time, because it has certainly been one of the most neglected aspects of medicine. I was always brought up to believe that prevention was better than cure, and I am glad to see a conversion to this approach and that we are dealing on a far better and more systematic basis than ever before with the various forms of cancer that afflict women.
Men should not be left out of the concept of preventive medicine. It would be wise if we considered the concept of both sexes, although I recognise that there are special women's illnesses that require very special attention.
I hope that women will come forward and co-operate in schemes that are now under way for testing for cervical and breast cancer. May I offer one small word of caution? Several months ago I conducted a mini campaign in my health district to encourage women to come forward for the cervical smear test. I was horrified to discover that although the authorities were ready to welcome them,

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there was a distinct reluctance on the part of many women to come forward and have the test. There almost seemed to be a suggestion that there was something shameful about doing so or that women were too embarassed to go through the very easy process.
Ms. Harman: Does the hon. Lady think that the Minister's comments that cervical cancer is increased by screwing around increases the reluctance of women to come forward for cervical cancer smears? Does the hon. Lady agree that the comments of the Minister that women should not screw around discourages women from coming forward because they feel a sense of shame?
Miss Fookes: My hon. Friend the Minister has a turn of phrase which is not always the one that I would use, but that is for her to decide.
It is important that women are encouraged to come forward. I made it plain that I had undergone this test, that there was nothing to it and that I would continue to have it regularly in the hope that as a woman in public life I was not simply urging other people to do what I was not prepared to do myself. That is a more effective encouragement.
I do not know whether my experience in my own limited area is common in the country as a whole. My hon. Friend the Minister will know better than I whether there is any widespread reluctance to undergo these tests on the scale that we think is necessary and proper. If my experience is symptomatic the matter needs to be looked at in health education measures and in public discussions.
I think it is correct to say, but perhaps the Minister will correct me if I am wrong, that young girls who engage in very early sexual activity have a statistically greater risk of contracting cervical cancer. If that is so it should be dealt with by health education for the young. It is not a matter of which anyone would immediately think, especially youngsters who have been brought up to think that there is nothing morally or practically wrong—contraception has developed—in engaging in early sexual activity. I look forward to hearing a reply about that from my hon. Friend the Minister.
The newer techniques that have been developed with breast cancer do not involve the drastic amputation that many, perhaps all, women have dreaded and have found so difficult to come to terms with when it happens to them. I am not sure that those newer techniques are always embraced by the medical profession. The Jeannie Campbell appeal, which has contacted all lady Members, has been campaigning for less drastic methods where they are suitable. In a recent letter, the appeal chairman, Peter Hawkins, says:
"I am extremely disturbed by the increasing number of cases being brought to my attention in which breast cancer patients actually have suffered, or have been threatened by, unnecessary breast amputation.
In the majority this has been because the possibility of alternative conservative treatment was never discussed between diagnosis and mastectomy. In an appalling minority the patient was found, after 'automatic' mastectomy wrongly had taken place, never to have had breast cancer in the beginning."
At the end of his letter he expresses his worry about the all-embracing consent form that patients must sign before having an operation. My hon. Friend the Minister should consider quickly, if she has not done so already, the terms
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of the consent form. There is nothing worse than giving general consent but discovering that the operation has been carried out in a way to which one would never have consented had one been aware of the full implications. If such a thing happened to me, I would be furious and boiling mad. It would be, however, too late and could not be redressed. I urge my hon. Friend to consider that as quickly as possible.
My hon. Friend the Minister did not deal much with stress-related diseases. It is a matter that the hon. Member for Barking (Ms. Richardson) had in mind when she gave her survey of what may lie behind women's ill health. It is true that many women are subject to much stress because of work, unemployment or family problems. They should never use excessively tranquillisers and sleeping tablets as an updated version of a medieval cure. I hope that the medical profession is far more aware of the dangers of long-term addiction to what appear to be harmless drugs and that it is far more wary of prescribing them.
I was shattered to be told by an organisation called Broadreach House, which operates in the Plymouth area and specialises in drug and general chemical dependency, that it found it more difficult to wean members of both sexes off such drugs than it did to wean people off heroin or the other so-called hard drugs. Unless tranquillisers are used on a short-term basis to deal with a crisis in a woman's life or health, they are worse than what they are supposedly trying to cure. We must be far more wary of prescribing them and we need a health education programme to explain to women the dangers of using them.
On many occasions, women have visited my constituency advice bureau and said, almost as a matter of course, "I am on X, Y or Z" as though it was the most natural thing in the world. The long-term use of those drugs horrified me even before we reached our present point of knowledge about them. We shall have to give urgent attention to that problem. It is easier to give urgent attention to something that directly threatens life, but emergency treatment should be available for those other ailments or stress-related diseases that do not necessary kill but cause many problems.
It is clear that many women suffer stress simply as a result of trying to perform the traditional tasks of being a housewife and mother while holding down a full or part-time job. I know that one suggestion to tackle the problem is the all-embracing creche facilities, nursery classes and the like. I am not against those facilities and I am sure that they have a valuable role to play. A futher solution that could run alongside those facilities, which would ease that burden, would be if women could take time off when their families were young without their employment and promotion prospects being impeded when they return to the market place. We must look far more closely than we have previously at the possibility of returning women to work after a period away from their working environment while they give their first attention to their families.
That may be the prerogative of other Departments, such as the Department of Employment, but I am sure it would not be beyond the powers of my hon. Friend the Minister to interfere, in the kindest possible way, in the activities of other Departments to ensure that they consider the woman's point of view.
It would be useful if medical practitioners and nurses were more aware of how much of a burden women carry

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in their domestic lives and jobs. I know that it is generally believed that the husband or partner give far more help with the housework than they used to, but my strong hunch is that for every man who does all those saintly duties there are a further nine who do precious little, continue in exactly the way that they always have but expect the women to hold down a job and carry out the domestic duties.
Ms. Richardson: I follow the hon. Lady's argument—and I apologise for being absent from the Chamber for a few minutes—but does she agree that the introduction of the concept of parental leave, whereby both partners would statutorily be allowed to take time off work, would encourage more men to take more interest and responsibility in home care?
Miss Fookes: The theory is good, but what worries me is that it might lead to one more visit to a darts, football or snooker match rather than doing what they should be while on parental leave. Having reached middle life, perhaps I am becoming slightly cynical. In theory, the concept of equal responsibility is all very well. I should like to be proved wrong and find that they might not use the opportunity for something other than for which it was intended.
As a former teacher, I am well aware of the importance of catching people young. It is important not only to have education processes and campaigns for adults but to ensure that those matters are dealt with at school. I know that teachers complain that they are always being asked to add a further item to the overloaded curriculum, but it could be subsumed, if the information were given, in the various subjects by which health education is taught.
I am particularly perturbed about the number of young girls who smoke cigarettes. It is much more difficult to give up the habit than never to start it. I have never smoked a cigarette, but those who do must feel that they are part of a highly threatened minority that is hardly allowed to exist. Even hardened smokers would probably agree, however, that it would be better if youngsters never started to smoke. A much tougher programme is needed to persuade youngsters never to begin the habit.
All the good reasons why young people should not start to smoke will not necessarily work. Young girls are most vulnerable about their appearance. They are usually deeply conscious of it. Health education must be related to how they look rather than to how they will feel or how health they will be in 20, 30, or 40 years' time. It is very easy to make a good case about never starting to smoke by relating it to their appearance.
Several Opposition Members have referred to the fact that women doctors ought to be available for those women who would prefer to see them. Some women are so diffident that they do not even make the point that they would prefer to see a woman doctor. For all those who say that they would prefer to see a woman doctor, I suspect that there are many more women who would greatly appreciate that facility but who would never voice it because they are accustomed to seeing male doctors. The most intimate details are frequently spoken about these days, but I am sure that the great majority of ordinary women are very reticent about doing so. They would find it far easier to talk to a sympathetic woman doctor whom they feel would instinctively understand what they are trying to say. However well intentioned male doctors may
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be, that is how very many women feel. This is particularly important to women who belong to the ethnic minority groups. It is a deep part of the culture of Asian women that they do not allow a man other than their husband to see or touch them. That may be misguided, but we shall not overcome that cultural opposition overnight. In the meantime, those women deserve as much care as any other women. They deserve the best care that is available. I hope that my hon. friend will look carefully at that aspect.
I am tempted to make a number of further points but I am aware that other hon. Members are anxious to speak in the debate. I hope that the few points that I have referred to will have made my hon. Friend the Minister aware of the fact that, although she has made an excellent start in dealing with the health of women, a great deal more remains to be done.
12.12 pm
Mr. Ronnie Fearn: Despite what was said earlier, I am not in the least embarrassed about being here this morning. Male Members of Parliament have wives and daughters and we speak to one another about these matters. Our constituents occasionally talk to us about them. I am pleased, therefore, to have this opportunity to join in the debate on women's health.
Due to the structure of our society, women play a central role in the health of the nation. They are in a position to influence the health of others and to promote good and preventive health habits in our children. They are the major carers through their role in the Health Service and in the family and the community. That is one reason why their health should be of prime importance to the Government and to this House.
Today, more than ever, women are expected to cope with a diversity of roles, with little or no support. More women work today than ever before—some out of choice, others because of the pressures of a materialistic and consumer society, and many out of pure need. Most are in low paid and low satisfaction work. Few are in positions of power or influence. At the same time we expect them to provide a good family life and to care for our children, the sick and the elderly.
In the poorer sections of the community, these pressures are added to by intolerable housing and living conditions. We hear a lot about Victorian values. In many respects this Government have reintroduced Victorian legislation for the social services and the welfare state. However, it is time that we recognised that the structure of society is not what it was. Gone is the extended family and the close-knit community that could offer help and relief from the pressures of caring for children, the sick and the elderly. Today our carers are often isolated and expected to cope on their own. I do not find it surprising that women suffer from the effects of stress, anxiety and depression. It is time that we cared for the carers.
With the emphasis on community care, it is important that we should replace the old network with a full range of community services. There should be adequate day care facilities, creches, mobile clinics, day centres, home helps and visits and short-term respite facilities. There should also be improved benefits to relieve the financial burden that is often placed on our carers. With an improvement in these services, it may be easier for men to take on the role of carers, thereby giving women the freedom of choice that they should have.

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It is with some concern that I note that district health authorities are finding it necessary to close down their family planning clinics in budget-saving exercises. Family planning clinics offer a wider choice of contraceptives. The staff are often better trained in these matters than the general practitioner and can offer more time for consultations than the average GP. It has already been said twice that many women prefer to go to clinics. Quite often, it is the only opportunity that they have to be seen by a woman doctor. Family planning clinics have proved to be cost-effective and we should consider expanding, not diminishing their number.
I welcome the Under-Secretary of State's claim in a speech to the Royal College of Nursing on 19 May 1988 that the Government do not want health authorities to cut back on the provision of family planning clinics. While district authorities continue to suffer from a shortage of funds, the position is unlikely to improve.
We hear much from the Government about freedom of choice. Many of their policies are justified by that cry, yet the centralisation and rationalisation programme in the hospital service and the cuts due to the financial crisis have limited the choice for many women. For instance, it is often the maternity wings of hospitals that are hit. Expectant mothers find that the criterion of choice becomes not the services provided but how far and for how long they will have to travel to reach a hospital.
The centralised programme is sometimes justified by the claim that health authorities are providing centres of excellence, equipped with all the latest advances in technology and equipment. When that claim is applied to obstetrics, we are in danger of pressurising women into giving birth in unnatural clinical surroundings and, in the majority of cases, with unnecessary technical equipment. The Government are on record as saying that their aim is to encourage hospital births in order to reduce the mortality rate, yet there is no confirmed evidence to support the theory that the fall in the mortality rate is due to hospital confinements. Hospitals have a far higher rate of infection of the mother than have home births. There needs to be more scientific evaluation of present methods before we continue to pressure women into high-tech births.
The real choice for women will come when we view pregnancy and birth as the natural phenomena that they are. We should provide the maternity services that the World Health Organisation recommends. The expectant mother must be given the opportunity, in consultation with her doctor and midwife, to choose the birth that suits her best. Therefore, the number of midwives needs to be increased and after-care services expanded.
That latter point is particularly important, because, as a result of financial and staffing pressures, more and more women are being sent home 24 hours after giving birth. The latest information from the Royal College of Midwives is that, between 1979 and 1987, the birth rate increased by a further 40,000 babies, but the claim that more midwives are being employed could be challenged and the Royal College of Midwives says that we are talking about only half a midwife per unit per week.
Later in life, many women have to suffer the effects of the menopause without any hope of alleviation of the symptoms of menopause-related diseases such as
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osteoporosis, which is connected with the death of many older women. In June 1986, the Nursing Times and Nursing Mirror estimated that osteoperosis treatment was costing the Health Service £2 million per week, with a third of hospital beds occupied by women suffering from related ailments. We have heard with interest about hormone replacement therapy, which may offer women a better quality of life. However, before it becomes commonplace, there should be a further investigation of the short and long-term effects of such treatments, and more information and training should be given in methods of prescribing it.
The current financial crisis and long waiting lists mean that many women needlessly suffer the pain and discomfort of osteoarthritis and other conditions. Yet we hear of more ward closures and of a doctor in Sheffield contributing a third of his salary to keep his specialist osteoporosis unit for another two months. In the majority of areas, provision is not good enough. In Southport, we are lucky: a new hospital is due to open at the end of the year, although there again, it is to replace outdated buildings.
Four major causes of death in women have been identified as coronary disease, lung cancer, breast cancer, and cervical cancer. The last two are specific to women and I welcome the Government's attempt to improve matters through screening programmes. However, those programmes will not be completely successful unless the Government also provide and fully fund the necessary back-up services. I note with concern that units that began their programmes in January are already having to close because of a shortage of scientific and laboratory staff. With increased emphasis on preventive screening and new laboratory techniques it is imperative that the Government tackle the problem by improving and funding pay awards and improving career structures in the service.
The mammography programme requires a better training scheme for radiologists to prevent unnecessary recalls, and possibly the employment of specialist teams to ensure that the correct diagnosis is made and the correct treatment given. Both screening programmes should involve more counselling and after-care services for women who are proved positive.
Perhaps most important of all, the hospital services must be given the means to provide the treatment necessary. There is little point in introducing systems of early detection if treatment is thwarted by lack of equipment, lack of staff, and long waiting lists. There is also a danger that in the current crisis, less serious gynaecological cases will be pushed further down the list, with the result that more women will suffer months, if not years, of ill health, perhaps with more serious consequences.
The Governnment must look at the whole picture. Women play a pivotal role in our society. In an ideal world, men would share that role, but until the structures of our society are changed to accommodate that, it is especially important that women are given the local, community and work-based services that they require to meet the demands that society and Government place on them. The better health that women enjoy, the more benefit will accrue to us all.
12.26 pm
Mr. John Browne: I declare an interest as a director of the Churchill Clinic, which is in the private sector. I very much welcome this first Government debate on women's health. The Minister, the hon. Member for Barking (Ms. Richardson) and others have alluded to the fact that not only is our total Health Service of vital national importance but it affects women more than men both because they live longer and because they have special roles such as childbirth, child care, and so on. They also have the role of educating children. As I hope to illustrate, preventive medicine is a key aspect. The debate is particularly timely and I am glad to have the opportunity to speak in it.
The National Health Service is about 40 years old and it is in a crisis of change. It has been alleged that the Government do not care and that they have instituted cuts. I find such allegations amazing. When I read Government statements or listen to Ministers, as I have over the past nine years, I find it hard to see how allegations of not caring could be justified. One type of caring is to give money away; the other is to ensure that that money is properly spent and that it genuinely goes to those who need it. That is effective care.
Let me deal with the allegation of cuts. Spending on the Health Service increased from £7.5 billion in 1979 to £22 billion this year. That is an amazing increase—30 per cent. and more ahead of inflation. Opposition Members' claims are therefore difficult to substantiate.
It is interesting to note that as more money has been spent on the National Health Service in vast amounts, so the complaints have increased. The complaints reached a crescendo last winter, which makes it obvious to me that the problem is not one of money and that we need to look somewhere else for the cause. Therefore, I greatly admired the Government's courage in not responding to the crescendo of complaint by pouring more money into what is effectively a leaking bucket. Instead, they decided to spend on a maintenance basis and conduct a top-level review to establish, on behalf of every citizen in the country, where the taxpayers' money must go to ensure that in the next 40 years the Health Service will still work, and work to the benefit of the nation as a whole.
As we all know, health is a complex problem. As has been said by the Minister and others, more people live for longer. As they live longer, more complex demands are placed on the Health Service. Furthermore, expectations have changed. When I was a lad, for the symptoms of many ailments one readily accepted a glass of hot milk and two aspirins and the recommendation that one should go to bed. Today people expect more sophisticated treatment, or at least more sophisticated consultation, for the same symptoms.
Technology has improved, and that is greatly to our advantage. But that has happened at a price far in excess of inflation. There is a technology expenditure curve, in addition to an inflation curve. Furthermore, high technology operations place much greater demands on the resources of the Health Service.
Technology has enabled operations such as kidney transplants, which were unheard of 30 or even 20 years ago, to become routine. They are very demanding on Health Service resources and there are huge opportunity costs. If kidney transplants are to be carried out, what operations will need to be stopped? What is the
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opportunity cost? There is also a greatly increased awareness of new types of disease such as stress, which has already been mentioned this morning. That all leads to increased demands on the Health Service.
Somewhat misguided comments have been made today about alcoholism and so on being directly related to unemployment. My county of Hampshire has recently been told that it has the worst record in the country for violence against the police. There were 34 cases last year, 90 per cent. of which were alcohol-related. Yet Hampshire is not an area of high unemployment—indeed, it has low unemployment and high earnings per head. Therefore, we cannot simply and justifiably relate stress to high unemployment.
The good health of the nation is absolutely essential to our survival as a developed nation. However, it is not just a question of money—although funding is, of course, a critical problem. I hope that, in their current top-level review the Government will turn heavily towards preventive medicine. I apologise to my hon. Friend the Minister for not having given her notice, but I would be interested to know how much of the NHS budget is spent on preventive medicine. Even without knowing the figure, I guess that it is not enough. In that top-level review, preventive medicine must be seen as a massive source of cost saving. Government spending on preventive medicine should be seen as an investment in the future to reduce potential costs and claims on the NHS. Just as with buildings, to modernise, maintain and take preventive action is a good philosophy.
I support the Government's aim of increasing the emphasis on self-reliance, and women can play an influential and important role in that. However, the Government must also play a key role in preventive medicine. First, they must regulate on matters such as pollution. Secondly, they must provide preventive services such as screening, and thirdly, they must publicise much more widely the good programmes that they are following, such as immunisation, and educate on such matters as diet.
I know that my hon. Friend the Minister has done a tremendous amount in that area and I much admire her courage in challenging even the sanctity of the English breakfast and other dishes that are thought to be sacred. That took guts. She had to take a great deal of flak following some of her comments. The Government's first role in preventive medicine should include action on pollution, especially passive smoking and leaded petrol. Secondly, there should be action on what I call lifestyle—diet, alcohol and active smoking. The third area is in services such as immunisation and screening.
The recent Froggatt report shows conclusively that passive smoking alone—and I am not yet speaking of active smoking—increases the incidence of lung cancer by between 10 and 30 per cent. That is an enormous figure. Think of how many people are suffering and using the resources of the Health Service because of lung cancer predominantly caused by smoking.
When I spoke in the Chamber on 9 May 1980 (luring a smoking and health debate, I said:
"I believe that the Government should consider legislation on non-smoking areas, particularly enclosed, confined public spaces, such as lifts, cinemas, waiting rooms and, indeed, the Committee Rooms and Dining Room of this House—a place where we are fortunate to have a specific Smoking Room set aside."—[Official Report, 9 May 1980; Vol. 984, c. 714.]

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I was almost laughed out of the Chamber for saying that. I am glad to say that, today, I think the story would be very different. Indeed, there is now an early-day motion along those lines.
Subsequent early-day motions have stated that we should not have such a tyranny of restricting smoking.
The Government must take strong action. Obviously,people have a right to smoke—I am not trying to take away that right—but the Government's duty is to defend a far more basic right than the right to smoke, and that is the right of the non smoker to breathe fresh air. The Government have not grasped that nettle firmly enough. Leaving it to the free market is not enough. Every day people are unnecessarily being caused mortal injury. More legislative action should be taken, and the voluntary codes and so on should be toughened up. I realise that the Government believe in the free market, but legislation can hasten the free market. We have seen that done in many areas.
I now refer to leaded petrol. As we know, there are approximately 18 million cars in the United Kingdom. Two million motor cars, without any adaptation, could use unleaded petrol. Another 7 million cars, with the smallest adjustment to their ignition timing, could immediately take unleaded petrol. In fact, as a demonstration, James Bond's Aston-Martin was converted in 25 seconds. It is not an expensive deal. Most garages could do it for free. If they charged £1, they would get a lot of money for it. So, today nine million cars or 50 per cent. of the cars on our roads—could run on unleaded fuel. Actually, the consumption of unleaded petrol, despite the fact that it is 6p a gallon cheaper than leaded petrol—thanks to the Chancellor—is less than I per cent. of petrol sales in this country. Again, the Government must invest more money in publicity to put the message across.
I now refer to what I call lifestyle—food, alcohol and tobacco. Cholesterol and calorie intake has been proved of great significance and importance to health. The Minister has done a tremendous job in highlighting that. I am pleased to hear about the new consultancy on breast feeding. Breast feeding and early feeding habits of children are an aspect of foods. That is why women's role is so important. Breast feeding can affect people's metabolism for the rest of their lives. They become fat-inclined or not fat-inclined, sweet-toothed or not sweet-toothed, and so on. Such matters must be drummed home and money must be spent in terms of investment by the Government. Much more publicity is needed about diet. In terms of legislation, the Government should demand that calorie and cholesterol contents should be printed on food packages at point of sale.
In terms of alcohol—you will be shocked, Mr. Deputy Speaker, by the statistics that I hope to give—750,000 Britons are seriously ill as a result of alcohol abuse. That means that 2 million or more families are affected. Alcohol abuse is the United Kingdom's third most dangerous disease. Women are particularly prone to the harm of excessive alcohol intake, especially in the 25 to 37 age group. Excessive drinking was involved in 80 per cent. of deaths by fire, 40 per cent. of pedestrian traffic accidents, 33 per cent. of child abuse cases, 50 per cent. of murders, 30 per cent. of non-traffic accident deaths, and 33 per cent. of domestic accidents.
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As I have said already, I am ashamed that, in Hampshire, we have experienced the worst rise in violence against the police. It occurs throughout the country, and it is rising at an alarming degree. Ninety per cent. of such offences are related to alcohol.
In the past 20 years, alcohol consumption has doubled, not declined. In 1982, £12·3 billion was spent on alcohol. No less than 38p of every leisure pound is spent on alcohol. That is more than is spent on food, light, newspapers, cigarettes, books or holidays. Alcohol has a high human cost—it is responsible for between 5,000 and 10,000 premature deaths each year, and for more than one in five patients being in NHS care. The monetary cost of alcohol misuse is estimated to be more than £1 billion in lost production and more than £1·7 billion in social costs.
The cost is huge. The Government have a duty to publicise that fact far more effectively. We have hard-hitting campaigns, which I support, on AIDS, for example, but the campaign on alcohol is nowhere near hard-hitting enough. Not enough money is spent on it. Will the Government seriously consider demanding through legislation that a health warning be printed on each bottle of alcohol? A label could be affixed, just as a duty-free label is attached. That would not be too expensive and it could be done quickly.
Mrs. Wise: Does the hon. Gentleman agree that it would be cheaper for the public purse if we restricted the amount of money spent by alcohol producers on promoting their products? If we did that, we might not need to spend public money combating their advertising.
Mr. Browne: I have some sympathy with that line, but I am more of a free marketeer than the hon. Lady. There are methods other than restricting producers, which I shall describe later. I believe that we should go for the advertisers and prohibit what can be advertised. That would have an immediate effect on what is spent on advertising.
The active smoking of tobacco is a major cause of lung cancer, heart disease and cervical cancer. It is estimated that smoking costs the NHS £500 million a year and that it causes more than 300 deaths a day. We have had pretty good results since 1979. Deaths from lung cancer have declined by 9 per cent., but among women have risen by more than 20 per cent. especially among women in their 20s. Girls aged between 11 and 15 now smoke nearly twice as much as boys of the same age. Smoking is a killer. I support the Government health warnings, but they are not enough. They are not hard-hitting enough. The Government must spend a lot more money to publicise the dangers of smoking. Alcohol and tobacco are killers and they require legislative action.
I am a director of a satellite television company. We have a self-denying ordinance—we will not accept any advertising of tobacco or alcohol products. That has an opportunity cost for us. We do it as a self-initiative, but I believe that the Government should prohibit advertising of tobacco and alcohol products on television, which is such an influential medium.
The Government have done a tremendous job on immunisation. The figures speak for themselves. There is now a 68 per cent. take-up of the vaccination for whooping cough, whereas it was only 31 per cent. in 1978, and there is now a 71 per cent. take-up of the measles vaccination, whereas it was only 48 per cent. in 1978. There is more to

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be done, however, and I welcome the introduction this October of the combined, measles, mumps and rubella vaccination. This is probably the biggest change for 20 years. However, when I look at the grant of £48,000 that the Government have given to the Rubella Council, I think that that illustrates the problem. When one looks at the cost to the National Health Service of £22 billion, the £48,000 shrinks into an insignificance that it does not deserve.
On the subject of screening, particularly for cancer of the cervix and breast, we know that early detection is critical in successfully treating many of these cancers. We have about 2,000 deaths a year from cervical cancer. The screening that has already been carried out is estimated to have saved about 14 per cent. of those under threat. However, the new five-year screening programme that my hon. Friend has announced is estimated to save 84 per cent. of those who are screened. It is, therefore, a very laudable scheme that has been introduced. It is the first fully comprehensive programme in the world. I believe that the Government should be praised for taking this initiative last February particularly by extending the programme to cover women from 20 years of age. I wholly support that. It is all good stuff. Obviously, as it is a trendsetter for the world, we can expect problems, because we are on the cutting edge.
I have to say—my hon. Friend has already mentioned it in her speech—that we have a problem in Winchester and in Basingstoke, because our district health authorities are situated in areas where competing earnings are very high, the cost of housing is very high, and the payment given to those laboratory technicians—people with two A-levels and six months' training—of £7,000 a year is not enough. They are not striking, as they would have done several years ago, but they are getting on their bikes and moving to other employment and to other agencies. Therefore, what has happened is that Winchester and Basingstoke health authorities do not have the laboratory technicians sufficient to support this excellent initiative. Something has to be done, because women in my constituency are now being re-exposed to the risks that existed before the Government took those initiatives. As my hon. Friend has said, I believe that there are 75 per cent. of other laboratories that are under-utilised. The problem is that Winchester local health authority does not know this. It does not know which those under-utilised health authorities are, so how can it send its smears to them?
Mrs. Currie: It does now.
Mr. Browne: My hon. Friend says that it does now, and I am very pleased to hear that. One alternative is to send them into the private sector.
The other idea I must mention to my hon. Friend is that of local pay premiums. Our problem is only the tip of the iceberg. There are people on the clerical staff in our family practitioner units, starting as VDU operators, who earn £4,200 a year; while British Telecom in the same area pay £6,000 a year; local government £5,500; and the Civil Service £6,000. Effectively, the FPC is becoming a training ground for other people. They train and then move on to higher salaries.
The Government have to look at the private sector, for examples. In the private sector, I understand that in Winchester the National Westminster bank, after someone
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has been on probation for four months, pay a £750 a year premium on their salary. I believe that the Government have to look at this in terms of the National Health Service and regional pay. As a result, Hampshire FPC is short of 25 people from a staff of 115. It is just under 25 per cent. understaffed. Unless this is sorted out, the system will collapse. It is an excellent system and highly efficient. The administrative charges are less than 1 per cent.
Our FPC is a very effective system and yet it is in danger of collapsing because of the low pay of certain of the staff. I think that the Government must examine it and consider stopping capital spending, maybe for a year, in order to put these wages right. They must regrade staff and pay regional cost-of-living premiums. As I have said, if it is not put right there will be a collapse of the cervical screening system let alone the breast screening system that we hope is to come. It will just not get off the ground unless collective action is taken.
To close, I believe that preventive medicine is absolutely essential. It is very cost-effective. The Government must legislate on smoking in enclosed public places. They must legislate on alcohol to get a health warning on bottles. They must legislate to curb advertising of alcoholic and tobacco products, particularly on television. I think that they also must also ensure that there is legislation to require that cholesterol and calorie values are printed on packs at point of sale.
As I have said many times, I think that the Goverment must spend much more on publicising both their own good works, such as immunisation and so on, and the whole concept of self-reliance and what people, particularly mothers, can do in this education process of preventive medicine. I know that the Minister, as I have said before, has already done a great job. I am sure that she will continue. She has shown great courage and I wish her good luck in this very challenging and exciting venture.
Several Hon. Members rose——
Mr. Deputy Speaker (Sir Paul Dean): Order. I ask hon. Members to keep at least one eye on the clock. There are at least five hon. Members who have been in the Chamber throughout the debate who are hoping to contribute to it. I am sure that we would all be disappointed if they were unable to do so.
12.52 pm
Ms. Hilary Armstrong: I have a train to catch, so I shall not be too long, Mr. Deputy Speaker.
I rise with some trepidation as a woman from the north, a category with which the Minister has not been too pleased. Women from the north have suffered some abuse of the past few years. I hope that the guilt that many women in the north have had laid upon them will not emerge in any way in my speech. I try not to behave in that way. As I have said, I rose with some trepidation.
One of the issues on which the Minister and I have corresponded on several occasions has been covered already in the debate, so I shall try to be brief about it. Cervical screening in my area is an issue that has been brought to my attention on numerous occasions. I have frequently found that the Minister's loose talk does not help. I ask her to examine again some of the reasons why

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women suffer from this form of cancer. I ask her to take on board the fact that there is a reason to which she has not alluded.
The incidence of cervical cancer is not necessarily because women have a number of partners. There are women who have a partner with whom they sleep who has a job which is normally classified as dirty—in coalmining or the steel industry, for example. The incidence of cervical cancer in areas where these occupations predominate is higher than elsewhere in the country. I assure the Minister that I and others are convinced that that is the major reason for the incidence of cervical cancer in my area.
As there are no longer any coalmines or steelworks in my constituency, the world may begin to change. Women in my constituency have been working hard to organise and improve the services that are available, and it is not exactly helpful to tell them that they suffer for the reason that the Minister has given. That does not encourage them to continue to strive for better services.
I ask the Minister to examine the priority age for screening. There seems to be evidence that more attention should be paid to it for those in a younger age group. I accept what she has said about breast cancer screening, but I do not think that that is true of cervical cancer screening. What is the cost of putting work out to private clinics?
Last year I wrote to the Minister about a particular case. A friend of mine was screened in November and did not hear until the end of March that she had had a positive test. It is exactly a year ago this week—I remember it well, because it was the week of the general election—that she eventually had an appointment at the clinic to have her condition dealt with. It was well into August before she knew that she was clear. It is not enough just to stand here and say that that is appalling. The effect of that on women is devastating. My friend was a nurse, but that did not seem to help her. It was a devastating experience, and she was almost agoraphobic. She managed to continue to work, but little else. It has had a devastating effect on her confidence in having tests and on her future life.
I was interested in what the Minister said about the rate of screening and the Government's objectives. In 1986, we knew that 60 per cent. of women with cervical cancer had never been screened. We know that elsewhere there is an effective screening programme which reaches 80 per cent. of all eligible women. At that stage, we could not say what percentage of women was reached by our programme, and I should be interested to know what progress has been made on that
I was interested in the speech of the hon. Member for Winchester (Mr. Browne). He represents a town which in a league table drawn up by a local northern university is shown to be the most prosperous town in Britain. That same table puts Consett, a town in my constituency, at the bottom. The problems that the hon. Gentleman identified in recruiting medical laboratory scientific officers are exactly the same in my constituency. We have enormous problems, particularly because of salary scales, so they are not just created by success and a high wage economy. Consett is at the bottom of the league table because, despite new jobs, we are a low-wage economy. Even then, it is incredibly difficult to recruit MLSOs in the area.
In a recent letter, the chair of the Northern Regional health authority states of north-west Durham:
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"Latterly the service has been affected by staff illness and this resulted in a reporting delay of around ten weeks by the end of December 1987, but again by the use of a private laboratory that interval is now down to around six weeks."
He tells me that, in the other district health authority that covers my constituency, the same sort of problems exist.
I know, partly because I was chair of the union which recruits MLSOs, that the recruiting problem in both areas was acute, as was the difficulty of retaining them. They feel that they are not recognised as part of a health care team, that their work and contribution is devalued, and that that is reflected in their salary. Everyone who works in the Health Service has a vital role to play. To see the whole work force as a health care team is crucial if we are to get our preventive health care and responses right. Some health care workers feel not only that their contribution has been devalued, but that they are played off against workers whom the Government see as the hands-on, face-to-face workers. In fact, the contribution of the other workers is equally important. I am not saying that the work of nurses and doctors is not important; of course it is. Others, however, have a vital role to play, and we look to the Government to recognise that.
How do we enable and encourage more women to know, and be confident in, their health services? One of my local community health councils recently carried out a detailed survey, which found that the most disturbing fact about cancer screening was that some 27·6 per cent. of those tested were never informed of the results. The majority presumably assumed that no news was good news, but for some, as I have said, that was very much the wrong assumption.
The survey also discovered that many women did not know or feel confident about finding out when and where to go. Working with women's health projects in the Tyneside area, I found that they were largely able to overcome the problem, vitally affecting the number of self-referrals. The atmosphere and the campaigning nature of the clinics gave women confidence, as they knew that they could go along, meet some of their friends and be dealt with by a woman who would not only do a test but talk to them, listen to their problems and ensure that there was a comprehensive response.
Another group who have been to see me, and who are very distressed about what they see as a breakdown in the service, are the community nurses. Those in one patch of my constituency say that exactly the same number of staff as 10 years ago deal with a caseload 70 per cent. higher. Given that sort of increased pressure on community nurses and on those who try to provide a more holistic approach to health care, is it any wonder that women feel unsure about where to go and what to do? It is partly because they do not want to put additional stress on those whom they know are already overstretched.
Whatever label is attached to the service—well woman clinics, or community health care—I think that the Minister knows what we are talking about. I hope that she will work carefully to ensure that opportunities are provided, particularly in areas in which health care is especially important, because the figures show women to be at higher risk. Cuts in the number of well woman clinics, and the reduction in spending on health education, are not what I see as a positive commitment to support.
I should like to mention many other matters, but I shall be brief. The community nursing problem affects specific issues, which the Minister mentioned and which I had

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meant to say something about—mental health. Community nurses have a crucial impact on that problem, and I hope that the Government will take it on. Let me also stress the importance of an effective occupational health service. There are now many more women at work; many more now have to work. There is clear evidence from Sheffield that an effective occupational health service improves not just attendance and sickness rates, but the general well-being of employees—and therefore I trust, that of employers. Moreover, it has increased productivity. The International Labour Organisation has suggested how specifically to encourage the development of a good occupational health service.
There are many other issues on the agenda and I believe that the Government know what they are. I press the Government not to lecture women about what they are not doing properly, but to ensure that women can meet their health worries and those of their families.
I remember when I spoke to one of the Minister's colleagues in the canteen downstairs. I noticed that he was having an extremely unhealthy lunch with lots of chips and other fried things. I said that a member of his Government would not be happy about that and he replied, "The trouble is that every time I hear her, it pushes me to have more chips." The Minister should learn from that. Lecturing people about what they should do frequently pushes them the other way.
The Government need to encourage and support good practices, and I accept that I must also do that. The Government must consider first how to give women positive support and encouragement rather than just lectures.
1.5 pm
Mrs. Gillian Shephard: I am glad to have the opportunity to take part in this debate and equally glad that it is taking place in this Chamber, which focuses all too infrequently on matters of exclusive concern to women. I congratulate the Minister on initiating this debate.
I should like to focus—perhaps more narrowly than other hon. Members—upon the current issues of cancer screening and well woman clinics. I should also like to mention the traditionally included specialisms of maternity and family planning and broader issues that are of particular interest to those who are practically involved in Health Service work—the way in which services that benefit women are delivered and health promotion and education specifically geared to women.
Funding is not the most important element in the successful promotion of women's health, but the way in which available funds are used is important. I am concerned about the effect that local professional enthusiasm may have either positively or negatively on the way in which women's health is regarded.
There should be a combination of Government initiatives and good work at local level, which stems from the health authorities or family practitioner committees as well as the involvement of other relevant local statutory and voluntary agencies. Obviously women must accept that their health is as important as the health of their families and they must accept that responsibility. The private sector must be involved, but most importantly, there must be professional enthusiasm for the cause.
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It is useful to consider what has been done by the Government to promote women's health. Obviously the Government can act not only by directly funding their own initiatives, but by pump-priming and initiating others' efforts. The most recent Government-funded initiative—it has had considerable airing this morning—has been the introduction of computerised call and recall systems for cervical cancer testing and the imminent introduction of mammography services. The introduction of the computerised cervical cancer testing system cost £10 million and involved an enormous amount of effort by Health Service staff to computerise many millions of manual records. When we last discussed the system during the passage of the Health and Medicines Bill, some hon. Members, notably Opposition Members, expressed their concern about the way in which the scheme was falling short. To redress the balance, I should like to illustrate the successful way in which that system is operating to serve the health authorities of my constituency.
In the area served by the Norfolk family practitioner committee as a whole, we had our computerised system of call and recall up and running by September, seven months before the Government deadline. The West Norfolk and Wisbech health authority has since January had a system of recall every three years for all women between the ages of 18 and 66, and of call every three years for all women between 35 and 66. The laboratory turn around is four weeks.
The Norwich health authority also serves part of north-west Norfolk, and its recall operates for women between the ages of 20 and 34 every three years. For women between the ages of 35 and 66, it operates every five years, and the call operates for women between 35 and 66 every five years. The laboratory turn around is just over four weeks despite the enormous increase in the amount of work with which the laboratories have had to deal.
While these authorities offer three-year periods of call, they are correctly concentrating their major efforts on getting an increased response to first-time call-out which in East Anglia as a whole is presently 40 per cent. That is not yet good enough, but there is a very good proportion of older women.
Ms. Ruddock: We all applaud the situation that the hon. Lady is outlining. The health authority in my area has been able to get that kind of system going. But a problem arises after the first laboratory turn around time of four weeks when there is an abnormal smear recording and women have to return. There are then enormous delays. Women have an abnormal smear and do not know what is wrong. That is because of the lack of colposcopy services. Perhaps the hon. Lady will tell the House about the colposcopy service in her health authority.
Mrs. Shephard: I shall he delighted to do that. In the West Norfolk and Wisbech health authority there is no problem. There has been some delay in the Norwich health authority but a colposcopy service is being instituted with the help of the voluntary sector. That will be instituted shortly in the Norwich health authority and that will reduce the problem. The problem is nothing like as extreme as that which the hon. Member for Lewisham, Deptford (Ms. Ruddock) described in her health authority.
These health districts have responded very positively to Government plans for mammography. The West Norfolk

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and Wisbech health authority is not the best known in the world, but since January it has been providing a mammography service for women between 50 and 64 on four evenings a week and on Saturday mornings. It is on a self-referral basis and geared to suit the hours when women are free to go along. Since January, 500 women have been examined and in some cases that has resulted in the saving of life.
The Government can be involved in ways other than the funding initiatives of which I have given examples. Sometimes they can achieve as much by pump-priming, an example of which was the £100,000 announced at the start of European Cancer Week. That will clearly help women's health causes in the broader sense. Sometimes Government can help by encouraging effort by others. An interesting example of this approach was described by the Minister in connection with the breast-feeding initiative. The Government deserve to be congratulated on bringing forward cancer screening. That has put the United Kingdom ahead of the rest of our European partners. The Government are also to be congratulated on taking the whole issue seriously and for raising the national consciousness about it.
As important as Government initiatives is the degree of professional enthusiasm for the cause at local level. There is no advantage in the Government insisting that women's health is important if those running local health services do not agree and do nothing about it. I am struck by the contrast between the achievements of the two health authorities that I have mentioned, which serve my constituency, and the problems described during the passage of the Health and Medicines Bill. Although East Anglia is a RAWP receiving region, it is still several percentage points below its full allocation.
I hope that no hon. Member will suggest that south-west Norfolk is somehow part of the palmy middle class south-eastern part of the United Kingdom, because it certainly is not. As well as the problems of sparsity of rural services that are costly to run, parts of it are submerged by water for three months of the year, which makes the delivery of services a challenge that is not commonly met elsewhere—I suggest not in inner cities.
The reason for west Norfolk's success is that for some years there has been a ready acceptance at professional level—at doctors' level—that women's health is important. A well woman clinic has been running at two centres in my constituency for years. When cancer-screening services were introduced, the professionals led the way, the Government provided the money and the political and administrative will followed.
When we tried to introduce a well woman clinic in Norwich, we met with less success. There is one there now, but there was resistance from the serried ranks of male GPs, backed up by male consultants, all of whom said plaintively, "If a woman has something to say, surely she can say it to me. I am always sympathetic." That encapsulates one of the problems with women's health. It is vital that there should be professional enthusiasm and commitment to the cause.
It is important that all professional and voluntary bodies should be involved when a cancer-screening initiative is launched. Any local initiative must reach women more effectively through GPs and dental surgeries,
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health centres, hospitals, schools, playgroups, voluntary organisations, women's organisations and the private sector than any national campaign, however well organised it is. Women need to know that the service is available, free and painless. An envelope dropping on to a doormat, backed up by extensive local publicity and all the relevant agencies, must be the right way forward.
I mentioned earlier the broader issue of the delivery of services, which in a rural area is vital. The Norwich health district has an excellent scheme of community care groups, which involves a range of health professionals attached to doctors' surgeries or groups of surgeries. Early incidence of forms of mental health that affect women, such as post-natal depression, is picked up by a range of health professionals.
Mention was made of carers, almost uniquely a women's group. Recently, one of our community care groups decided that more emphasis needed to be placed on the services available for carers. A meeting was arranged by the health educator. She involved the local youth and community services and provided a sitting service so that carers could attend the meeting. The Women's Royal Voluntary Service organised the transport and, as the meeting was held in a school, the local parent-teacher association provided refreshment. Information was given by the DHSS, voluntary organisations and Health Service staff. We must have such team work if we are effectively to deliver those services to women where it matters—close to their homes.
Much importance must be attached to the local promotion of cancer-screening services. If health education is to run effectively, it must involve all agencies and, where appropriate, the private sector. Large companies such as Tesco and Sainsbury concentrate on healthy lifestyles.
Health education is almost more important for women than men. Clearly, the advice that is taken on board by women is absorbed for the benefit of their families. In that regard, I am glad that the producer of a certain sunflower margarine has withdrawn the suggestion, which it extensively promoted in a former advertising campaign, that it was more important to keep one's man healthy than oneself. I note that Flora is now thought to be good for everyone, not just for men.
For the information of the hon. Member for Barking (Ms. Richardson), I live in Lambeth. I have no problem in obtaining cheap, healthy food at my local Sainsbury, Tesco or Bejam. Local competition provides a wonderful baked bean that is much cheaper than I can find in Downham Market.
The promotion of women's health is a team job. The Government have their part to play. The Government have done just that in many vital areas, but if their policies are to be translated into effective action there must be local professional conviction, local action, local promotion, local involvement of all agencies in both the private and the voluntary sector and acceptance by the individual woman that her health is her responsibility.
1.20 pm
Mr. John Hughes: I am most grateful for this opportunity to contribute to the debate. Having had to wait to speak for so long, I feel that I am suffering from what could accurately be diagnosed as "manopause."

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Due to the effect of Government policies, there exists what I would describe as a Dorian Gray health service. Its looks bear little reality to health in general and to the many specialist areas of health care that are so important to women—none more so than primary care in the home.
It is a fact that all the knowledge gained from many health surveys has established that in areas of deprivation where there is high unemployment the physical and mental health of families is considerably worse than that of families in employment. Until recently, however, direct evidence that unemployment causes poorer health was not available. There is now substantial evidence that unemployment causes a deterioration in both physical and mental health.
Although the well-established pattern of women having lower death rates than men but experiencing higher sickness rates still holds true, recent studies have shown that the position is far more complex. Women's health varies according to social class, employment and marital status in ways that are only just beginning to be understood. The health of working-class women is particularly poor.
Striking regional disparities in health can still be observed. What is becoming increasingly clear from fresh evidence are the great inequalities that exist between communities living side by side in the same region. Numerous studies at local authority ward level have pinpointed pockets of poor health that correspond to areas of social and material deprivation. Alongside them, areas with much better health profiles can be detected and they exhibit more affluent characteristics.
Ms. Mildred Gordon: My hon. Friend might like to know that in 1986 the key population and vital statistics of local authority and health authority areas showed that women married to men in the manual socio-economic category suffered from three times as much chronic sickness as the wives of men who are classified as professionals. I represent part of Tower Hamlets, one of the most deprived areas in the country. It has the highest morbidity rate in London. The morbidity rate is inversely related to socio-economic groups, so I could not agree more with what my hon. Friend has said.
Mr. Hughes: I thank my hon. Friend for that contribution and I hope that the Minister will note it.
The differential is also to be found in other groupings. Although there has been a fall in all-cause death rates in Britain, the improvements in health have not been experienced equally by all sections of the population. Non-manual groups have experienced a much greater decline in death rates than manual groups. Thus, the gap between the two groups has widened. Futhermore, the number of deaths from coronary heart disease and lung cancer has increased alarmingly in the manual groups, whereas there has been a substantial decline in the number of such deaths in non-manual groups. There is also a widening gap between rates of chronic sickness in the manual and non-manual groups.
In our society of abundant poverty, those are the inequalities of health that apply to the deprived areas of Coventry, such as Willenhall, Stoke Aldermoor, Wood End and Foleshill, which have higher mortality rates and more ill health than other areas. The provision of health care, which comes under the jurisdiction of Lady Butterworth, the chairperson of the Coventry family
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practitioner committee, fails to take that background into consideration. Instead, Lady Butterworth allocates the same number of deputising calls to each practice in Coventry. She makes no allowance for social class or the health status of the patients in a practice. In the process, she exacerbates the inequalities of health, to the detriment of young mothers with children and old women who require practitioner services.
During her period in office, Lady Butterworth has refused permanently to allocate an extra allowance for the deputising service to practices located in the areas that I have mentioned. That leaves doctors with two choices: they can dispense more prescriptions, which would result in a worsening service for women in deprived areas at even higher cost to the taxpayer, or they can caringly and humanely respond to calls above their allocation and find themselves subjected to the most detailed investigation. The doctors in one practice had to explain their actions over a period of 365 days.
With iron-fisted rigidity, Lady Butterworth applies the most draconian measures when a little understanding and a small amount of extra allowance—the cost of which would be far less than the cost of extra prescriptions—would result in better care for women. She refuses to recognise that women suffer from major illnesses and require visits from the doctor more frequently outside normal hours than is provided for in the average allowance. In women's interests, she is obliged to ensure that such visits are available. In other parts of the country such miserly allocation has led to general practitioners who realise that they cannot win applying to opt out of night and weekend work and to forgo the related fees. That is to the detriment of women and I am determined that that will not happen in Coventry.
I feel that it would be in the interests of the well-being of women patients in Coventry if a new chairperson were appointed to the Coventry family practitioner committee, as the present chair has failed to fulfil her duties in many ways. She has allowed money obtained by fraud, which should have been used for the well-being of women in the deprived areas of Coventry, to be retained by a practitioner. She has allowed a single-practice doctor, who claimed a partnership allowance, attracting a higher payment entitlement, fraudulently to retain £42,000, and so failed to imitate the exemplary chairmanship of her predecessor, who recovered £19,000 in similar circumstances. Fraud appears to be condoned when a chairperson of the FPC refuses to carry out the instructions of the committee by suggesting that the matter be buried and when no attempt is made to recover the money. The case was covered up and the police were not informed.
This culpable default of duty also applies in the case where a GP is allowed to retain a fortnight's income when that GP, against the interests of his women patients and in complete breach of his contract, disappeared for two weeks' holiday.
The circumstances in Coventry require immediate investigation. The present term of office of the chairperson should be instantly teminated if the chair has not the grace to resign in the meantime.
The attitude that prevailed impaired even my representations when I sought the assistance of the Minister because of the failure of the FPC to provide adequate and stable care for one of my chronically sick constituents, who had been shunted from doctor to doctor after being placed for only the minimum period. I am

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certain that that is only the tip of the iceberg and that many more patients are being subjected to a process that is a contradiction of the ethos of the Hippocratic oath.
The circumstances in Coventry, to which I have drawn the attention of the House, are not unique—I am sure that they exist elsewhere. In the interests of women patients, there should be a committee of inquiry into the whole process of the FPC service so that we can eliminate the malpractice that has occurred in Coventry. In the interests of my constituents, I shall resubmit to the Minister the names of Coventry patients who are currently experiencing serious problems under the FPC service. I hope that that will enable her to resolve the problems with some urgency during her ministerial investigation.
1.31 pm
Miss Emma Nicholson: Thank you for calling me to speak in this debate, Mr. Deputy Speaker. I am becoming a little worried about the health of the non-lady Members of the House who are not with us today. I am sure that they are grossly damaging their health with fatty lunches in pubs. I am sorry that they are not here to hear some very interesting speeches.
When I learnt of today's debate, I cancelled my constituency engagement with the Tavistock under-fives group this afternoon. The mothers asked me to raise a number of points on their behalf, but most of them have already been most capably raised by my hon. Friend the Member for Norfolk, South-West (Mrs. Shephard). However, one point that she did not raise—unless I missed it—is a crucial issue on which I intend to touch lightly, and that is the need for more women doctors. This is no sexist or feminist comment because it is of particular importance to the Moslem community.
Although I understand that the Koran does not literally forbid women to consult male doctors, by custom and habit many of the older women do not do that and their health is therefore significantly undermined. They may have potentially life-threatening conditions, that actually result in death, because they cannot consult a male doctor. Therefore, the provision of more women doctors is of acute importance to society.
The key to good health in our society lies in greater stress on preventive medicine. I want to talk a little about how preventive medicine is currently practised in the United Kingdom and how it could be improved. The most dramatic aspect of preventive medicine is immunisation, which can change the whole pattern of public health. It is, therefore, good news that the World Health Organisation has withdrawn its opposition to immunisation, which it once viewed as achievable only at the expense of building up the necessary infrastructures for health care.
Ms. Harman: I should not want this interesting debate to pass without some mention of the measles epidemic. Will the hon. Lady join me in urging everyone to take their children for immunisation, which is almost entirely without risk? I am glad to see the Minister nodding.
Miss Nicholson: I was intending to touch on that matter in a moment, but I am pleased to join my hon. Friend the Minister and the hon. Member for Peckham (Ms. Harman) in stressing the need for immunisation. In overseas countries, it is easier to spot the fact that the
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measles virus has mutated into a killer disease. It is no longer just the few lumps and bumps that it might have been in our childhoods.
Smallpox immunisation was the first great example of successful vertical programme intervention. Worldwide eradication of smallpox—the great achievement of the World Health Organisation—has been completed and is a triumph.
The United Nations task force on child survival recently announced that it planned globally to eradicate polio, another of the great crippling and killing childhood diseases, by the year 2000. That is a great tribute to the International Rotary Polio Plus campaign, which was launched some years ago. It has taken the World Health Organisation a little time to agree that the eradication of polio can be conducted separately from, but while continuing, immunisation against the other five major childhood diseases.
I pay tribute to the Save the Children Fund Stop Polio campaign. Ten million pounds was raised and spent in the first four years of its existence alongside the Rotary Polio Plus campaign. That campaign has now been subsumed into the overall immunisation programme.
Polio is a major problem for developing countries. For example, in India, every year 200,000 children catch polio. Many more do so in Africa. In Malawi, when we ran the Stop Polio campaign for the Save the Children Fund, five or six years ago we achieved 90 per cent. coverage. By contrast, at that time in Lambeth, polio immunisation had a 37 per cent. take-up. The crucial importance of communicating with mothers and children simply cannot be overestimated. It is almost the most important factor after development of the vaccine.
It is marvellous that, at last, in this country we are starting by immunisation, the long haul to eliminate CSR—congenital syndrome rubella. We should think hard about the initiatives taken by the Royal Commonwealth Society for the Blind. We clearly appreciate the values of immunisation in developing countries, so perhaps we should apply them nearer home. As recently as 1982, the Royal Commonwealth Society for the Blind convened a conference to discuss rubella and its tragic and miserable consequences. The risk of pre-natal damage from rubella is highest in the first four months of pregnancy. If a woman catches rubella in the first month, her child may suffer multiple handicaps—deafness, blindness, and physical and mental handicaps.
About a fortnight ago I talked to a man in my constituency about the Abortion (Amendment) Bill. His mother caught rubella in about the fourth or fifth month of pregnancy. He has a weak heart, poor eyes, poor ears, and bad health. He said how much he would have wished not to be alive had his mother caught that illness earlier. That is an important point to remember.
I strongly welcome the 1 October introduction of the MMR vaccine—measles mumps and rubella. Measles is a wretched, mutative virus. I recognise the need to get rid of it as fast as we can. Of course, we are late in that respect, as so often we are late. MMR has been used in the United States of America for perhaps 20 years. In 1970 we started our anti-rubella programme for schoolgirls of 10 to 14 years, whom we saw as the vunerable age group. But the MMR vaccine will be given to 15-month-old babies. I understand that we seek a 90 per cent. uptake, which will

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allow us to eliminate rubella in particular, and, I hope, measles and mumps. The booster pre-school package of diphtheria, tetanus and polio will include MMR.
It used to be said that one could not eliminate such contagious diseases and that smallpox was unique because it was carried only by humans. The great advantage of the polio immunisation programme was to counter that suggestion. Polio is carried by primates. It is a water-borne disease, and medical experts said for a long time that it was ineradicable because no sooner would it be eliminated in a group of human beings than they might catch it again from primates through the water supply. When immunisation is built up in children and babies, the human race seems able to deflect the disease. It is enormously encouraging, therefore, to see that genuine eradication of contagious diseases other than smallpox is a possibility.
I should like to pay a strong tribute, in regard to the measles, mumps and rubella vaccine, to the Rubella Council, which was formed as a result of the 1982 Royal Commonwealth Society for the Blind initiative. The council is chaired by Jean Wilson, who is the wife of the chairman of the Royal Commonwealth Society for the Blind. Like the council, I welcome the extra £40,000 a year grant, which brings its funding up to £83,000 a year.
I am sorry that my hon. Friend the Member for Winchester (Mr. Browne) has had to leave, because he would be interested to know that the funding is for promotional purposes, not for eradication. If the £35,000 that the council has been running on for the past five or six years is anything to go by. it will do a remarkable job with the additional £40,000. The funding is not to enable the council to immunise 15-month-old babies but to enable it to tell mothers and everyone else that 15-month-old babies need the new immunisation.
This is a good example of successful partnership between the Government and the voluntary sector. I welcome that in health care. I have participated in such partnership and I know that it works. With the Save the Children Fund, I participated in the anti-rickets campaign. We mistakenly thought that we had eliminated rickets from the United Kingdom many years ago, but without sufficient vitamin D people will still suffer from it. People with darker skins, particularly the Asian community, have a predisposition towards rickets if they live in Britain because there is considerably less sun here to enable them to synthesise vitamin D. People with darker skins need significantly more sun to achieve the synthesising effect.
We had to reach out to Asian mothers, through the Asian community, to teach them to bring their children forward for additional supplies of vitamin D. The mothers had rejected officialdom already and I suggest that the heavy hand of Government would not have had the same effect. The very best of the non-governmental organisations have a lighter touch, a more personal approach, a sharper eye for human needs and more flexible rules which enable them more swiftly to meet those needs. It is a matter not of the state not being able to provide everything, but that it should not provide everything, because non-governmental organisations can provide some services better than the state can. The quality and effectiveness of provision should be the determining factors.
Mrs. Wise: Does the hon. Lady agree that providing cheap or free welfare milk for infants made a considerable contribution to the elimination of rickets and that it is a great pity that that does not happen nowadays?
Miss Nicholson: I am not absolutely sure about the vitamin D content of milk as compared with the benefits of sunlight. It is certainly true that when we eliminated rickets in the United Kingdom, free milk was supplied. Vitamin D comes from other sources, too.
My point about the Asian community in the United Kingdom is that people with darker skin need more sun to synthesise vitamin D. Those of us who have paler skins are acclimatised to our miserable lack of sun, and we are therefore able to use the limited sunlight more effectively. Because of the miserable problems—such as fear of going out and worries about safety—of Asian mothers, they and their babies stay indoors, so they do not benefit even from the minimal sunlight that is available. Extra-rich vitamin D foods, suggestions on diet and more fresh air, and, of course, oils rich in vitamin D, cod liver oil and so on, are offered by the National Health Service. However, it was the outreach to that community which mattered most. That is where the valuable partnership between the voluntary organisation and the Government comes into play, with the Government providing virtually all the funds, and the work being done by a highly respected child care organisation, well known internationally.
I turn to one aspect of the care of the elderly, but only briefly, not because it is not important but because time is short. I feel justified in raising in a debate devoted to women and health the plight of blind women. Most of the constituency of the Royal National Institute for the Blind consists of elderly women with visual problems. Women are considerably healthier than men. They live longer, they are tougher when they are babies and in many ways we are luckier than men. However, because of our long life, more elderly women than men are blind or have sight problems. As everyone knows, only a third of those who have visual problems are registered. One hundred and forty-six thousand people are registered as being blind and 82,000 as being partially sighted.
Ophthalmic surgery has advanced so rapidly, with the new technology for the removal of cataracts—using laser beams and lens implants—that major surgery can now be undertaken for people who have cataracts and ocular degeneration in old age. However, it is expensive and is far down the Government's list of priorities. I suggest to my hon. Friend the Minister that more funding on this aspect of eye care would save money for the social services, apart from improving the quality of life of those who have their sight improved.
I welcome the recent announcement by the Minister for Social Security and the Disabled of a grant of £200,000 to the Royal National Institute for the Deaf, which is allowing fresh training provision to be undertaken by social workers who care for the deaf. That is an important element of work in our society, just as special training for social workers who care for the blind is important. That again is a partnership and an initiative involving a voluntary organisation and the Government.
1.47 pm
Mrs. Audrey Wise: I appreciate the remarks that the hon. Member for Torridge and Devon, West (Miss Nicholson) made about the Asian community and voluntary organisations. I share her wish that 'voluntary organisations should be helped and encouraged in their work. In fact, it has been noticeable that during the lifetime of the present Government many voluntary

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organisations have felt that they are being pushed into being a substitute for the Government rather than playing their proper role as partners and carrying out the kind of work which the hon. Lady correctly outlined, and which cannot be done simply through professional organisations or governmental bodies.
The debate has set the topic of women's health in context, both establishing the importance of good health to women and, as they are the majority of the population, to society in general. We need not justify our anxiety about our own health by reference to our partners or our children. We should defend our right to health in our own terms and for our own benefit.
Nevertheless, as women are the major planners of family diets and have responsibilities—some of them inescapable and some which should be more shared—for child care, they do have a special place in society. I associate myself with my hon. Friends who have set that in the context of poverty and have talked about the impact of bad housing and unemployment on health. It is impossible to consider ill health without considering the ills of society.
I associate myself also with my hon. Friends' remarks about the need for a cross-departmental approach. One of the distressing features of the British style of Government, and perhaps this it true of others—I am not singling out Britain but it is Britain that I observe at close quarters from day to day—is that policy appears to exist in little boxes. Governing in that way simply does not work properly, especially in matters concerning women. I associate myself entirely with the remarks of my hon. Friends on the importance of the Departments of Employment, Transport, and Energy in this context.
References have been made to food, and there has been some give and take about whether it is possible to buy cheap, healthy food as easily in working-class areas as elsewhere. I remind the House that the British Medical Association has established clearly that a healthy diet costs more than an unhealthy one because of the extra cost of supplying enough calories. The individual salad and vegetable items that go to make up a healthy diet may not be excessively priced individually, but it is necessary to provide more food of that sort to obtain enough calories. That should not be ignored. Cost is important, and studies have shown, for example, that it is impossible for expectant mothers on supplementary benefit to provide adequate diets for themselves and their coming babies. Not enough attention is given to these matters by the Government when they reduce the incomes of such mothers.
Even if someone has the money and the wish to eat a healthy diet, it can be well-nigh impossible to achieve it. For example, it is of doubtful benefit to eat lettuces in the winter because of their nitrate levels. A person may want to have good quality food and may have the money to buy it, yet still find it unavailable because of the distortion of agriculture policy. This arises for two main reasons. One is the pursuit of short-term profit and the second is the distortion and wrongful use of public subsidy for purposes that are connected with economic and agriculture objectives that are of less importance than the maintenance of health. The Ministry of Agriculture, Fisheries and Food has a great role to play in enabling the public to have a good diet, assuming that other
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Departments play their part and we manage to achieve suitable incomes and obtain sufficient knowledge to enable us to want and have a healthy diet.
I associate myself with the remarks that have been made about the desirablility of well woman clinics or centres. In Preston we have a good, popular well woman centre in which women doctors, non-professional helpers and counsellors participate, but it is absolutely tiny so it cannot cope with the demand that exists just underneath the surface. It does great work with ethnic minorities. Its ethnic minority worker, who has splendid contact with the whole of the considerable ethnic minority community, goes out from the clinic and does valuable work in the community.
We do not necessarily need a bigger centre—smallness can be desirable in this sort of context—but we need more of them. This one exists only because Preston borough council helped to find it premises and the district health authority helped it with money, but not enough. That is an area where we can have good partnership between voluntary workers, ancillary health-related people and professionals, such as doctors and nurses. But there needs to be pump priming, and that is not happening, so we have an inadequate network of well woman clinics—enough to show how valuable they are, but not enough to tackle the problems. I recommend the Minister to give that genuine consideration and to take action.
Well women give birth to babies, and maternity is not an illness. I greatly regret that over the years women have been forced into large district general hospitals which are geared to the treatment of illness and have found themselves cared for by people who are accustomed to abnormality rather than normality. The present concept of childbirth is almost one of medical crisis. That is wrong and we need to move in the opposite direction.
I urge the Minister most strongly to look at the need for continuity of care for women who are pregnant, in childbirth and after childbirth. It is monstrous when a woman goes to an antenatal clinic and does everything that the authorities exhort her to do—going monthly, then fortnightly and then weekly—that every time she sees a different midwife or doctor, and sometimes several of them attending to different bits of her. That is dehumanising for the woman and deskilling for the carers. We have gone too far along the wrong road.
I endorse what has been said about the need to pay women, nurses, doctors, health visitors and midwives properly. That is a necessary prerequisite, but job satisfaction, self-respect for clinical judgment are also important. Midwives have an excellent training which equips them to be practitioners in their own right and not to be the mere handmaidens of doctors. They exercise clinical judgment and are experts in normal birth. But they are not being given an adequate opportunity to exercise their clinical judgment. That is why the Labour party's approach in its good document on women and health, which will stand the test of time, puts great stress on the approach to maternity, maternity services and the role of midwives.
It is wrong for women to be treated as a collection of little "patches", which are seen by different people on every visit. It is also wrong that they are given entirely inadequate choice about the place and style of giving birth. More and more women are entering the controversy and making more and more demands, and I should like the Minister to commit herself to choice.

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We hear a great deal from the Government about choice. which often amounts to the choice between two indistinguishable products on the supermarket shelves. In this instance, however, choice is a genuinely important element, because women are different and have different needs and wishes. There is not only one good pattern or one simple recipe for a good birth experience and a good outcome. In this context, a good outcome does not merely mean that the baby does not die: that is obviously imperative. It also involves the opportunity for bonding, and a positive feeling that does not make a woman say—as so many say immediately after giving birth—"Never again." That is not conducive to the development of a good relationship and good child care.
The argument is not between high-tech and low-tech; that would be a stupid argument. It is a matter of appropriate technology and adequate choice, neither of which is at present available. Many women are subjected to far too much intervention when giving birth, and a much too lavish use of expensive technology which they do not want or need. Others are deprived of, for example, adequate anaesthesia when they need it, because anaesthetists are too scarce, and the one who is there is busy with someone else. That is a nonsense. We need appropriate technology, no unnecessary intrusion and respect for women's wishes—as well as an acknowledgement by all concerned that as women's bodies swell their brains do not shrink.
The position is now so serious that some midwives leave the service because they are unhappy with their conditions, while others are driven outside the NHS to practice independently so that they can provide continuity of care. That is not because they want to be outside the NHS, but because this approach to maternity care is becoming unavailable on the NHS. We should look carefully at this phenomenon.
We should also look at the effect on midwives' ability fo exercise their clinical judgement. I do not know whether the Minister is aware of the controversies that are currently raging, but they bear on this. One instance is the disciplining of a midwife who decided to transfer her patient to hospital and, instead of waiting for an ambulance, accompanied the patient in a car driven by the patient's husband. That midwife has been disciplined for not waiting for an ambulance, although she exercised her clinical judgement about what was suitable, and she was right. There was a good outcome.
I should like to know who would have been disciplined if the midwife had waited for the ambulance and it had not come—for ambulances are increasingly scarce—or if it had come and had therefore been unable to go to someone else. Such an approach to the exercise of a midwife's clinical judgment is absolute rubbish. I should also like to know who is disciplined if there is unnecessary and intrusive use in hospitals of techniques such as episiotomy, which often have a very bad effect on women. I urge the DHSS to investigate that very carefully.
I welcome the breast-feeding initiative and I applaud anything that is done to encourage it. Breast feeding is extremely important for both mother and baby. The more time that elapses, the more work is done and the more information published to strengthen the argument for it. It is not, however, simply a matter of lecturing women about its importance. One Conservative Member said that the importance of breast feeding had to be "drummed in" to women. I can think of nothing less effective than trying to
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drum something in to women, although I hope that the hon. Member did not mean it in quite the way it sounded. Unfortunately, much of the health exhortation to women comes over in exactly that way: "Why can't you be a good little girl and do what is proper? Don't you care about your baby?" And such like. It is monstrous to behave in such a manner to women who are frequently suffering the greatest stress and pressure which is not being addressed by those who exhort them
I should like steps taken to prevent, not just to discourage—we are not talking about voluntary codes of practice—the promotion of baby milk formulas in hospitals and clinics. Such promotion still takes place and as long as the manufacturers of powdered milk have access to clinics and hospitals, mothers will be influenced to think that such products are the best for their babies.
Staff must have not only the right attitude, but enough time. That may mean that more staff should be available. Staff should not be harassed and, in their approach to hospital activities, they should not be made to believe that the efficient use of hospital resources means that they are kept almost at a run all day long while on duty. Staff should have the time to develop relationships with the women and observe them to see what can be done to make breast feeding the joy that it can be.
I also think that the Department should consider weaning. It is virtually impossible to obtain single weaning foods. Foods like "bacon and egg dinners" thrust at women as weaning foods. Any mother who has an eye to weaning her child sensibly, food by food, finds it difficult to get to first base even if she has the knowledge and income to do so. Something should be done and that means interfering with the free market economy. Such a free market economy often puts our infants second to money making, and that is highly undesirable.
During and after maternity women need back-up help, not just lectures. They need home helps, for example. If they have a home help after childbirth they should not be made to feel that some elderly person has therefore been deprived of such help. The squeeze on local government is having a deplorable effect on the availability of such help.
I urge the Minister to consider a submission from the National Childbirth Trust on infant mortality It has suggested a number of topics for investigation, ranging from excessive obstetric interference through to tie effect of poverty and bad housing on the increase in respiratory infection among babies, which can be an underlying feature in cot deaths. The National Childbirth Trust has a great deal of experience of mothers and babies and it pinpoints poverty and bad housing as being likely to have an effect on infant mortality. It believes that such factors should be investigated.
Another matter that should be considered is the danger of radiation. It is appropriate that this debate has taken place this week, after the information published about Dounreay.
Ms. Ruddock: I had hoped to be able to make a speech about environmental pollutants but I shall not get the opportunity. May I draw the attention of my hon. Friend and the Minister to early-day motion 1080? It is the only one on the Order Paper about women and health matters. It is a request to the Government to instruct the National Radiological Protection Board to investigate radiological standards. Current standards are based on the whole body male. We know, and scientific evidence shows, that for

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women and children the risk from ionising radiation is much greater than the risk to men. The risk to the foetus in the womb is considerable and there is probable evidence that the tragic child leukaemia deaths from the Dounreay area may well have resulted from radiation affecting the foetus. Through my hon. Friend may I ask the Minister to look into this matter?
Mrs. Wise: I associate myself entirely with my hon. Friend's intervention. I shall not repeat it, but I reinforce it.
The hon. Member for Torridge and Devon, West said that women live longer than men. We are grateful for that, but it does not follow that the quality of life and health of most women is better than that of men. We are survivors, but women often survive against great odds and with greatly impaired health for many years. They suffer considerable stress and strain and physical ill health.
Simply living longer is not a good enough objective. We must achieve a better quality of health for women and it is not enough simply to say that we can stick a bandage on the Health Service or issue umpteen prescriptions for tranquilisers or tranquilise the whole population so that it does not see what happens to society. Sometimes I think that that is happening. We need an attitude to health that looks at the whole person in health care and medicine and not simply at isolated symptoms. As public policy we need to look at the whole of society. We need adequate preventive medicine for our society. I end as I began, by placing the matter of women's health care in the context of poverty and deprivation and the need for new priorities.
2.13 pm
Dr. Charles Goodson-Wickes: I am glad to have been called to speak in the debate. While it may appear to be discourteous to make my contribution late in the day, I trust that the fact that I have been treating patients is an acceptable reason. That also registers my interest in the subject.
I think that this is the first general debate that we have had on women's health. Nowadays it seems fashionable to link women's interests to those of various minority groups. I speak as a member of a minority group—as a member of the male sex—and I have never quite understood the logic of that linkage. I certainly make no complaints and hope that with improvements in women's health care the present ratio and happy state of affairs will continue. Perhaps I could make a plea to my hon. Friend the Minister for a debate in due course on men's health or perhaps for a debate on some non-sexist subject such as geriatric health.
I am sure that the House approves of the unmistakable trend in the world of medicine towards prevention. The last century saw the first public health revolution and a reduction in the ravages of infectious diseases by means of better nutrition, cleaner water and air, and innoculation. We are now in the era of the second public health revolution and it is possible to educate people to reduce the risk of developing disease by modifying their behaviour and lifestyle. This is applicable in cardiovascular, respiratory and gastro-intestinal conditions and can be done without making life miserable.
When I became a medical student 24 years ago, teaching was virtually confined to the cure of disease. The notion of screening apparently healthy individuals was in
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its infancy. Specific tests were introduced gradually for presymptomatic disease. In addition to the admirable work of the National Health Service, the private sector is to be congratulated on pioneering the general screening of individuals. For many years I have been active in that work and in the identification of occupational hazards to the health of male and female employees.
Screening for cancer of the cervix and breast will clearly attract most attention in any discussion of women's health. However important those aspects may be, they represent too narrow a view of women's health generally. The effectiveness of cervical smear testing, which has been available for more than 20 years, depends on technical efficiency. I was alarmed recently by reports of deficiencies in the taking of such tests, which often impede sound diagnosis by yielding false positive results, which alarm patients unduly, or false negatives, which create a false sense of security. The credibility of the test depends on the technique of taking it so as to ensure that the laboratory interpretation is valid. I cannot emphasise enough the input that there must be in teaching hospitals to ensure that medical students are adequately taught.
All such efforts are useless if those at risk do not come forward. For 20 years, Sutton and Merton health education unit has pioneered increasing awareness among the public and encouraged people to come forward through the National Health Service, voluntary organisations, industry and schools. Screening is flawed—perhaps fatally, in the true sense of the word—if the administration of recall is inadequate. I congratulate the Government on the steps that they have taken to computerise the recall system.
Breast cancer has, to an extent, been the poor relation in public awareness and resources allocation. That is curious because, on a per capita basis, more lives are saved at less cost. The incidence of mortality from breast cancer is far greater than that from cervical cancer, with 15,000 deaths per year at all ages as opposed to 2,000—a sevenfold difference, which the House would ignore at its peril. Those statistics show the way forward for the future, and I am delighted that St. Bartholomew's hospital has been active in implementing the recommendations of the Forrest report. I hope that the Government will be flexible and examine the results in relation to the right age bracket. We must bear in mind that if women have a family history of carcinoma of the breast they are far more at risk than others who have palpable findings on clinical examination.
I am amazed in my consulting room, at the many bright female graduates, who often work in the financial world and are clearly better at examining balance sheets than their breasts. I hope that the statement, "Doctor, I do not know what I am looking for", will have no relevance in the 1990s, and there will be no repetition of the heroic but horrific surgery that was recommended by some of my teachers, which resulted in physical and psychological mutilations to so many women. I do not deny that lives were saved, but at what cost?
Ms. Gordon: Will the hon. Gentleman give way?
Dr. Goodson-Wickes: I am working against the clock; I apologise for any discourtesy.
There is insufficient public recognition of the correlation between smoking and cancer of the cervix. The increased incidence of smoking by women is almost certainly the main factor behind cancer of the lung that is

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now challenging cancer of the breast as the main malignant killer of women. Smoking will also increase the major cause of death, which is ischemic heart disease. My hon. Friend the Minister referred to the fact that it results in the the delivery of small babies.
It is illogical and had medicine to limit the examination of women to organs that are peculiar to them without at the same time checking their blood pressure and advising them on issues such as weight and smoking. I hope that my hon. Friend will develop the theme of primary health care for women, since they are such valuable members of the community.
2.20 pm
Mrs. Currie: By leave of the House, I should like to respond to an excellent debate. I am conscious of the fact that some hon. Members have not had the opportunity to speak. We may need to have another debate. We heard splendid speeches, particularly from Lady Members, including my hon. Friends the Members for Plymouth, Drake (Miss Fookes), for Norfolk, South-West (Mrs. Shephard), for Billericay (Mrs. Gorman), for Torridge and Devon, West (Miss Nicholson), and from my hon. Friends the Members for Winchester (Mr. Browne) and for Wimbledon (Dr. Goodson-Wickes). I listened with interest to the speeches of other hon. Members. Some hon. Members have sat here for four hours waiting to speak. I apologise to any men including my hon. Friend the Member for Wimbledon, who felt left out. However, on 23 October we had a full day's debate on prevention when we concentrated on heart disease, which particularly affects men. Perhaps today, therefore, is the women's turn.
As to whether anybody is taking any notice of campaigns on health, I refer hon. Members to the food purchasing patterns, reported in the national food survey every quarter by the Ministry of Agriculture, Fisheries and Food. It shows that people are making strenuous efforts, by their purchasing patterns of food for consumption in the home, to eat much healthier food.
I am also grateful to those Lady Members who have had to leave but who were courteous enough to let me know. The hon. Member for Preston (Mrs. Wise) made quite the nicest speech that I have heard her make since she returned to the House. I am grateful to her for her kind remarks about our campaign on breast feeding. I suspect that female Members of Parliament on both sides of the House are much nicer and much more courteous to each other than their male counterparts. I venture to suggest—it is a remark of total prejudice—that if, nay when, there are more female Members of Parliament, behaviour will improve dramatically.
The hon. Member for Coventry, North-East (Mr. Hughes) asked a number of specific questions relating to Coventry. I hope that he will allow me to read what he has said and to write to him, particularly about the family practitioner committee. I am grateful to a number of hon. Members for referring to measles. We are very concerned about measles, as the disease has resulted in the death of six children this year. We have already made approaches to general practitioners. We shall have to consider whether those approaches have been successful and, if not, what else we can do.
A number of hon. Members, including my hon. Friend the Member for Torridge and Devon, West referred to the introduction of MMR—the measles, mumps and rubella
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vaccine—in the autumn. That is a major step forward and we hope that it will be of considerable benefit. It will cost the Government rather more than £40,000 or £80,000. We are budgeting for several million pounds because we shall have to pay for the vaccine. However, we expect it to result in a considerable long-term saving. About 2 per cent. of women who are susceptible to the disease catch rubella every year. Between 300 and 400 women feel obliged every year to check whether their babies have been handicapped in any way. We know of 20 cases of congenital syndrome rubella every year, each one of which could have been prevented.
The hon. Member for Barking (Ms. Richardson) referred to a number of issues and talked about the scandal of the VDUs. Unless any hon. Member should think that I am referring to a sexually transmitted disease, I should explain that VDU stands for visual display unit. The hon. Lady and I know that, but my experience in this job suggests that not everybody understands precisely what it means. The hon. Lady and I are referring to people who may or may not be affected by working in circumstances in which they are obliged to be close to a VDU for long periods.
The Industrial Injuries Advisory Council published a report on non-ionising radiation in December 1987. During its investigations, the council considered the possibility of VDUs being a potential source of harmful radiation. It concluded that there was no evidence to suggest that the present terms of prescription for industrial injuries purposes should be extended to cover any potential effects of non-ionising radiation from VDUs. The Government accepted those recommendations. As I have suggested, I suspect that at least part of the problem may arise from the fact that women get far too little exercise. Perhaps we may encourage companies and employees to take that into account. That is the scientific evidence on VDUs as it stands at the moment.
A number of Labour Members referred to the social security system. I would point out that in this country the pension scheme in particular contains several features that are very favourable to women. For example, we retire five years earlier than men. Under the United Kingdom scheme the married woman has the right to obtain a pension of her own through her husband's contributions if she wishes. There is nothing similar in most European countries.
Hon. Members have spoken of poverty. The hon. Member for Preston said that the BMA had established that a healthy diet cost more. My nutrition unit tells me that there has been no such report from the BMA, although the report from the Maternity Alliance was referred to earlier. If the hon. Lady has futher information, we should be delighted to hear it. We do not know that the BMA or anyone else has established that a healthy diet costs more. I do not believe it. It costs nothing to throw away the frying pan or to replace one kind of fat with another and it is probably cheaper simply to eat less fat.
A number of hon. Members on both sides of the House called for a cross-departmental committee. I am reminded of that splendid series, "The Wheeltappers' and Shunters' Club," which used to appear on television. The programme often used to start, "We've got to get a committee together on this." In fact, there is already a committee—the ministerial group on women's issues, which is chaired by my hon. Friend the Minister of State, Home Office and which considers some of the issues that

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have been raised. There is also the Women's National Commission, which is part of the Cabinet Office, which is ably chaired by my hon. Friend the Minister of State, Department of Education and Science. I have no doubt that that commission will take into account a number of points that have been made.
I see that my hon. Friend the Member for Plymouth, Drake is in her place. I do not know whether she has been reconstructed recently but she is looking absolutely splendid these days. It must be to do with her responding vigorously to everything that previous Ministers and I have said recently. I am very glad to see my hon. Friend, who has been a doughty fighter for women since she came to the House 18 years ago. I am extremely grateful to her for her remarks, and for encouraging women in her constituency to have smear tests.
My hon. Friend the Member for Plymouth, Drake mentioned breast amputation and women's concern about that. I am glad to be able to tell her that a recent study has shown that between 1980 and 1986 in 80 centres in this country the ratio of mastectomy to conservative surgery such as lumpectomy has shifted from around 50–50 to about 20–80. In other words, about 80 per cent. of surgery does not involve full amputation. However, conservative surgery is not suitable in all cases and clearly more work remains to be done on that.
My hon. Friend the Member for Plymouth, Drake and a number of other hon. Members referred to women doctors. I shall undertake to send a copy of the detailed press release sent out on Wednesday by my right hon. Friend the Minister for Health about the publication of Isobel Allen's report. The release is entitled "Women Doctors—Any Room at the Top?" Incidentally, a minute
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that I received about smoking in DHSS offices was entitled "The Empire Strikes Back"; clearly someone in my Department has a sense of humour.
The detailed minute that has been issued shows both our concern that there should be more women doctors and our interest in what happens when they start on their career path. Action is already under way, or is being set in hand, on a number of the issues identified in Isobel Allen's excellent report. We recognise, for example, the demands for more part-time career posts and we shall discuss with representatives of the Health Services and the medical profession the possibility of increasing them. We shall also discuss with the Royal colleges and faculties, postgraduate deans and health authorities, ways of eliminating questioning by appointments boards that can be seen to be discriminatory. To assist that process we are arranging two seminars to promote consideration of Miss Allen's report by representatives of health authorities and the medical professions. I am conscious that I lay myself open to the criticism from the hon. Member for Barking that there tend to be a great number of seminars—but they work. The hon. Lady will remember that in the Labour party document on health that it published in preparation for the election, the only picture of a doctor was of a man.
My hon. Friend the Member for Winchester raised issues concerning his constituency, and he knows that we are concerned about them. My hon. Friend the Member for Norfolk, South-West, in an outstanding contribution, set out exactly how a good service for women should be run. That spills over into other forms of health care, where the needs and the interests of the consumer, male and female, really start to matter. That is the sort of service that we are trying to promote for women, children and men throughout the country.
It being half-past Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.

Maternity Facilities (Moray)
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kenneth Carlisle.]
2.30 pm
Mrs. Margaret Ewing: It is, perhaps, appropriate that at the end of an extensive debate that touched on so many issues affecting women's health, we should move on to specific issues affecting the well-being of the women in my constituency.
I wish to start with a few personal remarks. Yesterday I attended the funeral of Dr. Allan Matheson, who was a key figure in all our efforts in Moray not only to improve maternity services but to enhance all of Moray's medical facilities. Like me, the community of Keith has been devastated by his tragic and untimely death at the age of 39. All of us remember his unstinting work in his community—his selfless, sincere and abiding concern for all the patients in the local practice. His commitment to those with special needs was reflected in his work for the Sunshine playgroup, his involvement with the Keith patients participation group, the local parent teachers' association and the Keith caring service. Keith has lost a great friend. As was said at his funeral yesterday, it is a fitting memorial to his life and his work that his activities helped to persuade Grampian health board to retain a maternity unit in the Turner memorial hospital. I am sure that the Minister, who met Allan Matheson during that campaign, will join me in recording our deepest sympathy to his wife Hazel and his children Kirsty, Rhona and Duncan.
To return to the issue of the debate, I understand that the Scottish Office has received a full submission from the Grampian health board recommending that five general practitioner maternity units should be closed. I note the Minister indicating dissent, but must tell him that I was given that advice last week when I spoke to a representative of the board. I apologise if the Minister has not yet received it, but it is certainly on its way. The submission is to close the five GP maternity units in the area, with no further consideration being given to the possible establishment of a specialist obstetric and gynaecological unit in Elgin.
My first key questions, therefore, are can the Minister say when the Scottish Office will give a response, how will the announcement be made, and what provision will be made in the coming weeks for representatives of the Scottish Office to meet local interested groups representing both the medical profession and the public? Such meetings would be desirable before any final decision is reached.
As the Minister well knows, the Grampian health board's proposals met with universal antagonism throughout the region. While this debate relates specifically to Moray, I wish to emphasise the general principles underpinning that reaction. Together with the right hon. Member for Kincardine and Deeside (Mr. Buchanan-Smith) and the hon. Member for Gordon (Mr. Bruce), I have argued that women in rural areas have the right to give birth in local hospitals. All three of us, irrespective of party politics, feel most strongly that choice and safety are being ignored, and we resent the centralising philosophy that denies our mothers the right to have access to local facilities that, over the years, have been marked by the highest standards of care and practice.
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Our mothers are to be asked to undertake hazardous and lengthy journeys. They will be removed from the familiar surroundings of their local units and distanced from family and friends at a time when they wish to be in their local communities. All three of us believe that that is against the interests of our constituents and communities. We are certain that no good reason has been put forward for doing that.
There are two key issues in Moray. First, Leanchoil hospital in Forres is to lose its maternity unit and all mothers are to be transferred to Raigmore hospital in Inverness, which is in a different health board area. It appears that complex negotiations—though not public negotiations—have taken place between Grampian and Highland health boards, and the former will pay the latter for such obstetric facilities. Will the Minister give me some guidance? First, what costing of that deal has Grampian health board given? Secondly, are the obstetricians based in Inverness prepared to accept full responsibility for all aspects of pregnancy, labour, delivery, neonatal and paediatric care that were previously dealt with by general practitioners in Forres?
Thirdly, is the Minister satisfied that Raigmore hospital will be able to cope with increased numbers, including the provision of lying-in facilities for new mothers? Fourthly, has any costing been made or will a costing be made of accepting the suggestion from Leanchoil general practitioners that the current 12-bed unit be reduced to six beds, with the other beds being given to orthopaedic facilities? Fifthly, has any account been taken of the importance attached to Leanchoil by young RAF families based at RAF Kinloss? Sixthly, what safety net is to be left for emergencies for Forres mothers who, for whatever reason, cannot travel to Raigmore?
Dr. Russell Lees, a consultant obstetrician and gynaecologist at Raigmore, commented:
"We, the Consultants in the Department of Obstetrics in Raigmore view with anxiety the prospect of an increased demand for home confinements which could conceivably arise as a result of the closure of the maternity unit at Leanchoil and it is for that reason that we would support the retention of a six bedded unit at Forres for uncomplicated deliveries with the additional benefit of "lying in" facilities for those mothers who deliver their babies in Raigmore but whose medical condition is such that they can be looked after in the early days … in a hospital nearer home."
That issue directly affects Forres and the western side of my constituency.
The next main issue for Moray is the need to establish a full-scale specialist obstetric unit in Elgin, which is regarded as the centre of the district. Perhaps the fate of the Turner memorial and Leanchoil hospitals would not have met such antagonism had Grampian health board offered us a locally based specialist facility. However, the long-held hope that Elgin would have such a unit has apparently been ditched for good by the board. Instead, Aberdeen and Inverness are to be the central points for such services. The suggestion is that all women east of the Spey will be asked to attend Aberdeen maternity hospital and that all women west of the Spey will be asked to attend Raigmore and Inverness hospitals.
On my latter point relating to the geographical area west of the river Spey, I again refer to comments made by Russell Lees, the consultant obstetrician at Raigrnore hospital in Inverness. He stated:
"I feel I should add that the Consultants in the Department of Obstetrics at Raigmore view with some concern the prospect of transfer of maternity care patients in

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the Elgin area from Grampian Health Board to Highland Health Board, and we are uniformly of the opinion that without additional facilities in terms of beds and staff at all levels we could not provide a similar quality of care to that which is already provided by this Department for mothers from the Highland Region."
Dr. Lees said that against the background of an increase in the bed complement at Raigmore from 56 to 72. It is not enough to say that facilities at Raigmore have already been increased.
In whatever direction the mums in my constituency are pointed, they face lengthy and hazardous journeys along the A96—a road that is notorious for delays and accidents at all times of the year. Obviously, that road is most dangerous in winter. Recently, it was branded by the Inverness chamber of commerce as a goat track, and by the Royal Automobile Club as a death trap. In conjunction with all the district councils near that road, Highland and Grampian regional councils are mounting a major campaign to improve the A96. It seems unlikely that that will be within the immediate future, although piecemeal opportunities have been given for slight improvements on the road.
We must think of women who are in distress—perhaps already aware that the life of their baby is at risk—being driven over a road that they know is in poor condition. Often, they are already in labour, strapped to a drip, and in severe pain. No one could harden his or her heart to the psychological and physical stress that such an experience must create. We must remember that such women may not have their husbands with them, and may have left behind young children.
There is, of course, the flying squad. On page 10 of unit II's strategic plan for maternity and neonatal services in Grampian, it says:
"Once the Flying Squad call is received it takes an average 30 minutes to assemble medical staff, equipment and taxi and if the call is to Elgin, for example, then a further one hour 45 minutes transport time ensues to reach the destination. This delay may be crucial to patient management. Often, because of the time factor involved, the patient is sent by ambulance to Aberdeen and may deliver en route."
So now it is being suggested that a helicopter could form part of the normal service to mums in my area. The same report says that it should be part of the normal service to have a helicopter as a standby to transport mums in labour from my constituency.
I have never travelled by helicopter, but many who have—including my husband who is a member of a mountain rescue team—tell me that it is without doubt the most unpleasant and uncomfortable form of transport imaginable. The idea that women in labour and in stress should be asked to regard a helicopter as a mainstay is unpalatable.
We should consider Grampian health board's reasons for opposing the establishment of a specialist unit such as we want in Moray. The board says:
"There is no definitive guidance on the optimum population to be served by a full specialist obstetric facility".
It seems that, in the absence of definitive guidance, the board is prepared to reach its own definition. By using the Gavin Shaw report, which recommends a minimum of three consultant obstetricians, Grampian health board concludes that 1,100 births per year do not justify the establishment of such a unit.
1180
My argument, like that of my fellow campaigners in Moray, challenges that assertion. I shall use the facts and fugures provided by MUM—theMaternity Unit for Moray campaign—which says:
"In a centre of population such as Moray, with 26,361 females aged 16–64 and 6,880 females aged 65–89, is it appropriate to provide obstetric and gynaecological services for the majority of these women, either 68 miles away in Aberdeen or 37 miles away in Inverness? Miss Hines, the Director of Midwifery Services in Grampian stated on 11 February 1988 at the public meeting in Elgin, that she could not justify or defend the decision of Grampian Health Board to continue to send mothers such distances for obstetric care."
On page 2 of its strategic plan, unit II says:
"The total number of births in Grampian will fall to approximately 6,500 by 1991: of these 1,300 babies will be born to women living in Moray. The numbers for 1996 are approximately 6,300 and 1,400 respectively."
In other words, we are anticipating an increased birth rate in the Moray district. We know that obstetric units which cater for smaller numbers have been established elsewhere in Scotland and I believe that, south of Perth, the norm for such facilities is a travelling distance of something less than 30 miles.
Grampian health board also believes that the number of cases that it predicts would not attract consultants of the quality that it desires. That must be one of the most spurious arguments that has been advanced. Elgin has never experienced any difficulty attracting consultants of the highest calibre on other specialties, and nobody but Grampian health board anticipates any difficulty in attracting obstetricians.
If population were used as the sole criterion for the establishment of specialist centres in rural communities, we could fully expect all specialist centres in Scotland to be based in cities. It is therefore an argument to which we cannot give any credence and I hope that the Minister, who also represents a rural constituency, will reject it.
I trust that the Minister will give us hope in Moray that the maternity services that we already have and appreciate will not be taken from us. Our GP units are of the highest standard and the public has shown its confidence in them by the demand for their retention. The files that I have on the Bench beside me represent the strength of feeling from my constituency. Those files contain letters of support and argument, not just from the GPs or from the medical practitioners within my constituency, but from hundreds of ordinary men and women who are deeply concerned about their community. This argument is not about statistics and, according to the Grampian health board, nor is it completely about costs. The argument is about life. It is about safety and proper medical care. In Moray we are refusing to be regarded as second-class citizens.
2.46 pm
The Parliamentary Under-Secretary of State for Scotland (Mr. Michael Forsyth): I was sad indeed to hear the news about Dr. Allan Matheson. I well recall the hon. Lady bringing a delegation to see me about the Keith maternity unit. The clear commitment that Dr. Matheson had to the community was evident from our discussions. I join the hon. Lady in expressing my condolences to his wife and family on such a tragic loss.
The hon. Lady expressed some surprise when I said from a sedentary position that I had not received the final submission from the Grampian health board. I received in April some preliminary material regarding its proposals for closure. Additional infomation was forwarded to my

1181
Department on 2 June, and the remainder is expected within the next fortnight. Therefore, I have to dissappoint the hon. Lady because I am unable to say very much today—in fact nothing—about the substance of the board's case or to reply to her arguments. However, I have had a large number of representations on this matter from a wide variety of opinions and from every section of the community in Moray. In fact, a few weeks ago I had a lengthy discussion with the chairman of the health council, Mrs. Rona Hossack. I have given an undertaking to the officers of the health council that before coming to any conclusions on the matter I will meet them to discuss the arguments. I hope that the hon. Lady will accept that as going some way towards meeting her request that I should take account of local opinion on this matter before reaching a conclusion.
It clearly would not be appropriate for the Scottish Office to embark upon a whole new consultation process, because these matters are for the board. I am sure that the hon. Lady will forgive me if I make one rather pertinent observation. In this debate the hon. Lady is asking me and my right hon. and learned Friend to overturn the decisions of the Grampian health board and direct it to do something else. It was only a few weeks ago that she was strongly chiding me and criticising me in public for directing the health board on competitive tendering. She was then arguing that it was no part of the Secretary of State's duty to undermine the local autonomy of health boards. Having said that, the breadth of feeling on this matter is clear.
Mrs. Margaret Ewing: I am grateful to the Minister for allowing me to intervene. I am conscious of the time constraint. Some of his latter comments have been mischievious but I shall not respond to them. On the issue of consultation within the community, and over and above meeting the representatives of the full health council, will it be possible for representations to be received from general practitioners in Forres, and will there be discussions with the obstetricians in Raigmore, which is within the Highlands health board.
Mr. Forsyth: I shall consider all the arguments, but it is the job of the health board to carry out the consultation process and reach conclusions, and it requires the consent of the Secretary of State. The hon. Lady is asking my right hon. and learned Friend to overturn its conclusions following its consultation, and it would not be appropriate for my right hon. and learned Friend to be involved in consultation. Having received strong representations from Mrs. Hossack, I agreed to meet officers of the health council before reaching any conclusion. I have agreed to meet a delegation that my right hon. Friend the Member for Kincardine and Deeside (Mr. Buchanan-Smith) is bringing to deal with the issue of Torphins prior to reaching any conclusions.
I have received representations from the Maternity Unit for Moray campaign and I shall examine carefully the specialist unit proposal. I have also received representations from regional and district councillors and others through the political network from the Moray Conservatives. I accept that it is an issue of concern to every sector of the community.
There was the hint in the hon. Lady's speech that resources have had a part to play—she referred to the overall level of funding available to the Grampian health
1182
board—but I do not believe that they have. Conclusions should have been reached on the basis of what will provide the best quality of patient care for the people of Moray. The Grampian health board has seen a substantial increase in the resources granted to it since the Government came to power. Since 1979, the amount of money available to the health board to meet running costs has increased by one third over and above inflation. The increase in capital resources that has been made available to the board to fund new developments and new hospital projects has been spectacular. That level of funding has almost doubled in real terms, there having been an increase of 96 per cent. since 1979.
I know that the hon. Lady will be aware of the difference between the resources that are available to the health boards now and those which were available when the Labour Government were in office, whom she and her party were keen to support.
When that Government were in office we saw a 28 per cent. cut in the capital expenditure made available to health boards in Scotland. These figures are sometimes dismissed as mere statistics or just numbers, but they are not. The increased funding that we have provided for Grampian is seen in new developments. Phase 1 of the new royal Cornhill hospital will begin construction in October and will improve the services that are available to the mentally ill. When I visited Foresterhill I announced that £3 million would be made available for the new blood transfusion centre that will open in 1991. More central to the hon. Lady's constituency interest is the redevelopment at Dr. Gray's hospital to replace the Maryhill maternity unit, which will cost more than £1 million. I recently announced the extension of cardiac surgery in Grampian that will result in a capital investment of about £1·2 million over a period. As we are now taking centrally the funding of cardiac surgery operations there, the result will he a windfall running cost benefit to the health board of about £250,000.
The board has benefited from some substantial extra money. I urge the hon. Lady to recognise that and to recognise also that any decisions should be based on what represents value for money. The review of maternity services is designed to ensure that the needs of the people are met as well as to ensure efficiency.
Lest these discussions seem to be limited to Grampian, let me say that other health boards are having to consider these matters. Lothian has had to consider the problem of the underutilisation of maternity beds. Clearly, it is in no one's interest to have beds which are staffed but which are not needed, because that constitutes a waste of resources. Today my right hon. and learned Friend has approved a restructuring of obstetric services in Lothian which will involve the closure of the Elsie Inglis maternity hospital in Edinburgh. He was prepared to give consent on the basis that for years there had been an oversupply and underuse of obstetric beds and that the position would be made worse because of the opening of new obstetric services in the Borders. He also took account of the facts that the proposals have the support of Lothian health board's professional advisory committees and that the savings will be fully available to the board to promote development and improvement in the services in other areas.
The hon. Lady asked about the A96. Fortunately, roads are not within my area of responsibility, but the importance of the A96 is fully recognised. Works worth some £6 million are under construction; £44 million worth

1183
of work is planned and a major feasibility study is under way. Progress on future schemes will be determined by the satisfactory completion of statutory procedures, the availability of finance and the priority of particular schemes within the context of competing claims from the entire trunk road network in Scotland.
The hon. Lady will forgive me for pointing out that in Scotland we enjoy a Health Service that is funded to the extent of rather more than a quarter more per head t n the Health Service in England. Our roads programme is also considerably better funded. Were it not for the fact that I would be called to order, I would be intrigued to hear from her how she imagines that continued support would be available if we were to follow the prescriptions of her party.
I shall listen carefully to all the arguments and study with the greatest possible care the papers, submissions and
1184
letters we receive in the Department. I am happy to hear from the hon. Lady of any additional arguments, other than those which she put in the debate and in correspondence with me. I will make arrangements to meet the officers of the health council. The personal remark which she addressed to me about my constituency interest and recognition of the problems of rural areas strikes home. I need no convincing because when my wife was expecting our latest child, the central thought in her mind was the 25 miles which were involved from Aberfoyle to Stirling, so I am aware of the anxieties and feelings. I shall ensure that the arguments are considered carefully before we reach a conclusion.
The hon. Lady asked when we would reach a conclusion. In the time-honoured phrase which trips off the tongue so easily after a mere year at this job, we would expect to reach a conclusion as soon as possible and shortly.
Question put and areed to.
Adjourned accordingly at two minutes to Three o'clock.

WALES

  Welsh Language
  Mr. Wigley
  To ask the Secretary of State for Wales (1) if he will list the certificate of education courses available(a) in English, and (b) in Welsh;

  (2) if he will list, by secondary school, the subject entries and number of candidates (a) per subject offered through the medium of Welsh and (b) per subject offered through the medium of English, for the certificate of education examination;

  (3)how many staff are employed by the Welsh Joint Examination Council to organise, administer and develop Welsh medium certificate of education courses.

  Mr. Wyn Roberts
  Certificate of education courses are administered by the Welsh joint education committee (WJEC). Information relating to courses is not held by the Department; any such requests should be directed to the WJEC.

  Mr. Wigley
  To ask the Secretary of State for Wales how many statemented children there are at present in Welsh medium or bilingual primary and secondary schools, and at Welsh units, in each Welsh local education authority area.

  Mr. Wyn Roberts
  The information as at January 1987 is as follows:

  Number of statemented pupils in Welsh medium or bilingual schools or Welsh units

  Local education authority

  Primary

  Secondary

  Clwyd

  43

  20

  Dyfed

  98

  15

  Gwent

  6

  —

  Gwynedd

  181

  117

  Mid Glamorgan

  69

  43

  Powys

  30

  4

  South Glamorgan

  5

  —

  West Glamorgan

  15

  1

  Mr. Wigley
  To ask the Secretary of State for Wales how many statemented children in each Welsh education authority area have been transferred from Welsh medium or bilingual schools as a result of the statementing.

  Mr. Wyn Roberts
  This information is not collected centrally.

  Mr. Wigley
  To ask the Secretary of State for Wales what information he has as to the numbers of the following professionals by local education authority in Wales; and in each case how many are able to carry out their work through medium of Welsh as well as English(a) educational psychologists, (b) educational social workers, (c) speech therapists, (d) advisory teachers in social and emotional problems, (e) special education advisers, (f) education welfare officers and (g) advisory teachers for the hearing impaired, visually impaired, etc.
  688
  Mr. Wyn Roberts
  Information on the number of specialist advisers employed by local education authorities is not held centrally. For information about the number of speech therapists, I refer the hon. Gentleman to my hon. Friend's reply to him of 1 March.

  Caergwrle Bypass
  Mr. Barry Jones
  To ask the Secretary of State for Wales (1) if he will meet Clwyd county councillors to discuss the Caergwrle bypass;

  (2)if he will meet Caergwrle residents who oppose the Caergwrle bypass green route;

  (3)if he will establish a public inquiry into the proposals for a Caergwrle bypass; and if he will make a statement;

  (4)if he will give financial assistance to Caergwrle, Clwyd, residents who seek to oppose the Caergwrle bypass green route.

  Mr. Wyn Roberts
  This is a county road scheme and therefore a matter for Clwyd county council.

OVERSEAS DEVELOPMENT

  Departmental Accommodation
  Mr. Ingram
  To ask the Secretary of State for Foreign and Commonwealth Affairs if he will make it his policy not to enter into any new long-term commitment for the Overseas Development Administration's London accommodation in the current financial year.

  Mr. Eggar
  No.

  Eland House
  Mr. Ingram
  To ask the Secretary of State for Foreign and Commonwealth Affairs what has been the cost to the Overseas Development Administration for the rental of Eland house over the last three years; and what has been the total cost to public funds of renting that building.

  Mr. Eggar
  The rent paid by the Overseas Development Administration to the Property Services Agency for Eland house under the property repayment services arrangements for each of the last three financial years was as follows:

  1985–86

  1986–87

  1987–88

  2,175,838

  1,927,294

  2,212,976

  Civil accommodation for Government Departments is held in the name of my right hon. Friend the Secretary of State for the Environment and managed by the PSA. The rents of leasehold buildings are determined on a strictly commercial and therefore confidential basis.

EDUCATION AND SCIENCE

  Student Unions
  Mr. Amess
  To ask the Secretary of State for Education and Science (1) if he will place in the Library details of any representations he has received concerning automatic membership of student unions; and if he will make a statement;
  689
  (2) if he will place in the Library a list of those organisations and individuals who made representations to him concerning automatic membership of student unions; and if he will make a statement;

  (3) if he will place in the Library the information he has on compulsory student union membership; and if he will make a statement.

  Mr. Jackson
  Students become members of the student union of their university, polytechnic or college of further or higher education by virtue of their being enrolled at the institution. They are not normally required to pay any subscription as a member and can decide whether or not to take part in the union's activities. As indicated in my right hon. Friend's reply to my hon. Friend the Member for Thurrock (Mr. Janman) on 18 April, the Government intend shortly to gather up-to-date factual information on the services available to students from their unions. Since the general election I have met the National Union of Students once to discuss the issue of union membership. The issue has also figured during visits I have made to institutions of higher and further education. In addition, over the period 1 June 1987 to 31 May 1988 we have received some 30 letters from hon. Members and members of the public about membership of local unions and a further 30 letters concerning membership of the National Union of Students. The letters have been evenly divided between those in favour of and those opposed to the present system of membership.

  I do not consider it appropriate to deposit this correspondence in the Library.

  Mr. H. W. Steggles
  Mr. Steen
  To ask the Secretary of State for Education and Science when he hopes to reply to the letter from the hon. Member for South Hams dated 23 March, enclosing a letter from Mr. H. W. Steggles of Eastern Hill, Middlecombe, Noss Mayo, Plymouth, dated 15 March.

  Mrs. Rumbold
  I replied to my hon. Friend on 8 June. I regret the delay in replying.

  Schools (Expenditure)
  Mr. Gordon Brown
  To ask the Secretary of State for Education and Science what information he has about the public spending per head of senior school population in pounds sterling for Germany, France, the United States of America and Italy.

  Mr. Dunn
  For international returns, data for the senior school population are included with non-advanced further education and therefore cannot be identified separately.

  Head Teachers
  Mr. Pawsey
  To ask the Secretary of State for Education and Science what evidence he has about the rate at which head teachers are now seeking early retirement, what comparable information he has on previous years; and to what factors he attributes the trend.

  Mrs. Rumbold
  For teachers as a whole, premature retirements have in recent years consistently accounted for about 60 per cent. of all retirements. Premature retirement has kept open promotion opportunities for teachers and improved the age structue of the profession. Information 690
  about premature retirements of head teachers is available only combined with information on college prinicpals and up to 1986–87. The number of premature retirements in these groups fell by 17 per cent. in 1986–87 compared with 1985–86. Pension is based on the best 12 months' salary over the last three years of service. It is likely that teachers were postponing retirement in 1986–87 in order to improve their pensions by awaiting the effect on pensions of the substantial pay increases of 25 per cent. between March 1986 and October 1987. We would expect premature retirements to rise again by 1988–89 as these increases feed through into pension entitlements.

  Mr. Pawsey
  To ask the Secretary of State for Education and Science what difficulties are being experienced in the recruitment of headteachers.

  Mrs. Rumbold
  Good up-to-date information is not available. The interim advisory committee on teachers' pay found no particular evidence of serious recruitment problems affecting heads and deputies. The Department estimates that at January 1988 approximately 300 headteacher posts were vacant, that is only slightly more than 1 per cent. of headteacher posts.

TRADE AND INDUSTRY

  Driving (Minimum Age)
  Miss Widdecombe
  To ask the Chancellor of the Duchy of Lancaster what is his assessment on the effect on the balance of payments current account of raising the minimum age requirement for the driving of(a) motor cars and (b) all motor vehicles to 18 years.

  Mr. Alan Clark
  Information on which to base an assessment is not available.

  Liquor Taxation (Japan)
  Miss Widdecombe
  To ask the Chancellor of the Duchy of Lancaster what is his assessment of the impact on the United Kingdom balance of payments current account of the Japanese Government's present discriminatory system of liquor taxation.

  Mr. Alan Clark
  We are currently awaiting the Japanese Government's response to the recommendations of the general agreement on tariffs and trade that the discriminatory element in Japanese taxation of imported wines and spirits should be removed. We expect substantially increased exports of Scotch whisky to Japan following tax reform.

  North Peckham Task Force
  Ms. Harman
  To ask the Chancellor of the Duchy of Lancaster (1) what are the running costs per year of the North Peckham task force;

  (2) how much Daniel Levy, the North Peckham task force leader, is paid per year.

  Mr. Kenneth Clarke
  I refer the hon. Member to the answer I gave to a similar question from her on Tuesday 12 April.

  Israel (Exports)
  Mr. Galloway
  To ask the Chancellor of the Duchy of Lancaster what is the current volume of Israeli exports to
  691
  the United Kingdom; what is the make-up of those exports; and what were the comparable figures for each year from 1966 to 1987.

  Mr. Alan Clark
  The current value of imports from Israel for the first four months to April 1988 are £167.00 million.

  United Kingdom imports from Israel

  Table 1

  Value £ thousands

  Division

  1970

  1971

  1972

  1973

  1974

  1975

  1976

  1977

  1978

  1979

  Total trade

  44,856

  54,745

  57,805

  69,740

  78,893

  91,183

  125,785

  159,680

  176,414

  219,297

  Of which:

  05

  Vegetables and fruit

  24,234

  32,558

  33,233

  35,325

  39,241

  47,107

  58,744

  67,724

  76,515

  86,099

  84

  Articles of apparel and clothing accessories

  1,282

  1,622

  1,912

  2,545

  5,061

  8,259

  12,350

  17,595

  21,531

  29,121

  65

  Textile yarn, fabrics, made-up articles NES, and related products

  1,598

  1,137

  1,264

  1,279

  2,170

  1,842

  2,601

  5,427

  8,327

  13,583

  89

  Miscellaneous manufactured articles NES

  756

  1,102

  762

  1,364

  1,421

  1,283

  1,566

  2,502

  3,142

  5,446

  66

  Non-metallic mineral manufactures NES

  3,994

  4,416

  6,019

  9,787

  8,115

  10,809

  18,794

  18,587

  31,987

  27,504

  29

  Crude animal and vegetable materials NES

  147

  249

  458

  331

  405

  586

  924

  2,145

  5,804

  10,579

  United Kingdom imports from Israel

  Table 2

  Value £ thousands

  Division

  1980

  1981

  1982

  1983

  1984

  1985

  1986

  1987

  April 1988

  Total trade

  232,746

  255,866

  276,011

  313,677

  392,744

  403,952

  385,175

  437,014

  167,049

  Of which

  05

  Vegetables and Fruit

  83,464

  95,288

  97,237

  100,420

  113,402

  142,562

  107,384

  123,687

  55,301

  84

  Articles of apparel and clothing accessories

  38,710

  46,359

  54,438

  62,792

  69,808

  71,379

  73,077

  71,022

  24,125

  65

  Textile yarn, Fabrics, made-up articles NES and related products

  13,431

  16,718

  16,674

  20,177

  25,627

  31,319

  35,550

  38,171

  14,634

  89

  Miscellaneous manufactured articles NES

  7,672

  9,803

  11,084

  11,452

  16,247

  16,609

  17,509

  24,418

  7,601

  66

  Non-metallic mineral manufactures NES

  19,644

  21,890

  17,287

  15,125

  13,795

  14,137

  16,272

  22,052

  7,207

  29

  Crude animal and vegetable materials NES

  6,231

  7,719

  6,627

  8,604

  9,565

  12,608

  13,023

  14,585

  9,343

  Source: Overseas Trade Statistics.

  Notes:

  (i) Total trade figures are on a 1981 basis throughout. Imports valued at (CIF).

  (ii) Figures for 1987 and for four months ended April 1988 are provisional.

  Computers
  Mr. Warren
  To ask the Chancellor of the Duchy of Lancaster (1) to whom the data are given which are supplied by applicants wishing to sell computers who are required to complete his Department's computer questionnaire; and if he will make a statement;
  692
  These figures should be treated with more than the usual caution because of major changes to customs procedures introduced in January 1988, details of which were given in a reply to my hon. Friend the Member for Hertfordshire, South-West (Mr. Page) on 7 December 1987, at columns 34–35.

  Information on the make up of imports, within acceptable cost limits, is given in the tables:

  (2) to whom the data are given which are supplied by applicants wishing to sell computers who are required to complete his Department's export licence application,; and if he will make a statement.

  Mr. Alan Clark
  Applications for export licences and supporting data are considered by DTI officials and, in many cases, by officials of other Departments from whom the DTI seeks advice.
  693
  In the case of applications to export certain items to the proscribed destinations, COCOM partners are also consulted. For this purpose, brief details, which do not identify the exporter, are provided to COCOM partners.

  The circulation of a particular export licence application and its supporting documents will depend upon the level of technology involved and the proposed ultimate destination.

NORTHERN IRELAND

  Belfast—Dublin Road, Newry (Parking)
  Mr. Mallon
  To ask the Secretary of State for Northern Ireland what measures are being taken to ensure that private entrances and exits, leading on to and off the main Belfast to Dublin road, in the immediate vicinity of the existing customs station at Newry, are kept clear of parked vehicles.

  Mr. Needham
  [holding answer 7 June 1988]: Prohibition of waiting by vehicles in the vicinity of the existing customs station, Newry, introduced by the Department of the Environment (NI) in 1981 and 1982 remain in force. Police and traffic wardens make every effort to ensure that traffic regulations in operation in the area are enforced.

  Chernobyl
  Mr. Boswell
  To ask the Secretary of State for Northern Ireland what has been the total staff and administration cost to his Department of the Chernobyl accident.

  Mr. Viggers
  [holding answer 7 June 1988]: Precise figures are not available but staff costs incurred, in the main by the Department of Agriculture, Northern Ireland, are estimated at around £300,000. Some £70,000 has been spent on the purchase of produce for testing, live monitoring equipment and paint in connection with the operation of the mark and release scheme. A further £12,900 has been paid in compensation to producers affected by the movement restrictions on sheep.

ENERGY

  Gas Disconnections
  Mr. Pike
  To ask the Secretary of State for Energy if he will make it his policy to monitor the numbers of gas disconnections; and if he will make a statement.

  Mr. Peter Morrison
  The numbers of gas disconnections are monitored by the Gas Consumers Council and Ofgas, and will continue to be so.

  Electricity Privatisation
  Mr. Harry Greenway
  To ask the Secretary of State for Energy if he will make a statement on the progress of plans to privatise electricity.

  Mr. Michael Spicer
  Discussions with the industry are continuing satisfactorily and our aim is to introduce legislation at the earliest opportunity.

  Dr. Michael Clark
  To ask the Secretary of State for Energy whether he is considering, in his proposals for electricity privatisation, a system of compensating owners of power stations which are not being run at any given time because they are too expensive.
  694
  Mr. Michael Spicer
  Arrangements governing the future operation of power stations will be set out in the power supply contracts. These should provide proper incentives to generators to provide supplies as economically as possible.

  Magnox Reactors
  Mr. Strang
  To ask the Secretary of State for Energy which nuclear power station Magnox reactors are currently out of operation; and when he expects each of them to he back in service.

  Mr. Michael Spicer
  I understand that the following four of the CEGB's Magnox reactors are out of service: Bradwell R1, Trawsfynydd R1, Berkeley R1 and Dungeness `A' R2. Bradwell R 1 and Trawsfynydd R1 are expected to return to service in June while Berkeley R1 and Dungeness 'A' R2 are expected to return in July.

FOREIGN AND COMMONWEALTH AFFAIRS

  Cyprus
  Mr. John D. Taylor
  To ask the Secretary of State for Foreign and Commonwealth Affairs if the United Kingdom continues to act as guarantor power for Cyprus; what information he has as to how many Turkish and Greek troops there are in Cyprus; how many troops from each of these countries are authorised to be in Cyprus; and what estimate he has as to how many non-Cypriots are resident in the Turkish and Greek sectors of the island.

  Mrs. Chalker
  The United Kingdom continues to fulfil its obligations under the 1960 treaty of guarantee, by consulting our fellow guarantor powers from time to time.

  We estimate that there are between 28,000 and 30,000 Turkish troops and between 2,500 and 3,500 Greek troops stationed in Cyprus. The 1960 treaty of alliance provided for 650 Turkish troops and 950 Greek troops. We estimate that there are about 35,000 non-Cypriot settlers in the north. We have no figures for non-Cypriots resident in the south.

  Nelson Mandela Concert
  Mr. John Carlisle
  To ask the Secretary of State for Foreign and Commonwealth Affairs what representations he has received concerning the implications for international relations of the proposal by the British Broadcasting Corporation to broadcast a concert celebrating the 70th birthday of Nelson Mandela.

  Mrs. Chalker
  The South African Government have made representations about the programme to us through the embassy at Pretoria.

HOME DEPARTMENT

  Remand Prisoners
  Mr. Alex Carlile
  To ask the Secretary of State for the Home Department how many people awaiting trial before magistrates and Crown courts were remanded in custody on 1 June; of that number, how many were held(a) in youth custody or juvenile remand centres, (b) in prisons, (c) in police stations, (d) in Army or other service establishments or (e) in other institutions; and if he will make a statement.
  695
  Mr. Douglas Hogg
  The most recent readily available information for prison department establishments is given in the following table. No untried prisoners were held in a youth custody centre or in Rollestone Army camp. In addition on 30 April, about 1,080 prisoners, most of whom were on remand, were held in police cells at police stations and magistrates courts.

  Population of untried prisoners in Prison Department establishments on 30 April 1988; by type of establishment and age group

  Type of establishment

  14–20

  21 and over

  All ages

  Remand centres

  2,164

  1,321

  3,485

  Prisons

  526

  4,851

  5,377

  All establishments

  2,690

  6,172

  8,862

  Mr. Alex Carlile
  To ask the Secretary of State for the Home Department if he will list the Army or other service establishments used to hold people remanded in custody awaiting trial before either magistrates or Crown courts on 1 June.

  Mr. Douglas Hogg
  Only two Army camps have been brought into use as temporary prisons and these held no untried prisoners on 1 June.

  Mr. Alex Carlile
  To ask the Secretary of State for the Home Department if he will list the establishments, other than youth custody or juvenile remand centres, prisons, police stations, or establishments of the armed forces, which were used to hold people remanded in custody awaiting trial before either magistrates or Crown courts on 1 June.

  Mr. Douglas Hogg
  Police cells at certain magistrates' courts were the only other type of accommodation used for untried prisoners on 1 June.

  Mr. Alex Carlile
  To ask the Secretary of State for the Home Department how many of the people remanded in custody awaiting trial before magistrates or Crown courts on 1 June had been held in custody for a continuous period greater than(a) 12 months and (b) six months.

  Mr. Douglas Hogg
  The latest information for untried prisoners on the length of time since initial remand in custody, relates to 30 June 1987 and is given in the reply I gave to a question from the hon. Member for St Helens, South (Mr. Bermingham) on 27 May 1988 at columns 379—80.

  Mr. Alex Carlile
  To ask the Secretary of State for the Home Department (1) how many of the people remanded in custody awaiting trial before magistrates or Crown courts on 1 June were women;

  (2) if he will list the establishments in which women were held on remand, and the numbers of women held in each one, on 1 June.

  Mr. Douglas Hogg
  The most recent readily available information for prison department establishements relates to 30 April and is given in the following table. On that date no female prisoners were held in police cells at police stations or magistrates' courts.
  696

  Population of female untried prisoners in Prison Department establishments on 30 April 1988: by establishment.

  Prison Department establishment

  Number of untried prisoners

  Holloway

  267

  Low Newton Remand Centre

  19

  New Hall

  29

  Pucklechurch Remand Centre

  27

  Risley Remand Centre

  75

  All establishments

  417

  Mr. Roc Sandford
  Mr. Frank Field
  To ask the Secretary of State for the Home Department when the hon. Member for Birkenhead will receive a reply to a letter written to the Parliamentary Under-Secretary of State, the hon. Member for Grantham (Mr. Hogg) on 28 April, regarding the case of Mr. Roc Sandford.

  Mr. Douglas Hogg
  I wrote to the hon. Member yesterday.

  Overseas Visitors
  Mr. Mudd
  To ask the Secretary of State for the Home Department what was the number of visitors to the United Kingdom from Indonesia, Malaysia, the Philippines, Singapore and Thailand in each of the years from 1976 to 1987 inclusive, broken down by country.

  Mr. Renton
  Information on the numbers of visitors admitted to the United Kingdom by nationality is published annually in table 1 of "Control of Immigration: Statistics, United Kingdom" (Cm 166 for the issue for 1986), copies of which are in the Library. The issue for 1987 will be published next month; however the figures requested for 1987 are as follows:

  Nationality

  Visitors given leave to enter for less than 12 months

  Ordinary

  Business

  Indonesia

  9,560

  2,000

  Malaysia

  32,500

  4,750

  Philippines

  14,900

  1,710

  Singapore

  23,800

  4,290

  Thailand

  13,100

  2,700

  Gatwick Airport (Exercise)
  Mr. Tony Banks
  To ask the Secretary of State for the Home Department how many police officers were involved in the security exercise at Gatwick airport on 7 June; how many vehicles were stopped and searched; on whose authority the exercise was mounted; and what was the total cost involved in the exercise.

  Mr. Douglas Hogg
  The security operation held at Gatwick airport on 7 June by the Sussex police was a routine operation and was approved by the Home Office. Because of the nature of the deployment it would not be appropriate to provide details of the number of police officers involved or the costs of the operation. The operation involved no change in the standard force procedures for stopping and searching vehicles.

  Concessionary Television Licences
  Mr. Alfred Morris
  To ask the Secretary of State for the Home Department what consultations he has had with disability organisations concerning the increase from 5p to £5 in the concessionary television licence for elderly and disabled people living in residential care; and if he will make a statement.

  Mr. Renton
  There was no need for consultation on this issue.

  Mr. Alfred Morris
  To ask the Secretary of State for the Home Department what the estimated net revenue will be from the recent increase in television licence fees for elderly and disabled people who live in sheltered housing or in residential homes.

  Mr. Renton
  About £2 million a year, which will cover the costs of collection and extensions to the scheme.

ATTORNEY-GENERAL

  McDonald Wheeler Fund Management Ltd.
  Mr. Franks
  To ask the Attorney-General what is the current position regarding the inquiry relating to McDonald Wheeler Fund Management Ltd.; and if he will make a statement.

  The Attorney-General
  The director of the serious fraud office now has the conduct of the inquiry to which my hon. Friend refers. It is being pursued by a team of police officers, accountants and lawyers, but it is not yet complete.

  "Spycatcher"
  Mr. Tony Banks
  To ask the Attorney-General what has been the total cost so far in terms of legal and other fees, travelling and expenses, Civil Service time and all other charges relating to the worldwide attempts by Her Majesty's Government to prevent the publication and distribution of the book "Spycatcher", including actions to prevent Mr. Peter Wright from receiving royalties from sales.

  The Attorney-General
  I refer the hon. Member to my answer of yesterday to the hon. Member for Walsall, North (Mr. Winnick).

  Rowntree
  Mr. Frank Field
  To ask the Attorney-General what were the reasons for his intervention with regard to the Joseph Rowntree charitable trust and the Joseph Rowntree memorial trust following the trusts' public stance on the takeover bids for Rowntree plc by Nestle and Suchard.

  The Attorney-General
  A request for information was made on my behalf to the trustees of the Joseph Rowntree charitable trust and the Joseph Rowntree memorial trust in exercise of my responsibilities as protector of charity under the Crown, in the light of a report in The Daily Telegraph on 2 June.

  Mr. Frank Field
  To ask the Attorney-General whether he consulted the charity commissioners or any other body 698
  before making representations to the trustees of the Joseph Rowntree memorial and charitable trusts regarding their charitable responsibilities to their beneficiaries in the context of the proposed takeover of Rowntree plc.

  The Attorney-General
  The Treasury Solicitor sought information from officials of the Charity Commission as to the likely identities of the charitable trusts referred to in The Daily Telegraph's report of 2 June and requested copies of the relevant trust documents. No other body was consulted before these inquiries were made on my behalf.

  Miss M. Murphy
  Mr. Frank Field
  To ask the Attorney-General when the social security commissioners will be ready to send the submission on the appeal made by Miss M. Murphy, promised within 30 days on 12 April, to Mr. A. McGuiness and Miss Murphy.

  The Attorney-General
  Copies of the document to which the hon. Member refers were sent to Mr. McGuiness and Miss Murphy on 8 June 1988.

  Unmarried Fathers
  Mr. McLeish
  To ask the Attorney-General what plans he has to introduce legislation relating to the parental rights of unmarried fathers; and if he will make a statement.

  The Attorney-General
  Part II of the Family Law Reform Act 1987 contains a number of provisions which improve the legal position of unmarried fathers. Other plans and priorities will determine when resources can be made available for the purpose of bringing part II into force, but the Lord Chancellor will keep the matter under close review.

NATIONAL FINANCE

  Personal Taxation
  Mr. Cousins
  To ask the Chancellor of the Exchequer if he will estimate the revenue effect in 1988–89 of(a) abolishing the high rate of income tax, (b) abolishing all personal tax reliefs other than the personal allowances, and (c) the net revenue effect of combining both measures.

  Mr. Norman Lamont
  The direct cost in income tax revenue for a full year at 1988–89 levels of income of abolishing the higher rate of income tax is estimated at £2·7 billion. The direct cost in capital gains tax revenue on disposals in 1988–89 is estimated at £0·2 billion.

  Information on income tax reliefs is available only in respect of mortgage interest, retirement annuity premiums, employees' superannuation contributions and the business expansion scheme. The total direct revenue yield from abolishing these reliefs is estimated at £6·7 billion. The capital gains tax cost would be small.

  The net effect of abolishing these reliefs and the higher rate of tax would be a yield of some £3 billion. This estimate includes the consequential effects on revenue from capital gains tax on disposals in 1988–89. The income tax component makes no allowance for possible behavioural effects arising from the changes.

  Taxation Changes
  Dr. Reid
  To ask the Chancellor of the Exchequer if he will make it his policy to publish at the time of his Budget statement a full study of the redistributive effects of the taxation changes he is introducing.

  Mr. Norman Lamont
  There are no plans at present to add to the substantial amount of information already published on the effect of Budget proposals.

  Incomes
  Mr. Nicholas Brown
  To ask the Chancellor of the Exchequer if he will publish figures showing, for families with one to four children, the income break-even levels, in £ sterling per week as a percentage of average male manual earnings, at which child benefit entitlement is the same as income tax liability.

  Mr. Norman Lamont
  The table sets out the weekly income levels for a married man whose wife is not working at which income tax liability equals child benefit entitlement at 1988–89 levels.

  Break-even levels

  Number of children

  £ per week

  As a percentage of average male manual earnings1

  1

  107·75

  52·0

  2

  136·75

  65·9

  3

  165·75

  79·9

  4

  194·75

  93·9

  1 Average manual earnings for male aged over 21 working a full week are estimated to be £207·40 per week in 1988–89.

  Mr. Gordon Brown
  To ask the Chancellor of the Exchequer if he will give for 1978–79 and 1988–89 or the most recent year available the total income before and after tax at constant prices for(a) the top 1 per cent., (b) the top 5 per cent. and (c) the top 10 per cent. and each 10 per cent. thereafter down to the bottom 10 per cent., including both working and non-working households in the figures and the percentage of income before and after tax accruing to each group.

  Mr. Norman Lamont
  [holding answer 7 June 1988]: Estimates for the years 1978–79, 1981–82 and 1984–85 of shares of income, before and after tax, received by quantile groups are contained in "The distribution of income in the United Kingdom 1984–85", published in the November 1987 edition of Economic Trends.

  Income Tax
  Mr. Harry Greenway
  To ask the Chancellor of the Exchequer if he will estimate the income tax remitted to taxpayers at all levels since 1979; and if he will make a statement.

  Mr. Norman Lamont
  The amount of income tax remitted to taxpayers at all levels since 1979 was:
  700

  Year (to 31 October)

  Amount (£ thousand)

  1979

  39,617

  1980

  45,091

  1981

  55,020

  1982

  70,143

  1983

  93,721

  1984

  126,905

  1985

  138,468

  1986

  187,088

  Tax is written off where there is no reasonable prospect of recovery—for example, because the taxpayer is insolvent.

  Corporation Tax
  Mr. Austin Mitchell
  To ask the Chancellor of the Exchequer whether he will publish in the Official Report his estimate of the gain to the revenue in a full year of increasing the rates of corporation tax and advance corporation tax, respectively, to 52 per cent.

  Mr. Norman Lamont
  The yield from increasing the main rate of corporation tax to 52 per cent. would be about £11 billion at 1987 levels of company profits and dividends. The additional yield from increasing the advance corporation tax rate and small companies rate to 52 per cent. would be about £2 billion. These estimates take no account of possible behavioural effects following such a change.

  Inland Revenue (Pre-paid Envelopes)
  Mr. Matthew Taylor
  To ask the Chancellor of the Exchequer if he will make a statement concerning the decision of the Inland Revenue to cease the practice of enclosing pre-paid envelopes in correspondence with taxpayers.

  Mr. Norman Lamont
  I refer the hon. Gentleman to the answer I gave on 29 January 1988 at column 420 and to the Inland Revenue press release of the same date.

  Mortgage Interest
  Mr. Soley
  To ask the Chancellor of the Exchequer what has been the total cost of mortgage interest tax relief for the United Kingdom as a whole and for England, also expressed in terms of the cost per mortgagor receiving tax relief and the cost per owner-occupied dwelling, for the financial years 1979–80 to 1987–88; and what is the estimated cost in respect of 1988–89.

  Mr. Norman Lamont
  Estimates for the United Kingdom for the years 1979–80 to 1988–89 and for England from 1979–80 to 1982–83 are given in the table. Figures for 1983–84 onwards include the cost of relief given to non-taxpayers.
  701

  Cost of mortgage interest relief

  Average cost of relief per mortgagor

  Average cost of relief per owner-occupied dwelling

  (£ million)

  (£)

  (£)

  England

  UK

  England

  UK

  England

  UK

  1979–80

  1,300

  1,450

  250

  245

  130

  125

  1980–81

  1,735

  1,960

  335

  335

  165

  160

  1981–82

  1,820

  2,050

  350

  350

  170

  165

  1982–83

  1,895

  2,150

  350

  350

  170

  170

  1983–84

  n/a

  2,780

  n/a

  370

  n/a

  210

  1984–85

  n/a

  3,580

  n/a

  460

  n/a

  265

  1985–86

  n/a

  4,750

  n/a

  595

  n/a

  340

  1986–871

  n/a

  4,750

  n/a

  580

  n/a

  335

  1987–881

  n/a

  4,850

  n/a

  575

  n/a

  330

  1988–891

  n/a

  4,250

  n/a

  495

  n/a

  n/a

  1 Provisional.

  n/a Not available.

  Following the introduction of MIRAS in April 1983, regional information on the cost of mortgage interest relief cannot be extracted from Inland Revenue records. The regional distribution of mortgage interest can be derived from the family expenditure survey (FES), but, as the sample size for the FES is relatively small, it is not possible to provide robust estimates of regional trends for the period after 1982–83. Separate figures for England for 1983–84 to 1988–89 are therefore not available.

  Mr. Chris Smith
  To ask the Chancellor of the Exchequer if he will publish a table showing the total value of mortgage interest relief forgone as tax income by the Inland Revenue, the total number of recipients of this relief and the average amount of relief received per mortgagor, respectively, in the United Kingdom, in England and in Greater London in each tax year from 1978–79 to 1987–88; and if he will give an estimate for 1988–89.

  Mr. Norman Lamont
  [holding answer 7 June 1988]: Estimates for the years 1978–79 to 1982–83 have been derived from the results of the survey of personal incomes and are given in the table.

  Mortgage interest tax relief

  Total cost

  Number of mortgagors

  Average cost of relief

  £ million

  thousands

  £

  1978–79

  London

  170

  680

  250

  England

  995

  5,010

  200

  United Kingdom

  1,110

  5,600

  200

  1979–80

  London

  235

  760

  310

  England

  1,300

  5,250

  250

  United Kingdom

  1,450

  5,890

  245

  1980–81

  London

  280

  710

  395

  England

  1,735

  5,210

  335

  United Kingdom

  1,960

  5,860

  335

  1981–82

  London

  290

  660

  440

  England

  1,820

  5,190

  350

  United Kingdom

  2,050

  5,850

  350

  1982–83

  London

  260

  620

  420

  702

  Total cost

  Number of mortgagors

  Average cost of relief

  £ million

  thousands

  £

  England

  1,895

  5,400

  350

  United Kingdom

  2,150

  6,130

  350

  Following the introduction of MIRAS in April 1983, regional information on the cost of mortgage interest relief cannot be extracted from Inland Revenue records. The regional distribution of mortgage interest can be estimated from the family expenditure survey (FES), but, as the sample size for the FES is relatively small, it is not possible to provide robust estimates of regional trends for the period after 1982–83. Accordingly, the following table shows the relevant figures for 1983–84 to 1988–89 for the United Kingdom only. FES data for 1983 to 1985 suggest that about 88 per cent. of total mortgage interest relief is attributable to England and 14·5 per cent. to London. The corresponding percentages for the number of mortgagors are 88 per cent. for England and 10·6 per cent. for London.

  United Kingdom

  Cost of mortgage interest relief1

  Number of mortgagors

  Average cost of relief

  £ million

  thousands

  £

  1983–84

  2,780

  7,500

  370

  1984–85

  3,580

  7,750

  460

  1985–86

  4,750

  8,000

  595

  1986–872

  4,750

  8,200

  580

  1987–882

  4,850

  8,400

  575

  1988–892

  4,250

  8,600

  495

  1 Includes the cost of mortgage interest relief given to non-taxpayers.

  2 Provisional.

  Housing (Expenditure)
  Mr. Soley
  To ask the Chancellor of the Exchequer what has been the total cost of identifiable public expenditure; according to the main functions for housing in the years 1980–81 to 1987–88; and what was the expenditure per head of population for each of those years.

  Mr. Major
  The table shows, in £ million and £ per head of the population, public expenditure on the housing function which can be identified as having been incurred in one of the four countries of the United Kingdom.
  703

  Identifiable Public Expenditure1

  1982–83

  1983–84

  1984–85

  1985–86

  1986–87

  £ million

  England

  2,709·6

  3,154·1

  3,264·5

  2,866·3

  2,558·1

  Scotland

  686·9

  717·0

  656·3

  614·7

  643·4

  Wales

  125·3

  194·9

  137·1

  126·1

  158·4

  Northern Ireland

  161·9

  193·0

  211·0

  227·3

  237·6

  United Kingdom

  3,683·7

  4,259·0

  4,268·9

  3,834·4

  3,597·5

  £ per head

  England

  57·9

  67·3

  69·5

  60·8

  54·1

  Scotland

  132·9

  139·2

  127·5

  119·7

  125·6

  Wales

  44·6

  69·4

  48·8

  44·8

  56·2

  Northern Ireland

  105·3

  125·1

  136·1

  145·9

  151·6

  United Kingdom

  65·4

  75·6

  75·6

  67·7

  63·4

  1 Excludes certain expenditure such as Government net lending to public corporations.

  Figures prior to 1982–83 are not available on a consistent basis because of changes in definition that have taken place between different public expenditure White Papers. Figures for 1987–88 are not yet available. The figures given above cannot be further disaggregated but a more detailed functional analysis of United Kingdom public expenditure can be found in table 2.7 of "The Government's Expenditure Plans 1988–89 to 1990–91" (Cmnd. 288-I).

  Departmental Land and Buildings
  Mr. Gordon Brown
  To ask the Chancellor of the Exchequer if he will publish a table comparable with that

  Sales of Land and Buildings by Department, 1979–80 to 1990–91 (£ million)

  1979–80

  1980–81

  1981–82

  1982–83

  1983–84

  1984–85

  1985–86

  1986–87

  1987–88

  1988–89

  1989–90

  1990–91

  outturn

  outturn

  outturn

  outturn

  outturn

  outturn

  outturn

  outturn

  estimated outturn

  plans

  plans

  plans

  Defence

  45

  66

  54

  41

  32

  28

  60

  76

  68

  81

  50

  50

  Foreign and Commonwealth Office1

  —

  —

  2

  —

  3

  2

  12

  6

  10

  10

  10

  10

  Ministry of Agriculture, Fisheries and Food2

  9

  21

  13

  12

  11

  11

  20

  31

  29

  10

  10

  10

  Trade and Industry3

  3

  3

  2

  7

  11

  16

  10

  —

  —

  —

  —

  —

  Employment

  —

  —

  —

  1

  1

  1

  —

  3

  4

  —

  —

  —

  Transport

  32

  44

  66

  41

  44

  53

  51

  51

  90

  47

  40

  40

  DOE-Housing

  544

  792

  1,392

  1,965

  1,525

  1,355

  1,286

  1,497

  2,063

  1,665

  1,750

  1,830

  DOE-Other Environmental Services

  121

  192

  215

  288

  314

  394

  458

  634

  883

  853

  720

  690

  Home Office and Legal departments4

  22

  26

  26

  39

  70

  69

  70

  90

  48

  65

  50

  40

  Education and Science

  20

  25

  47

  46

  46

  79

  101

  118

  114

  105

  110

  110

  Arts and Libraries

  —

  8

  2

  4

  3

  2

  1

  —

  —

  —

  —

  —

  DHSS-Health and Personal Social Services

  15

  22

  25

  27

  45

  64

  103

  164

  221

  212

  210

  210

  DHSS-Social Security

  —

  —

  —

  —

  —

  —

  —

  —

  —

  —

  —

  —

  Scotland

  42

  81

  133

  190

  230

  251

  228

  245

  292

  292

  260

  240

  Wales

  19

  27

  102

  137

  90

  82

  84

  92

  116

  111

  110

  110

  Northern Ireland

  1

  —

  1

  3

  3

  4

  4

  8

  13

  13

  10

  10

  Chancellor's Departments

  —

  —

  4

  —

  —

  —

  —

  —

  —

  —

  —

  —

  Other Departments5

  5

  9

  7

  16

  8

  8

  24

  39

  38

  35

  40

  50

  Total

  879

  1,316

  2,092

  2,816

  2,436

  2,419

  2,512

  3,054

  3,989

  3,500

  3,360

  3,420

  1 Including Overseas Development Administration.

  2 Including Intervention Board for Agricultural Produce and Forestry Commission.

  3 Including Export Credits Guarantee Department.

  704
  given to the hon. Member for Sedgefield (Mr. Blair) in the Official Report, 27 January 1987, columns 229–30, for sales of land and buildings by Departments, including plans for 1990–91.

  Mr. Major
  The table shows sales of land and buildings by Department for the years 1979–80 to 1990–91. The figures included sales by local authorities and new towns as well as central Government and are consistent with the figures published in the 1988 public expenditure White Paper (Cm. 288).
  705
  4 This group comprises the Home Office, Lord Chancellor's Department, Northern Ireland Court Service, the Crown Prosecution Service, the Serious Fraud Office and the Crown Office, Procurator Fiscal Service and Lord Advocate's Department.

  5 Including Property Services Agency and Civil Superannuation.

  House Prices
  Mr. Gordon Brown
  To ask the Chancellor of the Exchequer if he will give the assumption on the rise in house prices in 1988–89, 1989–90 and 1990–91 built into the figures given for receipts from sales of housing in table 3.6 Cm. 288–1.

  Mr. Major
  It is not Government practice to publish assumptions which may be market sensitive.

  Interest Rates
  Mr. Gordon Brown
  To ask the Chancellor of the Exchequer if he will give the assumptions on interest rates for 1988–89, 1989–90 and 1990–91 used in calculating table 2.17 of Cm. 288–1.

  Mr. Lilley
  It is not the practice to give interest rate assumptions, which are market sensitive.

  Chartered Accountants
  Mr. Barry Field
  To ask the Chancellor of the Exchequer how many chartered accountants are employed in the Civil Service.

  Mr. Brooke
  About 275, or around a third of fully qualified accountants in the Civil Service.

  National Health Service
  Mr. Harry Cohen
  To ask the Chancellor of the Exchequer what is his estimate of the employment effect of(a) reducing the income tax take from higher-rate payers by £2 billion in a full year, (b) reducing the income tax take for standard rate payers by £2 billion in a full year and (c) increasing by £2 billion the resources of the National Health Service.

  Mr. Major
  It has not been the practice to publish estimates of the economic effects of changes in taxation or public expenditure.

  Tourism
  Mr. Barry Field
  To ask the Chancellor of the Exchequer what proposals are being made to the European Commission on taxation on tourists, in the light of the introduction of the European single market; and what representations he has received seeking a tourism or landing tax in the United Kingdom.

  Mr. Lilley
  The Government have made no proposals to the European Commission on taxation of tourists. My right hon. Friend has received a small number of representations about imposing a tax on arrivals in or departures from the United Kingdom.

  Pensioners
  Mr. Jack
  To ask the Chancellor of the Exchequer (1) what is his estimate of the cost of raising the tax allowance to £3,498, £3,848, £4,233, £4,656, £5,122, £5,634, respectively, for single pensioners aged 65 to 79 years;

  (2) what is his estimate of the cost of raising the tax allowance to £3,641, £4,005, £4,406, £4,846, £5,331, and £5,864, respectively, for single pensioners aged 80 years and over;
  706
  (3) what is his estimate of the cost of raising the tax allowance to £5,538, £6,093, £6,702, £7,372, £8,109 and £8,920, respectively, for married pensioners aged between 65 and 79 years;

  (4) what is his estimate of the cost of raising the tax allowance to £5,726, £6,298, £6,927, £7,621, £8,383 and £9,221, respectively, for pensioners over the age of 80 years.

  Mr. Norman Lamont
  [holding answers 23 May 1988]: The estimated costs of increasing the age allowances from the levels proposed in the 1988 Budget are shown in the tables. All estimates are based on a projection of the 1985–86 survey of personal incomes and are therefore provisional.

  Personal allowance

  1988–89 Full year cost

  Personal allowance

  1988–89 Full year cost

  £

  £ million

  £

  £ million

  Single aged 65–79

  Single aged 80 years and over

  13,180

  —

  13,310

  —

  3,498

  60

  3,641

  15

  3,848

  115

  4,005

  35

  4,233

  170

  4,406

  50

  4,656

  225

  4,846

  65

  5,122

  285

  5,331

  80

  5,634

  325

  5,864

  95

  Personal allowance

  1988–89 Full year cost

  Personal allowance

  1988–89 Full year cost

  £

  £ million

  £

  £ million

  Married aged 65–79

  Married aged 80 years and over

  15,035

  —

  15,205

  —

  5,538

  85

  5,726

  5

  6,093

  165

  6,298

  15

  6,702

  245

  6,927

  20

  7,372

  325

  7,621

  25

  8,109

  400

  8,383

  35

  8,920

  480

  9,221

  40

  1Proposed level of allowance in 1988–89.

  Pensioners
  Mr. Jack
  To ask the Chancellor of the Exchequer how many pensioner tax units there are for the following levels of gross taxable earnings(a) £3,000 to £4,000, (b) £4,000 to £5,000, (c) £5,000 to £6,000, (d) £6,000 to £7,000, (e) £7,000 to £8,000, (f) £8,000 to £9,000, (g) £9,000 to £10,000, (h) £10,000 to £11,000, and (i) over £11,000, respectively.

  Mr. Norman Lamont
  [holding answer 23 May 1988]: Estimates are given in the table. The estimates are based on projections of the 1985–86 survey of personal incomes and the 1985 family expenditure survey and are therefore provisional.

  Range of total income1

  Estimated number of aged tax units2 in 1988–89

  £ per year

  thousands

  3,000-

  1,100

  4,000-

  860

  5,000-

  490

  6,000-

  290

  7,000-

  200

  707

  Range of total income1

  Estimated number of aged tax units2 in 1988–89

  £ per year

  thousands

  8,000-

  180

  9,000-

  140

  10,000-

  110

  11,000 and over

  730

  1 Earnings, pensions and investment income.

  2 Married couples and single people aged 65 or over.

DEFENCE

  Staff Losses
  Mr. Cohen
  To ask the Secretary of State for Defence why there has been a consistent loss of professional and technological staff from his Department over the last five years; and if he will make a statement.

  Mr. Sainsbury
  The number of MOD professional and technical officers (P and TOs) fell from 23,400 to 14,700 between 1 April 1983 and 1 January 1988. Most of this reduction is accounted for by the transfer out of MOD employment of P and TOs in the royal dockyards (3,200) and the royal ordnance factories (2,700). The balance is attributable partly to the general reduction in MOD manpower numbers and partly to a shortfall in replacing normal losses.

  As stated in paragraphs 518 to 520 of the "Statement on Defence Estimates 1988" the problems of recruitment and retention of civilian staff are being tackled in several ways: for P and TOs especially, by improved pay arrangements, a new recruitment strategy, and building on the progress made by the formation of the defence engineering service.

  Jaguar
  Mr. Rogers
  To ask the Secretary of State for Defence what is the cost of the upgrading of the navigation attack system for the Royal Air Force Jaguar aircraft.

  Mr. Sainsbury
  The update to the Jaguar navigation attack system is nearing completion at a cost of some £40 million.

  Mr. Rogers
  To ask the Secretary of State for Defence what is the cost of the chaff and flare dispensers for Royal Air Force Jaguar aircraft.

  Mr. Sainsbury
  My noble Friend the Minister of State for Defence Procurement will write to the hon. Member.

  Mr. Rogers
  To ask the Secretary of State for Defence how much longer the Royal Air Force Jaguar aircraft will remain in Royal Air Force service.

  Mr. Ian Stewart
  The Jaguar is planned to remain in service with the Royal Air Force until it is replaced by the European fighter aircraft, which we hope will enter service in the mid-1990s. This process is expected to be completed around the turn of the century.

  Tornado
  Mr. Rogers
  To ask the Secretary of State for Defence how many Tornado F2/3 aircraft have been delivered to the Royal Air Force to date.
  708
  Mr. Sainsbury
  By the end of May 1988, a total of 94 aircraft had been delivered.

  No. 51 Squadron
  Mr. Rogers
  To ask the Secretary of State for Defence why there is no mention of No. 51 squadron in the appendix to the current year's "Statement on Defence Estimates".

  Mr. Ian Stewart
  Annex C of volume 1 of the "Statement on the Defence Estimates 1988" is primarily concerned with front-line units. 51 squadron is not classified as a front-line unit.

  AWACS
  Mr. Rogers
  To ask the Secretary of State for Defence what is the cost of the strengthening of runways and taxiways at Royal Air Force Waddington for AWACS aircraft.

  Mr. Freeman
  The cost of strengthening the runways and taxiways at Royal Air Force Waddington for the Boeing E-3 aircraft, AWACS, is £6·5 million. However, the opportunity has also been taken to carry out simultaneously other routine airfield pavement maintenance work at a further cost of approximately £1 million.

  Agusta Helicopters
  Mr. Rogers
  To ask the Secretary of State for Defence how many Agusta helicopters are in service with British forces.

  Mr. Ian Stewart
  A small number of Agusta helicopters are in service with British forces. It is not our practice to publish numbers of operational aircraft.

  Nuclear Test Veterans
  Mr. Ashley
  To ask the Secretary of State for Defence if he will ask the National Radiological Protection Board to examine the incidence of(a) cataracts, (b) arthritis, (c) diabetes and (d) deformed children amongst nuclear test veterans.

  Mr. Sainsbury
  As the right hon. Member is aware, the NRPB has after careful consideration of all the data available to it, made recommendations for relevant follow-up studies in its report. The Government have endorsed these recommendations which do not include the diseases referred to, which in any event are not included in any national register.

  HMS Hermione
  Mr. Dalyell
  To ask the Secretary of State for Defence, pursuant to his answer of 27 May, when he expects the investigation into the loss and subsequent discovery of a document concerning routine refit work on HMS Hermione to be completed.

  Mr. Ian Stewart
  The investigation has been completed. It is not our normal practice to disclose the results of such investigations. However, I am satisfied that the loss of the document in question was accidental and measures have been taken to try and prevent a recurrence.

  Gatwick Airport (Exercise)
  Mr. Tony Banks
  To ask the Secretary of State for Defence how many troops were involved in the security
  709
  exercise at Gatwick airport on 7 June; what was the purpose of the exercise; what equipment was deployed; and if any military personnel searched vehicles.

  Mr. Ian Stewart
  This was a routine security operation in support of the police. Such operations are conducted regularly for deterrent purposes. It is not the policy to give details of operational matters.

EMPLOYMENT

  School Leavers
  Mr. Paice
  To ask the Secretary of State for Employment in each of the years 1980–81 to 1987–88 and in projections for each year until 1990–91, how many school leavers aged 15, 16 and 17 years entered the employment market; how many of these gained places on the YTS or its predecessors; how many entered employment; how many were unemployed; of those entering the YTS, how many had employee status; and in the years after the introduction of the two-year YTS, how many second year trainees there were and how many of these had employee status.

  Mr. Cope
  The information which is available is given in the tables:

  Table 1

  Young People in the Labour Market—Great Britain Thousands

  Young People leaving School for the Labour Market1

  YTS Entrants (Financial year) Beginning in Year Shown)

  (Academic Year Ending in Year Shown)

  Age 15

  Age 16

  Age 17

  All

  1981

  500

  70

  60

  630

  n/a

  1982

  480

  90

  70

  640

  n/a

  1983

  490

  90

  80

  660

  333

  1984

  490

  80

  70

  640

  356

  1985

  470

  80

  70

  620

  350

  1986

  460

  80

  60

  600

  344

  1987

  440

  80

  60

  580

  2328

  Projections

  1988

  410

  80

  60

  550

  331

  1989

  380

  70

  60

  510

  363

  1990

  360

  70

  60

  480

  358

  1 Age at beginning of academic year and excluding leavers from further education. Figures may not add up due to rounding.

  2 Provisional figure.

  Table 2

  Young People1 in training on YTS—Great Britain thousands

  All

  With Employee Status

  In First Year

  In Second Year

  January

  1985

  276

  19

  n/a

  n/a

  1986

  274

  22

  n/a

  n/a

  1987

  318

  44

  266

  52

  21988

  395

  57

  243

  152

  1 Aged 18 or under at previous 31 August. Training Commission estimates based on information from the YTS Management Information System.

  2 Provisional figures.

  The other information requested is not readily available on a comparable basis and could be provided only at disproportionate cost.

  Litter and Industrial Waste
  Mr. Amess
  To ask the Secretary of State for Employment how many people are employed in(a) the United Kingdom, by region, and (b) Basildon, in the collection and disposal of litter and industrial waste; and if he will express the figures as a percentage of the total local work force.

  Mr. Lee
  Estimates are not separately available for the industries specified. The latest available figures for the regions of the United Kingdom are for employment in all sanitary services (class 92 of the standard industrial classification 1980) in December 1987. These cover refuse disposal, public cleansing, street cleaning, fumigation, disinfection, pest destroying (including treatment against woodworm and woodrot), sewage disposal and cleaning services (including window cleaning, chimney sweeping and units specialising in cleaning industrial, commercial and Government premises).

  The information is as follows. The figures are unadjusted for the effects of seasonal variations.

  Employees in employment in the Sanitary Services Industry

  Numbers as a percentage of the (Civilian) (Working Population1)

  South East

  170,000

  1·8

  East Anglia

  13,000

  1·3

  South West

  40,000

  2·0

  West Midlands

  37,000

  1·4

  East Midlands

  21,000

  1·1

  Yorkshire and Humberside

  31,000

  1·3

  North West

  27,000

  0·9

  North

  14,000

  1·0

  Wales

  12,000

  1·0

  Scotland

  35,000

  1·5

  Northern Ireland

  4,000

  0·6

  1 The Civilian Working Population is the sum of Employees in Employment, the Self Employed, and Unemployed.

  The available information for Basildon is from the September 1984 census of employment. There were then 500 employees employed in the sanitary services industry. This represents 1 per cent. of the sum of all employees in employment and the unemployed in the area at that time.

  Fatal Accidents
  Mr. Flannery
  To ask the Secretary of State for Employment if he will publish in the Official Report (a) the number of fatal accidents investigated by Her Majesty's factory inspectorate, (b) the number of prosecutions arising from these investigations and (c) the number of these prosecutions taken in the Crown court, in each of the last five years.

  Mr. Nicholls
  The numbers of fatal accidents investigated by the Health and Safety Executive's factory inspectorate are set out in the table:

  Year

  Fatal accidents investigated

  1983

  384

  1984

  414

  1985

  412

  1986

  353

  1987

  365

  711
  The numbers of informations laid relating to prosecutions by the factory inspectorate are set out in the table. Not all these cases arose from accidents at work. The proportion of these that relates to fatal accidents and the number of subsequent prosecutions taken in the Crown court could be provided only at disproportionate cost. Information for 1987–88 is not yet available.

  Year

  Information laid

  1982

  2,134

  1983

  1,989

  1984

  1,882

  1985

  1,842

  11986

  Quarter 1

  446

  21986–87

  1,690

  1 Data for the 3-month period January 1986 to March 1986.

  2 Provisional data for the 12-month period April 1986 to March 1987.

  Health and Safety Executive (Inspectors)
  Mr. Flannery
  To ask the Secretary of State for Employment if he will publish in the Official Report the location and the number of inspectors at each grade, and each office address, of each Health and Safety Executive office in each year since 1978.

  Mr. Nicholls
  The information requested could be obtained only at disproportionate cost.

  Early Retirement
  Mr. Fatchett
  To ask the Secretary of State for Employment whether he has any plans to offer to disabled employees the opportunity for early retirement similar to that existing under the job release scheme; and if he will make a statement.

  Mr. Lee
  No. The job release scheme was closed on 31 January 1988 and its resources redirected to measures which would help longer-term unemployed people (including those with disabilities) more effectively. There are at present no plans to replace it.

  Employment Training
  Mr. Wareing
  To ask the Secretary of State for Employment what action he plans to take to protect projects which provide services for disabled people when employment training replaces the community programme in September.

  Mr. Nicholls
  Project-based training will be an important part of employment training with some 194,000 project-based opportunities in the first year, broadly the present level of community programme provision. I hope that most current community programme projects will move forward into employment training, bringing with them the worthwhile services that they currently provide.

  Enterprise Allowance
  Mr. Hayward
  To ask the Secretary of State for Employment, if he will make a statement on the recent value-for-money scrutiny of the enterprise allowance scheme.

  Mr. Cope
  The efficiency unit conducted a scrutiny of the enterprise allowance scheme in 1987 as part of its 712
  continuing programme of work. I have now considered the report prepared by the scrutiny team. The scrutiny found the scheme offered good value for money, and no major changes to the operation or rules of the scheme are planned. The report makes recommendations for improving the efficiency of the administration of the scheme, and for improving the success and growth of the businesses established through it. My Department has drawn up an action plan in response to the report and we will be introducing a number of pilot projects to implement the team's recommendations. These involve requiring every applicant to complete a simple business plan as a condition of entry to the scheme and reducing the number of monitoring visits made by officials. We also intend to take steps to make more and better training available to those applying for the scheme. I have arranged for copies of the scrutiny report and my Department's commentary to be placed in the Library.

  Single European Market
  Mr. Blunkett
  To ask the Secretary of State for Employment what advice his Department is giving to trade unions about the creation of a single European market in 1992; and if he will make a statement.

  Mr. Cope
  [holding answer 9 June 1988]: The Government aim, through their awareness campaign on the single European market, to stimulate everyone connected with business to be aware of the challenge of 1992, and to take action accordingly. The opportunities that the single market offers for boosting growth and so increasing employment are important for all union members. We hope that union members will encourage their employers to anticipate and take full advantage of I he opportunities.

HOUSE OF COMMONS

  Sittings of the House
  Mr. Amess
  To ask the Lord President of the Council if he will publish in the Official Report a consolidated list of the occasions which the House has sat later than 1.30 am since 1958.

  Mr. Wakeham
  I regret that it has not been possible to provide this information in the time available. I will reply shortly.

  Legislation
  Mr. Amess
  To ask the Lord President of the Council (1) if he will publish in the Official Report the total number of (a) Government Bills and (b) private Members' Bills introduced in each Session since 1958;

  (2) what percentage of (a) Government Bills, and (b) Private Members' Bills received the Royal Assent in each Session since 1958.

  Mr. Wakeham
  The information is as follows:

  Session

  Government Bills

  Private Members' Bills

  Number

  Per cent.

  Number

  Per cent.

  1958–59

  56

  98

  43

  48

  1959–60

  53

  100

  42

  45

  1960–61

  48

  94

  55

  36

  713

  Session

  Government Bills

  Private Members' Bills

  Number

  Per cent.

  Number

  Per cent.

  1961–62

  39

  100

  53

  38

  1962–63

  43

  98

  50

  36

  1963–64

  64

  98

  86

  40

  1964–65

  66

  98

  80

  21

  1965–66

  36

  58

  38

  —

  1966–67

  103

  100

  107

  22

  1967–68

  65

  97

  77

  17

  1968–69

  54

  94

  94

  13

  1969–70

  63

  60

  81

  19

  1970–71

  76

  100

  67

  18

  1971–72

  59

  100

  82

  21

  1972–73

  59

  100

  85

  18

  1973–74

  33

  45

  42

  —

  1974

  39

  90

  39

  18

  1974–75

  81

  90

  86

  12

  1975–76

  76

  95

  85

  19

  1976–77

  49

  86

  89

  12

  1977–78

  49

  100

  89

  12

  1978–79

  55

  80

  58

  5

  1979–80

  71

  100

  125

  8

  1980–81

  58

  98

  80

  18

  1981–82

  47

  98

  93

  11

  1982–83

  48

  85

  81

  12

  1983–84

  60

  100

  118

  11

  1984–85

  56

  96

  98

  21

  1985–86

  51

  96

  114

  18

  1986–87

  39

  92

  85

  18

  1987–88 to date

  43

  n/a

  88

  n/a

  Mr. Amess
  To ask the Lord President of the Council, if he will publish in the Official Report a list of private Members' Bills which were introduced (a) under Standing Order 58, (b) under the ten-minute rule, and (c) ballot Bills, which received the Royal Assent in each session since 1958.

  Mr. Wakeham
  The information is as follows:

  A. Private Members' Bills introduced under S.O. 58 receiving Royal Assent

  1958–59

  Agricultural Improvement Grants

  Hospital of St. Mary Magdalene and other Charities (Newcastle upon Tyne) Charity

  Hospital of St. Nicholas (Salisbury) Charity

  Jesus Hospital (Rothwell) Charity

  Poor's Coal Charity (Wavendon) Charity

  Small Lotteries and Gaming Act 1956 (Amendment) Solicitors (Amendment) [Lords]

  Supreme Court of Judicature (Amendment)

  1959–60

  Bromley College and other Charities

  Chipping Sodbury Town Trust

  Game Laws (Amendment)

  House of Commons Members' Fund

  Marriage (Enabling) [Lords]

  Pawnbrokers

  United Charities of Nathaniel Waterhouse, and other Charities (Halifax)

  1960–61

  Banisters (Qualification for Office)

  Court of Chancery of Lancaster (Amendment)

  Credit-Sale Agreements (Scotland)

  Nurses (Amendment)

  Oaths Act 1888 (Amendment)

  Private Street Works

  Public Authorities (Allowances)

  Small Estates (Representation)

  1961–62

  Animals (Cruel Poisons) [Lords]

  British Museum [Lords]

  Drainage Rates

  714

  House of Commons Members' Fund

  Law Reform (Damages and Solatium) (Scotland)

  Law Reform (Husband and Wife)

  Marriage (Wales and Monmouthshire)

  Recorded Delivery Service

  1962–63

  Dog Racing (Betting Days)

  Drainage Rates

  Performers' Protection [Lords]

  Public Lavatories (Turnstiles)

  Stock Transfer [Lords]

  1963–64

  Animals (Restriction of Importation)

  British Nationality (No. 2)

  Burgh Police (Amendment) (Scotland)

  Dangerous Drugs

  Divorce (Scotland) [Lords]

  Elections (Welsh Forms)

  Episcopal Church (Scotland) [Lords]

  Films [Lords]

  Fireworks

  Hairdressers (Registration)

  Married Women's Property [Lords]

  National Health Service (Hospital Boards)

  New Forest [Lords]

  Pharmacy and Poisons (Amendment)

  Protection of Animals (Anaesthetics) [Lords]

  Road Traffic

  Salmon and Freshwater Fisheries Act 1923 (Amendment)

  Trustee Savings Banks [Lords]

  1964–65

  British Nationality

  Criminal Justice

  Criminal Procedure (Attendance of Witnesses)

  Criminal Procedure (Scotland)

  Justices of the Peace [Lords]

  Local Government (Scotland)Act 1947 (Amendment) (No. 2)

  Lost Property (Scotland)

  Merchant Shipping

  Murder (Abolition of Death Penalty)

  Salmon and Freshwater Fisheries [Lords]

  Solicitors [Lords]

  Solicitors (Scotland) [Lords]

  1965–66

  None

  1966–67

  Deer (Amendment) (Scotland) [Lords]

  Land Registration [Lords]

  Llangollen International Music Eisteddfod

  Matrimonial Homes [Lords]

  Merchant Shipping

  Protection of Birds [Lords]

  Refreshment Houses [Lords]

  Slaughter of Poultry

  1967–68

  Sale of Venison (Scotland) (No. 2)

  Wills

  1968–69

  Betting, Gaming and Lotteries (Amendment) [Lords]

  Employers' Liability (Compulsory Insurance)

  Public Health (Recurring Nuisances)

  Sharing of Church Buildings [Lords]

  1969–70

  Education (School Milk)

  Food and Drugs (Milk)

  Game [Lords]

  Indecent Advertisements (Amendment) [Lords]

  Marriage (Registrar General's Licence)

  New Forest [Lords]

  Proceedings against Estates [Lords]

  Riding Establishments [Lords]

  Road Traffic (Disqualification)

  715
  1970–71

  Carriage of Goods by Sea

  Powers of Attorney

  Welsh National Opera Company

  1971–72

  Affiliated Proceedings (Amendment) (No. 2)

  Chronically Sick and Disabled Persons (Scotland)

  Civil Evidence

  Harbours, Piers and Ferries (Scotland) [Lords]

  National Health Service (Family Planning) Amendment

  Performers' Protection [Lords]

  Police

  Social Work (Scotland) [Lords]

  Sunday Cinema [Lords]

  Sunday Theatre (No. 2) [Lords]

  1972–73

  Badgers [Lords]

  Dentists (Amendment)

  Gaming (Amendment)

  Rate Rebate

  Sea Fisheries (Shellfish)

  Succession (Scotland) [Lords]

  1973–74

  None

  1974

  Lord Chancellor (Tenure of Office and Discharge of Ecclesiastical Functions) [Lords]

  Mines (Working Facilities and Support)

  Parks Regulation (Amendment) [Lords]

  1974–75

  Guard Dogs

  Hearing Aid Council (Extension)

  1975–76

  Licensing (Amendment) [Lords]

  Motor-Cycle Crash-Helmets (Religious Exemption)

  Protection of Birds (Amendment)

  Solicitors (Scotland) [Lords]

  1976–77

  Farriers Registration (Amendment) [Lords]

  Licensing (Amendment)

  Presumption of Death (Scotland)

  Roe Deer (Close Seasons)

  Unfair Contract Terms

  1977–78

  Chronically Sick and Disabled Persons (Northern Ireland)

  Education (Northern Ireland) [Lords]

  Import of Live Fish (Scotland) [Lords]

  Industrial and Provident Societies [Lords]

  Theatres Trust (Scotland)

  1978–79

  Confirmation to Small Estates (Scotland)

  Criminal Evidence [Lords]

  Films

  1979–80

  Betting, Gaming and Lotteries (Amendment) [Lords]

  Gaming (Amendment) [Lords]

  Import of Live Fish (England and Wales)

  Licensing (Amendment) (No. 2)

  Representation of the People

  1980–81

  Countryside (Scotland)

  Disused Burial Grounds (Amendment) [Lords]

  Food and Drugs (Amendment)

  Forgery and Counterfeiting [Lords]

  Licensing (Amendment) [Lords]

  Matrimonial Homes and Property [Lords]

  1981–82

  Copyright Act 1956 (Amendment) [Lords]

  Deer (Amendment) (Scotland) [Lords]

  Firearms

  716
  1982–83

  British Nationality (Falkland Islands) [Lords]

  Coroners' Juries

  National Audit

  Pet Animals Act 1951 (Amendment) [Lords]

  1983–84

  Education (Amendment) (Scotland) [Lords]

  Law Reform (Husband and Wife) (Scotland)

  Lotteries (Amendment) [Lords]

  1984–85

  Agricultural Training Board

  Betting, Gaming and Lotteries (Amendment) [Lords]

  Charities [Lords]

  Dangerous Vessels [Lords]

  Hill Farming

  Licensing (Amendment) [Lords]

  Prohibition of Female Circumcision

  Wildlife and Countryside (Service of Notices)

  1985–86

  Forestry

  Gaming (Amendment)

  Health Service Joint Consultative Committees (Access to Information)

  Highways (Amendment)

  Incest and Related Offences (Scotland) [Lords]

  Law Reform (Parent and Child) (Scotland)

  Marriage (Prohibited Degrees of Relationship) [Lords]

  Marriage (Wales)

  Prevention of Oil Pollution [Lords]

  Protection of Children (Tobacco)

  1986–87

  Animals (Scotland) [Lords]

  Billiards (Abolition of Restrictions) [Lords]

  Deer

  Gaming (Amendment) [Lords]

  Licensing (Restaurant Meals) [Lords]

  Prescription (Scotland)

  Protection of Animals (Penalties)

  Register of Sasines (Scotland)

  Registered Establishments (Scotland)

  1987–88 to date

  Land Registration [Lords]

  B. Private Members' Bills introduced under the Ten Minute Rule receiving Royal Assent

  1958–59

  Eisteddfod

  Housing (Underground Rooms)

  Obscene Publications

  Police Federation

  Restriction of Offensive Weapons

  1959–60

  Adoption

  Oil Burners (Standards)

  1960–61

  Companies (Floating Charges) (Scotland)

  Restriction of Offensive Weapons Act 1959 (Amendment)

  1961–62

  Penalties for Drunkenness

  1962–63

  None

  1963–64

  Law of Property (Joint Tenants)

  Local Government (Development and Finance) (Scotland)

  New Towns (No. 2)

  Young Persons (Employment)

  1964–65

  Shops (Early Closing Days)
  717
  1965–66

  None

  1966–67

  Farm and Garden Chemicals

  Private Places of Entertainment (Licensing)

  Sexual Offences (No. 2)

  Vessels Protection

  1967–68

  Design Copyright

  Hearing Aid Council

  Highlands and Islands Development (Scotland)

  1968–69

  Architects Registration (Amendment)

  Licensing (Scotland)

  National Mod (Scotland)

  Tattooing of Minors

  1969–70

  Trees

  1970–71 and 1971–72 None

  1972–73

  Breeding of Dogs

  London Cab Reform

  1973–74 to 1979–80 None

  1980–81

  Transport Act 1962 (Amended)

  1981–82

  None

  1982–83

  Solvent Abuse (Scotland)

  1983–84

  None

  1984–85

  Rent (Amendment)

  Town and Country Planning (Amendment)

  1985–86

  None

  1986–87

  None

  1987–88 to date

  None

  C. Ballot Bills receiving Royal Assent

  1958–59

  Criminal Justice Administration (Amendment)

  Family Allowances and National Insurance

  Fatal Accidents

  Intestate Husbands' Estate (Scotland)

  Landlord and Tenant (Furniture and Fittings)

  Legitimacy

  1959–60

  Abandonment of Animals

  Clean Rivers (Estuaries and Tidal Waters)

  Corporate Bodies Contracts

  First Offenders (Scotland)

  Noise Abatement

  Offices

  Public Bodies (Admission to Meetings)

  Road Traffic (Amendment)

  Road Traffic (Driving of Motor Cycles)

  Wages Arrestment Limitation (Amendment) (Scotland)

  1960–61

  Carriage by Air

  718

  Consumer Protection

  Highways (Miscellaneous Provisions)

  Home Safety

  Industrial and Provident Societies

  Mock Auctions

  Police Federation

  Printer's Imprint

  Rivers (Prevention of Pollution)

  Rural Water Supplies and Sewerage

  1961–62

  Agriculture and Forestry Associations

  Air Guns and Shot Guns etc

  Carriage by Air (Supplementary Provisions)

  Coal Consumers' Councils (Northern Irish Interests)

  Landlord and Tenant

  Local Authorities (Historic Buildings)

  Local Government (Records)

  Lotteries and Gaming

  National Assistance Act 1948 (Amendment)

  Police Federations

  Shops (Airports)

  1962–63

  Animal Boarding Establishments

  Corn Rents

  Deer

  Forestry (Sale of Land) (Scotland)

  Limitation

  Local Authorities (Land)

  Local Government (Financial Provisions)

  Matrimonial Causes and Reconciliation

  Nursing Homes

  Oaths and Evidence (Overseas Authorities) and Countries

  Oil in Navigable Waters

  Sheriff Courts (Civil Jurisdiction and Procedure) (Scotland)

  Wills

  1963–64

  Adoption

  Betting, Gaming and Lotteries (Amusements with Prizes)

  Criminal Procedure (Right of Reply)

  Local Government (Pecuniary Interests)

  Merchant Shipping

  Nurses

  Protection of Birds Act 1954 (Amendment)

  Riding Establishments

  Scrap Metal Dealers

  Trade Union (Amalgamations etc)

  Trading Stamps

  Universities and College Estates

  1964–65

  Administration of Estates (Small Payments)

  Carriage of Goods by Road

  Highways (Amendment)

  Public Health (Notification of Births)

  1965–66

  None

  1966–67

  Abortion

  Antarctic Treaty

  Civic Amenities

  Industrial and Provident Societies

  Licensing (Amendment)

  Licensing (Certificates in Suspense) (Scotland)

  National Health Service (Family Planning)

  National Insurance (Industrial Injuries) (Amendment)

  Road Traffic (Amendment)

  Road Traffic (Driving Instruction)

  Teachers of Nursing

  Tokyo Convention

  1967–68

  Adoption

  Caravan Sites

  Clean Air

  Domestic and Appellate Proceedings (Restriction of

  719
  Publicity)

  Friendly and Industrial and Provident Societies

  Local Authorities' Mutual Investment Trust

  Maintenance Orders

  Theatres

  1968–69

  Auctions (Bidding Agreements)

  Divorce Reform

  Employers' Liability (Defective Equipment)

  Ponies

  1969–70

  Chronically Sick and Disabled Persons

  Conservation of Seals

  Law Reform (Miscellaneous Provisions)

  Local Government (Footpaths and Open Spaces) (Scotland)

  Parish Councils and Burial Authorities (Miscellaneous Authorities)

  1970–71

  Administration of Estates

  Betting, Gaming and Lotteries (Amendment)

  Consumer Protection

  Dangerous Litter

  Interest on Damages (Scotland)

  Law Reform Miscellaneous Provisions

  Motor Vehicles (Passenger Insurance)

  Nullity of Marriage

  Unsolicited Goods and Services

  1971–72

  Carriage by Railway

  Defective Premises

  Matrimonial Proceedings (Polygamous Marriages)

  National Insurance (Amendment)

  Salmon and Freshwater Fisheries

  Trade Descriptions

  Trading Representations (Disabled Persons) (Amendment)

  1972–73

  Domicile and Matrimonial Proceedings

  Employment Agencies

  Employment of Children

  Hallmarking

  Heavy Commercial Vehicles (Control and Regulations)

  Law Reform (Diligence) (Scotland)

  Protection of Wrecks

  1973–74

  None

  1974

  Carriage of Passengers by Road

  Education (Mentally Handicapped Children) (Scotland)

  Rehabilitation of Offenders

  Town and Country Amenities

  1974–75

  Conservation of Wild Creatures and Wild Plants

  Evidence (Proceedings in Other Jurisdictions)

  Farriers (Registration)

  International Road Haulage Permits

  Litigants in Person (Costs and Expenses)

  Mental Health (Amendment)

  Mobile Homes

  Unsolicited Goods and Services (Amendment)

  1975–76

  Chronically Sick and Disabled Persons (Amendment) (No. 2)

  Congenital Disabilities (Civil Liability)

  Dangerous Wild Animals

  Divorce (Scotland) (No. 2)

  Domestic Violence and Matrimonial Proceedings

  Explosives (Age of Purchase &c.)

  Food and Drugs (Control of Food Premises)

  Industrial Common Ownership

  Representation of the People (Armed Forces)

  720

  Sexual Offences (Amendment)

  Stock Exchange (Completion of Bargains)

  Theatres Trust

  1976–77

  Control of Food Premises (Scotland)

  Housing (Homeless Persons)

  Insurance Brokers (Registration)

  Minibus

  Rentcharges

  Town and Country Planning (Amendment)

  1977–78

  Civil Liability (Contribution)

  Consumer Safety

  Internationally Protected Persons

  Local Government

  Protection of Children

  Rating (Disabled Persons)

  1978–79

  None

  1979–80

  Concessionary Travel for Handicapped Persons (Scotland)

  Coroners

  Deer

  Licensed Premises (Exclusion of Certain Persons)

  Married Women's Policies of Assurance (Scotland) (Amendment)

  1980–81

  Disabled Persons (No. 2)

  Horserace Betting Levy

  Indecent Displays (Control)

  Industrial Diseases (Notification)

  Licensing (Alcohol Education and Research)

  Local Government and Planning (Amendment)

  Zoo Licensing (No. 2)

  1981–82

  Children's Homes

  Cinematograph (Amendment)

  Food and Drugs (Amendment)

  Forfeiture

  Gaming (Amendment)

  Planning Inquiries (Attendance of Public)

  Supply of Goods and Services

  1982–83

  Copyright (Amendment)

  Diseases of Fish

  Level Crossings

  Licensing (Occasional Permissions)

  Road Traffic (Driving Licences)

  1983–84

  Agriculture (Amendment)

  Anatomy

  Betting, Gaming and Lotteries Amendment) (No. 2)

  Child Abduction

  Cycle Tracks

  Juries (Disqualification)

  Prescription and Limitation (Scotland)

  Road Traffic (Driving Instruction)

  Trade Marks (Amendment)

  Video Recordings

  1984–85

  Charter Trustees

  Controlled Drug (Penalties)

  Copyright (Computer Software) (Amendment)

  Gaming (Bingo)

  Hospitals Complaints Procedure

  Intoxicating Substances (Supply)

  Local Government (Access to Information)

  Motor-Cycle Crash Helmets (Restriction of Liability)

  Road Traffic (Production of Documents)

  Sexual Offences

  Wildlife and Countryside (Amendment)

  721
  1985–86

  Children and Young Persons (Amendment)

  Civil Protection in Peacetime

  Consumer Safety (Amendment)

  Corneal Tissue

  Disabled Persons (Services, Consultation and Representation)

  Drainage Rates (Disabled Persons)

  Horticultural Produce

  Industrial Training

  Protection of Military Remains

  Road Traffic Regulation (Parking)

  Safety at Sea

  1986–87

  Access to Personal Files

  Agricultural Training Board

  AIDS Control

  Crossbows

  Crown Proceedings (Armed Forces)

  Motorcycle Noise

  1987–88 to date

  None

  Mr. Amess
  To ask the Lord President of the Council if he will list those Bills which completed all stages in one sitting for each session since 1958, together with the dates of the sitting.

  Mr. Wakeham
  The information is as follows:

  Presentation, First Reading to Third Reading
  Session 1971–72

  23rd February 1972

  Northern Ireland Bill

  Session 1973–74

  7th February 1974

  Appropriation Bill

  Session 1978–79

  3rd April 1979

  Finance Bill

  Session 1979–80

  28th October 1980

  Imprisonment (Temporary Provisions) Bill

SCOTLAND

  Elsie Inglis Maternity Hospital
  Mr. Darling
  To ask the Secretary of State for Scotland what representations he has received in connection with Lothian health board's proposal to close the Elsie Inglis maternity hospital in Edinburgh.

  Mr. Michael Forsyth
  My right hon. and learned Friend has received a total of around 330 letters from MPs, individuals and groups.

  Mr. Darling
  To ask the Secretary of State for Scotland when he proposes to make his decision on the proposal by Lothian health board to close the Elsie Inglis maternity hospital in Edinburgh; and if he will make a statement.

  Mr. Michael Forsyth
  My right hon. and learned Friend has today approved a restructuring of obstetric services in Lothian, which means the closure from 1 August 1988 of the Elsie Inglis memorial maternity hospital. He took particular account of the fact that there has been an oversupply and underuse of obstetric beds in Lothian for a number of years and, without change, this would be even worse from 1 August when a consultant-led obstetric 722
  service will be available for the first time at Borders general hospital. He also took account of the fact that the board's proposals have the support of its professional advisory committees and that the resources released will be fully available to permit the board to develop and improve services within its area.

  Legal Aid
  Sir Hector Monro
  To ask the Secretary of State for Scotland whether he has made arrangements to deal with cases where, in terms of section 18 of the Legal Aid (Scotland) Act 1986, the court may not modify the loser's expenses in a civil action in which both parties are assisted persons.

  Lord James Douglas-Hamilton
  This unintended consequence of section 18 will be remedied by the provisions of schedule 4 to the Legal Aid Bill. I have authorised the Scottish Legal Aid Board to deal by write off with cases which arise before the Bill comes into force. In effect, the expenses of losing assisted persons will be borne by the Scottish legal aid fund exactly as if the court had modified them.

  Hospital Patients
  Mr. Graham
  To ask the Secretary of State for Scotland how many people have spent more than three months in hospital in(a) Scotland, (b) England, (c) Wales and (d) Northern Ireland in each year since 1979.

  Mr. Michael Forsyth
  [holding answer 27 May 1988]: Detailed information including length of stay is held centrally only for NHS hospitals. Corresponding information is not held for private hospitals. Readily available information relates not to individual patients but to discharges (including deaths) of patients from hospital after separate episodes of care. The same patient may therefore be counted more than once. The information in the table relates to the number of discharges of patients after a stay of more than three months from all NHS hospitals, except maternity hospitals, in eayc country and in each calendar year. It does not include people who spent more than three months in hospital and who were still in hospital at the end of the year because information held centrally is incomplete. Many long-stay patients are therefore excluded.

  Scotland

  England1

  Wales

  Northern2Ireland

  1979

  10,321

  93,700

  5,288

  3,070

  1980

  9,105

  88,823

  5,433

  2,600

  1981

  9,656

  87,599

  5,331

  2,990

  1982

  9,775

  87,560

  5,167

  3,560

  1983

  10,193

  86,540

  5,062

  3,380

  1984

  9,863

  87,460

  5,323

  3,190

  1985

  10,299

  84,830

  5,257

  2,700

  1986

  9,828

  n.a.

  4,974

  3,330

  1 The non-psychiatric component is estimated from a 10 per cent, sample of discharge records.

  2 Excludes discharges from mental handicap hospitals.

  Electricity Generation
  Mr. Kennedy
  To ask the Secretary of State for Scotland what is the average cost per kilowatt hour of electricity generation from(a) the North of Scotland Hydro-Electricity Board and (b) the South of Scotland Electricity Board.
  723
  Mr. Lang
  [holding answer 28 March 1988]: The average cost of generation, including electricity derived from interchange and purchases, borne by both Scottish electricity boards under their joint generating agreement in 1986–87 was 1·97p per kilowatt hour. An analysis of the boards' costs is contained in their annual reports for 1986–87, copies of which are available in the Library of the House.

SOCIAL SERVICES

  Means-tested Benefits
  Mr. Squire
  To ask the Secretary of State for Social Services what is his Department's budget devoted to promoting increased take-up of means-tested benefits.

  Mr. Portillo
  The Department's planned budget for publicising social security is £14 million for 1988–89.

  Slimming Products (Safety)
  Mrs. Golding
  To ask the Secretary of State for Social Services when the report of the advisory committee into the safety of slimming products will be available; and if he will make a statement.

  Mrs. Currie
  Guar gum and glucomannan are widely used as stabilisers in food and are approved for such use under regulations. It is the level of these substances in certain slimming products which has created some concern.

  Owner occupiers in receipt of Supplementary Benefit (Great Britain)

  1981

  1982

  1983

  1984

  11985

  1986

  31987

  1. Number of owner occupiers on Supplementary Benefit receiving help with mortgage interest (000s)

  196

  235

  242

  277

  —

  356

  334

  2. Total amount included in benefit assessments for help with mortgage interest (£ million)

  2124

  2170

  152

  219

  —

  351

  335

  3. Average weekly amount included in individual assessments (£)

  12·18

  13·87

  12·12

  15·18

  —

  18·96

  19·31

  Source: Annual Statistical Enquiry.

  1 No figures available for 1985.

  2 Data collected on a different basis and not directly comparable.

  3 Provisional figures.

  Disabled Persons
  Mr. Wigley
  To ask the Secretary of State for Social Services, pursuant to his answer to the hon. Member for Caernarfon of 19 May,Official Report, column 559, why no meetings have been held with representatives of local authorities on the implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986 since October 1987.

  Mr. Scott
  I refer the hon. Member to my reply to the hon. Member for Monklands, West (Mr. Clarke) on 7 June at column 573.

  Total expenditure on salaries and wages—Nurses and midwives

  1982–83

  1983–84

  1984–85

  1985–86

  1986–87

  Mersey Region

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  Chester

  12,102

  Nil

  12,823

  Nil

  13,529

  Nil

  14,301

  Nil

  15,451

  Nil

  Crewe

  11,339

  Nil

  11,977

  Nil

  13,033

  0·01

  14,095

  0·03

  15,201

  0·22

  Halton

  3,347

  Nil

  3,468

  0·12

  3,627

  0·28

  4,850

  0·79

  5,713

  1·96

  Macclesfield

  11,148

  0·01

  11,765

  —

  12,459

  0·08

  12,969

  0·05

  13,970

  0·36

  Warrington

  14,920

  Nil

  16,275

  Nil

  17,374

  Nil

  18,629

  Nil

  20,291

  Nil

  Liverpool

  36,143

  0·19

  36,535

  0·32

  38,170

  1·09

  40,335

  1·06

  44,577

  1·24

  St. Helens & Knowsley

  18,557

  Nil

  19,309

  Nil

  20,683

  Nil

  21,902

  Nil

  23,751

  Nil

  724
  We are seeking expert advice on the potential risks associated with taking these products and expect to obtain that in July. However, if the advice is to cast doubt on the safety of the products we shall then need to consider what action can be taken to control them, without affecting the proper use of these substances as stabilisers in food.

  Ambulance Service
  Mr. Evennett
  To ask the Secretary of State for Social Services how many ambulance service vehicles in England and Wales are used as emergency ambulances; and what proportion are equipped with cardiac defibrillators.

  Mrs. Currie
  Information is not available centrally, and could be obtained only at disproportionate cost.

  Mortgage Interest
  Mr. Soley
  To ask the Secretary of State for Social Services what has been the cost of providing supplementary benefit to assist with mortgage interest and/or ground rent; what were the numbers of claimants and the average weekly payments for the years 1979 to 1988; and what is the estimate for the current year for the present system of support.

  Mr. Portillo
  The available figures are shown in the table. Information specifically on assistance with ground rent is not collected centrally nor, prior to 1981, was information on mortgage interest. No specific estimate has been made of expenditure on these items in the current year.

  Nurses
  Mr. Wareing
  To ask the Secretary of State for Social Services what was the cost of nurses employed by each district health authority in the Mersey region in each of the last five years, showing what percentage of the cost resulted from the employment of agency nurses in each case.

  Mr. Newton
  The information requested for the latest available five-year period is shown in the table:
  725

  1982–83

  1983–84

  1984–85

  1985–86

  1986–87

  Mersey Region

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  £ thousand

  Non-NHS per cent.

  Southport & Formby

  8,410

  0·06

  8,605

  0·01

  8,992

  0·08

  9,432

  0·03

  10,279

  0·08

  South Sefton

  15,005

  0·07

  15,323

  Nil

  16,108

  Nil

  17,118

  Nil

  18,621

  —

  Wirral

  20,499

  Nil

  20,505

  Nil

  21,178

  Nil

  22,164

  Nil

  24,133

  Nil

  Districts Total

  151,470

  0·06

  156,585

  0·08

  165,153

  0·27

  175,795

  0·27

  191,987

  0·39

  Mersey RHA

  408

  1·64

  459

  1·19

  481

  0·89

  537

  1·53

  597

  0·82

  Region Total

  151,878

  0·06

  157,044

  0·08

  165,634

  0·27

  176,332

  0·28

  192,584

  0·39

  Note:The percentage figures show the proportion of total expenditure attributable to the employment of non-National Health Service (agency, etc.) nursing and midwifery staff. Insignificant percentage figures (ie less than 0·005 per cent.) have been indicated by the use of a dash (—).

  Source:Annual accounts submitted to the Department by the health authorities comprising the Mersey region.

  Community Care
  Mr. Wareing
  To ask the Secretary of State for Social Services if he will make a statement on the recent statements of the Health Service Commissioner on the issue of community care for mentally handicapped people.

  Mrs. Currie
  The Health Service Commissioner has investigated a number of complaints relating to community care for mentally handicapped people. We are studying the published reports of these cases and will be considering whether any advice needs to be given to health authorities in the light of them.

  Maternity Payments
  Mr. Nicholas Brown
  To ask the Secretary of State for Social Services how many women claimed maternity grants in the last year of availability in Kensington; and how many have received social fund maternity payments in the first years of availability.

  Mr. Portillo
  A total of 726 claims for non-contributory maternity grants were made from 7 April 1986 to 5 April 1987 in the Kensington DHSS local office area. 202 awards for social fund maternity payments were made from 6 April 1987 to 10 April 1988.

  Social Fund
  Mr. Madden
  To ask the Secretary of State for Social Services when information on the first month's operation of the social fund is to be placed in the Library; if he will list the type of information about the social fund to be placed in the Library monthly; if he intends to issue monthly releases to the media to coincide with the placing of information in the Library; and if he will make a statement.

  Mr. Portillo
  As I explained in a letter to the hon. Member on 26 May, data for the first month of operation of the social fund have been delayed due to technical problems. These should be resolved shortly. I have arranged for data for May to be placed in the Library next week, as these have not been affected by the same problems. Details of the monthly publication of data on the operation of the social fund were announced in my reply to the hon. Member for Derby, South (Mrs. Beckett) on 6 May at column 656. Press inquiries for data will be met by the Department in the normal way.

  Supplementary Benefit
  Mr. Clay
  To ask the Secretary of State for Social Services if he will publish the latest figures from the quarterly statistical inquiry showing the number of people in receipt of supplementary benefit and the numbers dependent on supplementary benefit.

  Mr. Portillo
  In November 1987, the latest date for which information is available, 4·85 million people were in receipt of supplementary benefit; and 8 million were dependent on that benefit.

  St. Peter's Hospital, London
  Mr. Dobson
  To ask the Secretary of State for Social Services if he will make it his policy to intervene to prevent the closure of national referral centres, with particular reference to St. Peter's hospital, Henrietta street, London WC2; and if he will make a statement.

  Mr. Newton
  When there is a proposal for a closure or substantial change of use of a Health Service building, there is a clear procedure set out in HSC (IS) 207, a copy of which is in the Library. This requires health authorities to consult on any such proposal which may then be referred for a final decision to the Secretary of State if the relevant community health council objects to the proposal, but the proposal is supported by the regional health authority.

  The relocation of St. Peter's hospital has been agreed by the community health council concerned and it would not therefore be appropriate for Ministers to intervene formally. We have nevertheless asked Bloomsbury health authority to ensure that the detailed plans for the relocation are feasible and that the future role of the St. Peter's group of hospitals as a national centre of excellence in urology and nephrology is safeguarded.

  Mr. Dobson
  To ask the Secretary of State for Social Services whether proceeds from the proposed sale of St. Peter's hospital, Henrietta street, London WC2, will revert to his Department; and if he will make a statement.

  Mr. Newton
  No. The receipts of such a sale would be received by the relevant health authorities. The hon. Member may wish to contact the chairman of North East Thames regional health authority for further details.

  Low Income (Scotland)
  Mr. Gordon Brown
  To ask the Secretary of State for Social Services if he will publish for Scotland tables for 1985 on low-income families.
  727
  Mr. Portillo
  I refer the hon. Member to my reply to the hon. Member for Livingston (Mr. Cook) on 27 May 1988 at columns 413–14.

  Health Service Closures
  Mr. Gordon Brown
  To ask the Secretary of State for Social Services if he will give the number of(a) hospitals, (b) antenatal clinics, (c) casualty wards and (d) geriatric units that have been closed since 1979.

  Mrs. Currie
  It is important to note that closures may be offset or balanced by openings or reprovision elsewhere. The number of units or facilities approved for closure between 1979 and end 1986 is as follows:

  Number

  (a)

  hospitals/units—total closure

  316

  (b)

  maternity units

  67

  (c)

  casualty wards

  Not known

  (d)

  geriatric units

  89

  The number of antenatel clinics within the maternity units at (b) is not known.

  We expect figures for the year 1987 to be available in the near future.

  Student Support
  Mr. Dalyell
  To ask the Secretary of State for Social Services what are the terms of reference of the committee reviewing student support; and what interim proposals he has in relation to the increasing use by students of the social security system.

  Mr. Portillo
  There are no plans to alter the social security entitlement of students in advance of any changes which may be proposed by the student support review, chaired by the Department of Education and Science, the terms of reference of which are:"To review the present arrangements for the financial support of students studying at first degree level or equivalent in Great Britain and to consider the future basis for such support, having regard to:

  (i) the situation and the maintenance needs of students, and the extent to which it is appropriate that those needs should be supported from public funds;

  (ii) other actual and possible sources of support which would allow the removal of students from the social security system—including the case for a system involving loans as well as grants, and the contribution of sponsorship to the needs of students on vocationally orientated courses;

  (iii) the Government's stated policies for higher education and access to it; and

  (iv) arrangements made in other countries with developed systems for the financial support of students."

  Benefit Disqualification
  Mr. McAllion
  To ask the Secretary of State for Social Services if he has any plans to review the operation of the current benefit disqualification rules.

  Mr. Portillo
  I assume that the hon. Member is referring to the rules governing disqualification for unemployment benefit for voluntary unemployment. There are no plans to change those rules or their operation.

  Baby Milk (Free Samples)
  Mrs. Gillian Shephard
  To ask the Secretary of State for Social Services if he will implement the recommendation in 728
  the COMA report entitled "Present-day Practice in Infant Feeding", that free samples of baby milk should not be allowed in hospitals.

  Mrs. Currie
  Yes. In 1981 the World Health Organisation issued a code on the marketing of breast milk substitutes (the WHO Code) and the report from the chief medical officer's committee on medical aspects of food policy "Present-day practice in Infant Feeding: Third Report" was published in January 1988. Both recommended that samples of baby milks should not be given to mothers.

  I have discussed this with the Infant and Dietetic Foods Association of the Food and Drink Federation, previously known as the Food Manufacturers' Federation. At the Government's request the industry has agreed the time is right to discontinue manufacturers' provision to hospitals of free samples and subsidised supplies of baby milks. This change would fully meet, within the United Kingdom, the World Health Assembly's more recent 1986 resolution that Governments should not allow free and subsidised supplies of breast milk substitutes in maternity wards and hospitals. We expect this change to be implemented fully by the end of 1988.

  We also agreed that the two instruments for securing within the United Kingdom the aim and principles of the WHO code, health circular HC(83)13 and the FMF code of practice for the marketing of infant formulae in the United Kingdom (the FMF code) should be revised and reissued to take account of this change and in the light of experience since they came into effect in 1983. The main change in the FMF code will be to reflect the cessation of samples and subsidised supplies. We anticipate that the revised health circular and FMF code should come into effect during the autumn.

  We intend these changes to coincide with the launch in October of the breastfeeding organisations' new initiative to promote breast feeding, which we welcome. I warmly congratulate the manufacturers on their helpfulness and in particular on their pledge to assist with the new initiative, to which they generously plan to give financial support.

  Benzodiazepines
  Mr. Wareing
  To ask the Secretary of State for Social Services if he will list those drug companies which supplied benzodiazepines to the National Health Service during each of the years 1978 to 1986 inclusive; and what was the amount of payments made to each of these companies.

  Mr. Newton
  [pursuant to his reply, 26 April 1988, c.130]: I regret that the list of companies provided in the previous reply was unfortunately incorrect. The correct list of companies supplying proprietary benzodiazepines to the family practitioner services in 1986 is:

  DDSA Pharmaceuticals Ltd.

  Farmitalia Ltd.

  Fisons plc

  Hoechst Pharmaceuticals Ltd.

  Norgine Ltd.

  Roussel Laboratories Ltd.

  Roche Products Ltd.

  Schering Chemicals Ltd.

  Steinhard Ltd.

  Upjohn Ltd.

  Wyeth Laboratories Ltd.

TRANSPORT

  Allerton Park, Knaresborough
  Mr. Robert Banks
  To ask the Secretary of State for Transport when he expects to receive the report from the inspectors on the public inquiry held to consider the proposals for ingress to and egress from Allerton park, Knaresborough, from the A1.

  Mr. Peter Bottomley
  The inspector has reported on proposals to improve the adjacent section of the A1. The report is being considered jointly by the Secretaries of State for Transport and for the Environment.

  Birmingham International Airport
  Sir Dudley Smith
  To ask the Secretary of State for Transport how many near misses have been reported, in the current year to date, involving aircraft flying to from Birmingham international airport; and how many are still under investigation.

  Mr. Peter Bottomley
  The Civil Aviation Authority has said that one such airmiss has been reported this year and is under investigation.

  Air Traffic Controllers
  Sir Dudley Smith
  To ask the Secretary of State for Transport how many air traffic controllers are currently under technical suspension as a result of airmisses between aircraft over United Kingdom territory.

  Mr. Peter Bottomley
  This is a matter for the management of the National Air Traffic Services.

  Settle Bypass
  Mr. Cryer
  To ask the Secretary of State for Transport what is the cost of the Settle bypass currently under construction; and when completion will take place.

  Mr. Peter Bottomley
  The land and works for the A65 Settle and Giggleswick bypass are estimated to cost £8·6 million. It is planned for completion by the end of the year.

  Civil Aviation
  Mr. McCrindle
  To ask the Secretary of State for Transport if he will introduce legislation to give the Civil Aviation Authority additional powers to alter the structure of civil aviation in the United Kingdom; and if he will make a statement.

  Mr. Peter Bottomley
  We have no plans at present to seek additional powers. The existing statutory framework has proved sufficiently flexible and adaptable to allow the competitive development of airline services.

  Air Traffic Controllers (Industrial Action)
  Mr. Shersby
  To ask the Secretary of State for Transport what assessment he has made of the level of inconvenience to British air passengers travelling to and from European destinations as a result of industrial action by air traffic controllers in various countries; and if he will initiate discussions with Transport Ministers in other European Community countries with a view to establishing employment agreements which prohibit such industrial action.
  730
  Mr. Peter Bottomley
  My right hon. Friend the Secretary of State is kept informed of serious air traffic delays by the Civil Aviation Authority, and by airlines and others in the industry. Delays occur for a variety of reasons. My right hon. Friend does not believe the initiative proposed by my hon. Friend would be a productive or appropriate one at this juncture.

  LRT (Chairman)
  Mr. Dobson
  To ask the Secretary of State for Transport if he will place in the Library a copy of his letter to the chairman of London Regional Transport refusing to accept the latter's resignation after the King's Cross underground fire.

  Mr. Channon
  I am not prepared to make available correspondence conducted on a personal basis.

  Railway Closures
  Mr. Gordon Brown
  To ask the Secretary of State for Transport if he will give a table showing since 1979 how many(a) railway stations have been closed, (b) miles of railway line have been taken out of use, (c) stations have ceased to be served on Sundays and (d) stations are no longer staffed at any time.

  Mr. Mitchell
  The table lists the number of railway stations and route miles of railway line closed to passengers each year since 1979.

  Station

  Routes miles of line closed

  1979

  —

  —

  1980

  —

  —

  1981

  2

  0·75

  1982

  —

  27·25

  1983

  14

  36·75

  1984

  2

  —

  1985

  8

  8·75

  1986

  5

  2·5

  1987

  1

  33·75

  This total of 32 stations closed should be seen in the context of 88 stations opened or reopened since 1980 (including 16 in Scotland) to give a net increase in stations opened of 56.

  Sunday services and the destaffing of stations are management matters for British Rail.

  LRT (Signalling)
  Mr. Gordon Brown
  To ask the Secretary of State for Transport if he will give the number of signal failures on London Regional Transport and the capital expenditure at constant prices by London Regional Transport on signalling equipment for each year since 1979.

  Mr. David Mitchell
  The incidence of routine signal failure is not reportable to my Department. That and the implications for expenditure on routine maintenance and ongoing renewal are matters for the operator.

ENVIRONMENT

  Planning Refusal (Dartford)
  Mr. Redwood
  To ask the Secretary of State for the Environment why he turned down a planning application
  731
  at Dartford to develop 1,000 acres for houses, jobs and leisure; and what representations were received from the local community.

  Mr. Waldegrave
  My right hon. Friend refused planning permission for this development for the reasons contained in the decision letter dated 24 May. I am today sending my hon. Friend a copy of that letter together with a copy of the inspector's report. The report summarises the representations received both in favour of and in opposition to the proposals.

  Housing Land (London)
  Mr. Redwood
  To ask the Secretary of State for the Environment what steps he is taking to make more land available for housing in London, so as to offer Londoners the opportunity to remain in London.

  Mr. Waldegrave
  The Secretary of State's strategic guidance will include guidance on the provision each borough should make in its unitary development plan to meet London's expected overall requirement for new housing in the 1990s. The guidance will be issued, following consultation, early next year.

  In addition, we are appointing consultants to conduct a major study of the potential of five areas of east London for housing, mainly for middle and low-income groups.

  We are maintaining the pressure on all public landowners to release their underused land for development. Since the land registers were introduced in 1981, some 4,700 acres of such land in London has been brought hack into use, much of it for housing.

  European Directives and Regulations
  Sir Richard Body
  To ask the Secretary of State for the Environment whether he will publish the list of directives and regulations with their subject matter relating to his Department that have been agreed by the European Economic Community Council of Ministers.

  Mr. Moynihan
  A list of over 200 environmental measures, including regulations and directives, is given in "EEC Environment Policy and Britain" by Nigel Haigh: The second edition of this useful reference work was commissioned by the Department of the Environment as a contribution to European Year of the Environment. I am arranging for copies to be placed in the Libraries of the House. The measures listed are all of interest to this Department although in a number of cases primary responsibility lies in other Departments. Since the second edition was prepared the following measures have been adopted by the Council of Ministers.Council Regulation (EEC) No. 2242/87 on action by the Community relating to the environment (OJ L207, 29 July 1987)
  Council Directive 87/405/EEC amending Directive 84/534/ EEC on the approximation of the laws of the Member States relating to the permissable sound power level of tower cranes (OJ L220, 8 August 1987)
  Council Directive 87/416/EEC amending Directive 85/210/ EEC on the approximation of the laws of the Member States concerning the lead content of petrol (OJ L225, 13 August 1987)
  Council Directive 87/432/EEC on the eighth adaptation to technical progress of Directive 67/548/EEC on the approximation of laws, regulations and administrative provisions relating to the classification, packaging and labelling of dangerous substances (OJ L239, 21 August 1987) Commission Directive 87/477/EEC amending for the third
  732
  time the Annex to Council Directive 79/117/EEC prohibiting the placing on the market and use of plant protection products containing certain active substances (OJ L273, 26 September 1987)
  Commission Regulation (EEC) No. 3143/87 amending Council Regulation (EEC) No 3626/82 on the implementation in the Community of the Convention on international trade in endangered species of wild fauna and flora (OJ L299, 22 October 1987)
  Council Directive 88/76/EEC amending Directive '70/220/ EEC on the approximation of the laws of the Member States relating to measures to be taken against air pollution by gases from the engines of motor vehicles (OJ L36, 9 February 1988) Council Directive 88/77/EEC on the approximation of the laws of the Member States relating to the measures to be taken against the emission of gaseous pollutants from diesel engines for use in vehicles (OJ L36, 9 February 1988)
  Council Directive 88/180/EEC amending Directive 84/538/ EEC on the approximation of the laws of the Member States relating to the permissible sound power level of lawnmowers (OJ L81, 26 March 1988)
  Council Directive 88/181/EEC amending Directive 84/538/ EEC on the approximation of the laws of the Member States relating to the permissible sound power level of lawnmowers (OJ L81, 26 March 1988)
  Commission Regulation (EEC) No. 869/88 replacing Annex B to Council Regulation (EEC) No. 3626/82 on the implementation in the Community of the Convention on international trade in endangered species of wild fauna and flora (OJ L87, 31 March 1988).
  Council Regulation (EEC) No. 1094/88 amending Regulations (EEC) No. 797/85 and (EEC) No. 1760/87 as regards the set-aside of arable land and the extensification and conversion of production (OJ L106, 27 April 1988).
  Commission Regulation (EEC) No. 1272/88 laying down detailed rules for applying the set-aside incentive scheme for arable land (OJ L121, 11 May 1988).
  Commission Regulation (EEC) No. 1273/88 laying down criteria for delimiting the regions or areas which may be exempted from the schemes for the set-aside of arable land, extensification and the conversion of production (OJ L121, 11 May 1988).
  Council Directive 88/298/EEC amending Annex II to Directives 76/895/EEC and 86/362/EEC relating to the fixing of maximum levels for pesticide residues in and on fruit and vegetables and cereals respectively (OJ L126, 20 May 1988).
  Commission Directive 88/302/EEC adapting to technical progress for the ninth time Council Directive 67/548/EEC on the approximation of laws, regulations and administrative provisions relating to the classification, packaging and labelling of dangerous substances (OJ L133, 30 May 1988).
  Resolution of the Council of the European Communities and of the Representatives of the Governments of the Member States, meeting within the Council on the continuation and implementation of a European Community policy and action programme on the environment (1987–1992) (OJ C328, 7 December 1987).
  Council Resolution of 25 January 1988 on a Community action programme to combat environmental pollution by cadmium (OJ C30, 4 February 1988).

  Home Improvement Grants
  Mr. Soley
  To ask the Secretary of State for the Environment what has been the cost of providing home improvement grants and what was the number of dwellings involved, for private owner-occupiers, landlords and housing associations, private tenants and public sector tenants; what were the total costs for private owners and tenants for the years 1980 to 1987; and what is the current estimate for 1988.

  Mr. Waldegrave
  Following are the estimates of the amount of home improvement grants paid and the numbers of dwellings covered by these grants, with the local authorities' expenditure on administration of home improvement and home insulation grants.
  733

  Improvement grants paid1: England

  Dwellings (thousands)

  Amount (£ million)

  Owner occupiers

  Landlords and housing associations

  Tenants (public and private)

  Owner occupiers, landlords and housing associations

  Tenants (public and private)

  Expenditure on improvement and home insulation grants administration (£ million)

  1980–81

  61·1

  10·3

  0·4

  126·0

  0·9

  n/a

  1981–82

  84·5

  12·0

  0·8

  166·1

  1·4

  n/a

  1982–83

  110·8

  18·8

  2·0

  364·1

  3·3

  33

  1983–84

  214·3

  30·3

  6·0

  778·3

  17·8

  45

  1984–85

  159·2

  31·4

  4·6

  726·3

  10·8

  41

  1985–86

  94·2

  24·9

  5·4

  451·6

  9·7

  42

  1986–87

  84·9

  19·8

  7·2

  378·4

  9·7

  42

  1987–88

  87·1

  16·5

  10·5

  361·1

  11·5

  43

  1 Improvement, conversion, repairs and intermediate grants.

  n/a—Not available.

  Local Authorities (Subsidies)
  Mr. Soley
  To ask the Secretary of State for the Environment what subsidy has been paid and is estimated to be paid in respect of English local authorities for the financial years 1979–80 to 1988–89 from the Exchequer, both in total and expressed as a subsidy per dwelling for the total number of dwellings in local authority control and in respect of those authorities in receipt of subsidy;

  Main housing subsidy and rate fund contributions 1981–82 to 1987–88 local authorities in England

  1981–82

  1982–83

  1983–84

  1984–85

  1985–86

  1986–87

  1987–88

  1988–89

  £

  £

  £

  £

  £

  £

  £

  £

  Main Housing Subsidy

  Total

  881·1M

  436·8M

  346·9M

  353·9M

  486·4M

  476·5M

  464·0M

  469·4M

  Per Dwelling:

  All LAs

  163

  92

  75

  77

  107

  107

  108

  —

  LAs in Subsidy

  167

  209

  250

  263

  342

  374

  371

  —

  Negative RFCs

  Total

  -17·1M

  -22·1M

  -28·0M

  -44·2M

  -58·3M

  -101·3M

  -59·7M

  —

  Per Dwelling:

  All LAs

  -3

  -5

  -6

  -10

  -13

  -23

  -14

  —

  LAs in Subsidy

  -3

  -11

  -20

  -33

  -41

  -80

  -48

  —

  Positive RFCs

  Total

  419·6M

  432·7M

  495·2M

  432·3M

  438·4M

  378·0M

  412·6M

  —

  Per Dwelling:

  All LAs

  78

  91

  106

  94

  97

  85

  96

  —

  LAs in Subsidy

  79

  184

  309

  207

  260

  242

  262

  —

  Note: Not all local authorities in receipt of Exchequer subsidy are also making contributions from the general rate fund.

  House Building
  Mr. Soley
  To ask the Secretary of State for the Environment what information he has about the level of investment in residential construction, expressed as a percentage of gross domestic product, for the European and other major developed nations.

  Mr. Trippier
  International differences in housebuilding costs, population growth and internal migration affection comparisons of this kind.

  The available information given in the table is taken from the "OECD National Accounts" vol II detailed tables 1973–1985.

  Residential Construction as a Percentage of GDP in 1985

  Country

  Per cent.

  Austria

  4·6

  Belgium

  3·2

  734
  and what is the position, expressed in similar terms, for rate fund contributions, for both negative and positive contributions.

  Mr. Waldegrave
  Housing subsidy up to 1980–81 was paid under a different system, so I am using 1981–82 as the first year. The information requested is shown in the tables. The rate fund contribution figures (RFCs) are net amounts. The 1987–88 and 1988–89 figures are estimates. Only a provisional housing subsidy figure is available for 1988–89 at this stage in the year.

  Country

  Per cent.

  Finland

  6·2

  France

  4·6

  Germany (Federal Republic)

  5·5

  Greece

  3·9

  Iceland

  n/a

  Ireland

  4·5 (1984)

  Italy

  4·0

  Luxembourg

  4·7 (1982)

  Netherlands

  4·6

  Norway

  4·1

  Portugal

  6·4 (1981)

  Spain

  4·6 (1984)

  Sweden

  4·1

  Switzerland

  n/a

  Turkey

  n/a

  United Kingdom

  3·5

  Yugoslavia

  n/a

  Australia

  5·2

  Canada

  5·4

  Japan

  4·9

  735

  Country

  Per cent.

  New Zealand

  4·3 (1984)

  United States (America)

  4·8

  n/a Not available

  It is estimated that the 1987 equivalent percentage for the United Kingdom is 3·7 per cent.

  Abercrombie House, East Kilbride
  Mr. Ingram
  To ask the Secretary of State for the Environment if he will make it his policy not to enter into any arrangements to sublet any part of Abercrombie house, East Kilbride.

  Mr. Chope
  No.

  Rating Reform
  Mr. Ashley
  To ask the Secretary of State for the Environment whether he will take steps to ensure that residential volunteers carers who receive only a nominal subsistence allowance will he exempt from the community charge.

  Mr. Howard
  I refer the hon. Member to what was said by my noble Friend the Minister of State during the Committee stage of the Local Government Finance Bill in another place on 24 May, at columns 814–15. The matter is currently under consideration.

  Homelessness
  Mr. Nicholas Brown
  To ask the Secretary of State for the Environment if he will give the number of homeless households in priority need in England in each year since 1979; and if he will give this information for England as a whole and for each district council and London borough.

  Mr. Waldegrave
  The estimated numbers of households accepted by local authorities under the homelessness provisions of the housing Acts, are derived from quarterly returns. The figures for England are in the table. I regret that in the reply given by my hon. Friend the Parliamentary Under-Secretary to the hon. Member for Redcar (Ms. Mowlam) on 18 May at column 481 the acceptance figures quoted for 1979 to 1987 were those for 1978 to 1986.

  Total acceptances

  of which priority need

  1979

  57,200

  55,030

  1980

  62,920

  60,390

  1981

  70,010

  65,530

  1982

  74,800

  69,930

  1983

  78,240

  71,590

  1984

  83,550

  76,760

  1985

  94,530

  87,540

  1986

  105,280

  96,490

  1987

  112,730

  102,440

  The readily available information on priority need acceptances by individual authorities comes from their housing investment programme returns. The figures appear in column B5 of the "HIP1 all items print" for each of the years 1981–82 to 1983–84, column B6B for 1984–85 and column C1B for 1985–86 and for 1986–87; copies of these documents are in the Library. In some cases, figures in HIP returns may differ slightly from those reported in the quarterly returns.

  Landfill Sites
  Mr. Pawsey
  To ask the Secretary of State for the Environment how many landfill sites in current use exist in Warwickshire; and how many have been identified as emitting methane or carbon dioxide.

  Mr. Moynihan
  I am advised by Warwickshire county council that there are 98 landfill sites currently in use in Warwickshire, of which nine have been identified as emitting landfill gas.

  Mr. Pawsey
  To ask the Secretary of State for the Environment what regulations exist covering the control of landfill sites; and if he has any plans to review their working.

  Mr. Moynihan
  Landfill sites are licensed by waste disposal authorities under the Control of Pollution Act 1974. Clarification of the types of activity which are and are not subject to licensing is contained in the Licensing of Waste Disposal Regulations: 1976 and 1977, which will be superseded by the Collection and Disposal of Waste Regulations 1988 in October next. We expect to announce shortly our conclusions on proposals for legislative changes to improve arrangements for waste disposal.

  Mr. Pawsey
  To ask the Secretary of State for the Environment how often disused landfill sites are inspected and by whom; what record of such visits exists; and if the public are permitted to inspect such records.

  Mr. Moynihan
  District councils have a duty under the Public Health Act 1936 to inspect their districts from time to time for the detection of statutory nuisance which may be caused by, inter alia, any accumulation or deposit which is prejudicial to health or is a nuisance. In general, Government advice to authorities is that information collected from exercises of this kind should be made available to the public.

  Mr. Pawsey
  To ask the Secretary of State for the Environment how many explosions have occurred on or near landfill sites as a result of methane or carbon dioxide gas in each year since 1960.

  Mr. Moynihan
  This information is not held by my Department.

  Waste Disposal
  Mr. Butler
  To ask the Secretary of State for the Environment what changes he plans to the laws which control special wastes and the arrangements for monitoring breaches in disposal licences.

  Mr. Moynihan
  We plan to issue a consultation paper with proposals to amend the Control of Pollution (Special Wastes) Regulations 1980 later this year. Responsibility for monitoring that conditions specified in disposal licences are complied with rests with waste disposal authorities. It is for each authority to make suitable arrangements for this.

  Palace of Westminster (Water Samples)
  Ms. Walley
  To ask the Secretary of State for the Environment if he will list each of the occasions since May 1987 when each of the shower heads, water tanks central
  737
  heating and all other water tanks and systems at the Palace of Westminster were sampled; if he will publish the results; who carried out the monitoring; and whether any action has been taken.

  Date

  Location

  Reason for test

  Result

  21 May 1987

  Palace of Westminster Engineers Control

  Warm Water issuing from drinking water tap

  Sample was chemically and bacteriologically suitable for drinking.

  Problem overcome by increasing lagging in adjacent hot water pipe.

  4 February 1988

  Norman Shaw North

  Dirty Water

  Samples were chemically and bacteriologically suitable for drinking.

  Problem probably caused by work on Bridge Street site disturbing the water main.

  22 February 1988

  Sales Office and PSA Tea Point

  Complaint about skin irritation

  Water samples would not be expected to cause any skin irritation.

  10–13 May 1988

  Palace of Westminster Kitchens

  Outbreak of illness in House of Lords

  Preliminary results shows adequate chlorine levels and no colorform organisms were detected.

  Note: The samples were analysed by the laboratory of the Government Chemist.

  Water for hot water services is stored at 60°C and kept at 50°C in the distribution system. No water samples have been taken from shower heads. Nor has water quality sampling been carried out on central heating water tanks.

  The cooling towers of the air conditioning system in the Palace and the standby generator serving the underground car park are dosed to minimise microbiological contamination. The water quality is tested by an approved specialist contractor, Betz. All the tests carried out since
  738
  Mr. Chope
  [holding answer 7 June 1988]: Routine testing of drinking water supplied direct from the water authority's main is not normally required. But bacteriological and chemical tests have been carried out on four occasions since May 1987 for the reasons shown in the table.

  May 1987—August and November 1987 and February and May 1988 were satisfactory. In addition, the water in the air conditioning system and boiler plant is chemically tested every month by the same company. All the results have been satisfactory since May 1987.

  Water sampling is undertaken in accordance with a PSA technical instruction (No. 22) which incorporates the standards detailed in an EEC directive and current DHSS guidelines.

Preamble
The House met at eleven of the clock: The LORD CHANCELLOR on the Woolsack.
Prayers—Read by the Lord Bishop of Chelmsford.

National Engineering Laboratory
Lord Carmichael of Kelvingrove Lord Carmichael of Kelvingrove asked Her Majesty's Government:
What arrangements are proposed to maintain the reputation of the National Engineering Laboratory for independent research and development, if it were to be acquired by a private company following the recent announcement by the Lord Young of Graffham (Official Report, 7th June 1988, cols. 1397–8).
The Secretary of State for Trade and Industry (Lord Young of Graffham): My Lords, I am inviting proposals only from organisations which already have experience of carrying out research and development and I have made clear that any acceptable proposals must involve the development of NEL as a contract research organisation. Contract research organisations must maintain a reputation for independence since their success depends on it. I should also be happy to receive proposals from NEL staff and this too would maintain NEL's current reputation. I have placed a copy of the notes of guidance for potential bidders in the Library.
Lord Carmichael of Kelvingrove: My Lords, before I speak on the Question I should like to say a word about the fact that my noble friend Lord Ross of Marnock—who directly preceded me in this job and who was a Member of this and of the other House for a long time—died this morning after a fairly long illness. I am sure that the House will wish to convey its sorrow to Lady Ross and her family.
Noble Lords: Hear, hear!
Lord Carmichael of Kelvingrove: My Lords, I thank the Minister for his Answer. He will realise that the announcement of the closure was a shock to the people of Scotland, despite the fact that he visited NEL some weeks ago. He made statements there which were interpreted as meaning that the Government were to withdraw from the NEL. Nevertheless it came as a great shock to learn that the last important and prestigious government-sponsored research establishment in Scotland will change in status.
Is the Minister aware that the independence of the National Engineering Laboratory's research and evaluation of systems and high-tech products was one of its great strengths? Is he also aware that it can never be the same, particularly in its pure research and evaluation, if it has too strong a link with industry?
The Minister may be aware that during the Californian government's efforts to obtain large pumping equipment for the watercourses running
1608
along each side of the San Andreas Fault they could not find a single college or research facility in America which did not have some industrial tie-up with the NEL. They brought their equipment over for testing by the NEL. Is the Minister aware that that is the kind of institution that we may lose in Scotland?
Lord Young of Graffham: My Lords, we on this side of the House should also like to pay tribute to the noble Lord, Lord Ross. We shall certainly miss his advice and wise counsel to your Lordships' House.
Noble Lords: Hear, hear!
Lord Young of Graffham: My Lords, if the National Engineering Laboratory is to fulfil its function, which is to provide independent research and development of which our industrial base in this country can take advantage, it is important that it has better links with the private sector. In doing that we anticipate enhancing the National Engineering Laboratory in order to make it more relevant to the work that is being carried out. I have no reason to suppose that it will not be a better research organisation as soon as it is in private sector hands.
There are many ways in which the laboratory can go into the private sector. The notes of guidance, a copy of which I have placed in the Library, will show that we are insisting that it will do so only under the control of an existing organisation which has a good record in contract research and development. Part of the work at NEL concerns measurements and standards of flow, which is part of the national measurement system. For that reason we are taking steps to ensure that that work will not leave state ownership. However, its management could or could not be with the new organisation. We are also taking steps to ensure that research and development work will continue on the site and that it will not in the future be used for other purposes.
Lord Carmichael of Kelvingrove: My Lords, I thank the Minister for announcing that he has placed a copy of the notes of guidance in the Library and that he will send a copy to me. Perhaps after it has been thoroughly studied we can discuss the matter again.
Lord Mackie of Benshie: My Lords, can the Minister say whether any independent body will remain to assess the varied work that the NEL carried out in the past?
Lord Young of Graffham: My Lords, no, I was referring specifically to the national measurement system on flow measurement. The notes of guidance suggest that that part of its work and the specific building concerned could be either a self-contained, free-standing agency within government or it could continue to be owned by government with its management given over to the new organisation. We are awaiting detailed proposals in order to decide which alternative will work best.

Hong Kong: Joint Declaration
11.12 a.m.
Lord Cledwyn of Penrhos Lord Cledwyn of Penrhos rose to call attention to recent developments in Hong Kong relating to the

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implementation of the joint declaration; and to move for Papers.
The noble Lord said: My Lords, I beg to move the Motion standing in my name on the Order Paper. Over the years this House has taken a close interest in the affairs of Hong Kong. That is due in part to the experience and knowledge of Hong Kong of several noble Lords, many of whom are listed to speak in the debate. The interest was intensified by the joint declaration and by subsequent events. We have known from the start that the Basic Law would be the single most important factor following the transfer of power in 1997 and that more than anything else, it would reflect the will and attitude of the Chinese Government. It will be the constitutional instrument by which China will govern Hong Kong.
Therefore, it is nautral that the people of Hong Kong should scrutinise the draft Basic Law in a mood of both hope and apprehension. The first draft of this crucial document was published on 28th April and consultation upon it will go on until September next. A second draft will be published next year and the final version will be put to the Chinese National People's Congress in 1990. Legally, the formulation of the Basic Law is a matter for the Chinese Government. They have the last word. Neither the Government of Hong Kong nor of Britain have any rights regarding this drafting. However, in practice there is an acceptance that it should comply with the words and spirit of the joint declaration.
The Basic Law drafting committee of 59 members chosen by the Chinese Government includes 23 members from Hong Kong. The Basic Law consultative committee, whose duty is to evaluate the draft on behalf of the people of Hong Kong, has 180 members, mostly from Hong Kong and representative of a wide range of interests in the colony. A Hong Kong view is therefore very much in evidence and if there is no reason at this moment for euphoria, there is also no reason for undiluted pessimism. I believe that it is important to note that Chinese spokesmen have expressed the hope that the people of Hong Kong will comment freely on the draft and that the Chinese Government will readily take those comments into account. That should surely be taken seriously and taken advantage of and we should welcome the Chinese Government's readiness to listen to those two major committees.
Finally, there is no reason why the British Government, as a signatory to the declaration, should not, if necessary, make representations on any important aspect of the Basic Law to the Chinese Government. The right honourable and learned gentleman the Foreign Secretary, who visited Hong Kong last week said at a press conference that the Basic Law,
"will be discussed by Parliament in the UK, and I do not doubt that the outcome of those discussions will reach the eyes and ears of those who are concerned with the future of the Basic Law. Certainly, we shall play our part in seeing that they do".
I warmly welcome what Sir Geoffrey Howe said on returning from his visit.
As we know a lively and well informed debate is going on in the Hong Kong community, mainly under the aegis of the BLCC. Members of the drafting committee from China are visiting Hong Kong to hear the general reaction of the people. In this debate we in this House art anxious to know how
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the draft Basic Law is being received in Hong Kong; what are the subjects of greatest interest and which areas, if any, are causing concern.
The big question is whether the Hong Kong special administrative region will, after 1997, enjoy the high degree of autonomy promised in the joint declaration. Article 2 of the draft Basic Law deals with this clearly, or so it seems to me. It says that after 1997 the SAR will have the authority:
"to exercise a high degree of autonomy in accordance with the provisions of this law and to enjoy executive, legislative and independent judicial power, including that of final adjudication".
That is a very positive statement. All the subsequent articles in Chapter 1, as noble Lords will have noted, under the heading "General Principles" would appear to underline the general statement in Article 2. Even so, from what we have read in the press and letters we have received, doubts, uncertainties and suspicions still remain in many quarters and, in my submission, it is the Government's responsibility to study these carefully.
One of the issues on which there has been a development disagreement is that of so-called democratisation. That was mentioned in our exchange on the White Paper in the House on 10th February. Personally I believe that there should be direct elections to the legislative council this year. On this side we believe that there should be more than the 10 proposed in 1991. Sir Geoffrey Howe does not disagree with this proposition. On January 20th in another place he said:
"In due course we need an element of direct elections—a modest proportion but certainly not going all the way … The question is one of timing … on that there is a difference of view … We need to secure a timetable for progress".—[Official Report, Commons, 20/1/88; col. 1017.]
I agree with Sir Geoffrey on the point about a timetable but I do not want it to extend too far into the future. The Foreign Secretary seems to be saying that he has no objection to direct elections but that he does not want to throw a spanner into the works at a sensitive moment when other things are happening. It is a sentiment with which all former Ministers must have sympathy. Perhaps Sir Geoffrey will have something to say about that in the next few days following his recent visit to Hong Kong.
Several other points of concern have been passed to me and indeed to other noble Lords. I do not wish my speech to be too long or too detailed and I shall seek to summarise the worries of correspondents as briefly as I can. First, there is real concern about the authority given to the National People's Congress of China to return or to revoke laws passed by the legislature of the SAR under Article 16. Secondly, there is concern that laws passed by the National People's Congress on matters other than foreign affairs and defence, which were agreed to be reserved, will apply to Hong Kong. That concern refers to Article 17, which needs to be looked at carefully as it could in practice contravene Article 1 of the draft.
We then come to Articles 105 and 107, which need further careful discussion. Furthermore, the requirement to maintain a basic balance between total budgetary revenues and expenditure and to practise a low tax policy seems to be inappropriate in a constitutional document and could, as all of us know only too well, restrict the fiscal powers of a future administration. Perhaps the noble Lord, Lord

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Glenarthur, will give his reaction to that provision when he replies.
I also read Annexes 1 and 2 of the draft with great interest. These deal with selecting the chief executive and constituting the legislative council of the SAR. I am sure that these will be the subject of further discussion. It may be suggested that they do not make adequate provision for direct elections. Furthermore, Annexe 3 needs careful thought as its proposals may not provide for the continuity of government through the transitional period. It seems to weigh far too heavily on the side of the Chinese Government in appointing the executive. That does not tend to create the kind of confidence that no doubt both sides desire.
The House will further recall that the joint declaration provides that the executive shall be accountable to the legislature. The Basic Law makes no reference to this important constitutional requirement and no doubt that will be taken up in the discussions which are now proceeding.
A small ad hoc committee of young professional people in Hong Kong, led by Miss Gladys Li, has taken a proper and acute interest in the draft Basic Law since it was published. I believe she has sent to most noble Lords a letter and a memorandum dated 16th April. Most of us will have read them. Their comments about judicial independence as affected by Articles 18 and 169, on the precise extent of the high degree of autonomy referred to in the joint declaration and in Article 2, on the articles which deal with the economy and finance (Articles 103 to 115) and on the need for stronger guarantees on human rights, need to be given the most careful thought.
Miss Li and her colleagues make a telling point when they state in the memorandum:
"If China intends the Hong Kong SAR to be 'financially independent' as stated in Article 104, it should refrain from pre-empting—as Article 105 seeks to do—the Financial Secretary's freedom to make pragmatic economic policy decisions after 1997".
Here again, I am sure the House will value the comments of the noble Lord when he replies.
Criticisms of the Basic Law were inevitable from the start. It is a detailed and complex document with 172 articles and three annexes. It will be subjected to scrutiny and placed under the magnifying glass many times over the next two years or so. The Chinese authorities anticipate this and we hope and expect that they will be receptive to reasonable argument. In my view, the future of Hong Kong depends largely upon the readiness to listen to reasonable argument.
We should pay tribute to the members of the drafting committee who have worked hard over the past three years to produce this draft and to bring together and blend two dissimilar systems of law. Let me repeat that the words which created confidence in the joint declaration were the promise of a high degree of autonomy for Hong Kong under the new dispensation. Do Her Majesty's Government believe that the draft Basic Law in principle fulfils that promise? Are they satisfied that at this stage there is reasonable hope that the draft will in due course be a reasonable document which will fulfil the original hopes set out in the joint declaration?
I have already mentioned the concern which exists as 1997 gets nearer; and that time will come all too
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quickly, as noble Lords know. The clearest evidence of this is emigration, which I believe has been running at between 3,000 and 4,000 a month from Hong Kong. That is a large figure. Perhaps the noble Lord can give the House the latest figures. The Government of Hong Kong, Her Majesty's Government and indeed the Chinese Government must consider what actions may be necessary to stem this outflow. Could it be more directly elected members to the Legislative Council? In my view, civic, community and economic stability are the key to confidence.
The Basic Law at present provides for 25 per cent. of the council to be directly elected. That is an encouraging step forward. However, I am sure that the Chinese Government know that they have nothing to fear from a further increase which will give more people a stake and an involvement in the future of Hong Kong. A comparatively small concession would go a long way.
I referred to the knowledge of Hong Kong which so many noble Lords possess. I am sure that the House is particularly glad that my noble friend Lady Ewart-Biggs and the noble Baroness, Lady Young, are due to speak in this debate. Both returned from Hong Kong last Sunday and they will no doubt have information of great interest to give us.
I have so far confined myself to the Basic Law because I believe it to be the most important issue in relation to the future of the colony. But there are other immediate problems. The most acute concerns the Vietnamese refugees who continue to flow into Hong Kong in large numbers. The noble Lord, Lord Glenarthur, told me in reply to a recent Question that he thought the problem might well be resolved before 1997. I am sure that we all hope he is right. However, many people are now beginning to have doubts, and I hope that the noble Lord will be able to say a little more on that issue.
In particular, I ask him to confirm that the British Government are reviewing the position and to expand on the comment made by his right honourable and learned friend last week—I quote Sir Geoffrey—that,
"most boat people are not political refugees proper".
I understand that both my noble friend Lady Ewart-Biggs and the noble Baroness, Lady Young, and other noble Lords will say something about this distressing problem.
At this stage, this debate is no more than an interim look at the developing scene but I believe it is essential that the people of Hong Kong should know that the British Government, all opposition parties and the two Houses of Parliament are taking a lively interest in their problems and views at this crucial moment in their history. We hope to have further debates as the situation demands. Meantime, we hope that confidence and stability are maintained as discussions proceed. My Lords, I beg to move for Papers.
11.30 a.m.
Lord Bonham-Carter: My Lords, first, we must all thank the noble Lord, Lord Cledwyn of Penrhos, for raising this issue at this very timely moment. Secondly, I apologise to noble Lords and to this House because I have to depart at 12.45 p.m. for an

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engagement which I could not break, but I hope very much to return before the conclusion of the debate. Thirdly, I confess that, unlike many other of your Lordships here today I have not been to Hong Kong and I cannot pretend that I am particularly expert in its affairs. On the other hand, this does not seem a disqualification from participating in this debate, because what I hope and think the House should be doing is raising questions to which the noble Lord, Lord Glenarthur, may be able to give answers and to which this country, as well as the people of Hong Kong, have a duty to pay attention.
I shall inevitably cover briefly some of the same ground as that covered by the noble Lord, Lord Cledwyn of Penrhos, in his opening statement. The questions to which the Basic Law gives rise will be the same for almost all people, both for the inhabitants of Hong Kong and for the people of this country who have some reponsibility towards those inhabitants. I, like the noble Lord, Lord Cledwyn, start from the joint declaration and the statement in it that the Hong Kong Special Adminstrative Region will enjoy a high degree of autonomy, apart from foreign and defence affairs which are the responsibility of the People's Republic of China.
It seems that that proposition is entirely acceptable and a reasonable one to which one can take no exception. We continue from there to the statement from the Parliamentary Under-Secretary of State in another place on 10th March in which he said:
"The draft Basic Law is intended to implement the policies that are contained in the joint declaration that forms part of a solemn and internationally binding treaty between the People's Republic of China and the United Kingdom."
He continues by saying:
"Therefore, it is right that the House should wish to give its views on the implementation of the treaty in the draft Basic Law."—[Official Report, Commons, 10/3/88; col. 679.]
That is precisely what we are doing. What we should be discovering during the course of the debate today is how far those acceptable intentions set forth in the joint declaration are fulfilled in the Articles of the Basic Law. When one looks at it in that way a number of questions arise to which we should be given answers.
In another place the Minister whom I have just quoted said on the same date at col. 680:
"It also requres the proper involvement of the people of Hong Kong in the process, to ensure that their views are fully taken into account at all stages."
One immediate question arises; namely, how effective are the processes of consultation in which we are now engaged and which will continue intensively between now and September? One recognises that the results of that consultation will require negotiation with the People's Republic of China. It is inescapable that no-one can foretell in what spirit the results of those consultations will be received by the Government of the People's Republic of China. Nonetheless, if the consultations are to mean anything whatever we must assume that the People's Republic of China is acting in good faith and that the conclusions reached by consultation will be considered reasonably by that authority. If anything else is the case then the process of consultation is a pointless exercise.
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We come to the crucial issue; namely, to what extent does the Basic Law safeguard the high degree of autonomy? It is here, as the noble Lord, Lord Cledwyn, indicated, that one becomes worried. The joint declaration states unequivocally that the "high degree of autonomy" will only be limited by matters of "foreign affairs and defence". When one looks at the draft Basic Law we find that in Article 17 there are the following glosses:
"Laws, enacted by the National People's Congress or its Standing Committee, which relate to defence and foreign affairs as well as other laws which give expression to national unity and territorial integrity…"
Article 18, in the case of the jurisdiction of the Hong Kong Special Administrative Region, reads:
"Courts of the Hong Kong Special Administrative Region shall have no jurisdiction over cases relating to defence and foreign affairs, … and cases relating to the executive acts of the Central People's Government."
I ask, what kind of autonomy is this? What interpretation is to be put upon executive acts of the PRC? What interpretation is to be put upon other laws which give expression to national unity and territorial integrity? Those are very broad words, open to very broad interpretation.
If I were living in Hong Kong and saw those glosses put as modifications of an unequivocal commitment to a high degree of autonomy, I should be worried that that autonomy was being eroded already and would be eroded further in the future. Beyond that, who is to interpret the Basic Law? It is here that we come upon a rare and fundamental difficulty. Who will interpret the law that defines the intentions of the joint declaration?
It seems that the problem which confronts the Basic Law and upon which its validity depends, is this: can one graft onto a system based on the common law, which is the system which pertains in Hong Kong today, one which has no conception, culturally or historically, of such a system? That is what we are trying to do and it is a most ambitious and difficult project. For example, who will resolve a conflict between the Hong Kong Special Administrative Region and the People's Republic of China about the interpretation of the Basic Law?
Under our system we would answer quite simply by saying that it would be up to the judiciary. Articles 17, 18, 19 and 169 and the glosses to which I have referred, may demand interpretation. As I understand the Basic Law, that interpretation will be undertaken by the State Council of the People's Republic of China. The State Council of the People's Republic of China is de facto the government, the legislature and also the interpreter of laws. Therefore, we have a situation in which our idea of law interpretation by an independent judiciary simply does not exist.
Therefore, one very important question that noble Lords must consider and continue to watch is in what manner Basic Law—no matter how good and how well it is drafted, and how good are its intentions—is to be interpreted and how the differences in its interpretation between the Hong Kong Special Administrative Region and the People's Republic of China are to be resolved. This is the central issue we have to confront.
As the noble Lord, Lord Cledwyn, said, there are other more immediate concerns, to which I hope the

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noble Lord, Lord Glenarthur, will address himself when he comes to reply. I wholly agree with what the noble Lord, Lord Cledwyn, said about elections. The process of consultation between now and 1997 will be difficult if it has to be done indirectly. We are accustomed on the whole to consulting via people who are elected. Elected representatives are in our view the best representatives to express the opinions of those whom they represent. Therefore one wonders why the process of electing a relatively small proportion of the Legislative Council has been postponed.
One must inevitably be deeply disturbed by the massive emigration of boat people from Vietnam which has gone on and is going on. One would welcome any information the Minister can give us as to the steps the Government are taking to deal with this.
Finally, I hope that in the course of the debate we shall hear the noble Lord's views on the very substantial emigration from Hong Kong of some of its most important and talented figures, who appear to be going to Canada, Australia and the United States. It is undesirable that they should leave Hong Kong, which lives on its wits and is bereft of raw material except intelligence and therefore needs high-quality people to stay there if it is to survive. They will do so only if confidence in the future of Hong Kong is established. That confidence will be established only if the kind of considerations that have been raised in the debate are satisfactorily answered by the Government and by the Chinese People's Republic. That having been said, one can only hope that the best interpretation can be put on the Basic Law. I look forward to reassurance on this matter from the noble Lord in the course of his reply.
11.43 a.m.
Baroness Young: My Lords, I am sure that the whole House is grateful to the noble Lord, Lord Cledwyn of Penrhos, for introducing this important debate today. I spoke on this important part of the world, Hong Kong, on a number of occasions as a Minister in the Foreign and Commonwealth Office. However, this is the first opportunity I have had to speak after a personal visit to Hong Kong. Once again I discovered the great truth that there is no substitute for a visit and a look for oneself. I should like to start by placing on record my gratitude to the Hong Kong Government for arranging such an interesting and valuable programme. In saying that, I am sure that I speak on behalf of the noble Baroness, Lady Ewart-Biggs, and my noble friend Lord Torrington.
No one can go to Hong Kong without being conscious of its booming economy. I had always read of this and I was reassured that there was no sign of a crisis of confidence among international investors. The container port, I was told, has just overtaken Rotterdam to become the first container port of the world. There are two industrial estates and a third is planned. Talk was all about the necessity for a new airport, better communications with China and better roads in Hong Kong. A second tunnel is being built under the sea between Kowloon and Hong Kong Island. I could go on. Never have I been to a more stimulating, vibrant and economically
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successful place. There is full employment, rising real wages, two years of double-digit growth and a mobile labour force. It is all incredibly impressive.
The full meaning of the words "maintaining stability and prosperity", which I have used and which have been used today, came home to me in a very real way. However, beneath the vitality and prosperity there are real concerns which express themselves in different ways. One of the most serious is the flight of the professional middle managers and entrepreneurs. It was difficult to get reliable figures. A number of different ones were given, but generally it seemed to be thought that some 27,000 people left in 1987 and that possibly as many as 37,000 will leave in 1988. As we would put it, unhappily people are voting with their feet.
What, if anything, can we do? The truth is that Hong Kong people have emigrated throughout time. Most, after all, have already come from mainland China, and most would like to return to Hong Kong because of its economic success. One thing is quite clear. We should bring all our influence to bear wherever we can to try to meet the concerns of the people of Hong Kong over a number of matters, including that of the Basic Law, the specific subject of the debate today.
When one reads the Basic Law, and when one reads again the joint declaration, one cannot help but be struck by how amazing it is that the Chinese Government have set out this long period of consultation about the Basic Law—five months this year, followed by further discussions, and then another round of consultation. This is the first part. During my visit Mr. Ji Pengtei, the Chinese official responsible for Hong Kong matters, visited Hong Kong. Who would have thought five years ago that he would arrive and be reported as saying that he wished to come to hear the opinions of the people of Hong Kong? This is greatly to be welcomed.
In discussing the concerns about the Basic Law and about other matters it is important to acknowledge the progress that has been made. As my right honourable and learned friend Sir Geoffrey Howe said in Hong Kong, agreement has been reached on a number of international agreements. There is, for example, Hong Kong's separate membership of GATT and agreement on Hong Kong's participation in a number of international organisations. There are wide-ranging agreements on travel documents, air services and civil service pensions.
In considering the Basic Law, my colleagues and I had the opportunity to talk to Omelco, to the urban councillors, to the Group of 88, to the Far Eastern Economic Review Group and to many others, in particular businessmen and women and bankers of different shades of opinion. One important point emerged. They all want the Basic Law to come into line with the text and spirit of the joint declaration. They rely on the United Kingdom to explain these concerns and to put Hong Kong's views to the Chinese Government, though we ourselves are not a direct party to these negotiations.
It would be easy to devote a long speech to a textual analysis of the differences between the joint declaration and the Basic Law. I should like to touch briefly on four areas of concern to re-emphasise the points. I refer first to the judiciary. Paragraphs 56 to 60 of the joint declaration provide for the

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continuation of the present common law system and for an independent judiciary. The power of final judgment is vested in the Hong Kong courts. It is important that those provisions are faithfully reflected in the Basic Law. For example, Article 169 of the Basic Law gives the power of final interpretation of the Basic Law to the NPC Standing Committee.
Then there is the question of the autonomy and the protection of basic rights. There is a belief that the principle of "one country two systems" has not been fully reflected in the Basic Law. Sovereignty has been emphasised to the detriment of the high degree of autonomy promised to the special administrative region in the joint declaration. The articles on human rights are especially thought to be defective. For example, Article 39 of the Basic Law could allow the SAR legislator to enact laws to restrict basic human rights beyond the limits permitted by the two international covenants on human rights.
There is also the importance of continuity; continuity between what exists now and what will exist after 1997. The arrangements contained in Annexe III concerning the formation of the first special administrative region government appear to constitute a sharp break in the commitment to continuity of administration after 1997.
Finally there are a number of provisions in the Basic Law, which have already been quoted, which seem to me to be inappropriate and which I think many people would regard as inappropriate in a constitution; such as, the need for a balanced budget. However, much as I support that general principle it is not something that one would normally write into a constitution. Indeed, there are other such matters. The serious point is that these provisions could well be found to be most restrictive for some future government.
There are two further areas of concern. However, if I do not go into either of them in great detail it is not because they are not important—they are; it is because time does not allow me to do so. The first was touched upon by the noble Lords, Lord Cledwyn and Lord Bonham-Carter, and that is the whole question of moving towards democracy. Clearly there are divided views, as one might expect, on so important a subject. There have already been some direct elections and there will be 10 more elected people by 1991. It is the intention to move towards an all-elected legislature.
However, the truth of the matter is that in moving slowly we have let the genie of democracy out of the bottle and, having let it out, it is difficult to control. Of course there is a fear that China will put a cork in the bottle which would raise many difficult problems. One can listen to all those arguments but it is difficult for an outsider to stand in judgment and say what it is that the people want. The fact is that they are moving towards a directly elected legislature, but for some people, especially the professionals and the intellectuals in Hong Kong, they are moving at far too slow a pace. They feel themselves to be disregarded and that their views are not taken fully into account. Nevertheless, as we all know, it is very difficult to determine exactly what people want on these constitutional issues. One can only hope that stability and prosperity—one goes back to those two important words—will be maintained.
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Another area in which the British Government have an important role to play—and it has already been touched upon—is in connection with the Vietnamese refugees. There is intense resentment in Hong Kong that the Chinese refugees are stopped coming into Hong Kong at the points of entry; whereas the Vietnamese refugees appear to be allowed in—and they are coming into Hong Kong in increasing numbers. Indeed, since leaving Hong Kong last weekend I understand another 200 or 300 more have arrived.
We had the opportunity to visit one of the closed camps which I thought, under the circumstances, was kept remarkably well. I was much struck by the medical arrangements for the refugees. However, having said that, it was grossly overcrowded and some people had spent up to five years in the camp. Under no circumstances can that situation be regarded as anything but appalling for the people involved. Therefore I greatly welcome the reported remarks of my right honourable and learned friend Sir Geoffrey Howe, that we are looking actively at the matter to see whether we can determine those refugees who are genuine refugees and those who are coming to Hong Kong merely because they are looking for a better life from the economic point of view. We cannot allow the situation to continue as it is at present. There is a real sense of urgency about it. Therefore I ask my noble friend Lord Glenarthur to look with some urgency at the matter and give an indication that something will be done, because I think the situation is currently worsening and it is one which none of us would wish to see continue. It is a matter within our control and we should do something about it.
I have mentioned many concerns. I have also mentioned the vitality and prosperity of Hong Kong. In my view, at the end of the day, although I hope that the areas of concern in regard to the problems over democracy and the problems over refugees will be put right, the big issue is that of the Basic Law. It is that which is generating the outflow of talented people from Hong Kong, and it is a matter of trust; that is, trust in our relations and Hong Kong's relations with China.
Many people pointed out how far China is linked to the prosperity of Hong Kong. China is Hong Kong's largest trading partner. All the time China receives enormous sums of money in remittances from the Chinese people who are living in Hong Kong. Hong Kong is its largest source of foreign currency. I understand that 80 per cent. of investment in southern China is from Hong Kong money. There is considerable Chinese investment in Hong Kong itself. I was interested when visiting the Hong Kong Bank to be told that the Bank of China building was being erected next to it and it would be an even taller building so as to make that point quite clear.
Interestingly, I was told that between 1 million and 2 million Chinese people are employed by Hong Kong industries within China itself. I was also told that the productivity in some of those industries is in some cases higher than that of Hong Kong. Unquestionably the Chinese Government are learning a great deal about what an efficient free enterprise economy means from the talented Hong Kong people who are working there.

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All that I have said has to be seen against a background where not so long ago the border with China was closed. Therefore both on the political front, and on the economic front, we can see that there are extraordinary developments taking place within China itself, especially in Canton which is near and adjacent to Hong Kong. Indeed, on a helicopter flight over the border it was possible to see something which looked extraordinarily like Hong Kong but which was in fact growing just on the other side of the frontier without, one imagines, all the problems of building tall on a very small space. Those developments must be put in the balance when one comes to judge what the issues are. In other words, when considering the future of Hong Kong, one must consider the changes taking place in China. Whatever happens in Hong Kong, and whatever China's treatment of Hong Kong may be, one country will be watching closely; namely, Taiwan.
In conclusion, I hope that my noble friend Lord Glenarthur will be able to give the people of Hong Kong the kind of assurances that I think they want; namely, that Britain is standing behind them over their concerns on the Basic Law. I hope that we will take the opportunity to raise those concerns in all the appropriate fora so that it is known that we want the points to be in line with the context and spirit of the joint declaration. I hope that on matters such as the Vietnamese refugees, where we have a direct chance of dealing with the issue, we will do what we can in pressing the Vietnamese Government in relation to the serious situation that exists on the ground.
All of Hong Kong's friends, with whom I would number myself as one, want nothing so much than that those words "stability and prosperity" will continue to mean in the future what they do today.
12 noon
Lord MacLehose of Beoch: My Lords, I should like to congratulate the noble Baroness, Lady Young, on her speech. I was delighted by her positive reaction to her recent visit to Hong Kong. Perhaps I may also say how good it is to see so many of your Lordships participating in this debate on a summer Friday morning. As the noble Lord, Lord Cledwyn, said, the drafting of the Basic Law, which is what we are considering this morning, is the responsibility of the Chinese Government, but there is a British obligation, which is to satisfy itself that in the end the Basic Law fulfils precisely the commitments of the joint declaration.
I, like the noble Lord, Lord Cledwyn, welcome the fact that on Tuesday the Foreign Secretary emphasised that point to his Chinese colleague. It is most important that when the drafting of the Basic Law has reached an appropriate point the Government will be prepared to state whether it does or does not fulfil the commitments of the joint declaration and will enable Parliament to debate it.
The implementation of the joint declaration—the subject of the debate—has in my view made steady progress. Indeed, the two governments are to be congratulated on the work of the joint liaison group and on the substantial area covered in the first draft of the Basic Law. The text of the eventual law will of course be crucial to Hong Kong; but the draft is
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merely what it says; that is to say, a first draft. In my opinion it provides a good basis for consultation and further progress through redrafting this autumn. All in all, the progress and implementation of the joint declaration is good, even though much remains to be done.
However, handing out congratulations will not assist the drafting committee. It has solicited opinions, and in the same spirit I shall give mine, for what they are worth, given that the general sense of opinion in Hong Kong and, in particular, of the Legislative Council has not yet been received, although we have had some valuable notes from some groups.
There is much that could be commented upon; for instance, the restraints on the proposed SAR budget which have already been mentioned. I shall confine myself to three general points. One of the major groups of issues, which I think need further consideration by the drafting committee, is the definition of the relative powers and competence of the National People's Congress and its standing committee on the one hand, and of the legislature and judicial courts of the Hong Kong SAR on the other. They are referred to in Articles 16, 17 18 and 169 which have been mentioned by all previous speakers.
While the sentiments in the articles may in theory be unobjectionable, the reservations in favour of the legislation of the congress and the powers of the standing committee, including its powers of interpretation which were so emphasised by the noble Lord, Lord Bonham-Carter, seem unnecessarily widely drawn for practical purposes.
Obviously, the People's Government and the standing committee should have a role consistent with China's sovereignty and the joint declaration; but I suggest that the drafting committee will need to look carefully again at those articles so that central government powers and policies and the SAR's high degree of autonomy are more correctly and consistently balanced.
The draft focuses on options for different forms of election. The noble Baroness, Lady Young, referred to that point. There has been sharp debate in Hong Kong about electoral systems and the timing of their introduction. Some of those favouring quick, universal, direct elections claim, in all sincerity, that that procedure will help to insulate Hong Kong against interference from Peking. I must confess that that logic seems dubious, because if interference were intended an electoral system could be used to further it as well as any other method.
The purpose of the concept of "one country, two systems" and of the joint declaration was such insulation. I think that the immediate requirement is to obtain wording for the Basic Law that clearly and correctly reflects those concepts rather than in any way to be diverted into seeking them through one electoral system or another.
However that may be, it seems desirable that as soon as possible a consensus in Hong Kong should be reached on a method of electing the present legislative council. I do not wish to put forward any view on what that should be. It should be done as soon as possible so that an acceptable method for the legislature of the SAR can be agreed. Surely it is desirable that an electoral method, suitable for the

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SAR, be introduced and running well in advance of 1997 so that at that point continuity of the legislature, as well as the public service, could maintain confidence and assist the new chief executive.
I suggest that in the 1997 scenario, it is crucial to let everyone know what to expect and what to aim for as soon as possible. That brings me to my third point, which is Annexe 3, about which the noble Lord, Lord Cledwyn, and the noble Baroness, Lady Young, have spoken. That annexe would affect the whole composition of the legislature at the moment of transition. The practical implication would be that no one would know, up to 1997, what the composition of the legislature would be after 1st July of that year.
I should have thought that that uncertainty was likely to invite rumour, suspicion and speculation, just when there will be the greatest need for calm and confidence. I understand the need for change in the exercise of sovereignty to be appropriately marked, but I hope that the drafting committee can devise some way to achieve that without affecting those members of the current legislature eligible to continue to serve. I hope that it will take another look to see how the principle of sovereignty should be reconciled with the other principles that are applied; that is, the principles of smooth transition and continuity.
I do not wish to detain your Lordships for long. I conclude with two thoughts only. The first is that from what has already been said this morning, your Lordships must appreciate the complex and many-sided pressures under which Hong Kong is at present being governed and under which progress is steadily being made to work out its future. In the circumstances, and given the success with which he is grappling with those twin problems, our support and commendation are due to Sir David Wilson.
Secondly, I wish to point out that comment on the draft Basic Law inevitably focuses, as previous speakers have done and as I have done, on what one thinks is wrong in it. That should not detract from the underlying fact that a substantial amount is along satisfactory lines and that offers real hope that a major effort by all concerned over the next year could get the bulk of it right.
12.10 p.m.
Lord Kennet: My Lords, I think the noble Lord, Lord MacLehose, could well have detained the House for longer than nine minutes if he had wished, because there is no other Member who knows as much as he does about Hong Kong, to the present condition of which he so largely contributed. I also wish to congratulate the noble Lord, Lord Cledwyn, on his methodical and humane introduction of the subject of debate this afternoon and to state that I for one agree, I think, with everything he said.
I shall start my remarks about the draft Basic Law on the question of the relationship between Chinese sovereignty and Hong Kong local autonomy, as is reflected in the draft Basic Law and particularly in the portions dealing with the functioning of the legal system, the judiciary, in Hong Kong after 1997. Many noble Lords have agreed, and I too agree, that the fact that foreign affairs and defence are reserved to the centre in Peking is absolutely normal and to be
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expected. Consequently the courts of Hong Kong should not have jurisdiction in matters "affecting" foreign affairs and defence. There is a frontier problem here, of course, because many matters will concern foreign affairs or defence in a trivial manner and their principal content will be local to Hong Kong, whether we are talking about criminal or civil jurisdiction. However, I think that is something which can be left to be worked out without undue disquiet on the part of this Parliament at this stage.
The remaining matters which are reserved by the draft Basic Law to Peking, and particularly the "executive acts" of which my noble friend Lord Bonham-Carter complained—he complained about their reservation—are at another level of difficulty altogether. I for one would welcome some guidance about what we believe Peking means by "executive acts". I simply do not know what the phrase means in Chinese. It could mean pretty well anything done by the Peking Government. In that case it would not be possible to subject the proceedings in the Hong Kong courts to it. That would certainly be dangerous, and it should not be allowed to pass by us here, or, I hope, by the Hong Kong negotiators on the drafting committee.
Again, there is the question of the interpretation of the Basic Law. My noble friend Lord Bonham-Carter seemed unsure as to who would do the interpreting. He pointed out the desirability of it being done by the judiciary somewhere. As I read the Basic Law, it is all too clear who does it. Perhaps noble Lords will turn to Article 169, which I shall read, since I wish to get it into Hansard. It is a very clear turn of phrase.
The power of interpretation of this Law is vested in the Standing Committee of the National People's Congress.
"When the Standing Committee of the National People's Congress makes an interpretation of a provision of this Law, the courts of the Hong Kong Special Administrative Region, in applying that provision, shall follow the interpretion of the Standing Committee".
It also says that the Hong Kong Special Administrative Region courts must apply in certain circumstances to the Standing Committee of the National People's Congress for an interpretation before undertaking the hearing and judgment of a case. I very much hope that that provision will not last through the consultation period.
To me, the heart of this report is the means of producing an executive and legislature in Hong Kong after 1997; namely, the election law. It strikes the eye at once that the report presents a surprisingly wide spectrum of alternatives—four. That can only be extremely good news. That the government in Peking should be prepared to go public with four alternatives, which it considers at least worthy of discussion on the crucial point of Hong Kong autonomy and democracy, can only be a very good sign for the future.
It makes the draft Basic Law itself necessarily a very preliminary document and because of that fact I think it poses certain problems for our Government in the matter of convergence. When we started down this road between London and Peking, "convergence" was the watchword. The development of Hong Kong internally between the joint statement and 1997 was regarded as being something to be handled in such a way as to bring London and Peking together at the last moment, to converge on the desired final stage.

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The great thing is that this Basic Law, as regards Hong Kong elections, does not give a final state on which any convergence can be done. There is nothing to converge on—not yet. There is a danger in that it will put off all the converging until quite a late stage in the period before 1997, when it may be hurried.
Let us look now at the spectrum of choices offered. The worst alternatives are a caricature of the secret and bureaucratic constitution. They show members of the future executive and legislature appearing by the choice of persons unnamed from bodies which have themselves been empowered by persons unnamed and which have no recognisable membership that could form an electoral roll. These alternatives freely use the word "election" when they seem to mean "selection". They are—not to put too fine a point on it—in Kafka land. The best alternative—by which I mean the second of the four set out in Annexe II—takes the proposed constitution exactly 51 per cent. of the way to direct democracy.
I wish to raise once again the problem of elections which I have raised on at least two occasions before when the matter has been debated in this House. Do we believe that democracy by direct general election is in some way the best and most just of all the ways of government which exist? If we do, have we any right not to introduce it into Hong Kong before 1997? Have we any right not to introduce 100 per cent. of it before 1997? Our judgment of this question must depend on our judgment of what would be the likely Peking reaction if we did so. If we did so, and if China extinguished it when it took over, that is China's business.
I do not quite follow the argument of the noble Lord, Lord Mac Lehose, if I understood it rightly, that elections could be used by Peking as a means to reduce Hong Kong independence as well as any other means. It seems to me that free elections are in themselves rather a means of preserving the liberties of the people and preventing their reduction. They are not to be classed with bureaucracy or military tyranny in a list of equal means of reducing popular liberties. My own belief, which is based on discussions in both Peking and Hong Kong over the years, is that whatever government is in power in Peking in 1997—it is unlikely to be anything like the present one—will be unwilling to extinguish whatever liberties Hong Kong may then have. The prosperity of Hong Kong which is so obviously important to China depends on that, and that is well understood in Peking.
If I am right, then it is up to us to launch Hong Kong on its future within China with liberties as broad and as inextinguishable as we can now obtain from Peking. When I say "we can now obtain from Peking", I am speaking in the very broad "we" of London and the colonial Government of Hong Kong acting together. How far that is possible I am in no position to say, but I hope that most Members of this House would agree that 51 per cent. direct general election well before 1997 is the absolute minimum, and that it would be better to have a legislature, from which is drawn an executive council, which has a clear majority of directly elected members leavened by a sizeable minority of indirectly elected, or proportional, or corporate members, or even conceivably by some appointed members.
12.21 p.m.
Lord Irvine of Lairg: My Lords, I have in the past six or seven years visited Hong Kong about two or three times in each of those years. I can, I think, lay fair claim to being a friend of Hong Kong and an admirer of its energy and vitality. I was in Hong Kong at the time of the joint declaration. I well recall the excitement and the debate that it engendered. It is right to say of the Foreign Secretary, Sir Geoffrey Howe, that it represents on his part a triumph of imaginative diplomacy.
I can also, I think, lay fair claim to some experience over these years of the Hong Kong legal system. That is a system which is of very high quality indeed and one that is held in high regard internationally. The joint declaration provided for a Basic Law of the special administrative region to be drafted by the National People's Congress of the People's Republic of China.
The joint declaration was in both the English and the Chinese languages, both texts being equally authentic. It stipulated that English might be used, in addition to Chinese, both in government and in the courts. Thus, I hope we will find that the Basic Law in due course will also be set out in both languages, with the English text being equally authentic. I ask the Minister to confirm whether there will be, in due course, such a text.
The Basic Law is the constitutional instrument from which all other laws derive their legitimacy. The laws previously in force in Hong Kong, essentially English law, will continue to apply after 1997, apart from any that contravene the Basic Law. It is important for Hong Kong's future as an international commercial centre that the status of the English language is not lowered. For "one country two systems" to work, there must surely be an authentic English text of the Basic Law.
I agree with the noble Baroness, Lady Young, that every group in Hong Kong is looking to this country to ensure, so far as it can, that the Basic Law is faithful in letter and spirit to the joint declaration. One of the most important characteristics of the Hong Kong system is its legal system. One of its key characteristics is the right of the courts to interpret and develop the law. In that, as has been pointed out, it differs from the mainland system. In China courts do not have that right. That is reserved to the National People's Congress which both enacts and interprets laws.
In Hong Kong today, just as in England, the legislature can change the laws but does not interpret them. The joint declaration had stated:
"after the establishment of the Hong Kong Special Administrative Region the judicial system previously practised in Hong Kong shall be maintained; … The courts shall exercise judicial power independently and free from any interference.".
I therefore join with other noble Lords in registering great concern that this has not been carried into the draft of the Basic Law. It provides that the power of interpretation of the Basic Law shall be vested in the Standing Committee of the National People's Congress.
I hope that the Government will think it right to try to persuade our Chinese friends that this should be changed. I entirely appreciate that the Basic Law will be Chinese law; that it will be promulgated by the

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National People's Congress; and that our Chinese friends may feel that it should be treated like all other Chinese laws, that is, subject to interpretation by the National People's Congress.
But I hope that the Government will say something along the lines of the following, and that China will listen sympathetically. The Basic Law is different from any other Chinese law. It will have practical effect only in Hong Kong. It does not therefore need to be interpreted by the National People's Congress for the benefit of courts elsewhere in China. The Basic Law is to be the foundation of Hong Kong domestic law. It should be interpreted by the Hong Kong courts and, if it is not, the Hong Kong judiciary will not be seen to be independent. There is in Hong Kong a vast amount of litigation of an international character, which is part and parcel of Hong Kong being a great international commercial centre. The international community respects and trusts Hong Kong's independent judiciary.
The joint declaration had declared that the courts of the Hong Kong Special Administrative Region would be vested with:
"the power of final adjudication.".
I hope the Minister will feel able to say in reply to this debate that he shares my concern that the draft Basic Law has seriously departed from an important part of what was agreed in 1984. The draft Basic Law proposes that the final court of appeal in Hong Kong shall be subject to decisions made by the National People's Congress. Article 169 has already been cited by other noble Lords. I hope that the Government will put to our Chinese friends the case for changing this. The joint declaration had provided that the region would be "vested" with:
"independent judicial power, including that of final adjudication.".
Both these promises are undermined by Article 169. Surely, again in the interests of "one country two systems", the Hong Kong system should not be made subject to the mainland system. There is another highly troubling deviation in the draft Basic Law from the joint declaration. The joint declaration had stated quite clearly—I quote from Part II of the Annex which discusses the laws in the special administrative region:
"the laws of the Hong Kong Special Administrative Region shall be the Basic Law, and the laws previously in force in Hong Kong and laws enacted by the Hong Kong Special Administrative Region legislature."
So that was quite clear. After 1997 the laws would consist of existing Hong Kong laws; the Basic Law; and those laws enacted by the new Hong Kong legislature. But the draft Basic Law contains a very troubling provision, and I shall read it in full. The noble Lord, Lord Bonham-Carter, has already referred to it. It states:
"Laws enacted by the National People's Congress or its standing committee which relate to defence and foreign affairs as well as"
—I emphasise the following words—:
"other laws which give expression to national unity and territorial integrity and which, in accordance with the provisions of the law, are outside the limits of the high degree of autonomy of the Hong Kong Special Administrative Region, shall be applied locally by the government of the Hong Kong Special Administrative Region by way of promulgation or legislation on the directives of the State Council, whenever there is the need to apply any such laws in the Region."
I must say, and I hope the Minister will agree, that this appears to be in direct conflict with the joint
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declaration. Laws concerning defence or foreign affairs are one thing, but I find the rubric:
"other laws relating to the expression of national unity and territorial integrity,"
both vague and worrying. I share the reservations of the noble Lord, Lord Bonham-Carter, about that provision.
I also have difficulty in seeing how the provision squares with China's constitution. In 1982, China's National People's Congress amended the Chinese constitution to include an important new article, Article 31. It provided:
"The state may establish special administrative regions when necessary. The systems to be instituted in special administrative regions shall be prescribed by law enacted by the National People's Congress in the light of specific conditions."
That article was introduced for such areas as Hong Kong. It was intended to keep mainland law away from such regions, except for special laws such as the Basic Law:
"enacted by the National People's Congress in the light of specific conditions."
The provision of the draft Basic Law to which I have just called attention appears to be a potentially serious departure both from what was always understood to be the intent of Article 31 of China's constitution and from the joint declaration.
Perhaps I may add a word or two about human rights. The joint declaration was heartening. It declared that the provisions of the International Covenant on Civil and Political Rights should remain in force in Hong Kong and that human rights and fundamental freedoms would be ensured by law in the Hong Kong Special Administrative Region. That, I think, can only have meant that the region was to have an enforceable Bill of Rights. Encouragingly at first sight, the draft Basic Law provides:
"The provisions of the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights as applied to Hong Kong shall be enforced in accordance with the law of the Hong Kong SAR."
But these covenants are not written into the Basic Law. There would be no difficulty in doing so. One of the five authentic versions of these covenants is in the Chinese language. What we find in the Basic Law is a statement of fundamental rights that are to apply in the Hong Kong SAR, essentially in Chapter 3, supplemented by a few provisions in some of the other chapters; that is, a purpose built Bill of Rights but one which I have to say is deficient by comparison with the international covenants.
I do not wish to lengthen this speech unduly but I urge those concerned to scan the relevant provisions of the Basic Law line by line and to note every occasion where it does not match up to the international covenants. Without attempting to be exhaustive, I shall list a number of human rights, universally accepted as human rights, to which the Basic Law makes no reference at all. I take all my examples from articles of the International Covenant on Civil and Political Rights.
The draft Basic Law makes no reference to the right to life (Article 6); to freedom from torture and cruel, inhuman or degrading treatment or punishment (Article 7); the freedom from forced or compulsory labour (Article 8); the minimum rights of prisoners (Article 10); the right not to be imprisoned

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for inability to fulfil a contractual obligation (Article 11); the rights of aliens lawfully in Hong Kong (Article 13); the right not to be subjected to retroactive criminal law (Article 15); the right to recognition as a person before the law (Article 16); the rights of children (Article 24); and the rights of minorities (Article 27).
There are many provisions of the draft Basic Law which provide for human rights in specific areas, but less comprehensively and less satisfactorily than the international covenants. I do not like, for example, the provision of the draft Basic Law which provides that Hong Kong inhabitants,
"shall not be unlawfully"—
I underline the word "unlawfully";—
"arrested, defamed or imprisoned".
I think that that may have been borrowed from the Malaysian constitution. "Unlawfully" means that the legislature is free to prescribe whatever grounds it may choose to take away individual liberty.
I have similar criticisms of other provisions of the Basic Law. Freedom of speech of the press and of publication is guaranteed "in accordance with law". Again, it is "unlawful" search or "unlawful" entry into the home that is prohibited. Correspondence and telephone communications can be intercepted "according to the procedure prescribed by law". A person may travel "if he holds a valid travel document". Constitutional lawyers know only too well that provisions of that kind provide no absolute guarantees. The legislature of the Hong Kong SAR will be free to encroach in any way it chooses on any of these rights.
With great respect for all those concerned with the draft Basic Law, I suggest that the most straightforward way of carrying into effect the commitments on human rights contained in the joint declaration is either to write the international covenants in their entirety into the Basic Law, to have the Hong Kong SAR enact them in future or, better still, with the agreement of the People's Republic, to have the Legislative Council enact the international covenants here and now.
The draft Basic Law is an important further step in the long march to 1997. Its authors are to be congratulated on their initial efforts. I hope that all those concerned will see some wisdom in altering some of its provisions in the respects to which I have endeavoured to call attention.
12.35 p.m.
Lord Derwent: My Lords, those of us who are concerned with Hong Kong on a daily basis are grateful to the noble Lord, Lord Cledwyn of Penrhos, for giving us the opportunity to take stock at this important stage in the implementation of the joint declaration. I venture to speak in this debate because I am able to do so from a slightly different angle to some, though not all, of your Lordships. I have the honour to be part of what is now perhaps the largest business group in Hong Kong. It accounts for nearly 20 per cent. of the capitalisation of the stock market. Its controlling shareholder and most of its remaining shareholders are Hong Kong Chinese. Furthermore, over 95 per cent. of the group's assets are in Hong Kong. Therefore, the subjects under discussion today
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are not of merely academic interest. Our whole future is at stake.
I should make it absolutely clear that the views which I shall put forward are my own and are not necessarily those of my colleagues. Perhaps I may also express my apologies to the House in that, should the debate continue beyond 2.30, I shall have to leave to attend an unavoidable engagement. To help ensure that that does not happen, my remarks will be as brief as possible.
I am constantly asked whether my Hong Kong friends are not worried about life after 1997. The answer is, that of course they are worried. They are capitalists and their employees are workers who are prospering under the capitalist system. They will soon have to be dependent on a communist state. It must not be forgotten that many of them are refugees from the mainland. At the same time, they are Chinese and they feel 100 per cent. Chinese. They are excited by the prospect that Hong Kong may become the financial and commercial engine room for the country with the largest population on earth.
In a recent speech in New York, the chairman of the Hong Kong and Shanghai Bank—a respected Scottish banker who is not given to wild flights of fancy—said that he saw 1997 as an opportunity, and not as a threat, for Hong Kong. The People's Republic of China now comprises about one-fifth of the world's inhabitants. One American think-tank has calculated that on present projections the economy of China, including Hong Kong, could be the second largest in the world by the year 2010, surpassing both the Soviet Union and Japan. The people of Hong Kong see themselves facing great possible risks and also great possible opportunities. That is something which has occurred frequently in Hong Kong's history. However, this time the stakes are higher than ever.
I confess that I find much of the debate in Britain outside your Lordships' Chamber about the future of Hong Kong distressingly theoretical. That has been particularly so since the publication of the first draft of the Basic Law. While we have been the colonial power we have had the wisdom not to seek to impose our Westminster style institutions too precisely on a country and a population whose circumstances and needs are quite different from our own. While it has been pointed out that there are differing views within Hong Kong on the speed with which democracy should be introduced I am bound to say that I do not myself feel that that is the most important issue at stake.
It is fair to say that the absence of full democracy in Hong Kong has never until now stopped the Hong Kong Chinese from prospering or leading their own lives in their own way. Nor has the majority of the population shown much interest in copying our political system in the past. They have been quite content to see us exercise the ultimate authority provided we did not interfere too much with their daily lives. I believe that what most individual Hong Kong Chinese really want after 1997 is to be allowed to carry on as before.
From the beginning of Hong Kong as a colony until today its people have in fact enjoyed no political rights which theoretically at least could not have been changed by the intervention of the Westminster

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Parliament—over 10,000 miles away and populated by non-Chinese. Whatever the safeguards and whatever the legal pieties, that is the truth. What is happening is that after 1997, for Westminster we must read Beijing.
Your Lordships may however regard it as a sign of considerable statesmanship on the part of the Beijing Government that they have been prepared to limit their total freedom of action post-1997 by entering into a solemn international agreement to do so. Hong Kong therefore will be exchanging total dependence on a colonial power for dependence on a China limited by international obligations freely entered into and accepted by Beijing.
But, some say, there have been great upheavals in China in the recent past, and even if one accepts the good faith of the present government in Beijing such upheavals may recur. What then? The question is entirely fair. My answer is that if the worst occurred, if there were another cultural revolution in China or a dramatic heightening of East-West tension, debates on the details of the Basic Law and the degree of autonomy or otherwise in Hong Kong would be largely irrelevant anyway. I cannot believe that Hong Kong could prosper in such circumstances whatever the Basic Law may say. The same would probably have been true even if Hong Kong had still been a British colony.
I suggest to your Lordships that even in such dreadful circumstances Hong Kong would probably be better off now that its relationship with the rest of China has been explicitly recognised and enshrined in an international agreement than it has been in the past when the relationship between Hong Kong and China was based on treaties between Great Britain and the pre-revolutionary China which were never recognised by the People's Republic. In any event, we are not faced with the China of the cultural revolution but with a country which has made and is making enormous advances in its efforts to open itself to the outside world.
I have no doubt that the present government in Beijing are absolutely genuine when they say that they wish Hong Kong to prosper and that their commitment to "one country two systems" is total. The likelihood is that future Chinese governments will hold the same view.
The reason I say that with such confidence is that I am quite sure that the only reason they have reached such a policy is entirely on the grounds of their own self-interest. The PRC today is an underdeveloped country. Suddenly, in one bound, through the quirks of history, they can acquire one of the most sophisticated financial and commercial centres in the world to whose dynamism the noble Baroness, Lady Young, has just paid tribute. Thus they can jump forward about 50 years overnight. It must be their policy to bring that about.
To achieve that they must acquire Hong Kong as a going concern. Otherwise what have they done? They have acquired a densely-populated barren rock and merely added to their own internal problems. It is because the prize is, for China, so glittering that they have been prepared to accept what must be for them—and let us look at it from their point of view—domestically an extremely awkward concept of one country two systems.
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That concept is absolutely revolutionary. Let me put it like this. Suppose the British Government decided that it would bring great financial benefits to the United Kingdom to give the City of London special status and exempt it from the law of the land. Whatever the financial logic, one can imagine the howls of outrage from outside London and the rest of Britain. In the same way one must suppose that the adoption of the two systems policy potentially has cause for embarrassment for the Beijing Government elsewhere in China.
It is for that reason that I am uneasy about the barrage of complaints which we have seen from some quarters and particularly in the press that Hong Kong's autonomy as at present defined in the first draft of the Basic Law is not total. I believe that there is—not in the perfect world but in the real world—one main criterion against which the Basic Law and its related constitutional arrangements must be judged: is it of a nature which allows the people of Hong Kong to prosper and at the same time is capable of being stomached by China because it does not cause too many problems elsewhere in China?
Beijing governments will change, as do governments in London. Successive Chinese governments, not just the Ministers who happen to be in power in 1997, must be able to perceive readily that the economic advantages of Hong Kong outweigh for them the doctrinal and domestic political disadvantages of its special status. If pre-1997 we try to make the Hong Kong political system too alien to Chinese ways, we could just tip the balance of the argument from the Chinese point of view and live to regret it 10, 20 or 30 years after 1997.
Having said that, I fully recognise that we have a duty to do all that we can to lend confidence to the people of Hong Kong by ensuring that the joint declaration is applied in toto. It is for Hong Kong an undoubted safeguard that China cannot be seen without great harm to herself internationally to renege on the joint declaration. Both Her Majesty's Government and the British Parliament must be vigilant during the consultation period to ensure that nothing in the Basic Law as it eventually emerges is inconsistent with the joint declaration.
The first draft is not in all respects what we should like to see. Noble Lords who have spoken—I do not intend to follow them in discussing the details—have mentioned many of the points on which further negotiation is necessary. I for my part pay tribute to the work the Government are doing to ensure that the apprehensions of the people of Hong Kong are taken into account. Beyond that, however, beyond making sure that no part of the joint declaration is departed from, it is not for us but for the people of Hong Kong to give their views on which alternative detailed provisions they prefer inside the general framework of the joint declaration.
I hope people will realise that on the ground conditions dictate that good faith on both sides may be more important than every single textual nicety. We should not get so carried away with a sense of the superiority of our own system that we sacrifice the people of Hong Kong to our theories. Let us remember that all parties have problems and that all parties are negotiating in good faith to find a reasonable solution. Better, my Lords, three-quarters of a cake than none at all.
12.50 p.m.
Lord Tanlaw: My Lords, I am very pleased to follow the noble Lord, Lord Derwent. I have listened with interest to his contribution, which was based on his valuable experience in the business world. In what I hope will be a brief intervention this afternoon I wish also to emphasise that side of this topic.
I should like to declare an interest in that I am proud to have originated from a Scottish trading family which has operated in the South China Seas for more than 150 years. My wife is Chinese and has the ability to speak at least six dialects, so I have through her the ability to listen to what people say and I get some idea of the thinking of the people of the area during the many visits that I make to Hong Kong from time to time. I am also an outside director of Inchcape and Company plc which employs, through one of its subsidiaries, more than 5,000 Hong Kong citizens. That company has every intention of remaining and trading in Hong Kong and the new special administrative region beyond 1997 and for the next 150 years if necessary, provided that the business is there. I see nothing of substance in the draft Basic Law before us which would prevent Inchcape Pacific or any other company from taking that same view.
In the preamble to the draft Basic Law it is stated that although Hong Kong has been part of China since ancient times, it was occupied by Britain in 1840 after the Opium War. Only 150 years ago it was a barren rock and a haven for seagulls and itinerant fishermen. Today it is the world's third largest financial centre and, as the noble Baroness, Lady Young, said, it is now the world's biggest container port.
It was the financiers, businessmen and traders from all sections of the community—not politicians or constitutional lawyers—who brought about the amazing transformation over the last century. The business community of Hong Kong evolved mainly from ordinary people, most of whom had fled from oppression with nothing but the clothes in which they stood up. Those new arrivals were prepared not only to work hard but to create the term "work ethic" based on self-help, for which the citizens of Hong Kong are now rightly famous. I have seen nothing in either the joint declaration or the draft Basic Law which indicates a need for those same refugees to repack their bags in order to seek fame and fortune as second-class citizens, more often than not in second-rate jobs, outside Hong Kong. In fact, I see quite the reverse.
Due to accelerated economic growth in the region and in Hong Kong especially there is an increasing shortage of middle management in both the executive and in commerce which cannot continue to be filled for much longer by expatriate staff. Those who carry the false insurance of dual nationality or residence may not be asked to fill that gap because at the first major hiccough of the Hang Seng index—and there will be one—it will be assumed that they will take advantage of their new residence abroad. Therefore I wonder whether the Minister agrees that perhaps for the first time there is a real opportunity for qualified local management who speak at least one Chinese language—those who do not have any other nationality and who are prepared to stay on after 1997—to get to the top in the SAR.
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The noble Lord, Lord Cledwyn of Penrhos, raised the question of the worries of emigration, as did other noble Lords. I am not particularly worried about emigration and I do not think one ought to be. It can easily be stopped, and quite simply in my personal view, if the executive and indeed commercial companies make quite clear that they are not happy with people who have dual nationality continuing to go up the ladder, that their places will not be guaranteed and that they would much prefer to employ those local citizens who do not, cannot or have no wish to take up dual nationality and are prepared to throw in their lot with the future of Hong Kong and the SAR. If that were made quite clear I feel sure that emigration would certainly slow down if not stop altogether. I know of no other place in the world where people wish more strongly to get up that ladder and rise to the top. We should start to make some rules about this situation which would allow companies and the executive to create a management structure that will last beyond 1997.
If there is to be continued growth in the economy after 1997—and Chapter V of the draft Basic Law makes that assumption—businessmen and traders must be given conditions, which are the same conditions as now, in which they can flourish. All governments should have that objective and the Hong Kong Special Administrative Region should be no exception. If that objective is not achieved because business cannot operate efficiently owing to, for instance, excessive bureaucracy, corruption or organised crime, then Basic Law will become quite inoperable.
I wonder whether the noble Lord would be prepared to say that it is the intention of the SAR to protect business interests from those hazards as far as possible through the continuation of an authoritarian type of rule, as was previously conducted under Britain, but with the leavening of consensus democracy through the 25 per cent. proportion of direct elections as set out in the draft Basic Law, and that universal suffrage will be deferred for a long time to come.
Basic Law must be seen only in the context of Hong Kong. Other noble Lords have made that same observation and there is no point in my elaborating it further. However, it must also be recognised that the people of Hong Kong have special conditions and different social and cultural backgrounds which perhaps do not apply elsewhere.
In the debate on Hong Kong in another place on 20th January 1988, as reported at col. 1009 of the Official Report, a spokesman from the opposition party, Mr. Andrew Faulds, underlined that point. He said:
"Most of us forget … that China and Chinese people everywhere have totally different cultural and social traditions from ours. The concept of democracy is at variance with their political thought over the many centuries of Chinese life. China, both Confucian and Communist has shown a long respect for authority and social order".
He said, if I may paraphrase him slightly, that this was perhaps something that we in the individualistic West have been committed to for far too long to understand or to accept.
The people of Hong Kong do not have a Graeco-Roman cultural background as do the Western democracies, yet in my view Hong Kong is in every sense a city state of the kind envisaged by ancient

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Greek political thinkers. I cannot resist quoting a poet of that period, named Phoclydes, who was an advocate of the good life in the city state. In the sixth century BC he wrote:
"Better a tiny and orderly city set high upon a rock than the senseless disorder of Nineveh".
Although that was written a very long time ago I believe that those words sum up the average Hong Kong businessman's philosophy for the future. Hong Kong has seen the apparent "disorder of Nineveh" take place across the border in mainland China. The Chinese people experienced it during the cultural revolution, which I think was the ultimate experiment in democracy. In my view neither government would wish it to be repeated. Therefore the objectives of both sets of authors of the draft Basic Law appear to me to be the outcome of one mind on the subject of democratic representation.
Yet of course there are objectors to consensus democracy, such as Mr. Martin Lee and his friends who, although they have assumed the role of the Socratic gadfly, in my view have failed to produce for Hong Kong the convincing Socratic argument for a full democracy which would not endanger the prosperity of the entire economy.
The SAR will be an international economy. It can do without undue influence of local politics and local politicians, who are unlikely to make a contribution to its growth. A thriving middle-class of professional business managers on the other hand will, in my view, create a positive and stabilising influence for government for the future; and that applies to any government, whether or not it is the Government of Hong Kong. I am sure that noble Lords do not wish me to quote Aristotle and the Golden Mean or any other philosophers of that period who believed in that same doctrine.
However, there is one other point that I should like to raise. If Aristotle is a little far back in history, I should like instead to quote Mr. Hilton CheongLeem of the Legislative Council, from the contribution that he made to the debate some time ago about representation and the various timings involved. In my view he is one of the wiser counsels of Hong Kong. He came to the conclusion:
"My assessment therefore … is that there is no overwhelming majority among the population in general for direct elections to be introduced in 1988".
I believe that the reason in brief—and I shall say it quite bluntly—is that full democracy in Hong Kong at this time is simply bad for business; and I do not mind saying so. We have to accept that. That is the view put forward to me and to many others who go to Hong Kong. Often it is awkward to say so in a democracy such as ours. I have said that things are different in Hong Kong. We have to recognise that, and we should do so quite soon.
I shall not take up more time, except perhaps to underline the worries that have already been expressed. First, on refugees, the history of Hong Kong has been founded on the refugees escaping oppression and being allowed to ascend the ladder of prosperity. There has been one exception in that matter. It is the boat people, the Vietnamese refugees, and their present position. This must be brought to a conclusion one way or the other. If they are to make a contribution, as the noble Baroness said, they should be allowed to do so as all others have done in
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Hong Kong, and be given a chance to make their future. Such people who can be described only as bad hats—one can have them anywhere—can perhaps be treated differently. But, generally speaking, the majority could make a good contribution to the future of Hong Kong.
One other area has not been touched upon. It is the possibility that in what might be an interregnum, or a period of hesitation by executives of the new government of the SAR, organised crime might take this opportunity to establish further power and inroads into the infrastructure of Hong Kong. This is outside the terms of this debate. However, all I shall say is that concerning the tarnished crown of organised crime the unattainable jewel has been Hong Kong. It will require the determination of all those responsible after 1997 to maintain the record of integrity sustained by colonial government.
I wish to sum up by saying that if business fails to continue to grow at present levels in Hong Kong after 1997 for whatever reason, Basic Law in my view will become an irrelevance. The economy of Hong Kong is unsustainable on its own. Therefore the island can always return to being a colony again, a colony fit only for the sea birds, whose ancestors were Hong Kong's original settlers prior to 150 years ago.
1.2 p.m.
Lord Geddes: my Lords, one of the great advantages of batting number nine in your Lordships' House, in particular at two minutes past one on a Friday afternoon, is that most of what one had down to say has been said. The other advantage from your Lordships' viewpoint is that the ninth batsman does not normally last very long. I shall try to keep roughly to that timescale.
I wish to give an overview of one or two points that noble Lords have already mentioned, and one which has not been mentioned. It will not surprise some of those present. It is the question of passports. I wish to raise the question of passports, the issue of dual nationality and freedom of emigration.
Article 30 on page 39 of the draft Basic Law states:
"Hong Kong residents shall have … the freedom of emigration to other countries and regions".
However, in December last year the Director of the Foreign Ministry's Hong Kong and Macau Affairs Office was quoted as saying that China was aware of the need of many Hong Kong people to hold foreign passports. However, it was illegal to hold dual nationality in China and therefore a change in Chinese law would be necessary. There is certainly no guarantee that such a change would be made. Indeed, there is no indication that it is even contemplated. My noble friend Lord Glenarthur has probably anticipated that I shall bring up this problem. I hope very much that he will give us some comments on that.
In December last year, Mr. Tam Yiu-chung, a Basic Law drafter, was quoted as saying:
"It is logical that the future Beijing government will, through administrative rule, ban a person holding two passports".
That particular comment seems to run counter to the 1984 Chinese memorandum in the joint declaration. That memorandum stated that taking account of the historical background of Hong Kong, and so on, the People's Republic of China will with effect from 1st

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July 1997 permit Chinese nationals in Hong Kong who were previously called British Dependent Territories Citizens to use travel documents issued by the Government of the United Kingdom. I shall not bore your Lordships by quoting any further. Generally, the effect of these statements must make the promise of freedom of emigration look perhaps a limited and qualified freedom. The draft Basic Law seems to have ducked the specific issue of dual nationality. This cannot be in the interests of the Hong Kong people.
Before I leave the question of passports, perhaps I may ask my noble friend this question. From the example that I quoted from the joint declaration, I noticed only this morning that there is specific reference to persons who were British Dependent Territories Citizens. As your Lordships will be fully aware, a large number of those will either have converted, or may convert, to full British National Overseas status. Can we assume that the undertaking given by the People's Republic of China regarding the BDTCs will still apply to BNOs? It is a rather technical point but I should like my noble friend to answer it if he can.
The second subject that I should like to raise concerns the problem of refugees from Vietnam. A great deal has been said on this subject by noble Lords in this debate. I do not intend to rehearse the arguments. I too find it an urgent problem of horrifying magnitude. The statistics tend to vary slightly, but whatever the statistics are they are appalling from Hong Kong's point of view. This is surely a problem with which Hong Kong can no longer be expected to deal in the way that it has done in the past. It appears that these refugees are now much more an economic than political problem. The rest of the world, including your Lordships' House, must assist. A definite timetable for implementation of changes to the first asylum policy must surely be agreed without further delay.
My third point in summing up is on autonomy. Members of your Lordships' House who have already spoken are a great deal more expert on this subject than I. However, this concerns me as a lover of Hong Kong, and with a certain knowledge of that quite excellent place. Perhaps I may give one or two specific instances. The first refers to the election of the first chief executive. It has been debated in several quarters since the draft Basic Law was published. As I read it, it seems that the relevant paragraphs of the draft Basic Law do not seem to comply with the spirit of the joint declaration. The first part of paragraph 3(2) has been quoted today already. It continues:
"The Hong Kong Special Administrative Region will enjoy a high degree of autonomy".
It continues in Annex I, pages 14 and 15, to say:
"The Chief Executive of the Hong Kong SAR shall be selected by election or through consultations held locally and be appointed by the Central People's Government".
However, on page 87, Annex III of the draft Basic Law, it states that the election of the first chief executive is to be by recommendation from an election committee, which committee is established by a preparatory committee—and the preparatory committee is appointed by the National People's Congress. There seems to be there a slight discrepancy.
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Many noble Lords have mentioned Article 169. I wish to go a little further than that. More important is that the laws of the Hong Kong SAR, and the joint declaration, as they presently stand, do not seem to match. As we know, the Hong Kong SAR will be vested with executive, legislative and independent judicial power, including that of final adjudication. The laws currently in force in Hong Kong will remain basically unchanged.
Paragraph 3(12) of the joint declaration, the summing up paragraph, states:
"The above-stated basic policies of the People's Republic of China regarding Hong Kong and the elaboration of them in Annexe 2 to this joint declaration will be stipulated in the Basic Law of Hong Kong SAR".
I should like to turn to Article 169, which has already been widely mentioned, and Articles 170 and 172 of the draft Basic Law. I shall quote selected extracts. As we have already heard, Article 169 states:
"The power of interpretation of this law is vested in the Standing Committee of the National People's Congress. When the Standing Committee of the National People's Congress makes an interpretation of the provision in this Law, the courts of the Hong Kong Special Administrative Region, in applying that provision, shall follow the interpretation of the Standing Committee".
Article 170 states:
"The power of amendment of the Law is vested in the National People's Congress".
Article 172 states:
"At the time of the establishment of the Hong Kong Special Administrative Region, the laws previously in force in Hong Kong shall be adopted as laws of the Region except for those which the Standing Committee of the National People's Congress declares to be in contravention of this Law. If any laws are later discovered to be in contravention of this Law, they can be annulled or revised according to the procedure as described by this Law".
I shall cut short the rest of my comments on that subject. I am concerned that there appears to be in the first draft quite significant conflict between the spirit of the joint declaration, and on occasions the words of the joint declaration, and the first draft of the Basic Law.
I should now like to use a word which I have used many times in your Lordships' House in this context. The noble Lord, Lord Cledwyn of Penrhos, also used it. It is the word "confidence". I am not that proud to say that I spoke in your Lordships' House in May, 1984, on exactly this subject and on what the lack of confidence would do as regards emigration from Hong Kong. Many words have been said on that subject and I do not wish to repeat them. I believe that, despite the fact that your Lordships may become tired of a well-worn gramophone record—perhaps I should call it a "disc"—nevertheless, if the tune is good (which I in turn interpret as right) it is well worth playing again. In debates in this House my tune has consistently been entitled "Confidence in Hong Kong". To keep that record playing in an unscratched state the serious discrepancies between the draft Basic Law and the joint declaration need to be looked at thoroughly and resolved before it arrives at its final state.
I warmly endorse the remarks made by the noble Lord, Lord Maclehose, about the tremendous job which is being done by Sir David Wilson and his colleagues. Surely all Members of your Lordships' House will give them and the people of Hong Kong their support.
1.14 p.m.
Lord McGregor of Durris: My Lords, from the point of view of the quality of life in Hong Kong after 1997, the implementation of paragraph 13 of the joint declaration is of central importance. The paragraph declares that the Hong Kong Special Administrative Region Government:
"shall protect the rights and freedoms of the inhabitants and other persons in the Hong Kong Special Administrative Region according to law … the Government shall maintain the rights and freedoms as provided for by the laws previously in force in Hong Kong, including freedom of person, of speech, of the press, of assembly, of association …".
and many other rights besides. The declaration provides that the legislature of the special administrative region shall be constituted by elections.
Freedom of the press is as fundamental to the maintenance and enjoyment of the freedoms listed in paragraph 13 as it is to the conduct of' present negotiations as well as of elections, whatever form they may take. They will be a charade unless the well-informed electorate can make responsible judgments. They will depend on an assured flow of accurate information and a variety of critical commentaries upon the policies and activities of all the governments involved and on their concentrations of power.
The Hong Kong Government caused great anxiety in the democratic world when in March last year they adopted a new section (Section 27) of the Public Order Ordinance. That provides:
"(1) any person who publishes false news which is likely to cause alarm to the public, or a section thereof, or disturbs public order shall be guilty of an offence and shall be liable … on conviction on indictment to a fine of $100,000 and imprisonment for two years; and … on summary conviction, to a fine of $30,000 and to imprisonment for six months.".
That highly restrictive and ambiguous power to prosecute the media under a criminal law is a very serious threat to freedom of expression. Of course it: is possible for anyone charged under the section to offer a defence of having reasonable grounds for believing that the news to which the charge relates was true. But of course such a defence would violate the very basis upon which journalists work; namely, by requiring them to divulge the source of their information.
Oddly enough, this new legislation was introduced at a time when the Hong Kong Government repealed a wide range of repressive legislation. They insisted that their new powers would be used only in rare circumstances arising from the unique position of Hong Kong. It is a small area with a large population concentrated in that area of land and hence it is vulnerable to social and economic instabilities resulting from the spread of malicious rumours. Moreover, it was said that the law would be invoked only under stringent guidelines to be laid down by the Attorney-General.
That explanation did not give confidence to the local press or satisfy it because the press knows perfectly well that all governments will harass and censor the press and that all governments which harass and censor the press—from South Africa to Singapore—justify their policies by reference to the unique circumstances of their own countries.
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This development resulted in many protests from Commonwealth countries and from the Commonwealth Press Union. I was invited to join a small delegation under the leadership of Mr. Leonard Marks from the World Press Freedom Committee in Washington. It went to Hong Kong a year ago to urge the repeal of Section 27. For me that was one of four recent visits to the media in Hong Kong. We urged upon officials—the Attorney-General and the Governor—that that section violates Article 19 of the Universal Declaration of' Human Rights. We argued further that the implications of the section run far wider than the domestic affairs of Hong Kong.
Hong Kong's long-standing tradition of a free press has been regarded as a model for Asia for the last generation. That is especially significant at a time when the existence of the free press is being destroyed in such countries as Singapore, Malaysia and Indonesia. The delegation expressed the view that the repeal of this legislation would be very helpful in restoring the standing of Hong Kong as a country protecting free expression.
Finally, and this was the delegation's most important point, there is concern lest the very wide section should become a means of enabling the Chinese Government to legitimise their control over the press of Hong Kong in 1997. It is essential that we do not neglect the present and future role of the Hong Kong press when taking what the noble Lord, Lord Cledwyn, described as an interim look at a developing situation. As my noble friend Lord Kennet has emphasised, we must seek liberties as broad as we can obtain from Peking. Among these liberties, that of the press is crucial and I am sure that your Lordships will have noted the limitations of the draft Basic Law in this as in other respects which were outlined by the noble Lord, Lord Irvine of Lairg.
The delegation to which I have referred was treated with great courtesy and understanding by everyone it met in Hong Kong and was encouraged by the constructive attitude of the officials and by their willingness to consider seriously the consequences of these restrictions for the press. The delegation was assured that the legislation would be monitored and that the issue would be re-examiend if it appeared that the anxieties expressed were justified. The delegation had met leading journalists in Hong Kong working on local and international publications and they all pointed to "the chilling effect"—and that was their own phrase—on their coverage of news events. They said that an atmosphere of self censorship, incompatible with a free and responsible press, had already been created and was in particular affecting the reporting of the attitude and policy of the Chinese Government towards the implementation of the joint declaration; that is to say, officials undertook to examine the effects of such self-censorship in any review which was undertaken.
Therefore, I was not surprised to read in the Hong Kong Sunday Morning Post on 24th April of this year a report, described as being from "a source", that senior government officials desire to delete the section altogether. Sir David Ford, the Chief Secretary, was reported as saying that a monitoring committee of councillors, civil servants and journalists would be set up and that a review would take place before the end of this year. It will be good for the implementation of' the joint declaration if this review leads to the repeal

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of the unfortunate Section 27 and perhaps the Minister may feel able to encourage this hope.
1.25 p.m.
Viscount Torrington: My Lords, as your Lordships have already heard, I have, in company with two noble Baronesses, Lady Young, and Lady Ewart-Biggs, just had the privilege of visiting Hong Kong, which is what I can only describe as the most vibrant and successful modern city state in the world. I find the analogy of the noble Lord, Lord Tanlaw, particularly apt. Indeed, I only returned from Hong Kong yesterday and I should like to echo the words of thanks expressed by my noble friend Lady Young to the Hong Kong Government for all the facilities which they provided to us and for the opportunity to talk to people of all shades of opinion.
I believe that Hong Kong's success comes from a combination of several important factors, chief among which are obviously its position on the edge of China, its "hands off" rule by a benign and virtually incorruptible colonial administration and, above all, the immense energy and vitality of its people. There at the mouth of the Pearl River sits a city which rivals New York, London or Tokyo, where the inhabitants never seem to sleep, where the streets are free from litter, where mugging is relatively rare and where for nine more years the Union Jack will flutter.
However, as my noble friend Lady Young implied, among the visible signs of success run currents of deep foreboding. Hong Kong is quietly bleeding, in spite of what the noble Lord, Lord Tanlaw, said. The outward flow of talent is more than a trickle but as yet is less than a flood as hundreds of middle-management and professional people emigrate to Australia and Canada. Perhaps 50,000 will do so this year, denuding industry and commerce of vital skills. Industry and commerce—business—is the very life blood of Hong Kong.
The worries can be summed up as a number—1997. What those four digits mean underneath it all is a sort of disillusionment with Britain and a fear of China. Why is there disillusionment with Britain? I shall not dwell on the background to the Sino-British joint declaration. The fortification of Hong Kong Island and Kowloon to Boundary Street and the abandonment of the New Territories with their 3 million population was never a serious option, nor was the idea of doing nothing in the hope that life could just go on. I, for one, cannot believe that China would espouse the socialist concept that a sitting tenant, in this case Britain, should have security of tenure beyond the expiry of its lease. What really rankles with the people of Hong Kong is the feeling, rightly or wrongly, that Britain sees its future relationship with China as more important than the fate of Hong Kong. Add to this the feeling that the BNO passport will be a stateless person's document by another name and the bitter cocktail is complete.
Why is there a fear of China? We all know that the world is changing fast. Old-fashioned totalitarian Marxist communism seems today to be in retreat on all fronts and China is a very different country from what it was 10 years ago. Cross the border at Lo Wu to Sum Chun City and you scarcely realise that you have left Hong Kong. Super-highways, new factories,
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office blocks and hotels with revolving restaurants festoon the landscape giving the appearance, but not quite the substance of Hong Kong.
For all the "four modernisations" China is not Hong Kong but a land where political reversals have flowed as regularly as the tide, where long marches have been followed by retreats into isolation, where the blossoming of a hundred flowers has been expunged by the herbicide of the cultural revolution. China today looks to be a land of opportunity for its millions and for the businessmen and the people of Hong Kong but it is not a state with democratic traditions or with non-political administration of justice. It has no history which suggests that it can smoothly assume the role played by Britain in the affairs of Hong Kong. We all hope that it can do so and wish it well.
However, Hong Kong itself is, sadly, not a democracy in the accepted sense of the word albeit that its people are free. Its people can only vote one way as the noble Baroness, Lady Young said—namely, with their feet, enriching the old Commonwealth countries at the expense of Hong Kong and, ultimately, China. Britain and China now have a common interest to stop that process but with the carrot rather than the stick.
The draft Basic Law—that document described by some as not bad for a first attempt—falls on closer inspection somewhat short of the principles of the joint declaration in many important respects, and many noble Lord have already pointed to those deficiences. Britain's last great colonial duty is to ensure that the final Basic Law does not so fall short. China, by contrast, has the opportunity to gain the respect of Hong Kong by making the Basic Law perhaps even more favourable to Hong Kong than the joint declaration. It will gain, not lose face by so doing.
I shall not go into too many examples of what I consider deficiencies in the Basic Law. Indeed, I agree with the noble Lord, Lord MacLehose, that there are many good points in the Basic Law, but I find it to be a woolly document. American lawyers often use the expression "gross negligence" in legal documents. English law, however, does not recognise degrees—the defendant is either negligent or he is not negligent. Hong Kong must either be autonomous or not autonomous—"highly autonomous" is merely a relative term which can be interpreted by any judge in whatever way he feels best. Let Hong Kong be autonomous, subject only to clearly defined exceptions in the fields of defence and foreign affairs.
Of course, the Basic Law must give effect to the independence of the judiciary. After 1997, as currently envisaged under Article 169, the body which will ultimately interpret the Basic Law will be the National People's Congress—an avowedly political body. Is it perhaps too much to suggest to China that as an alternative it might use the next nine years to establish its own independent judical body on which, if it is ultimately to interpret Hong Kong's constitution, its Basic Law, Hong Kong itself should be represented from 1997?
In referring to constitutions, I have, in common with many other noble Lords who have spoken, one great sadness; that is, that as Britain moves to return the sovereignty of Hong Kong to China it cannot hand with it a shining example of representative

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democracy. The economic sophistication of Hong Kong is not matched—at least technically—in the political sphere. Yes, the government is efficient, open and benign, but it is not truly democratic.
I have listened to the many arguments for and against an indecent rush for full pre-1997 democracy. The arguments on both sides seem seductive. On balance, the cries and shouts from both sides suggest to me that the pace more or less as envisaged in the White Paper, though not ideal, is about right. A headlong rush would add yet one more uncertainty and push business confidence down the same slope as personal confidence, as evidenced by the brain drain. I have no doubt that my remarks will be a disappointment to Mr. Martin Lee, who I thought I saw below the Bar.
An immediate election by universal suffrage would require instant political parties in a hitherto unpoliticised country. Votes would probably have to group under instantly recognisable labels and to most Chinese there have only ever been two such labels Communist and Kuomintang. Both are totally inappropriate to modern Hong Kong. Neither is likely to inspire stability or confidence.
I agree with the noble Lord, Lord Derwent, that whatever the Basic Law finally says, it will only be a piece of paper; and it will only work if China, Hong Kong and Britain are determined to make it work. The next nine years must be used to regain the confidence of the people of Hong Kong. Only in that way will stability and prosperity be maintained.
In conclusion, to the Chinese government in Peking I would respectfully say,
"Yao you zi zhu quan bi xu xian jian li zin lai"—
that is, of course, a transliteration from the Mandarin: the English would be:
"To have true sovereignty one must gain the trust of the people".
1.34 p.m.
Lord Chalfont: My Lords, I apologise to the noble Baroness who is to speak next for intervening at such short notice. I do so briefly and for one reason, which is this. In the debate so far there has been no shortage of remarks and comments on the deficiencies of the draft Basic Law document. It is therefore right that someone at least should say that it is also in many ways a remarkable document considering the problems.
Here we have a document which contains the beginnings, the seeds, of a detailed constitution, arrived at by open discussion and containing a number of options. It is submitted for a five-month consultation period, to be returned to the drafting committee, and to come back for further consultation. It seems to me right to say that when one considers that only a short while ago the People's Republic of China was passing through an agonising cultural revolution, this is indeed a remarkable achievement at this stage. In my view, it displays on the part of the Government of the People's Republic of China an admirably flexible attitude towards the emergence of what will be the final Basic Law.
Of course, it is understandable that there are doubts in Hong Kong. Like other Members of your Lordships' House, I have recently returned from Hong Kong where I have been a frequent visitor, as I have to the People's Republic of China over the past
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15 years. It would be foolish to deny that there are doubts and fears among some of the people of Hong Kong. My impression was that among the ordinary people of Hong Kong the main concern is an unformed but very real fear that the quality of life in respect of human rights might suffer after 1997. Among those more closely involved with the detail of these matters it seemed to me that the main fears in the Basic Law concerned Annexes 1, 2 and 3, which deal with the election or selection of the chief executive, the legislature and the government.
It is right to point out at this stage that there is no conflict between those annexes and the joint declaration. They will, of course, need refining, discussion and a great deal of concession by the People's Republic of China in the face of the just aspirations of the people of Hong Kong. However, in that context the noble Lord, Lord Cledwyn of Penrhos, in his thoughtful opening speech, mentioned that the joint declaration called for a high degree of autonomy for Hong Kong. With respect, I should say that to call for a high degree of autonomy is like calling for a long piece of string—how long? How high a degree of autonomy? That is what will be at the root of the debate which will take place over the coming months.
There will be those who will be pushing one way and those who will be pushing the other way. There will be a wide divergence of views which will have to be resolved between now and the promulgation of the Basic Law.
I conclude by saying that what is needed now is a serious debate in Hong Kong and elsewhere about the Basic Law and the need to bring it further into a consistent position with the joint declaration. Something has been said about the desire in Hong Kong for a move towards direct elections in advance of the 1997 hand-over. As other noble Lords have said, that is a complicated issue and it would not be for me to attempt to deliver any judgment upon it.
I say only this. I have some sympathy with the British Government if they believe, as they are reported to believe, that any unilateral move of that kind in the meantime might well offend and outrage the People's Republic of China—the government in Beijing. That is not, however, to say that we should not be extremely vigilant about the way in which the debate and the discussion is conducted in the coming months of consultation.
It would be quite wrong, as has been suggested, to suppose that if we take a strong line in support of the legitimate aspirations of Hong Kong people we shall cause offence in Peking. We shall not. The Chinese are an intelligent people. Above all, they are tough, hard negotiators and they understand tough, hard negotiations. In these coming months let us have no doubt that they will look after themselves. They know how to look after their own interests and I believe it is for us, as the Government who still carry the responsibility for Hong Kong, to ensure that in the coming months it is not only the people of Hong Kong who must look after their interests but we as well.
I hope that Her Majesty's Government will play a full part in ensuring, as other noble Lords have suggested, that in the long run, when the draft Basic Law, which is only a consultation document, finally emerges as the Basic Law for Hong Kong after 1997,

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it is as indistinguishable from the joint declaration as it is possible to make it. Nevertheless, I believe that we should not underestimate the political sacrifices and the high degree of flexibility in Peking which has led to what I consider to be a very promising consultative document.
1.40 p.m.
Baroness Ewart-Biggs: My Lords, my noble friend Lord Cledwyn opened the debate with a very full and comprehensive introduction. He put some searching questions to the Minister and I very much look forward to hearing his replies. There have also been some valuable and well-informed contributions from other Members of your Lordships' House. I hope that the friends whom I recognise listening to the debate today will be pleased that the subject has been gone into so fully, and that when this debate is recorded on BBC Hong Kong they, too, will realise the very great seriousness with which the subject has been taken.
As my noble friend said, I had the good fortune to go to Hong Kong last week on a visit initiated by the Hong Kong Government. I wish to say how grateful I am for all the care and attention and for the very careful programme that we were given while we were there, and how happy we were made to feel. The noble Baroness, Lady Young, and the noble Viscount, Lord Torrington, and I very much welcome the opportunity presented by this debate to describe to your Lordships what we saw. The noble Baroness, Lady Young, said that anyone visiting the colony could not fail to be enormously impressed by the way in which Hong Kong works. There is the great energy and the dynamism of the people, and in effect an economic miracle has been brought about.
Besides that, one is reassured to see the remarkable strides made as regards the housing needs of Hong Kong. For example, the vast construction programme in the New Territories has made such an enormous difference to the housing needs of the people of Hong Kong. More than half the population are now accommodated in adequate public sector housing. There is a thriving community of nearly 6 million people with the blessing of full employment and who have enjoyed political and economic liberty under British rule. As the noble Viscount, Lord Torrington, said, there can be little doubt that those freedoms are at the heart of their economic success.
One also recognises the paradoxical situation which exists at present where, on the one side, there is tangible proof of confidence reflected by the booming economy, high investment, massive construction work, and on the other, there are visible signs of panic represented by a steady drift away to Canada, the United States of America and Australia of the most valuable members of Hong Kong's middle management and high-level members of financial and business circles. To restore confidence sufficiently to stem that flow before it becomes a torrent must be the major preoccupation for Britain and the Hong Kong Government in the coming months.
Previous speakers have described the events of recent years and the initial incredulity that Britain
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was, in effect, transferring power to China in 1997. After that came relief at the satisfactory terms and the necessary safeguards contained in the joint declaration. In turn this was replaced by mistrust of the draft Basic Law which is now under intense scrutiny in Beijing and Hong Kong. As my noble friend said, that is central to our debate today and it is the very kernel of the whole situation in Hong Kong.
My noble friend and other noble Lords have gone deeply into the complexities and weaknesses of the document. I wish to add one or two general points to what has already been said. It must be recognised that never before has there been a situation whereby the writing of a constitution, which is what the Basic Law will become, is being conducted in the open accompanied by full consultation with the entire people through the Basic Law Consultative Committee. Therefore, Beijing can certainly not be accused of secrecy and conspiracy.
What are the reasons why Beijing wants so much to get it right and to make the transition period work? I believe that the noble Baroness, Lady Young, described these. They are mainly that Hong Kong presents a very big market which brings in 30 per cent. to 40 per cent. of China's foreign currency. The majority of foreign investment into China comes from Hong Kong. Trade between the two is in China's favour. China has many companies in Hong Kong and at present it benefits from a great amount in remittances coming each year from 20 million Hong Kong people who go to see their relatives in China.
China is keen on a policy of reunification and believes that if the reunification with Hong Kong can be made to work, then Taiwan may well follow suit. Here it is worth noting the evidence that Chinese communities work hard and successfully everywhere at present except in China. This situation must have been perceived in Beijing; so it is possible that the NPC might wish to establish a whole series of small, Hong Kong-style financial centres in China in the hope that they will work as well there as they have done in Hong Kong.
What are the other major criticisms about the draft Basic Law coming from the people of Hong Kong? These have been gone into, but it is most important to recognise that though some parts of the joint declaration have been transposed to the draft Basic Law, there are others that are in direct conflict or which do not reflect accurately the provisions of the joint declaration.
As the noble Baroness, Lady Young, and others said, the principle of one country and two systems has not been realised. Sovereignty has been emphasised to the detriment of the high degree of autonomy promised to the SAR in the joint declaration. The definition of high autonomy is difficult, and the concept of one country and two systems is sure to run into trouble when the two different systems come together, touch and clash. It is seen there that one cannot get away with the one country aspect. One must remember that the bottom line is Chinese sovereignty and that the Basic Law is part of the Chinese constitution. It is vital to find ways of mitigating the bad effects of any clash by the establishment of an arbitration committee which

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would be consulted when there is a divergence over the interpretation of the Basic Law.
My noble friend Lord Irvine spoke of this concern with all the authority that he has. He also spoke about Article 39 of the Basic Law which could allow the SAR legislators to enact laws to restrict basic human rights beyond the limits permitted by the two international covenants on human rights. He made some very valuable suggestions about how this may be rectified.
There is an animated discussion taking place in Hong Kong, as previous speakers said, about the future electoral system. There is a strongly articulated voice coming from a radical, intellectual group that is asking for direct elections, saying that the future leaders of Hong Kong would be much strengthened by having been given a mandate from the people. I do not believe anyone could contradict them. My noble friend Lord Cledwyn has described in some detail what the group is saying and that it would be very unwise to ignore the significance of its feelings, although I noticed that the noble Lord, Lord Tanlaw, did not agree very much with what it thought.
Another shade of opinion would like to see a grand electoral college made up of 600 people chosen from different sections of the community. They would elect the chief executive and a quarter of the legislature. It is believed that this would be a compromise between the democratic system used in Britain and the system used in China. It is argued with logic that if for so many years Britain did not allow the democratic process to be used in Hong Kong, why should it be introduced just prior to departure. The group argues against direct elections because it says that the party political system that would emanate from direct elections would bring with it the presence of a Communist Party and a party representing Taiwan's interest.
This is what the noble Lord, Lord MacLehose, meant when he said that direct elections might increase Chinese interference in Hong Kong through the participation of a Chinese political party in the legislature. My view is that a larger proportion of directly elected members of the legislature should be included in the final Basic Law, and that there should be a movement towards universal suffrage as soon as possible.
It is clear that the discussion will continue to rage during the two consultative periods that are still ahead of us. However, what stands out in my view is that the role of the chief executive is all-important, and that he will need to have credibility and support in Hong Kong. Equally important is the fact that the relationship between the executive and the legislature should be based on a system which provides for both checks and balances as well as co-operation. I agree with what the noble Lord, Lord MacLehose, said about a decision on this question being made as soon as possible.
It is very much up to the people of Hong Kong to make their views known on all these important matters, and this is clearly beginning to happen. One wonders what the role and responsibility of Her Majesty's Government should be. It is to use its influence to further this discussion on the Basic Law through its negotiations with Beijing. I should like to end my remarks by pointing out two other areas in
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which the Government can help to resolve other problems which lie outside that process but are nevertheless a burden for Hong Kong to carry at the moment. I know that the refugee problem has already been discussed. I spoke about it in some depth with Rita Fan, who was asked to put forward a report on the matter, and we also visited a closed camp. Within what is possible, the Hong Kong authorities run the closed camps with efficiency and fairness. However, that is no solution. There are approximately 14,000 refugees, termed economic migrants—mainly ethnic Vietnamese coming from North Vietnam. I should like to hear from the Minister whether he has any further figures. I know that when we were there each day the numbers were increasing. Hong Kong pays 75 per cent. of the cost of these camps and the Save the Children Fund and the UNHCR pay the other quarter. Hong Kong has been blamed for not resettling many of the refugees. Hong Kong offers 250 places a year for resettlement but these are not taken up by the refugees because they want to go to Canada, the United States or Australia, countries with low quotas, and see Hong Kong merely as the first stage in their journey. Hong Kong is in a Catch-22 situation. Unlike other countries it is still conforming to the 1979 Geneva Agreement which proposed that anyone arriving by boat should be presumed a refugee and given asylum. But these migrants from Vietnam see Hong Kong simply as the first stage of the journey and other countries will not take them; nor will Vietnam receive them back. Other countries do not conform to the Geneva Agreement but to the United Nations one.
I have no doubt that the Government are fully aware of this problem and are engaged in finding a solution. An added urgency is that the policy towards the people of Hong Kong's own race—the Chinese—contrasts so cruelly, in that any illegal Chinese immigrants are immediately returned in handcuffs to the mainland of China while the Vietnamese are given asylum.
There is an urgent need to approach this tragic situation from different angles. An international decision is required; Hong Kong cannot take this decision itself. First, there must be a decision about the definition of a refugee. A mechanism must be developed for distinguishing bona fide refugees from non-refugees. Secondly, the UNHCR should take a lead in developing such a policy. Thirdly, there must be more pressure on the international community to persuade Vietnam to co-operate in resolving the problem. Aid arrangements to Vietnam should not be discounted. Fourthly, other countries must assist in the resettlement programme. Nearly 30 per cent. of the refugees in Hong Kong have been there for more than three years. Lastly, the Government should liaise with the Foreign Ministers of the ASEAN countries who will be meeting in July this year, to explore with them a more pragmatic approach to the problem. Something must be done to find a humane solution to this tragic affair. Hong Kong needs and deserves help and support in finding it.
Another area of concern to Hong Kong which was described to us by members of Omelco is the problem some Hong Kong visitors encounter when they arrive at ports of entry. These visitors hold the new BDTC passport. Many of them are refused entry, often it seems for a trumped-up reason and sometimes through confusion over the new passport. We were

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told that, out of 40,000 visitors to Hong Kong, as many as 330 encountered problems and were turned away. I am sure that something can be done to rectify this problem. It would make a great difference to the attitude towards Britain of the people of Hong Kong. It is important to remember that Britain's standing in the eyes of Hong Kong is very low. Anything we can do to re-establish confidence in the British Government is of enormous importance. It is also important to recognise the deep distrust which Hong Kong people can feel towards the country from which they came.
I am grateful to have visited Hong Kong and I look forward to a solution which will be of help to all the people of Hong Kong, especially those who will not be able to leave and therefore need a stable community in which to remain.
1.58 p.m.
The Minister of State, Foreign and Commonwealth Office (Lord Glenarthur): My Lords, I too am grateful to the noble Lord, Lord Cledwyn of Penrhos, for giving us a further opportunity to discuss developments in Hong Kong. I must begin by assuring the House of our responsibility for Hong Kong and of the fact that its future is a matter of the highest priority for Her Majesty's Government. My right honourable and learned friend the Foreign and Commonwealth Secretary made that plain when he visited the territory only very recently.
Today's debate has underlined the continuing interest and concern for Hong Kong which is felt by your Lordships. It has also demonstrated an impressively high level of understanding and knowledge of Hong Kong's current preoccupations. As the noble Lord, Lord Cledwyn, said, some of it stems from the recent visits to the territory by some of your Lordships, which I know the Hong Kong Government greatly appreciated. Here I should like to express my admiration for the thoughtful comments made by my noble friends Lady Young and Lord Torrington and the noble Baroness, Lady Ewart-Biggs. I can assure them that their interest, and indeed all interest, in the subject is a matter of great reassurance to the people of Hong Kong.
The noble Lord's Motion draws attention to recent developments relating to the implementation of the Sino-British joint declaration on the future of Hong Kong. The debate has focused largely on the publication by China of the draft Basic Law of the Hong Kong special administration region of China. I shall do likewise. However, I propose first to touch briefly on two other aspects; namely, progress in the work of the Sino-British Joint Liaison Group and the development of the representative government. I shall also mention the recent influx to Hong Kong of large numbers of boat people from Vietnam, about whom many of your Lordships have expressed great concern; concern, I must say, which the Government fully share.
The work of the joint liaison group is proceeding steadily and smoothly. As your Lordships know, its main functions are consultation on the implementation of the joint declaration and discussion of matters relating to the smooth transfer of government in 1997. In the three years of its existence it has achieved a great deal. Much of its
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subject matter is undramatic, technical and perhaps even dry. However, all of it is important in giving substance to Hong Kong's future and certainty to the people of Hong Kong.
Perhaps at this point I may deal with two matters which concern the present, rather than the future. I am most grateful for the supportive comments of the noble Lord, Lord McGregor of Durris, on the review of the provisions in the Public Order Amendment Ordinance on the publication of false news that might threaten public order. I am confident that the Hong Kong Government will approach the matter in their customary positive manner and will carefully consider all comments.
I should like here to pick up one point made by the noble Baroness, Lady Ewart-Biggs, about Hong Kong British passport holders and entry refusals. We are urgently looking into incidents where Hong Kong British passport holders were refused entry. There is no question of the validity of BNO or BDT passports being in doubt, or of discrimination against holders at UK ports of entry. The holders do not require visas or entry certificates to enter the United Kingdom as visitors; but they are subject to British immigration rules.
Hong Kong was previously discussed in this Chamber on 10th February—the day on which the Hong Kong Government published their White Paper on the development of representative government in the territory. The reaction in Hong Kong was generally positive. The White Paper was widely seen as a balanced and well-judged response to the views which had been expressed by the community during an extensive exercise of public consultation. It was overwhelmingly endorsed by the legislative council. A proposed amendment regretting that direct elections were to be introduced in 1991, rather than this year, was rejected by 42 votes to seven. It is especially noteworthy that in that vote each element making up the legislative council, including those members directly elected to lower levels of government, was opposed to the amendment.
It is important that we should not forget that we have come a considerable distance over the past four years in responding to the aspirations of the people of Hong Kong for greater participation in their government. The legislation council formed in 1982 contained no elected members. All non-official members were appointed by the Governor; the joint declaration, concluded in 1984, provided that after 1997 the legislature should be constituted by elections, and the legislative council formed in 1985 introduced two categories of indirectly elected members, together making up just over 40 per cent. of the total membership. That component will be slightly strengthened in the coming autumn's elections and in 1991 10 directly elected seats will be introduced. It is already clear from the various options contained in the draft Basic Law, that after 1997 at least 25 per cent. of the legislature of the special administrative region will be directly elected.
I shall now pick up a point made by the noble Lord, Lord Cledwyn, which was also touched upon by the noble Lord, Lord Kennet. We certainly do not

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rule out further changes before 1997, including the possibility of directly elected seats after 1991. However, this will be assessed in the light of Hong Kong's circumstances and experience of the new arrangements in 1991, and in the light of the Basic Law which will be promulgated in 1990. Of course we must keep in mind the need to ensure continuity and a smooth transition in 1997.
Therefore it follows that I cannot agree with the comments of the noble Lord, Lord Kennet, about direct elections. We consider that this evolution, steady and gradual, constitutes an appropriate response to the wishes expressed by the people of Hong Kong. It also accommodates well the traditions of Hong Kong and its unique historical and geographical circumstances. Like my noble friend Lord Derwent and the noble Lord, Lord Tanlaw, I suggest it is by those criteria that it should be judged and not by comparison, for example, with the Westminster model.
I turn now to the draft Basic Law. I should begin by briefly rehearsing the background. The joint declaration provides that the policies of China, which it sets out, will be stipulated in a Basic Law to be promulgated by the National People's Congress of China. To this end the Chinese Government established in 1985 a Basic Law Drafting Committee, just under half of whose membership is drawn from various circles in Hong Kong. That committee in turn set up a broadly based consultative committee consisting entirely of Hong Kong people with the task of consulting all sections of the community from which they were drawn and reflecting their views to the Basic Law drafters.
Therefore I can assure the noble Lord, Lord Bonham-Carter—who, sadly, is not now in his place—that there have thus been elaborate arrangements to involve the people of Hong Kong in the drafting process. We welcome that development. As the noble Baroness, Lady Ewart-Biggs, said, the exercise has also been a most open one. The media have been kept briefed on discussion in the drafting committee and even on the progress of the draft as it has evolved. There has been a very free exchange of views within the committee.
Responsibility for the drafting and promulgation of the Basic Law, as with any other Chinese law, rests with the Central People's Government and the National People's Congress of China. But the provision of the joint declaration, to which I have referred, linking the content of the joint declaration with that of the Basic Law, gives the British Government an explicit locus standi. The noble Lord, Lord MacLehose, said, and he was right, that we are entitled to satisfy ourselves that the Basic Law fully and accurately reflects the joint declaration of which we, with the Chinese Government, are co-signatories. I assure the noble Lord that that we shall do.
The production of the first draft of the Basic Law is the outcome of considerable effort. The noble Lord, Lord Chalfont, rightly reminded us that the joint declaration itself was an international instrument without precedent. Its provisions are now to be reflected in China's domestic law, giving assurance that for 50 years a dynamic, free-trading
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economy will retain a high degree of autonomy within a socialist state. The imaginative concept of "one country, two systems" is thus taking legal shape.
The draft Basic Law is a long and complex instrument. Much of it reproduces word for word provisions of the joint declaration. That is obviously reassuring. For the rest, we shall continue to study it carefully and to pay close attention to comments made on the draft, especially in Hong Kong. I must stress that the Basic Law, as now drafted, is no more than an initial text. It is not yet complete. Parts of it are certainly not yet right. Chinese spokesmen also readily acknowledge that fact.
My noble friend Lady Young referred to consistency with the joint declaration. As I have said, much of the draft Basic Law reproduces, word for word, provisions of the joint declaration. Some parts of the joint declaration are in general terms. It would be possible to give effect to them in more than one way. Here, the question of consistency is much more complex. More than one assessment may be possible, as I am sure my noble friend will recognise. We do not wish to come to premature conclusions. We shall be listening carefully to all the views expressed in your Lordships' House and in Hong Kong. So, I am sure, will the Chinese authorities.
Some of your Lordships raised points of detail on specific articles of the draft. I hope that your Lordships will undertand if I do not respond in similar detail—the type of detail into which my noble friend Lord Geddes went. Some of the issues raised are highly complex. At this early stage we do not believe that it would be right to express a particular view. We wish, first, to be able to take into account the whole range of views expressed in Hong Kong and on occasions such as this debate; but the comments which have been made today will be carefully noted by Her Majesty's Government. We shall also ensure that they are brought to the attention of the Chinese Government,
Perhaps I may refer briefly, and in general terms, to some of the concerns expressed. The noble Lords, Lord Cledwyn, and Lord Irvine of Lairg, raised the question of human rights provisions in the Basic Law. We welcome the provision in Article 38 of the draft Basic Law which stipulates that the provisions of the two international covenants on human rights shall be implemented in the Hong Kong SAR. We are aware of criticisms in Hong Kong that other parts of the draft are inconsistent with Article 38.
It is by no means clear at this stage whether that is a matter of substance or drafting. We think that it should be possible to devise drafting improvements which would bring those parts into line with Article 38; but we shall continue to consider the point carefully in the light of views that have been expressed.
I turn to the judicial system and autonomy. A number of your Lordships, principally the noble Lords, Lord Bonham-Carter, Lord MacLehose and Lord Irvine of Lairg, raised points arising from Articles 16, 17, 18 and 169 of the Basic Law. Those articles relate to the relationship between the Hong Kong SAR and the Central People's Government in legislative and judicial matters. We recognise that

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that area is especially sensitive, where it is particularly important to get the relationship right. It is also highly complex. We are studying closely the comments which have been made here and in Hong Kong, and we shall also ensure that the Chinese authorities are fully aware of all the anxieties that have been expressed.
I noted too the concerns expressed by several noble Lords, that the high degree of autonomy which Hong Kong is to enjoy under the terms of the joint declaration should be accurately reflected in the provisions of the Basic Law.
The noble Baroness, Lady Ewart-Biggs, referred to the grand electoral college concept. I am aware of criticism of this concept in Hong Kong. If people have reservations about the idea or about any of the options for election to the legislature, it is important that they should come forward with feasible alternatives. It does not appear that any of the options in the draft is contrary to the joint declaration. Nevertheless, I noted the remarks which the noble Baroness made. As for the need for an authentic English text to which the noble Lord, Lord Irvine of Lairg, referred, there is considerable force in that argument. The Hong Kong courts will be working on the basis of the common law system and will need an official English text to be able to function properly. Article 9 of the draft Basic Law provides that the English language may also be used by the executive authorities, legislature and judicial organs of the Hong Kong SAR.
The noble Lord, Lord Cledwyn, referred to the provisions on the economy. We are well aware of the criticisms that some provisions in the draft—for example, provisions on low tax policy; a balanced budget and open financial and monetary policies—are inconsistent with the joint declaration provisions stipulating that the handling of policies in these areas will fall within the autonomy of the Hong Kong SAR Government. There is a cogent argument that it is inappropriate to enshrine such provisions in the Basic Law. We feel sure that the Chinese authorities will take account of criticism of these articles.
The formation of the first SAR government—a point raised by my noble friend, Lady Young, the noble Lord, Lord Cledwyn, and the noble Lord. Lord MacLehose—is a matter which is understandably generating much interest in Hong Kong. We are listening carefully to all views. We recognise that it is right for the arrangements for the first SAR government clearly to mark the change of sovereignty. But it is equally important that there should be continuity and a smooth transfer of government so as to maintain confidence both in Hong Kong and internationally.
My noble friend Lord Geddes raised the eligibility of Hong Kong people with foreign passports for certain political and civil service posts. I am aware of the concerns expressed about this issue in Hong Kong. It is a complex question which depends on the interpretation of Chinese nationality law. I know that the Chinese authorities are fully seized of the problem; only in the last few days senior Chinese officials visiting Hong Kong have indicated possible ways forward.
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On a related point, perhaps I may also reassure my noble friend that the references to British Dependent Territories citizens in the Chinese memorandum associated with the joint declaration are in a form that clearly also applies to holders of BNO passports.
As the noble Lord, Lord Cledwyn, has said, we are now at the beginning of a lengthy period of consultation. The present draft, published on 28th April, will be open for comment for five months. During that period, delegations of drafters from the mainland will visit Hong Kong for intensive programmes of consultation. The first such delegation is at present in Hong Kong. A timetable has been drawn up to ensure that consideration is given systematically and in turn to each part of the draft. Thereafter the draft will be revised.
A second draft will be published in 1989 and the entire consultation process repeated before a further revision of the text is formally submitted to the National People's Congress in 1990, to be passed into law. That is, in total, no small consultative process. We heartily welcome the very considerable efforts in this direction made by the Chinese authorities. I hope that the noble Lord, Lord Kennet, will acknowledge that.
I am sure that the people of Hong Kong will participate fully in the consultative exercise and make known their views on the draft. It is important that they do so. There is every reason to believe that those responsible for drafting the Basic Law will be receptive to their views. We are assured that the draft is open to amendment in the light of the comments which are expressed.
Where Her Majesty's Government are concerned, I have explained our relationship to the drafting process. The Basic Law has already figured in a number of our exchanges with the Chinese Government. We are grateful for their readiness to brief us on progress and to explain their intentions.
I can assure the noble Lord, Lord Cledwyn, that Chinese Government spokesmen have encouraged us to convey our comments on the text to them through diplomatic channels, together with comments from the various organs of the Hong Kong Government. We shall certainly do this in pursuance of the contacts we have already had. In particular, where we conclude that there are elements in the text which may not be consistent with the joint declaration, we are bringing these to the attention of the Chinese Government. We shall continue to do so. I hope this will reassure my noble friend. Lady Young, whose thoughtful speech included comments on this aspect.
Our representations will continue to be vigilant and firm, but I think that your Lordships will understand if I suggest that those representations can most effectively be made in confidence through the various channels open to us.
It seems to me that the feelings of your Lordships on the draft Basic Law are as follows: that the drafting exercise is a remarkable one, carried out with a considerable openness and commitment to consultation; but that the draft is not yet right in all its parts, as all those involved readily acknowledge. Further we must acknowledge that concerns have been expressed in Hong Kong about certain articles

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of the draft, particularly perhaps those articles referred to today—16, 17, 18 and 169—and that those concerns should be given the most careful consideration by the British Government, and by the Chinese authorities too. I can assure your Lordships that that will be the case as regards the British Government, and, I have no doubt, as regards the Chinese too.
The noble Lords, Lord Cledwyn of Penrhos and Lord Tanlaw, and my noble friend Lord Geddes referred to the matter of emigration from Hong Kong or, as my noble friend put it, confidence in Hong Kong. We and the Hong Kong Government are watching trends carefully. It is clear that emigration trends are up. The latest available figures for which the noble Lord, Lord Cledwyn, asked, show that 27,000 departures occurred in 1987. That figure is higher than the figure for 1986, but not out of line with the historical average. Nevertheless, it seems that an increasing number of those leaving are from the professional and middle management areas.
There are a number of reasons for the increase in emigration. Hong Kong people are traditionally very mobile. Concern about the future is, no doubt, a factor influencing people's decisions, but it is by no means the only one. There has also been a marked increase in opportunities for emigration to some leading recipient countries, particularly Canada and Australia.
The Hong Kong Government have made it clear that they have no intention of stopping people leaving. Their efforts and ours will continue to be concentrated on making Hong Kong an attractive place in which to live and a place to which those who have left want to return. We welcome the recent decision by the Hong Kong Government to set up a taskforce to look into the reasons for emigration and to consider practical measures to counter its effects. I was interested to hear the views of the noble Lord, Lord Tanlaw, in this respect.
I referred earlier to the problems caused by the fresh influx of Vietnamese boat people into Hong Kong. I can assure your Lordships that we are acutely aware of the gravity of the crisis facing the territory. So far this year there have been more than 6,000 arrivals. The population of boat people has almost doubled in the past year. It now stands at 15,600. So far there have been about 1,500 arrivals in June alone. I am grateful to the noble Baroness Lady Ewart-Biggs, for her comments on the way in which these unfortunate people are looked after in Hong Kong in all the circumstances.
My right honourable and learned friend the Foreign Secretary made it clear when he was in Hong Kong—I endorse his remarks again today—that things simply cannot go on as they are. I can confirm to the noble Lord, Lord Cledwyn, that, as far as we can tell, the great majority of those now leaving Vietnam cannot be described as political refugees according to the definition of the UNHCR. The automatic resettlement of all those leaving Vietnam, for whatever reason, is not a practical proposition. Other countries cannot be expected to carry the burden of Vietnam's abysmal economic mismanagement, least of all a small and overcrowded territory such as Hong Kong.
It must be right in principle for these people, who are Vietnamese, to find their future in Vietnam. But
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despite international pressure the Vietnamese authorities refuse to take them back. I can assure the House that we are considering urgently, in the light of the discussions in Hong Kong of my right honourable and learned friend, how this grave problem can best be tackled.
My right honourable and learned friend also took the opportunity to raise the problem of the Vietnamese boat people with the Vietnamese, Chinese and Soviet Foreign Ministers in New York on 7th June. All three took careful note of our concerns. We shall continue to take every opportunity to emphasise to all governments concerned the need to find a durable solution to this sad problem. The noble Baroness, Lady Ewart-Biggs, is right; it is an international problem.
Perhaps I may conclude by emphasising three points. First, the joint declaration is standing the test of time. It was and is an excellent agreement for Hong Kong. We and the Chinese Government are totally committed to its implementation. Secondly, the people of Hong Kong have the talent and energy to make their future work. They have made Hong Kong a model of free enterprise. It is a success formula which the joint declaration and the draft Basic Law are designed to preserve.
Finally, the noble Lord, Lord Derwent, who speaks with particular authority and thoughtfulness on the subject of Hong Kong, rightly put in perspective the concerns that inevitably exist about the uncertainties of the future. To meet the point made by the noble Lord, Lord Tanlaw, I assure him that the Basic Law is indeed designed to ensure that the present dynamic business culture will continue to flourish. We shall pay careful attention to the concerns voiced in Hong Kong and do all we can to meet them. However, I have no doubt that the resilience of the Hong Kong people, the skill and experience of their government (I endorse every word of the noble Lord, Lord MacLehose, concerning Sir David Wilson) and the shared commitment of the British and Chinese governments can together turn the prospects enshrined in the joint declaration into reality to provide the stability and prosperity that Hong Kong so richly deserves.
2.27 p.m.
Lord Cledwyn of Penrhos: My Lords, I am grateful to all noble Lords who have contributed to the debate and made it such a significant occasion. I believe that the House will wish me to thank particularly the noble Lord, Lord Glenarthur, for his comprehensive reply. I am sure that all of us will be studying what he has said so that we may appreciate the full implications of his speech and his references to the problems raised in the debate.
I hope that the people of Hong Kong will have access to the record of our debate so that they may appreciate the authoritative and impressive discussion which we have had in the House today and also so that they may be assured of our commitment to their interests. I hope that they will further rest assured that we shall come back to these problems time and time again between now and 1997. My Lords, I beg leave to withdraw my Motion for Papers.
Motion for Papers, by leave, withdrawn.

Mentally Disturbed Prisoners: Remand
2.28 p.m.
Lord Harris of Greenwich Lord Harris of Greenwich rose to ask Her Majesty's Government what action they propose to take regarding mentally disturbed remand prisoners being kept in custody in police cells.
The noble Lord said: My Lords, just over three months ago I raised in the House the case of a mentally ill remand prisoner, Mr. Michael Flynn. Mr. Flynn had been remanded in police custody despite persistent efforts in the courts to have him sent to a mental hospital under Section 35 of the Mental Health Act 1983. Those efforts failed and, as we all know, shortly afterwards Mr. Flynn hanged himself in Brixton Prison.
I propose to return this afternoon to some of the issues raised in that debate. I do so partly because of what was said in the debate and also because of the recent opening of two temporary prisons run by the army. As a result of those developments, I hope that the noble Earl who is to reply to the debate will be able to tell us what progress the Government have been able to make in dealing with the deplorable situation in which mentally ill prisoners are held in small police cells in various parts of England and Wales and are denied the privileges obtained by mentally balanced remand prisoners who are held in prisons.
I should like to say a word about the privileges that they are denied as a result of being held in police custody rather than in prison department establishments. Of course they do not have the same visiting rights, as I am sure the noble Earl will agree. They do not have a member of a board of visitors to come round and talk to them and to be available for them to raise problems with. There is no governor whom they can ask to see. It is ludicrous to imagine that a chief constable, with all the other heavy responsibilities which he carries, can possibly take the place of the governor of a prison department establishment. The Chief Inspector of Prisons has no locus, as the noble Earl and his colleagues have confirmed on a number of occasions. There is, therefore, nobody at all supervising what is going on.
What I have to say at the outset will not, I suspect, come as a surprise to the noble Earl, because I should be astonished if he has not been told by chief officers of police what I am about to say. I have certainly been made aware of the anxiety of many senior police officers about the responsibilities which they are now being called upon to undertake. As the Minister knows, there is deep anxiety among many chief officers about the wider issue—which I do not propose to discuss today—of the use of cells in their police stations to hold Home Office remand prisoners. I believe that there are still over 900 such prisoners.
There is even more concern about the position of those who are mentally ill. A number of chief officers have told me in the most emphatic terms that their officers did not join the police service in order to become mental nurses. They do not have the training and they do not have the expertise to handle mentally ill prisoners for substantial periods of time. That is precisely what they are now being called upon to do.
I propose to illustrate the extent of the problem by referring to the cases of some of those sick people: the case of Mr. Garcia to which I referred briefly in the debate on 4th March; the case of Mr. Hollett and the case of Mr. Hector MacFarland. The noble Earl will be aware that I have given notice to his private office of those particular cases, which have also been the subject of Questions for Written Answer.
I turn now to the case of Mr. Garcia. I first heard about this man only just before the debate on 4th March. In the course of his speech on that occasion the noble Earl undertook to investigate the case. I am most grateful to him for having sent me an extremely frank letter setting out the details. This man, as the noble Earl has now confirmed, was held on remand for three months awaiting psychiatric reports. Mr. Garcia first appeared before Horseferry Road Magistrates' Court on 1st December last year. He was charged with police assault and the theft of property worth less than £16. The police assault case was subsequently withdrawn. Thereafter he was held exclusively on a charge alleging that he had stolen property worth less than £16. The reason he was so held was because everyone concerned realised that he was mentally ill, a problem made even more difficult because of his inablility to discuss his case intelligibly with his defending solicitor.
The court certainly did everything in its power to obtain a satisfactory psychiatric report on Mr. Garcia. It failed for two reasons. First, Mr. Garcia was being shuttled between one police station and another with periodic calls on prison department establishments. On two occasions he was held in cells at Highbury Corner Magistrates' Court. Twice he went to Brixton. He was then at Wood Street police station in the City of London, then at Cowley in Oxford; for 20 days he was held in a police cell in King's Lynn in Norfolk and finally he was held at Camberwell Magistrates' Court, subsequently being transferred to Brentford police station—all this on a charge of theft of property worth less then £16; and this went on for three months.
There was a second reason for the failure to secure a satisfactory disposal of this case under the Mental Health Act. In the letter to which I have already referred, the noble Earl informed me that the medical officer at Brixton, on a number of occasions between 4th December, when he first saw Mr. Garcia, and 4th January, when Mr. Garcia left Brixton on the final occasion, tried to arrange for a consultant psychiatrist at St. Luke's Hospital (which was the catchment area hospital) to go to Brixton to examine him. As the noble Earl confirmed, that hospital, I am afraid, did not comply with the request.
So between 4th January, when he left Brixton, and 1st March when the Horseferry Road magistrate eventually lost his patience over the way in which the authorities were handling this case and declined to remand Mr Garcia in custody yet again, this man who was charged with a trivial offence was held exclusively in police custody, this making it virtually impossible to have him properly examined by a consultant psychiatrist.
After reciting these events the noble Earl said in his letter that this must be totally unsatisfactory and he added:

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"Of course the court should have been provided with the psychiatric report for which he was remanded. However, as you know, prison medical officers have no authority to compel National Health Service consultants to attend a prison to interview any patient".
That of course is entirely true, but, having recited those events, what precisely does the noble Earl, who has the ministerial responsibility, intend to do about the situation?
We are all aware of the hideous problems that face our underfinanced National Health Service, but it is plainly and incontrovertibly unacceptable that a sick man should be held in police cells for that length of time because a consultant psychiatrist finds it impossible to see him for a period of over a month. How many other men and women now in police cells are receiving the same wretched treatment as did Mr. Garcia? I suggest that immediate action must be taken by the noble Earl and his department to ensure that such persons held in custody receive urgent attention by our hospitals.
I very much hope that in the first instance the Minister will undertake to write to the Department of Health and Social Security drawing attention to this case, if the department is not already aware of it; and, secondly, that he will discuss its wider implications with Ministers in that department. If I may say so, I had a particular reason for saying "write to the department" and asking him to discuss this case with Ministers. Ministers sometimes use the phrase, "I shall draw this matter to the attention of my right honourable friend". Indeed, I have been guilty in the past of that same offence. They may do so by writing, but sometimes they do it by hoping that the right honourable friend regularly reads Hansard, which no doubt is sometimes the case but not always. I have chosen my language with particular care and I very much hope that the Minister will undertake to write to DHSS Ministers about the precise circumstances of this case and some of its wider implications.
I turn now to the case of Mr. Hector MacFarland. This man was held in custody for a period of nearly three months. The magistrates were so concerned about the manner in which this case had been handled that, as the noble Earl will be aware, they asked their clerk to write to the Home Office about it. Indeed, the noble Earl in a Written Answer confirmed that they had received such a letter and that the Home Office had replied to it. Mr. MacFarland was clearly ill when he first appeared at the South Western Magistrates' Court on 16th November. He was unrepresented and was remanded in custody for psychiatric reports.
Once again, we had the same wearisome routine: three stays at Brixton; eight stays in police cells; and all this for a man whom two psychiatrists said should be "sectioned". On four separate occasions at the South Western Magistrates' Court his papers were marked, "Must go to Brixton", but on each occasion he was sent to a police station. Why? Eventually, after nearly three months in custody Mr. MacFarland was finally, belatedly, admitted to Springfield Hospital. Again, I should be grateful to know what the noble Earl proposed to do to investigate the circumstances of this case.
I hope he will not say that matters of this kind are exclusively the responsibility of the police. In my view they are not. Remand prisoners are the responsibility of the Home Office, not of the police. Ultimately Ministers must be accountable to Parliament for what is going on and must not hide behind chief officers of police who have enormous responsibilities in other areas, as the noble Earl, who has responsibilities himself to the police, will be the first to confirm.
I now turn to the case of Mr. Winston Hollett. He was charged with threatening to kill a gas board official. At an early stage it became clear to everyone concerned that he was mentally ill. He was bailed to appear in court but did not do so. Subsequently he was arrested and appeared at the South Western Magistrates' Court in London on 5th April. He was then, understandably, remanded in custody. Then for a month this sick man, after two spells in Brixton, was moved from one police station to another on five separate occasions, once spending a week in Doncaster.
I should like to say two things about this case. First, in his letter to me of 27th April—a letter which was obviously drafted several days earlier, quite understandably—the noble Earl assured me that the aim was,
"to arrange for prisoners who are awaiting medical reports, if they cannot be immediately admitted to prison, to be held as close to London as possible".
But this man was held for a week at Doncaster. Was that, to quote the Minister again, "as close to London as possible"? No doubt the noble Earl will have something to say about that.
The second issue to which I should like to draw the Minister's attention is the circumstances in which he was eventually admitted to a mental hospital, as he was. Fortunately for Mr. Hollett he had an exceptionally tenacious woman solicitor. On the fourth occasion on which he appeared in court following her strong representations the magistrates—who were clearly deeply troubled about the manner in which this case was being handled by the authorities—agreed to this exceptional course. Those of us who have experience in these matters will agree that it is undoubtedly an exceptional course of action. They agreed to bail him on condition that he accompanied her to the St. Thomas's clinic and remained in her custody until he was admitted to that clinic. So off she went with three police officers in a police van to the clinic.
After something of an argument, eventually the authorities there agreed to take him. This man was therefore admitted to a hospital entirely because he had an exceptionally vigorous and concerned solicitor. That is why he was subsequently admitted as a patient to St. Thomas's Hospital. If he had not had such a solicitor—if she had been overwhelmed with other cases; if that afternoon she had had two or three other cases before the same magistrates' court—Mr. Hollett would once again have been sent off to spend days or weeks in police cells in various parts of the country. I hope that the noble Earl will deal in some detail with the manner in which these cases were handled and with some of the wider issues involved.
I should like to ask the noble Earl two further specific questions. I understand from his letter to me dated 27th April that in February there were only 14 available prison places in Brixton Prison. However, on that same day 80 or more prisoners required those places. Is that still the position? I presume that because of the use of two army establishments, which has enabled the Home Office to transfer 700 or more men from local prisons, there are now more hospital places available. In that situation I hope that the noble Earl will be able to assure the House that it is now possible for him to guarantee that no longer will any prisoner with the kind of psychiatric problems which I have outlined be kept in custody in a police cell.
Secondly, I return to the case of Mr. Garcia who was not seen by a consultant psychiatrist for a month, despite the efforts of the medical officer at Brixton Prison, to raise his case and the general issue of mentally ill people remanded in custody with the DHSS. I do not want to be unfair to the DHSS but many consider that for many years even before the present Government's period of office the department has been shuffling off its responsibilities on to the shoulders of the Home Office. If it is determined to clear out large numbers of mental patients from the hospitals into what it is pleased to describe as "treatment in the community", in the certain knowledge that the resources for such treatment are scandalously inadequate, it should at least be asked to give an assurance that when consultants are asked to examine mentally ill patients in prison department custody such requests will be given absolute priority. Will the Minister ask his right honourable friend to give such an undertaking?
I very much hope that the noble Earl will be prepared to give clear, positive answers to those questions. In his letter to me regarding the case of Mr. Garcia, the noble Earl said:
"This was a particularly serious example of the kind of thing which can go sadly wrong when the system is operating under heavy pressure".
I believe that it is idle to imagine that Mr. Garcia's is an isolated case. The other examples that I have given this afternoon demonstrate that that is clearly not so. I believe that today we expect from the noble Earl an unequivocal assurance that urgent action is now being taken to deal with the situation in which many sad, confused, sick men are being treated in a manner which is a reproach to our society and which is creating justifiable indignation in our criminal justice system.
2.49 p.m.
The Earl of Longford: My Lords, we should all be grateful to the noble Lord, Lord Harris, for raising the Question so cogently this afternoon, following his arresting speech on 4th March. I believe that all noble Lords can agree that in the whole field of social problems there is none more pithy—if that is the right word—than the question of mental offenders. I ventured to say that in a debate which I raised on the subject a little while ago. We punish offenders, delinquents and criminals. In my opinion we do not punish them very constructively but we have this
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idea, accepted throughout society, of punishing them.
I am bound to say in passing that I am very sorry that the Home Secretary, to whom I have paid tribute more than once in this House, should now apparently be intending to use his powers in order to keep some people who are already serving long sentences in prison for a still longer period. We understand the pressures under which he is working when he is working for a Prime Minister who is devoted to hanging, but I am still sorry that the Home Secretary should have stooped to that. However, that is all by the way.
When it comes to sick people, we do not punish them; we try to treat them. However, when we have mental offenders—people who have broken the law but are apparently sick as far as we can judge—we find ourselves in a grey area. With all the resources in the world, I do not believe that any of us could claim to know exactly how those people should be treated and we do not have all the resources in the world. Many of us believe that the Government should be devoting more resources to this problem but whether the resources are great or small it is a very difficult problem. Whether there be one or a thousand mental offenders, I do not want to pretend to claim that anybody could come up with a slick answer.
I shall not speak for long and I shall try to look at this problem raised by the noble Lord, Lord Harris, through two pairs of eyes—through a mother's eyes and a chief inspector's eyes—both the mother and the chief inspector trying to do their duty. A mother brought her son to see me at the end of last week. He was a nice-looking young man, just over 20 years of age. He would be perfectly presentable if he came to visit the House. In fact he could be here this afternoon but I do not believe that he is. There is nothing whatever wrong with his appearance. I am told that, when well, he is quite a happy person, amusing and so on. However, when his mother brought him to see me last Thursday he was incapable of speech. I do not believe that a single word was extracted from him during our conversation. That is the state to which he has been reduced. It is an open question as to why he should find himself in that situation but that is how he is.
I have mentioned the case to the noble Earl but I am not expecting him to reply to it in detail. I am simply taking this as an example of the problem and not bringing it before the Government as an official complaint. It may or may not come before them in some other way. Here was a young man who was in a state of coma when he came to see me although on the whole he has led a normal life until he reached the age of about 20. According to his mother and other people who know him, about five years ago he was beaten up in a police cell. I do not ask the noble Earl to accept that version today but he certainly suffered injuries which his mother saw at that time after he had been apparently knocked about. I have no idea what the excuse was for knocking him about.
Since that time he has been in police custody several times but never for serious offences. About two or three years ago he developed epilepsy; there is no doubt about that. That is a medical fact. It can well be said that that was a result of being beaten up

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in a police cell. It may be said that he would have developed epilepsy anyway; I have no means of judging that. However, he has developed epilepsy. From that time until now when he has been in custody those concerned with him have shown themselves totally unable to deal with him. He is an epileptic who has broken the law or is said to have broken the law—because there is some argument about that—but there could be a distinct problem. The fact is, his epilepsy seems to be worse, so that now, although he did not have a fit when I saw him, he has been reduced to a state of being in a walking coma.
Mr. Peter Thompson, who I have said on previous occasions, and will say again, has done more for mental health through the Matthew Trust than any layman known to me, in recent years has raised the case of this young man with Ministers, as I mentioned in advance to the noble Earl. It was in November 1986 that Mr. Douglas Hurd, the Home Secretary, wrote to Mr. Thompson:
"I understand that you discussed [the easel with Dr. John Kilgour, Director of the Prison Medical Services, at a meeting on 5th November and that the general points you made in your letter to me were also raised. I do not think that I can add anything to what was obviously a most useful and frank discussion."
From that we can say that this issue was taken seriously by the Home Secretary and the chief of the medical services. Mr. Hurd's letter continued:
"I have, however, sent a copy of your letter to the Lord Chancellor's Department and asked them to reply".
The noble and learned Lord, Lord Hailsham, then Lord Chancellor, wrote a long kindly reply, but it concluded with this passage:
"Whether or not a transfer to hospital under Section 47 of the Mental Health Act is the appropriate one in his case is a matter entirely for the Home Secretary. Naturally, I am unable to predict the outcome of any such application."
So the ball was played backwards and forwards between the two of them. At any rate, with the best will in the world those two eminent gentlemen were unable to do anything useful.
The young man is now awaiting a brain scan which may help to decide whether he has suffered permanent brain damage as a result of a blow or blows on the head. I do not predict the outcome of that brain scan. I leave his case there for the moment. I am certainly not asking the Minister to admit that there has been failure on the part of any of his officers. Personally, I think there has been, but today I am concerned with the wider issue. I merely give that example as an illustration of what happens to someone who is now admittedly mentally disturbed.
Let us leave out of our discussion the responsibility for the original injury—the blow which must have occurred. How can we make sure that epileptics and all others with mental troubles of one kind or another are looked after with any degree of humanity or efficiency in police cells? It may be said that if they are transferred immediately to prison and, it is to be hoped, to the prison hospital, even there it will be difficult to know exactly what should be done. However, if they are transferred to the prison hospital at Brixton, which I have visited frequently, they will be dealt with by doctors who have some
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psychiatric training. I understand that in police cells that would be extremely unlikely.
I said that I would look at this matter from two perspectives—through two pairs of eyes. The mother has told me her tale, which I believe, but it is a mother's story. I now look at the matter from the perspective of the chief inspector of a large holding unit not 100 miles from here which I visited this week. We must put ourselves in his position. Two hundred prisoners a day come in from the courts. Somehow or other, before nightfall they have to be found accommodation for the night. There is hardly any accommodation in the holding unit.
When I visited the unit it had on its books over 400 remand prisoners whom the courts intended to go to Brixton but for whom Brixton has no accommodation. I am not seeking to derogate from the force of what was said by the noble Lord, Lord Harris, but to the argument that they should go to Brixton, and yet do not, the answer is that there is no room in Brixton. That is the situation. As regards the chief inspector, the answer is that at Brixton there is no joy. The holding unit has to find such accommodation as it can in the police cells of London. When that accommodation resource fails, which it does habitually, it must scour the country to discover where the remand prisoners can be placed and very often they can be placed only in extremely remote places.
However, we should not blame the police for this situation because it is one in which the police find themselves when the remand prisoners come from the courts. There may be some difference of opinion as to whether it is possible, in the rush and bustle of these 200 arrivals, to identify those who are mentally disturbed. I believe that to be hardly possible. There are two doctors, one of whom is permanent and the other attached. The permanent doctor, who is a general practitioner, told me that there was usually sufficient information to decide which of his daily intake are mentally disturbed.
I was introduced this week to two remand prisoners who were alleged to be disturbed. One was a former solicitor who had fallen on evil days and the other was a gentleman who had no desire whatever to shake hands or to talk with me, which, I suppose, some people would consider a kind of good sense. However, that struck me as a sign of mental disturbance.
Lord Mishcon: My Lords, that is very subjective.
The Earl of Longford: My Lords, the doctor told me that in his opinion the real problem was what to do with the prisoners after they had been identified as mentally disturbed. In the opinion of the doctor who examined this man, there was a total shortage of accommodation for remand prisoners in general and obviously for remand prisoners who were likely to suffer much more than the ordinary prisoners who are being pushed around in this manner. Taking a broad picture, we should have much more accommodation.
I did not prepare my final remarks until I heard the noble Lord, Lord Harris. There was a phrase that he used that struck me most forcibly. He said that there

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must be urgent treatment for those who have been identified as mentally disturbed. That is the key point. When such people are identified there should be urgent treatment. However, what happens is that they are sent off to police cells in London or it may be much further afield. I have a question to put to the noble Earl but I do not believe that he will be able to answer me. Mentally disturbed people are identified as such from the holding unit and they are sent to the police cells. Can the noble Earl tell us whether they are given urgent attention? If he can answer that question I shall be surprised.
I put that question forward from the point of view of the Matthew Trust, which has asked me to indicate that it feels strongly about this matter. The trust feels that as doctors are not available generally when prisoners arrive at the police cells, someone in the police station should be sufficiently trained to say that a person is mentally disturbed and needs urgent attention. I am raising the problem, but the obvious solution is the provision of much more accommodation. The short-term solution is to make sure that in the police stations there is someone, whether a police officer or a doctor, who can identify these people and then put in an urgent plea to the effect that such people require top priority and urgent attention, which the noble Lord. Lord Harris, demanded.
I put this question to the noble Earl: taking London as an example, if a mentally disturbed person arrives in a police cell, what are the prospects of his receiving any expert attention and how soon can he expect to receive it? I support the general tenor of what the noble Lord, Lord Harris, said and I am sure that I shall support the noble Lord, Lord Mishcon, when it is his turn to speak.
3.5 p.m.
Baroness Faithfull: My Lords, I am grateful to the noble Lord, Lord Harris of Greenwich, for bringing forward this matter today. I am grateful for two reasons; first, because of the problem itself; and secondly, because on the last occasion I saw the late Lord Butler of Saffron Walden before he died, he said to me, "When will they implement my report?" That was a long time ago and the report has not been implemented. I have a deep feeling of sympathy both for prison officers and for the police. We are asking prison officers and the police to do a job for which they are not trained, in which they are not experienced and which is not their job. We should not ask them to look after the mentally disturbed and mentally ill prisoners, whether on remand or in prison.
I wonder whether the noble Lord, Lord Harris of Greenwich, will forgive me if I widen the debate. I wish that on occasions it were possible to have two Ministers at the Dispatch Box at the same time. I should like to have seen Ministers from the Department of Health and Social Security and from the Home Office. While remand prisoners at police stations are the direct responsibility of the Home Office, nevertheless I believe that this a joint problem shared between the Department of Health and Social
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Security and the Home Office. The Home Office cannot deal with it alone, and I am not at all sure that it is right that the Home Office should deal with it alone.
There is no strategy between the two departments in handling mentally disturbed and mentally ill patients. Until we have a strategy we shall continue to have the problems we have now. It will not be solely the responsibility and fault of the Home Office, the police or the prison service. In order to have a strategy one has to have knowledge. In order to gain that knowledge one needs to undertake a great deal of research into the Mental Health Acts and the criminal justice system. Until those are linked together we shall never have a sensible policy for prisoners on remand, either in police cells or in prison.
The noble Lord, Lord Harris, referred to care in the community. How many mental patients have been dischared from mental hospitals because of this wonderful concept of care in the community? It is a wonderful concept but at the moment it is a poor concept because it is not being properly carried out. I know of a mental hospital that closed down with a proportion of the patients—I am not saying all—being discharged. They did not have an address to go to; they did not have social workers or doctors in charge of their cases. They were dispersed from the mental hospital right along the South coast. They had money in the form of income support and they were given clothes. The landladies took them in because they saw these nice respectable gentlemen and only realised, perhaps a week or so later, that they had mental patients in their hoarding houses.
Not one of those patients had a social worker or a doctor assigned to his case. They were not planned discharges. If mental hospitals are to discharge patients into the community, there must be planned accommodation, planned treatment and social workers to take charge of their cases. Care in the community for patients cannot succeed unless there is a plan for every patient who is discharged. Therefore I should have liked research carried out to determine how many patients discharged from mental hospitals have found their way into prison or police cells. I do not believe that this is the fault of the Home Office; I believe it is the fault of our mental health system under the Mental Health Acts.
It is always an invidious task to put people into categories, but I think I must do so for the purposes of the debate. I speak of the mentally ill. Doctors will accept the mentally ill into hospital because they are mentally ill and can be treated. However, if one asks a psychiatrist or a consultant to look after a mentally-ill patient who cannot be treated, he will say that it is not a case for the hospital. Well, in those circumstances, who is it a case for? Further, what happens to those patients? Such patients come out into the community and, in fairness to my own profession, the social workers do their best to deal with them against fearful odds.
Then we have the mentally handicapped. Those people, whether fairly normal or ill, cannot survive in the community without help. As the noble Lord, Lord Harris of Greenwich, said, many of them find themselves in police cells or in prison.

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Therefore, I think that there ought to be a joint review between the two departments; namely, the Department of Health and Social Security and the Home Office. One department cannot do it without the other. Until a joint committee is set up for both departments to look at the situation, we shall continue to have the problems that the late Lord Butler of Saffron Walden found; problems that we have today and upon which we have made no progress.
I turn now to my second point; that is, the issue of facilities. One year, when I was working as a director of social services, old Joe came in to see me two days before Christmas. He came in every Christmas. He came in and said, "I want to wish you a happy Christmas". I said, "But Joe, it's not Christmas yet. We have two more days to go". He then said, "No, I have business to do". Of course I never wonderd what the business was, I merely thought that he was getting ready for Christmas.
However, that night I opened my newspaper and saw that a policeman had been assaulted and badly injured. Old Joe was responsible and he had been put in a police cell. I went round to see him and said, "What on earth did you do that for?" He said, "Well, I have to have somewhere for Christmas, don't I?" In fact I looked up his record and found that every Christmas he bashed a policeman. Nevertheless, because the police and the prison service were so generous they put him in prison each Christmas where he could have a good Christmas dinner.
However, worse was yet to come. On this particular Christmas I was sent for by the prison governor as old Joe was making a frightful row in the prison because he had not been given his usual cell. Of course I was appalled by all of this. So, subsequently, a group of us joined together and we have now opened—although it took some time—a Simon Community, a Richmond Fellowship house and a Church Army hostel. Needless to say since that time we have never had any trouble with old Joe, or any of his compatriots, because we have had the facilities to offer such people. Old Joe was mentally handicapped; he was also mildly mentally ill.
I should like to follow the noble Lord, Lord Harris of Greenwich, and mention another similar case. I knew a girl who flung a brick into the window of a Marks & Spencer shop and cracked it from top to bottom. I begged the police not to take her into a police cell and in fact I cared for her in one of our children's homes. However, she escaped—having already attempted suicide—and I sat with her in the dock of the court. It was said in court that she must go to prison merely because there was no place in any mental hospital for her. I stood up in the dock and begged the judge not to allow that to happen.
The judge adjourned the court and himself rang up the then Home Secretary, who in turn got hold of the Secretary of State for Health and Social Services, and that girl went to Rampton. If it had not been that judge, and if I had not stood in the dock with the girl, and absolutely refused to give her up unless she went somewhere else, she would have gone into a cell. I suggest that she would have committed suicide because she had already attempted to do so on two or
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three occasions. She was in Rampton for many, many years. I visited her frequently.
I therefore come to my final points. One is that we need a strategy. To have a strategy, there must he research, jointly, by the Department of Health and Social Security and the Home Office. Secondly, we must have facilities and resources in the community—hospitals and small homes. Lastly, we must not discharge patients from mental hospitals unless it is on a planned basis and they have the facilities, the wherewithal and the help to enable them to live in society without going to prison and into police cells.
3.16 p.m.
Lord Mishcon: My Lords, the House will be grateful, and not for the first time, to the noble Lord, Lord Harris of Greenwich, for raising a serious matter with regard to our prisons. If he will allow me to say so, we have been jointly concerned about the figures for remand prisoners in police cells. I raised that question in the House only a couple of days ago by way of a supplementary question to the Home Office Minister who was then, if I may use the phrase, on duty. I asked whether the Home Office had any programme date by which the target would be reached of no more remand prisoners in police cells.
The junior Minister replied with his usual courtesy, but said that it was not possible for such a date to be given. He was kind enough to say that the remarks that had been made on that occasion would be communicated to his right honourable friend.
Today, we are dealing with part of that issue, and it is a serious one; namely, those who are mentally disturbed and who find themselves in police cells. It is not only a question of those who have not been convicted. We are dealing today with the narrower, and it may be more human, issue—the other issue is a human one as well—of those who are on remand and have not been convicted and who are thought to be mentally disturbed.
The noble Lord, Lord Harris of Greenwich, dealt, I thought to great effect, with four cases that he brought to the attention of the House; one of them—that of Flynn—with which we were jointly associated. It was the very first case and a very tragic one.
It may help if the House realises the extent of the problem. The research that I have done shows that the Question was raised in another place as recently as December 1987. It was a Question that was asked by Mr. Holland of the Minister, Mr. John Patten. It was one that required and obtained a Written Answer. The question was:
"To ask the Secretary of State for the Home Department how many people currently being held on remand in police cells (a) nationally and (b) in London, require psychiatric assessment or treatment; and if he will make a statement".
This was the reply of the Minister, a matter of six months ago:
"On the night of 6/7 December—the most recent date for which information is available—51 remand prisoners awaiting state of health or psychiatric reports were held in police cells in England and Wales. All were awaiting transfer to Brixton Prison. Thirty-five were held in London and 16 elsewhere. Information on prisoners requiring

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psychiatric treatment is not held centrally and could be obtained only at disproportionate cost".—[Official Report, Commons, 14/12/87; col. 345.]
The House will realise that this is not—the noble Lord, Lord Harris, in his presentation never suggested that it was—a matter of having just four, five or six cases at any one time with which we are dealing. It would be interesting to know whether the Minister happens to have the figures available; but frankly I confess that I did not give him notice of this question. It is very pertinent to note that at a recent date there were 51 remand prisoners awaiting examination in prison cells because it was thought that they might need psychiatric treatment.
I shall now follow the line that was taken by the noble Baroness, Lady Faithfull. I ask: if we are really to deal with this problem and know statistically the problem with which we are dealing, both at the Home Office and the health service level, why is it that there are no nationally prepared figures available for those who are actually found to be in need of psychiatric treatment? If we are to deal with this problem, how odd that those figures are not being compiled and how necessary, if I may respectfully suggest this to the Minister, it is that there should be such statistics.
This matter has not been mentioned so far, but I have no doubt that the noble Earl will draw our attention to it. There was an interdepartmental committee set up only a year ago. It reported. It was the interdepartmental working group of Home Office and DHSS officials on mentally disturbed offenders in the prison system in England and Wales. That is a rather pertinent matter and I have taken the trouble to read the report. All that I shall do—I hope not at length—is to try to trace a logical series of mental reasoning, if you like, as to where we have reached today.
I wish the House to know that the Government announced that they accepted all the 16 recommendations of this interdepartmental working group in May 1987. If I may ask the Minister to do so, it would be interesting if he indicated, since this interdepartmental committee reported exactly a year ago, how many of those 16 recommendations have been implemented and what is happening to the rest of them.
Let us start on the logical line with page 3 of the report and what is said at paragraph 3.5. I need read only one sentence:
"Government has a responsibility to mentally disturbed offenders to ensure that they receive appropriate care and management, and treatment where that is indicated, whether that falls to be provided in the prison system or elsewhere".
I pass from there to page 29 of the report, all of which, as I said, has been accepted by the Government. I shall read very briefly from the background note on page 29, which states:
"Mentally ill patients normally need to be held in establishments with hospital officer night cover to provide the necessary degree of observation".
It is completely obvious that no such provision is made or can practically be made in police cells.
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Following upon that, I turn to page 10 of the accepted report where one reads:
"Remand and Short Sentence Prisoners
5.7 The censuses and research study concentrate on sentenced inmates … There remains unexplored the extent and nature of mental abnormality that falls short of the provisions of the MHA amongst the remand population and (until the research study is completed) those serving short sentences, which will include a number of 'skid row' personalities".
Following, if I may, the words of the noble Baroness, Lady Faithfull, I ask whether that research was carried out; whether it is being carried out; and if not, in the famous following words, why not? I end my quotations from this report by referring to page 22 and conclusion 8.6, which states:
There is a need for (and there is scope for) improved co-ordination between penal and health and social services".
That was the final recommendation of the report. That is the whole central theme of this debate. I follow the noble Baroness, Lady Faithfull, but not in her recommendation that there should be only the research and the inquiry. Some part of that may have been met by the setting up of this interdepartmental committee between the two government departments. I assure the noble Baroness that I was going to make this recommendation before I had the pleasure of hearing her speak, but she has given me the courage to make it with more emphasis than I otherwise should have done.
I see no reason why, as a result of this debate and the serious nature of the matters to which the attention of the House has been called, there should not be set up a completely running committee consisting of representatives of the police, the prison service and the DHSS to tackle this problem until it is dealt with satisfactorily and in a civilised way.
3.28 p.m.
The Minister of State, Home Office (Earl Ferrers): My Lords, on a Friday afternoon, which is not always a well attended afternoon, we have had a debate of great importance. If I may say so without being platitudinous, it has been a debate of considerable humanity. The noble Lord, Lord Harris of Greenwich, who put down this Question, made some characteristically trenchant and forceful points in what I thought was an important speech.
He raised many points of detail on matters of great importance to a small area of our life which must not go unforgotten. The concern of the noble Lord, Lord Harris, for the circumstances of mentally disturbed prisoners in police cells is well known. It is right that he should continue to press the Government on these matters because they are important. I was grateful to my noble friend Lady Faithfull when she said that she wished there were two Ministers on the Front Bench to reply to this Question. I too should have been happy to see that situation. However, as my noble friend will know only too well, Ministers answer on behalf of the Government and not on behalf of a department. Perhaps she will be good enough to bear with me and with the inadequacies not only of my own department but of another department over which I have no direct responsibility.
The Question which your Lordships face today deals with one of the effects of prison overcrowding.

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Every day the courts in London commit some 400 people into custody. Every day between 30 and 40 of those people are remanded for the purpose of obtaining medical or psychiatric reports. One must remember that not all of those who are remanded for a psychiatric report will prove to be mentally disturbed people. The purpose of the report is not just to find out whether they are mentally disturbed—although that is of course important—but also to assist the court in determining the case.
A minority of those 30 to 40 prisoners remanded in London cannot be admitted to prison hospitals. As a result, they have to spend some time in police custody. The noble Lord, Lord Mishcon, asked how many people were being held in police custody. On 31st May, there were 43 people held in police cells. By 8th June, that number was reduced to 28. That is a bad state of affairs, which we should not wish to see exist. The encouraging part is that the number of those in police cells who were awaiting medical or psychiatric reports on 31st May is 50 per cent. less than it was when we last debated the matter on a Question which was put down by the noble Lord, Lord Harris of Greenwich, on 4th March. The figure of 28 for 8th June means that the percentage is even higher.
The situation has improved and it is still improving. However, the figure of 28 people in police cells must be seen in the context of the 2,000 or more prisoners who are committed for psychiatric reports each year to Brixton Prison, and of the situation in which that prison was holding 50 per cent. more prisoners than it was designed to hold. All of that represents a major burden to the police force, to which the noble Lord, Lord Harris, rightly referred. Ill-equipped as it is for the task, it manages with the kind of resourcefulness and adaptability for which we have come to respect it.
However, the noble Lord, Lord Harris, and my noble friend Lady Faithfull were quite correct to say that people join the police force to become police officers and not to become prison officers. It is a situation which we do not like to see. It remains our aim to get all prisoners out of police cells as soon as we can possibly manage it. We have opened two temporary prisons, to which the noble Lord, Lord Harris, referred, to help to do just that. As a result, the total number of prisoners in police cells has been reduced from 1,575 at its peak on 8th March to just over 800 today.
That is the background to the problem. We must see the facts as they are. We are bound to see, though we may not like it, the existence of an undesirably high number of prisoners in police cells for the time being. There is simply nowhere else to put them. However, we are making significant improvements, particularly in regard to the situation of prisoners who are remanded for medical or psychiatric reports.
The question which the noble Lords, Lord Harris and Lord Mishcon, have asked, and which is in the back of all our minds, is, "Are we doing all that we can to get psychiatric cases into prison hospitals?". I use that term as shorthand, to mean those who are remanded for psychiatric reports and others who appear to be in some way mentally disordered. The
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police have an established policy of making every effort to place such people into prison as quickly as possible. They are given a high priority for prison places, as and when those places become available.
Obviously, it is easier to take advantage of available places in Brixton Prison if the priority cases are held in, or near, London. Unfortunately, it is not possible to ensure that every psychiatric case is held in London or in the Home Counties, although the majority now are. And this is a further improvement which has taken place since the last debate initiated by the noble Lord, Lord Harris, on this subject.
The Earl of Longford: My Lords, may I ask the noble Earl how that priority works? The noble Earl says there is a system of priority and I am sure, therefore, that there must be. However, there are no signs of it. Does it work from the holding unit here, from police cells, or Brixton? I have no impression myself of the operation of any system for giving priority to psychiatric cases in Brixton.
Earl Ferrers: My Lords, I shall come to the point when I answer the noble Earl's original question. When people are sent to police cells they are inspected and given medical attention where that is considered appropriate. It is after medical attention has been given that the decision about priority has to be taken.
The noble Lord, Lord Harris, referred to Mr. Hollett, who was in Doncaster. The noble Lord asked whether I thought that Doncaster was close to London. As he will appreciate, I said that it was the aim of the Metropolitan Police to arrange for prisoners awaiting reports to be held as close as possible to London. Unfortunately, given the complexity of the situation, it is not possible to achieve that objective in all cases. It was not possible in Mr. Hollett's case. It is not always possible now, but matters are improving in that respect.
Cell space in London continues to be limited, and much of it has to be used for prisoners who are in transit, otherwise the whole complex logistical system would grind to a halt. The overriding factor is, of course, the availability of space in prison hospitals. The resources of Brixton Prison are finite. Inevitably, that constitutes a constraint. But the situation is improving. In recent weeks, it has generally been possible to find a place at Brixton for all urgent cases shortly after they have been identified a such.
The noble Lord, Lord Harris, referred to Mr. MacFarland and asked why he was not admitted to Brixton. Regrettably, it was not possible for the police to comply with the court's wish that Mr. MacFarland be admitted to Brixton because there were no available places at Brixton at the time in question. Since then the situation has improved and urgent cases can be found a place at Brixton quickly, usually—and I hope that this will satisfy the noble Earl, Lord Longford—within about 24 hours.
We also hope that "Fresh Start", which began operating at Wandsworth Prison only this week, will help alleviate the problem. The lifting of restrictions on admissions by the Prison Officers' Association is also a very welcome move. We hope shortly to see the Wandsworth Prison hospital beginning to relieve

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Brixton Prison hospital of many of its convicted medical cases. That will enable Brixton to take more unconvicted medical cases.
A further benefit of the ending of industrial action at Wandsworth Prison will be to relieve Brixton of some of its overcrowding, which in turn will enable the Governor of Brixton to devote more of the accommodation at that prison to medical use. Plans are also well advanced for the hospital at Pentonville to accept transfers from Brixton whenever possible. That, too, will help.
The prison medical service is at present undertaking an urgent review of the existing population in the Brixton hospital in order to identify possible candidates for transfer to those other hospitals. That process will not end when the first batch of prisoners is transferred. It is intended that reviews will be undertaken on a regular basis—at least weekly—in order to secure the greatest possible transfer of medical cases from Brixton.
I hope that these measures relating to prison hospitals which I have described and which will be complemented by the continuing efforts of the police to ensure that psychiatric cases are accorded priority treatment will continue to improve the present position. But we cannot relax our efforts. As long as significant numbers of psychiatric cases remain in police cells, we have to do whatever we can for them. The police take all possible care in dealing with such cases.
The noble Earl, Lord Longford, was especially concerned about what happens to these people from a medical point of view. All prisoners are medically examined on arrival from the courts. While they are in police cells, police surgeons are called in whenever necessary and the police act on their advice in each case. The general instructions to the police are clear. The police will request the attendance of a police surgeon when a prisoner in their care appears to be suffering from any medical or psychiatric symptoms which require urgent treatment. A police surgeon is also called in to a police station if a prisoner requests medical examination.
The police are alert to prisoners who display bizarre behaviour or signs of distress, and will contact a police surgeon or take the prisoner to a hospital if necessary. As I have said, all prisoners are medically examined on arrival from the courts. The police will call upon the services of police surgeons whenever necessary, and in each case will act upon their advice.
The noble Earl, Lord Longford, asked how long prisoners will have to wait. I am bound to tell him that those who are identified as being seriously mentally disturbed are given a high priority for transfer to prison. From the point of view of medical assistance they will receive the same treatment as do other patients under the National Health Service. If a prisoner's condition deteriorates, urgent action will be taken to secure the first available place in a prison hospital. That is arranged through the well established channels of liaison between the police and the prison service.
In addition to these procedures, the Metropolitan Police and the prison medical service have worked
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together so that certain London police station cells are set aside for psychiatric cases. Medical officers from Brixton Prison visit these cells in order to examine the prisoners. Where it is possible, the visiting medical officers produce reports as a result of those examinations. That avoids the need for those cases to wait for places at Brixton in order to undergo examinations and for the reports to be made. The reports which I have received from the police and the prison service show that this system is working well.
The noble Lord, Lord Harris, drew attention to a number of specific instances in which it appears to have taken a long time for the prison service to provide the necessary reports to the courts. It is a fact that the Government devote considerable effort to reducing delay in the criminal justice system. But we must recognise that the provisions which empower the courts to commit people compulsorily to a psychiatric hospital for treatment are also designed to protect the right of the individual. That is why the law provides that the court first must have received medical evidence as to the appropriateness of that course, and then must be assured that a hospital place is available.
These procedures inevitably take time. Unlike a patient who is in an ordinary hospital or who is in one which is administered by the prison medical service, a person who is compulsorily detained in a psychiatric hospital under the provisions of the Mental Health Act 1983 may be given treatment without his consent.
The recent cases of delay to which the noble Lord, Lord Harris, had drawn attention emphasise the importance, in suitable instances, of the mentally disturbed, the feeble-minded or the inadequate being channelled into the health or social services system rather than the prison system. My noble friend Lady Faithfull made an enormously helpful contribution, with her vast experience of the problems of social workers and those who are disturbed.
The Mental Health Act 1983 provides for the transferring out of the prison system into the social services system of those who are mentally disordered. This aspect of the work of the Act featured in the report of the committee to which the noble Lord, Lord Mishcon, quite rightly drew attention. It is the report of the Inter-Departmental Working Group of Officials on Mentally Disturbed Offenders in the prison system. Discussions within and between the Home Office and the Department of Health continue in order to channel the mentally disordered away from the prison system.
I should like to give my noble friend Lady Faithfull, and the noble Lord, Lord Mishcon, who referred to this matter, this assurance. It is a matter of very considerable concern. We are having conversations between the two departments in order to try to see whether there are ways in which this can operate better.
The Flynn case, to which the noble Lord, Lord Harris, referred, raised questions about the adequacy of procedures for obtaining a medical report on a prisoner of no fixed abode. My officials in the Directorate of Prison Medical Services have written to the Department of Health and Social Security

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seeking further information about the guidance which is given to NHS consultants in such cases. Once they have responded, we shall be better placed to decide whether any amendment or clarification may be needed.
The delay in obtaining psychiatric assessment in the case of Mr. Garcia was also obviously unsatisfactory. The noble Lord, Lord Harris, expressed that concern most forcefully. As I explained in my letter of 27th April to the noble Lord, prison medical officers have no authority to compel NHS consultants to attend a prison in order to interview any patient. But, as a general rule, the prison medical officers receive ready help from their NHS colleagues. However, there are occasions when the arrangements for the consultant's visit break down. The noble Lord, Lord Harris, mentioned a number of these cases. I think it is right to say that when a breakdown occurs it is not always the fault of the consultant. Indeed, it may not be anybody's fault.
One factor which may delay matters is that not just any consultant will do. Before it makes an order that a hospital place is available, the court has to satisfy itself that the consultant chosen will be able to offer a bed in a hospital within the appropriate catchment area. That may not be the area in which the court or the prison itself was located. It may be a quite different part of the country from that where the prisoner or his family live. Where the prisoner is of no fixed abode, identification of the right catchment area, and therefore of the appropriate hospital and consultant, can be difficult. It can be a time-consuming process. I share the concern which the noble Lord, Lord Harris, expressed about the delays which can occur in getting these patients the psychiatric attention which they need. That is an expression of concern which has appeared from all parts of the House and from all noble Lords who have contributed this afternoon.
The Home Office officials are in touch with officials in the DHSS on the issues which arise from the Garcia case and others. We shall continue to do our utmost to ensure that prisoners and consultants are mutually accessible.
My noble friend Lady Faithfull referred to the treatment of the mentally ill and the mentally handicapped. The interdepartmental working group considered the interface between the criminal justice and health and social services systems. The various facets of the problems continue to receive attention in discussions between the Home Office and the DHSS. I realise the force with which my noble friend has made her points this afternoon. I shall ensure that they are noted, in the same way as I shall ensure that all your Lordships' remarks are noted.
The noble Lord, Lord Harris of Greenwich, said that when he stood at this Dispatch Box he used the time-honoured expression that he would draw the
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point to the attention of his right honourable friend. He was slightly sceptical as to whether his right honourable friend ever received the points which the noble Lord indicated he would draw to his attention. I shall give the noble Lord, Lord Harris, the assurance that I shall write to my right honourable friend the Minister for Health to draw to his attention the concern which has been expressed not only by him but also by the noble Lord, Lord Mishcon, the noble Earl, Lord Longford, and my noble friend Lady Faithfull. This is an important matter.
With regard to the general problem of mentally disturbed prisoners in police cells, I can assure your Lordships that we are not satisfied with the conditions that exist at the moment. They have improved considerably and we are hoping to improve them further.
Lord Mishcon: My Lords, before the noble Earl sits down and leaves for a restful weekend, I should like to ask him to refer to the suggestion that I ventured to make. I suggested that in view of the urgency of the problem—and there is no doubt that discussions are taking place but, as we know, they often consist of a game of ping-pong between departments—would it not be worth at least considering my suggestion that a committee should be set up consisting of representatives of the police, the prison service and the DHSS until the situation is, we hope, dealt with. Obviously I do not ask for the Misnister's assurance that such a committee will be set up; I merely ask that the suggestion should be seriously considered.
Lord Harris of Greenwich: My Lords, before the noble Earl leaves to enjoy his weekend, as we hope he will, I should like to support what was said by the noble Lord, Lord Mishcon. I believe that there would be strong support among many senior police officers for such a committee. I hope that the Minister and his right honourable friend will consider the matter seriously.
Earl Ferrers: My Lords, I should like to apologise to the noble Lord, Lord Mishcon, for not having referred to his important suggestion. One of the drawbacks of the noble Lord speaking in the position that he does, immediately in advance of myself, is that sometimes I find it impossible to write appropriate notes of all that the noble Lord says. I try to write some notes but I omitted that particularly important point. Of course I shall consider the suggestion and I shall ensure that the problem which the noble Lord has identified is given consideration. It would be unwise of me to say at this moment what the result will be but I shall ensure that the matter is considered.
House adjourned at seven minutes before four o'clock.