Sitting of 1 February 1991

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

National Health Service (Compensation) Bill
Order for Second Reading read.
9.34 am
Mrs. Rosie Barnes: I beg to move, That the Bill be now read a Second time.
I feel privileged to be able to introduce a Bill which will spare thousands of people unnecessary distress, uncertainty and, often, bitterness. My proposals are fair, just and reasonable. As a civilised society, we have a responsibility for each other. In providing the invaluable services of the national health service, we must ensure that the highest standards are observed and that the quality of care is carefully maintained and monitored. It is our national health service and it owes us a duty of care. We should not accept anything less than the best.
We place our trust in doctors in the health service. It is an ethos that has been fostered and encouraged. To shy away from the consequences of medical accidents would be to undermine and to betray that trust. Most people are thankful for and satisfied with the care that they receive from the national health service, but a few have unfortunate or even tragic experiences. The Bill is intended to help that minority.
I used the words "unfortunate or even tragic" with care, because it is important to establish straightaway that I am not proposing compensation for every minor incident, thus creating a system that would soon become bogged down under myriad trivial complaints. I felt that it was right to restrict compensation to those whose lives have been seriously adversely affected by medical accident—not, of course, excluding anyone who is currently eligible for compensation under the present legal system.
The Bill provides that people injured, distressed or subjected to unnecessary pain or suffering during care by the national health service may be awarded compensation. Injury is defined as the result of a mishap in NHS care and not as the foreseeable and reasonable result of that care or of the person's pre-existing condition. The Bill also covers patients who, as a result of injury, die, require hospital treatment for 10 days or more, are prevented from engaging in normal activities for more than 28 days, suffer significant pain, disability, harm, distress or significant loss of amenity, or suffer from a reduction in life expectancy.
I propose a medical injuries compensation board which, with the approval of the Secretary of State, will lay down a code of guidance establishing criteria by which it will determine whether a mishap has occurred during NHS
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care. The hurdles are rightly high and include death, lengthy hospitalisation, being unable to work or to pursue one's normal life for a period of a month or more and unnecessary pain and distress, which are, as I said, eligible for compensation under the present system. Amounts offered would take into account the severity and duration of the suffering. If a full recovery is made, the award would reflect that.
Some people receive compensation at present. I know that the Government believe that the current system is reasonable and, with modifications, can be made acceptable. I dispute that wholeheartedly. The current system is a lottery and it is necessary to prove negligence to be awarded compensation. There may be negligence, but proving it can be distressing, costly and time consuming—and quite often impossible. The only witness may be unconscious at the time of the incident, unaware of what is being done and why. Finding out exactly what happened, who made what decision, what might have been done instead and who took what action is often virtually impossible. Even if the patient is not unconscious, he is often far from at his best and most alert; he may be alone, in pain and frightened, and is probably undressed. Those are hardly the best circumstances in which to be impartial and to take careful note of what is going on around one, so that the necessary evidence can subsequently be produced in a court of law.
The miseries involved in proving negligence were graphically described by a woman who discussed her plight in a number of recent television interviews. Her husband died some seven years ago, as a result of what she believed to be negligence following a fairly routine and relatively minor piece of surgery. She was left a young widow, with three children. She took the matter to court, and was eventually awarded £250,000 in compensation —although she made it clear that it was not the money, but a proper investigation and explanation, in which she was interested.
The matter did not end there, however. The health authority chose to appeal and, seven years after her husband's death, the woman discovered that she had lost her £250,000 award; even worse, costs of £150,000 were awarded against her. The only way in which she can meet those costs is by selling her house.
Any civilised society would recognise that what happened to that young woman and her family is a tragedy —and we have made matters not better, but considerably worse. In many ways, the most damning aspect of the incident is what those seven years have done: they have melted into a sea of bitterness and legal wrangles. A speedy and just settlement of the woman's case would perhaps have enabled her to come to terms with her loss and to start to rebuild her life and those of her children; instead, she is embittered and obsessed by the whole experience.
I have noticed that, in the many cases that have been brought to my attention, the misery caused by prolonged and uncertain court proceedings often matches, and in some instances even outweighs, the effect of the original tragedy. A study of claims made against one English district health authority between 1984 and 1987 found that, on average, abandoned-claim cases lasted between one and three years, settled cases two years and defended cases four to seven years. We are talking about years of prolonging the agony.
We should bear it in mind that the worst cases are always settled out of court. Those who say that the current

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legal system brings important matters to light, introduces an element of human justice and brings negligence to the forefront of the public's attention are misleading themselves. Only the more controversial cases reach the court; severe cases of reprehensible behaviour and negligence are settled quickly and quietly and we, the public, hear nothing. I dispute the adequacy of the legal system in cases of medical negligence, because the die is loaded so heavily against the patient. Right may not always be done; in fact, I believe that it is rarely done.
Let me go a stage further. My second reason for challenging the legal system is that—apart from the delay and the cost involved in proving negligence where it exists —there will inevitably be genuine accidents in an organisation as large as the national health service. Things go wrong as a result of a variety of decisions made by many people and may culminate in a tragic outcome which is no one person's fault.
The philosophy behind my Bill accepts that a degree of human error and human frailty is inevitable and understandable. We all make mistakes, but most of those mistakes will not adversely affect the rest of someone's life so dramatically. We are asking our doctors and nurses —our medical practitioners—to shoulder that burden and we should recognise it.
I do not intend the Bill to be in any way punitive towards practitioners or staff. In a humane and civilised society, however, we should be prepared to make amends when something goes wrong that is no one's fault, or no fault can be proved, or we do not wish to pin the fault on a respected and trusted practitioner. Let me give an example. Three young brothers are admitted to an emergency and casualty department. The doctor in charge must make immediate decisions. He perceives that two of the young men are critically injured, while the third appears not to be so badly hurt. He attends immediately to the first two and saves their lives. But he has omitted to notice that what he put down to a whiplash injury in the case of the third brother is, in fact, a broken neck. As a result of his failure to stabilise the neck, the third brother's spinal cord is severed and he becomes paraplegic.
What are the family to do? Are they to take to court, on grounds of negligence, the doctor who has saved two of their sons and whose judgments and actions no one could have challenged? The relationship between doctor and patient has sometimes been carefully fostered and a patient who has been on the receiving end of one mistake may not wish to bring the doctor to his knees. A confrontational and adversarial approach does nothing to sustain the vital doctor-patient relationship.
My Bill provides for what I judge to be appropriate levels of accountability. While I emphasise again that I have no intention of instigating a witch hunt, when reprehensible behaviour or repeated mistakes by one practitioner come to the attention of the compensation board, it will surely be inappropriate for the board simply to pay up, say nothing and wait for the next case. I suggest that the board be empowered to refer the matter to the appropriate authority—be it the professional body to which the practitioner belongs, the health authority or, in the most extreme cases, the Director of Public
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Prosecutions. Let me stress that I would expect that power to be used only in the event of reprehensible behaviour or repeated acts of negligence.
The Bill allows for compensation to be paid without evidence of negligence, although there must, of course, be evidence that the injury was caused by national health service treatment—or lack of it—and was not a result of inevitable progression of a disease, a known and disclosed side-effect of a drug or treatment, an agreed risk or some other cause.
I find it extraordinary that my Bill has been attacked for allowing the problem of causation to remain. In what circumstances does the state provide money without demanding evidence that the appropriate criteria have been met? The Criminal Injuries Compensation Board must establish that a criminal injury has occurred and that someone did not simply fall down stairs. When unemployment benefit is paid, the authorities go to great lengths to ensure that the recipient is genuinely available for work and is not simply sponging. All social security benefits are carefully vetted. It is quite within the medical injury compensation board's ability and remit to take sensible decisions about mistakes that were caused by NHS treatment and to differentiate between those and mishaps that have nothing to do with the service.
Mr. Patrick Nicholls: The hon. Lady is making an important point and it would be wrong to attack her Bill on the causation issue in that way. However, what troubles some of us, and particularly legal practitioners in the area, is that, because the hon. Lady has sensibly restricted the kind of cases that can qualify for compensation, there are bound to be matters of causation that will concern the board. In other words, the board will have to decide whether particular cases fit in with its criteria. There will be quasi-litigation around the margins to decide whether people qualify for compensation. The problem of proving negligence will be removed, but causation problems will then arise in respect of whether a particular case fits the criteria. The only way in which the hon. Lady can solve that problem is to have compensation across the board without any criteria, and that would be prohibitively expensive.
Mrs. Barnes: I do not accept that argument. It has never been my intention to have an across-the-board compensation scheme, on the lines of the scheme in New Zealand, for all accidents. My Bill is about accidents and mishaps in the NHS. If the hon. Gentleman will allow me, I want to make progress because I intend to cover in more detail the point that he has raised, which I believe is very important.
No one can challenge the fact that I have reduced the hurdles that must be crossed. Instead of having to prove negligence and causation, there is simply an obligation to establish causation. That is perfectly within the powers of the board.
Of course, there are inherent problems in establishing causation. Many cases will be quite straightforward, but none will perhaps cause quite so much heartache and soul searching as those caused by cerebral palsy. In a recent address to the Royal College of Midwives, the chief medical officer said that the upward trend of lawsuits against obstetricians for cases of cerebral palsy is both unjustifiable in the face of present medical evidence and unacceptable in terms of its potential consequence to the

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quality of care available for pregnant women. In 1983, 50 legal cases were brought claiming medical negligence in cases of cerebral palsy. By 1989 there were 200 and it seems that the final figure for 1990 will be nearly 600—and that out of approximately 1,500 cases of cerebral palsy a year. It may not be long before all those cases come to court. With or without my Bill, that matter must be addressed seriously.
The levels of award are also soaring.
Mr. Peter Thurnham: How would the Bill treat the victims of cerebral palsy? There may be 1,500 such cases every year, but it is uncertain how many of those result from NHS treatment and how many occur during pregnancy. How would that be resolved? Would they all receive compensation under the terms of the Bill?
Mrs. Barnes: I shall deal with that in a moment.
There is growing evidence and consensus in medical opinion and research that very few cases of cerebral palsy are caused by the birth process. There seems to be a conviction stemming from papers that were written during the last century that asphyxiation during the birth process is the cause of cerebral palsy. However, that view is now widely and legitimately challenged.
The needs of those tragic children in many cases would not be met by my Bill. Some of the aspects of the problems created by decisions taken by midwives and obstetricians while attending to the births of some children when they may have an eye as to what might happen in a future court of law rather than be considering what is best for the mother and child would certainly be addressed by the Bill. The Bill would allow the board to decide that cerebral palsy was caused by the birth process if that could be demonstrated, but it would not have to attribute negligence or fault to the practitioner. That is what must happen at the moment.
At present is is not just a matter of establishing that cerebral palsy occurred at birth. It is a matter of establishing that someone was at fault. Even if it occurred at birth, that birth might have been properly handled by the midwife or obstetrician in charge. The Bill would remove one major anxiety—defensive medicine—which particularly threatens our maternity services.
Mr. Tony Favell: The hon. Lady is referring to children who suffer from cerebral palsy or other kinds of brain damage. I am president of my local Mencap organisation. Enormous problems would be caused for parents of mentally handicapped children, especially those who are profoundly mentally handicapped, if some were to scoop the pool because they could establish that their children suffered because of a mishap within the definition of the Bill while other parents could not prove that. How will the hon. Lady overcome that problem? The hon. Lady's proposal seems almost to replace one lottery with another.
Mrs. Barnes: Mencap firmly and completely supports my Bill. It accepts that there are instances when mental handicap may be caused by the birth process or as a result of other medical injury for which compensation should be paid. Mencap is also aware that in other cases that might not apply.
My Bill will redress the difference in some respects. I will consider those points in a moment. However, my Bill
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is not intended to compensate according to need all those with an inherited or congenital disease. I am honest about that, but I am also sad about it.
I should like a system of generous benefit based on need and everyone in the House would favour that if it were possible. However, I have not tried to change the world with one Bill. I have tried to tackle the problem of NHS accidents that cause harm to patients and I do not apologise for those limitations. I had to set the boundaries and I knew that there would be tragedies. I considered the possibility because, as a human being I was tempted, as I am sure many judges are, to say, "What if we told the board 'nod and a wink, let all the cerebral palsy cases have compensation'?" However, only 8 or 13 per cent. of those cases may have been caused at birth. And what about the deaf children? What about the blind children? What about the spina bifida children?
The Bill is about accidents and mishaps caused by the NHS. While I regret that it does not allay every kind of human misery, I make no apologies for sticking to the main thrust of the principle.
Mr. Roger Gale: This is a crucial issue. A young friend of mine suffers from cerebral palsy and I do not know, and the hon. Lady does not know, whether it is congenital or it happened at birth. The Royal School for Deaf Children is in my constituency and it deals with kids who suffer from deafness and other unfortunate multiple handicaps. In many cases no one knows why or how those children came to suffer as they do. Will not the hon. Lady's process simply create a desperate scramble after birth to jump on to a bandwagon? Will she really solve the problem?
Mrs. Barnes: Perhaps one of the main disservices done to children with cerebral palsy is the conviction that has pertained for many years that the condition is due to asphyxiation during the birth process. If the medical experts are right and that is not the case, the current legal scramble has inhibited what is really needed, which is research into the cause of cerebral palsy, establishing much earlier in a pregnancy when it is present and addressing that issue in the same way as many others have been addressed.
Miss Emma Nicholson: The present system has not inhibited research into the causes of cerebral palsy. I am glad to tell the hon. Lady about the Little Foundation, which was launched last November and of which I have the honour to be a trustee, whose whole basis of existence is to examine the formation of the brain pre-conceptually and post-conceptually, because it is thought that that will be the way forward to understanding the causes of cerebral palsy.
I am enormously concerned. I deal a lot with handicapped children. As I shall say later, if I am fortunate enough to catch Mr. Deputy Speaker's eye, the Bill will create extraordinary misery for somebody who falls on one side of the Bill and a handicapped child who falls on the other side. As the hon. Lady correctly said, medical knowledge is not perfect. One minute we know one thing, and another minute research shows that a medical matter is due to something else.
Mrs. Barnes: I do not wish to trade credentials for the care of and concern about handicapped children. The Bill is not about handicapped children. That is not a

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shortcoming in the Bill. It is a shortcoming in our society, perhaps, that we are not sufficiently generous to some of those unfortunate people. The Bill is about mishaps or accidents that are caused by the NHS when a patient who puts himself into the hands of the NHS, rightly expecting and, let us remember, having paid for the best, does not get it. Something goes dreadfully wrong and we leave them worse off. That is what the Bill is about.
I accept—indeed, it is my intention—that more people will be allowed through the net. In addition to those who experience and can prove negligence, my Bill will cover people who experienced negligence but could not prove it and people who experienced a genuine accident that was nobody's fault.
However, I challenge the assertion that the proposals will attract infinitely more cases than would be just. With or without the Bill, the number of claims will rise. It is widely acknowledged that the frequency and number of medical negligence claims has risen markedly over recent years. The Medical Protection Society and the Medical Defence Union have produced figures showing that claims have at least doubled. However, a major further boost to claims is about to happen. As from 1 November, patients will have access to all their medical records, the handwritten ones as well as the computerised ones to which they already have access. We all know that gaining access to medical records has been a major barrier to initiating a claim in the past. That will change.
We have only to examine what has happened in the United States to know that, for a variety of reasons, people are demanding more and expecting better and that the consumer society and consumer associations are fostering expectations. I challenge the Government to commit themselves, in deeds as well as words, to the rights and demands of consumers.
Again, I emphasise that I am not offering a soft option for anyone wishing to exploit the system. My attention has been drawn to some ludicrous examples of what happens in New Zealand. For instance, when a prisoner tries to escape, falls and breaks his leg, he is entitled to compensation. Theirs is a general scheme including car crashes and sports injuries. Indeed, there is evidence that the New Zealand system has worked poorly for the victims of medical negligence.
My scheme is confined to the national health service. After all, the national health service accounts for a huge proportion of our national expenditure—nearly 15 per cent., or £27 billion this year if yesterday's Library figures are accepted. We have a duty to ensure that that money is properly spent and that standards are safeguarded.
Also, if serious mistakes are made or if accidents occur, we cannot simply wash our hands of the matter and say, "Tough luck. You put yourelves in the hands of the NHS. The staff did their best, but they inadvertently made matters much worse. It was nobody's fault. You are on your own; there is nothing that we can do about it." That is what the debate about the haemophiliacs was about. It is now academic whether there was negligence by the NHS. We all know that imported blood products were used some time after the possible dangers of those products were known. There is no question that anyone intended haemophiliacs to be infected with the HIV virus with all its horrific consequences. A blood-clotting agent, which for
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many years made their lives infinitely more tolerable, was found to be the carrier of an even more virulent disease. Something went terribly wrong.
Those who were greatly disadvantaged by the miseries of haemophilia were dealt a cruel blow. We as a society sat wringing our hands watching the tortuous legal proceedings while they died. It is to the Government's credit and to that of the new leadership that they brought that appalling situation to an end with a financial offer. What was that if not no-fault compensation? It was a recognition of intolerable circumstances that were brought about by the well-intentioned actions of our national health service. It was a response to the public clamour for justice and recompense. It was a long-overdue gesture to put an end to the obscene sight of those hapless victims struggling on through the courts knowing that, before verdicts, appeals and counter-appeals were reached, many of them would be dead. They would have died, as many did, not knowing what provision, if any, was made for their families.
I was invited to appear on a Channel 4 "Comment" programme some months ago and I chose the subject of the haemophiliacs. While I was researching that subject, one thing struck me very forcefully. We all hear of the haemophiliacs, the Thalidomide victims and the Opren victims. It is hard to say that anyone has an advantage if they have been on the receiving end of such a tragedy, but one benefit that they have is that there are enough of them to form pressure groups to maintain media attention and to keep in the newspaper headlines until the public clamour for action is heeded. However, what about all the one-off cases about which we never hear anything? They are perhaps reported once in a local newspaper and then they are forgotten—they are on their own.
Sir Robert McCrindle: Is not there also the further point, which the hon. Lady might deploy in defence of her Bill, that if, as at the moment, one or two cases occur in a certain health authority area, with considerable necessary outlay by that health authority, it could be to the disadvantage of patients who are served in that area, whereas another area that may be fortunate enough not to have had such a series of claims is able to direct its finances to where they were intended to be spent —on patient care?
Mrs. Barnes: That is a fair point and I shall refer to it in a few moments.
When the next tragedy strikes—and strike it will; the House will have to deal with it and may regret the decision not to support my Bill—on behalf of the haemophiliacs and the Thalidomide and Opren victims and, perhaps, more important, all those cases that we will never know about, we must effect a fairer, speedier and more suitably generous system than the courts. Hence my proposal to establish a medical injury compensation board to define eligibility for compensation, make the necessary assessments and make payments speedily and fairly, ending the bitterness and uncertainty of the current system.
I have not suggested that people should be denied access to the courts. That would impinge on their constitutional rights. The Bill proposes that all claims for compensation should be directed to the board first and should be made within six months of the claimant's becoming aware of the relationship between his or her injury and NHS care. The Bill says that the board should

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notify the claimant of the result of its investigation within three months of receiving the claim or, where that is not practicable, at the earliest opportunity. The reason why I have kept the timing tight is that, in order to find out what happened, it is important that the investigation is carried out as soon as possible after the injury occurs. Of course, that will not always be possible, but we hear too often of investigations that could have been made much earlier being carried out after doctors and nurses have dispersed to various parts of the world and no one can get to the bottom of the matter.
The board would have a variety of options open to it, including giving an explanation and, where appropriate, an apology, as well as compensation, of course. It could refer any serious matters on to other bodies for further consideration.
Mr. Favell: I had better confess that I am a lawyer. Clearly, an enormous number of cases will be referred to the board. Any right hon. and hon. Members will know from their surgeries that people regularly come and say, "Auntie Flo has died in odd circumstances. Would you have a look at it?" When people lose a loved one, they look around to find a reason for the person's death. I have experienced that myself. How will the supposed victim or the family be sure that the board will go through the procedures properly? It is a great tragedy when anyone dies. In the law courts at least people can see what is going on. Will the board operate behind closed doors? Will lawyers be involved? If so, shall not we return to the position that we are now in?
Mrs. Barnes: There are possibilities for appeals and judicial reviews. Once established, the board, like many other similar bodies, will achieve a proper professional code of conduct and will he respected. It will complete the necessary investigations properly.
It is important to stress that many organisations to which I have spoken who represent the patients' or consumers' view feel strongly that explanations and, where appropriate, apologies are as important as, if not more important than, financial compensation. If a child's life is lost as a result of a medical mishap, it is virtually impossible to put a price on that loss. In monetary terms, nothing will alleviate the misery. The only constructive outcome is a proper explanation of what went wrong and some reassurance that lessons have been learnt and that, as a result of that tradegy, it is less likely that someone else will experience the same misery. Therefore, it is important to ensure that explanations are given and people have the answers to the questions that so often drive them to the courts. So many people say—it is not a cynical statement —"I did not take this matter to the courts for the money but to get to the bottom of it."
Mr. Nicholls: Will the hon. Lady give way?
Mrs. Barnes: No, I must press on.
After the loss of a loved one, finding out exactly what happened is not only a dominant force within a person but becomes a right. With a proper answer at an early stage, much of the bitterness and the punitive approach that we see in the courts will evaporate.
Patients will have two months to decide whether to accept the offer. If they accept, any legal claim that they may have will fall and become the property of the board.
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If they reject the offer, they will, of course, be free to pursue the matter through the courts independently, with all the risks and uncertainty that that involves.
I believe that if the scheme is properly funded it will satisfy all but the most litigious. If it is not adequately funded there will be obvious and inherent problems. The fundamental problem will be that all the claims that did not have a chance in the courts will take the board route and the others will go via the courts as usual. I recognise that that will be an inherent problem unless the funding is right. I shall address the matter of funding in a little more detail in a moment.
I have included measures to help to control the level of the board's income and expenditure. I am all too aware of the genuine fear of escalating and uncontrollable costs. I sincerely believe that that is a misplaced fear. I have included the power for the Secretary of State to control the level of the board's expenditure. If he feels it appropriate to fix the amount at the current level of expenditure on administering, litigating and compensating current claims, he has that right. Some would argue that the Bill gives the Secretary of State too many powers, but I judged it necessary to allay his and the Government's fears that the system could run amok and out of control.
It is important to remind ourselves of how the money is currently spent. It is conservatively estimated that under the current system almost half the money spent on compensating, administering and paying legal costs goes on legal and administrative costs. More recent evidence shows that the breakdown may be even less favourably inclined towards the patient and that perhaps as much as two thirds of the costs go on lawyers and administrators. My Bill would enable that money to be directed, at a stroke, to patients, which is where it should be spent.
Another financial aspect that my Bill addresses is the provision in the Law Reform (Personal Injuries) Act 1948 that the availability of national health service care shall be ignored when awarding compensation for personal injuries. In practice that means that when a judge is calculating an appropriate level of compensation, he or she cannot take into account any provision made by the NHS for on-going medical needs, even though NHS care may be the best available and what the patient wants. For example, a patient with a spinal injury caused as a result of a medical mishap may feel that the best place for him is in Stoke Mandeville where he will receive national health service treatment and he will go there, but a judge making an award is not allowed to include that in his calculation. He must calculate all medical costs at private levels and there is no obligation on the patient to avail himself of private care. Indeed, many do not.
Often, compensation is a windfall for relatives. That clause of an Act passed when the NHS was in its infancy and many remained suspicious of it has caused some of the headline-grabbing figures that we see in the newspapers nowadays. The measure is inappropriate in this day and age. High-quality NHS care should be included as an in-kind element of compensation. To return briefly to the argument about cerebral palsy children, such a measure would reduce at a stroke a great deal of the disparity between children who receive awards and those who do not. A large part of the awards made at present is based on on-going medical care for the rest of the patient's life at private levels, when many do not need private care because the state makes adequate provision.

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The board will also be in a position to settle any claims involving a third-party supplier of goods to the health service. That will particularly affect suppliers of drugs. Again, that frees the claimant from lengthy and uncertain court proceedings. Only yesterday we heard that some Opren victims are to be denied compensation because the time for claims has run out. However, the board would be able to pursue any legal claim that has arisen from a case, so if there is another Thalidomide or Opren tragedy the board could, where appropriate, award compensation and then take the pharmaceutical company to the courts itself. That will take away the misery caused to individuals in the present unacceptable situation.
For that reason a number of pharmaceutical companies and the Royal Pharmaceutical Society have expressed enthusiasm for my Bill. They are only too aware of the adverse effects of the publicity that some cases have brougnt to their door. They recongise that the current situation is, not to put too fine a point on it, a mess. They also recognise the advantages of dealing with one board rather than tens, hundreds or thousands of individual cases.
The Bill will also allow for periodic payment of compensation. At present, a judge is in the impossible position of having to decide how long someone will live. In the event that someone dies much earlier than expected the compensation is simply a windfall to relatives. Conversely, as a result of medical development, a child who is not expected to live beyond its teens may live to 40 or 50. The parents of that child must continue to cope long after the money has run out.
Mr. Michael Shersby: The hon. Lady has said that her Bill is supported by the Royal Pharmaceutical Society and by some pharmaceutical companies. Would she care to name one or two of those companies, as that may be helpful?
Mrs. Barnes: Eli Lilly has written to express support for the Bill, as have a number of others. I should be happy to give the hon. Gentleman a list of them.
The Bill will seek to ensure that NHS patients have the same benefits as private patients by applying the terms of the Sale of Goods Act 1979 to all goods supplied through the NHS. I have examined the specific financial aspects connected with the Bill and I am of the firmest opinion that, in the long run, the scheme will be virtually self-financing.
We must remember that medical error does not have a cost implication only for the victim. The NHS is already having to bear the cost of mistakes that have been made. Those mistakes can be extremely costly in terms of the emergency treatment that may be necessary following avoidable complications as well as in terms of additional surgery and the occupation of a bed, which will mean the postponement of other patient admissions. In some cases such mistakes require the facilities of intensive-care units. The cost of such mistakes is, at present, unidentified, but it should be brought to the attention of NHS managers, along with the current total cost of negligence litigation, which possibly amounts to £100 million.
At present there are no reliable figures on the aggregate expenditure on compensation and related legal, administrative and professional costs. Careful research
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undertaken in 1988 suggested that that cost was about £75 million. Given the increased number of cases and the level of awards since then, it is not unreasonable to suggest that that cost is now £100 million.
I have researched the issue of costs thoroughly, but reliable information is scarce. I suspect, however, that the hidden cost of subsequent NHS care following negligence, including those cases that never come to light, combined with the direct costs of compensating, may put a new perspective on the desirability of a medical injury compensation board.
The BMA has suggested that the likely cost of establishing that board would be £100 million—the Secretary of State has suggested that the cost might be slightly higher—but that cost would account for only 0·37 per cent. of the £27 billion that we spend on the NHS. We should also remember that in 1986–87 the cost of the privatisation of British Gas was £162 million—those costs were incurred in just one year.
We should regard the board as a quality-control measure, rather than as a charter for incompetence, as some have suggested. If the board were able to publish reports and research programmes it could make an additional contribution to cost effectiveness in the NHS. Such information would certainly help to raise standards of care and management that would benefit the victims of negligence, other patients and the nation.
The hon. Member for Brentwood and Ongar (Sir R. McCrindle) drew attention to the anxiety now felt by health authorities as a result of the introduction of the Crown indemnity scheme. There is little in the current system to deter negligence, which, according to its proponents, is one of its main advantages. The Crown indemnity scheme means that all direct financial liability is met by the health authority and is not passed on, either in part or whole, to the individual concerned.
We should not ignore the dilemma that will be faced by health authorities in the coming years. South Western regional health authority, for example, has estimated that medical negligence cases now in the pipeline could cost £20 million in the next four years. There are major doubts about regional health authorities' ability to cope with that. Patient care will inevitably be affected. The unpredictable nature of such costs make planning almost impossible.
Sir Robert McCrindle: It might help the hon. Lady to know that the BMA has suggested that, by 1996, under the present scheme it is estimated that no less than 13 per cent. of total resources available to the average health authority may go towards paying compensation for negligence claims.
Mrs. Barnes: That is a valuable point.
I am aware that many other hon. Members want to participate and I know that I have gone on longer than I intended, partly because of the number of interventions I have taken.
I pay tribute to the many individuals and organisations that have provided support and help towards the Bill. I put on record my thanks to the hon. Member for Peckham (Ms. Harman) for her earlier work on the subject and her support throughout the Bill's development. I also thank its sponsors from both sides of the House. I could not let this opportunity go by, however, without paying particular

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tribute to the hon. Member for Newbury (Sir M. McNair-Wilson), whom we are so pleased to see in the Chamber today.
I also pay tribute to the contributions made by the National Consumer Council, the Law Society and the BMA. I am grateful for the detailed work that was undertaken by the Royal College of Physicians—many of my proposals arise from, or are supported by, its work. I am also grateful for the research provided by the Institute of Socio-Legal Studies at Oxford university and the King's Fund.
I remind the House that the Bill has had the overwhelming support of a vast number of professional and voluntary organisations. I have received support from the General Council of the Bar, the Royal Colleges of Physicians, of Midwives, of Obstetricians and Gynaecologists, of Psychiatrists and of Nursing. I have received support from the Patients Association, the Haemaophilia Society, Mencap, the National Confederation of Consumer Groups and the Thalidomide Society, to name but a few.
I commend the Bill to the House for further serious consideration.
Several Hon. Members rose—
Mr. Deputy Speaker (Sir Paul Dean): Order. More than 20 hon. Members want to speak, so I hope that those who are fortunate enough to be called will make brief speeches.
10.28 am
Mr. Michael Morris: I thank the hon. Member for Greenwich (Mrs. Barnes) for the depth of her work on the Bill. It is not often that we get a private Member's Bill that is backed by such research.
I also thank my right hon. Friend the Secretary of State for Health. I recognise that he is unlikely to support the Bill, but the way in which he has deployed the argument about the problems connected with it have made those of us interested in the Bill think long and hard about it and, therefore, to make a conscious decision on its merits.
We all know that there are patients who are adversely affected by negligence, and through no fault of any party. I shall concentrate my remarks on no-fault cases. I recognise that the negligence dimension is essentially a category for the law and for tort. I therefore welcome the proposals that I hear are to be brought forward to speed up negligence claims and I shall listen with interest to what my right hon. Friend the Secretary of State has to say about them. Such changes, if they take place, will be greatly welcomed.
I suspect that most of us have reread the Pearson commission report, in particular that rather damning paragraph which describes the tort system as
"too costly, too cumbersome, too prone to delay, too capricious in its operation to be defensible."
I also suspect that no hon. Member would like to copy the American system under which lawyers go trailing behind the ambulance.
No fault arises because medicine is an inexact science and the human body is one of the most complex of organisms. Medicine often operates on the frontiers and we do not exactly know what its results will be. And occasionally, as the hon. Member for Greenwich said, accidents just happen.
One reason why the Bill has attracted support is that it is all very well for those who take their cases to court to be
1236
paid compensation of £500,000, £750,000 or £1·2 million, but the haemophiliac case was a prime example of the fact that sums of that size are often not needed to alleviate distress and to rectify problems associated with restrictions on lifestyle. Often £50,000 will go a long way to helping people who have suffered through no one's fault.
I declare an interest in respect of one area of the Bill. I advise two pharmaceutical companies—Upjohn and Reckitt and Colman. I have a slight reservation about this part of the measure. These pharmaceutical products are properly researched, tested and checked under all the mechanisms that we have established in this country. They are properly marketed and used for the purposes for which they are prescribed. We are now part of Europe, not merely an independent country. The House sends me to the Council of Europe, where I sit on the health committee. About six months ago I proposed a motion, with the support of a majority of the countries in the Council of Europe, proposing that the health committee look into a no-fault compensation scheme for drugs and appliances. The motion has now gone to the health committee for consideration.
The Secretary of State rightly makes the point that it is doubtful whether the public sector should pay for problems that arise, albeit through no one's fault, in the private sector. Some hon. Members who are present this morning will remember when we brought in the air travel reserve fund. My hon. Friend the Member for Brentwood and Ongar (Sir R. McCrindle) was much involved in it. It works well because it is based on a levy paid by everyone who takes a package holiday. If someone is stranded abroad the fund is used to bring him home again. The health committee of the Council of Europe—the idea has received some support from the pharmaceutical industry —is looking into the possibility of devising a tiny levy on every scrip in order to create a fund from which payments in no-fault cases could be made.
Although I understand the Bill and broadly support its intentions, I wonder whether enough work has been done in the area that I have discussed, bearing in mind the Secretary of State's anxiety about financing this exercise. I believe that we should allow the Council of Europe to do its work alongside this Bill.
Sir Robert McCrindle: Like my hon. Friend I broadly support the hon. Lady's aims, but I have some reservations about the part of the Bill that relates to the use of drugs. Is not there a danger that, if we pass the Bill, it may become attractive to use proprietary drugs? Although that might suit the two companies with which my hon. Friend is associated, it could also lead to increased expenditure in the health service; whereas it is generally known that generic drugs are perfectly acceptable for treating many maladies.
Mr. Morris: I am not sure whether I agree. There are slight dangers with some products that are not necessarily generic but are imported from third world countries. There have been claims in cases associated with them, too. I merely suggest that this subject needs to be dealt with and I question whether it should be dealt with in this Bill.
A new federal law has been passed in the United States covering life-saving appliances and the need to ensure that if something goes wrong with a heart valve the company involved will contact the patient through the medical

1237
profession and warn him that there is a problem. If the Secretary of State catches the Chair's eye later perhaps he will tell us whether the same applies here.
The Council of Europe is doing some work on drugs and appliances. It is an area which is not central to the Bill. I hope that it will be given a Second Reading, but that this area will be dropped so that the hon. Member for Greenwich can concentrate on the Bill's key element—no fault—and return to us when more work has been done on drugs and appliances.
10.38 am
Mr. Jack Ashley: I disagreed with a great deal of what the hon. Member for Northampton, South (Mr. Morris) said, but I begin by congratulating the hon. Member for Greenwich (Mrs. Barnes), who has produced a valuable and comprehensive piece of social legislation. If the Secretary of State opposes the Bill that will be disgraceful. This Bill will be a model for legislation that the House will pass in the future. We are not prepared to tolerate this shocking system of gross injustice to many victims. I am very sorry to hear on the grapevine that the Secretary of State intends to oppose the Bill. No sane person can defend the present lottery: fortunes for the few and nothing for the vast majority. It is a shocking and disgraceful system imposing stress, anxiety and injustice.
Under the present system, the multinationals and large organisations almost always win cases against individuals. That is also intolerable. Some of these organisations are —frankly—crooked; they hedge, fudge and even lie in defence of their interests. I campaigned on these issues before the hon. Member for Greenwich and my hon. Friend the Member for Peckham (Ms. Harman) became Members of Parliament. I have a great deal of experience of these organisations. Some are honest and straightforward and act legitimately but others are unscrupulous. The individual suffers as a consequence of the tactics that they employ.
The House of Commons cannot accept the existing system. It must be changed. The Bill provides a splendid opportunity to change it. If the Government oppose the Bill—I wait to hear what the Secretary of State has to say —it will suggest that they are in alliance with the multinationals to deny justice to individuals who are suffering.
I noted what the hon. Member for Northampton, South said about drugs, but I particularly welcome the inclusion in the Bill of a provision relating to the victims of drug disasters. The British Medical Association's opposition to the provision, on the ground that it is too complex, is nonsensical. I do not believe that the BMA understands how essential this provision is. It is vital because of the absurdity that private patients occupy a privileged position compared with national health service patients. The Bill would put an end to that. The provision is also vital because alleged drug disasters are common and widespread. I do not want to blow my own trumpet, but over the years I have been involved in many of these issues and I am glad that the hon. Member for Reading, East (Sir G. Vaughan) is here. He and I worked closely together many years ago on Thalidomide. He did wonderful work for Thalidomide children. We dealt with complex issues
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that cause great anguish. However, the hon. Gentleman may have reservations about the Bill, which we may hear about later in the debate. I have also worked on Opren, vaccine damage, tranquillisers and Debendox and in each case the individual suffered because of the existing system. It is the system which is at fault. I blame the multinational companies in many cases, but they say that they are the victims of the system. Therefore, it is the Government's responsibility to change that system. This Bill provides them with the opportunity to do so.
An important concomitant of the Bill is that it would change the attitude of all Secretaries of State for Health. All too often in the past Secretaries of State for Health have shown a lofty disdain for drug-damaged people. Throughout all the campaigns we have heard formal expressions of sympathy and a disclaimer of interest and involvement. The usual formula is for previous Secretaries of State to say, "It's not our fault, we are not responsible. We sympathise, but it's just too bad." The Bill will put pressure on future Secretaries of State in appropriate cases to sue the drug companies and recoup the money paid to them.
That would certainly cure complacency. The Secretary of State would be transformed into the protector of the consumer instead of being the guardian of the drugs industry, the role which he has filled far too often. It would be a long-awaited transformation. Who knows—the Secretary of State may even end up studying the vital need for tighter regulation of the drug industry's irresponsible marketing and testing practices. Those who have dealt with the subject know how poor some of those practices are. Every patient wants prevention, not compensation.
I understand that the Association of Victims of Medical Accidents does not support the Bill. I deeply regret that. The association, and Arnold Simanowitz who leads it, have done wonderful work for patients, but they fear that the Bill gives a blank cheque to the proposed board which would produce the code of guidance. However, I should prefer a blank cheque for the board—particularly as its proposals would have to be endorsed by Parliament and could be modified by Parliament—rather than expensive cheques for lawyers and frustration for victims, as now.
The association's other major objection relates to the provision of information and accountability. It is right that the association should be concerned about these matters. People are entitled to know how and why personal disasters happen, in addition to seeking compensation. However, the Bill provides a mechanism that would directly increase the provision of information. That should allay the association's anxiety. I hope that Mr. Simanowitz will change his mind.
Equally important is the need to diminish the adversarial system. The hon. Member for Greenwich explained how the Bill would lead to a diminution of the adversarial system. In the past, the medical profession has tended to close ranks to try to defend colleagues. That is fine in the army and in universities and colleges. I have done that myself. We all defend colleagues out of a common sense of loyalty. That is admirable, but doctors who attempt to defend colleagues when they know they are in the wrong are greatly to blame for their actions.
If the Bill were passed, the medical profession would no longer be encouraged to close ranks. Far fewer of their colleagues would have to be dragged before the courts, if the Bill became law. There would no longer be the need for secrecy, collusion and sometimes even distortion to defend

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colleagues. The medical profession would more readily appreciate its responsibility to protect patients rather than colleagues, regardless of whether they are innocent or guilty.
The General Medical Council is already rethinking its disciplinary procedures. There will be substantial pressure on the GMC to get it right. The weakness of the NHS complaints procedure will be exposed by the Bill. It must be made effective. I remember hon. Members falling about with laughter when I explained some years ago how the GMC proposed to deal with complaints. It intended to give to consultants against whom a complaint had been made the right to veto who was to examine the complaint. The GMC was defending an absurd system, but now at last it has changed its mind. I hope that the new system will be both speedy and realistic.
The Bill will not solve all the problems. If enacted, the central difficulty will shift from proving negligence to proving causation. I appreciate and understand the exchanges between the hon. Member for Greenwich and other hon. Members during her speech. We cannot shirk the issue. Causation is always difficult. In the campaigns that I fought, including those on Thalidomide and Opren, causation was at the nub of the matter.
There can be heartbreaking aspects. After we won the thalidomide campaign and were awarded millions of pounds in damages from the company, an x list and a y list was drawn up. The x list comprised people who had definitely been damaged by Thalidomide. The hon. Member for Reading, East will recall that there was also a y list, comprising the people who probably had not been damaged by the drug. I fought savagely against the Distillers company, but I accept that the people on the y list should not receive any compensation. It should be a fundamental principle that compensation is paid only if causation is proved.
Sir Gerard Vaughan: On Thalidomide, the right hon. Gentleman may recollect that both he and I informed the House that the courts had recommended that adjudicating panels be established, to ascertain who should be compensated and who should not. The company agreed that the panels should have the final say and that there would be no argument. The membership of those panels—which I set up throughout the country—included lawyers, but when it came to allotting compensation, they went over every single detail with the families yet again, causing them great hardship and anxiety. The legal attitude adopted in those cases was disgraceful.
Mr. Ashley: I vividly recollect the panels of which the hon. Gentleman speaks, and he played an important role in that controversy. I accept the relevance to the Bill of that incident, but the fact remains that causation is crucial.
If there is no causation, no compensation should be paid. That is only fair and reasonable. It would be unfair and unreasonable to demand compensation for negligence when no damage has been caused.
The objections to the Bill have no validity. Of course it does not cover every contingency. No legislation can do that. But it does represent a major advance for the House. If the Minister opposes the Bill, I shall be very sad and angry. If the Secretary of State acts like King Canute and tries to turn back the tide, he will find that he is trying to turn back the tide of public opinion. More than that, there comes a time for change with everything, and when it
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arrives nothing can stop it happening—not even Governments. The Bill will give justice to people who are horrendously, and in some cases appallingly, denied justice under the present system. Reform is long overdue. The Bill proposes reform, and I hope that the House will support it.
10.54 am
Sir Gerard Vaughan: The House congratulates the hon. Member for Greenwich (Mrs. Barnes) on the way in which she presented her Bill and on the enormous care and thought that has gone into it. None of us can be happy with the present situation, which is grossly unsatisfactory and unacceptable in a modern society. The matter needs urgent attention, for all the reasons that the hon. Member for Greenwich advanced.
I am deeply concerned about the enormous increase in defensive medicine in recent years. Few of us are aware of the extent to which it has developed and of the damage and dangers that it brings for patient care. Thousands of investigations are undertaken at great cost in terms of money and skilled time. Both would be better directed at reducing waiting lists, rather than being expended on investigations that doctors know are unnecessary but which lawyers and patients with high expectations think are needed.
I am concerned also about the number of X-rays undertaken for purely legal purposes. Every person who receives an injury to his chest thinks that he should have a chest X-ray, not realising that fractured ribs do not show up on X-rays for the first few days. The same applies in respect of suspected spinal injuries. Spine X-rays can be very dangerous in the case of pregnant women itn particular.
The present situation is, for a whole range of reasons, intolerable. The right hon. Member for Stoke-on-Trent, South (Mr. Ashley) spoke about Thalidomide cases. More recently, there were the appalling cases involving haemophiliacs. Only the sensitive awareness and action of my right hon. Friend the present Secretary of State resolved a public disgrace.
For all these reasons, I am deeply sympathetic to the Bill, but I have reservations about it. I fear that it will increase bureaucracy, litigation and the amount of defensive medicine. Few people realise that it would also lead to a reduction in the compensation paid in some cases, because of the application of overall rules. Although the Bill is of immense service in bringing the subject of medical compensation to our attention, I hope that it will not receive a Second Reading. I shall not vote for it.
Mr. Win Griffiths: Although the hon. Gentleman has certain reservations about the Bill, would not it be better to allow them to be dealt with by amendments in Committee?
Sir Gerard Vaughan: That is a reasonable argument which I considered carefully, but I reluctantly dismissed it. My right hon. Friend the Secretary of State should not shelter behind a few minor alterations or changes to the present system. Instead, he should accept that it is unsatisfactory and undertake to establish a proper working party to investigate the whole area and make recommendations, which my right hon. Friend should then implement speedily. The present situation cannot be allowed to continue.
10.57 am
Rev. Martin Smyth: I appreciate the opportunity to support the Bill. Given the reservations that have been expressed, it may be difficult to persuade the Government to introduce the kind of legislation that some right hon. and hon. Members claim is really needed. It is not enough for the Government to oppose the Bill unless they have an alternative that will redress grievances. Therefore, I hope that the Bill will receive a Second Reading, so that there can be further discussion and positive improvements.
Although I am not keen on separate Northern Ireland legislation, I thank the hon. Member for Greenwich (Mrs. Barnes) for taking the precaution of including Northern Ireland in the Bill, so that by the negative order procedure, its provisions could be extended to Northern Ireland—where the problems described today have been experienced.
The organisations that support the Bill include the Spinal Injuries Association and the Royal Association for Disability and Rehabilitation. In a perceptive article that appeared in January in The Independent and was headed
"Why medical negligence should be no one's fault"
a consultant in radiotherapy and oncology gave several examples showing why changes should be made and concluded:
"Such sad examples highlight not only the inefficiency of the present system, but also its immorality and its antipathy to what most of us would regard as 'natural justice'. It is also absurdly expensive. Few members of the public appreciate that lawyers and medical experts may well expect to be paid at least £100 an hour for this work—a sum that ensures a fat income for the growing army of medical negligence lawyers, yet could perhaps be better spent to benefit patients themselves."
I am not criticising the medical fraternity and the professions that supplement medicine. As one who owes more than one debt to careful medical provision, I pay tribute to the bulk of the profession who are careful and seek to serve their patients.
None the less, as the hon. Lady and others have admitted, the medical profession is made up of humans, as I discovered as a young man many years ago when my mother went into hospital for an appendix operation. I admit that perhaps the attitude of the public to the profession has changed somewhat over the years. We no longer naturally think of them as demi-gods, who have all knowledge and all experience and are therefore to be obeyed. When my mother was being prepared for her operation she discovered that the doctor was preparing the wrong side. She asked, "Doctor, is that the right side?" To which she got an expletive and, "Do you think that you can do this job better than me?" As a woman of 19, her response was, "No, doctor, I just thought that the appendix was on the other side of the body" at which there was another expletive and the doctor said, "1 thought that you were in for something else." If she had not spoken out when she did God alone knows what would have been the result of that operation. Therefore, I believe that there is a case for compensation for mishaps, without going into the argument about negligence.
I shall briefly mention the poignant case of a dead constituent of mine who had a traumatic experience for five years, as she sought to have her case properly examined. On 17 September 1985 she entered hospital for a minor operation the next day, expecting to be discharged
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on 19 September. She was discharged a little more than three months later, on Christmas eve. A consultant, speaking to students around her bed said:
"This is what an anaesthetic can do to a patient."
However, we recognise that doctors differ and patients can die. A consultant neurologist was called in to examine her and said:
"I am sure this is a depressive illness with hysterical features."
He prescribed anti-depressant tablets. A senior registrar said that she was
"psychologically disturbed and had a morbid personality."
The first consultant did not believe any of those diagnoses, but did nothing about it and the hospital refused to let a consultant from another hospital see her files. The report took a long time to come through—until 1988. My constituent had to take early retirement through ill-health, and a dramatic change of lifestyle and a low pension.
The solicitor whom she engaged to look into the case said:
"It would be extremely hard to prove 'breach of duty of care for patient.—'"
"Negligence" and "breach of duty" have to be proved. The consultant neurologist later said to her:
"I'm all in favour of patients knowing what we doctors write about in their files, but I think in your case it was a mistake that you found out."
There was a failure to follow through the formal procedures. There was an element of doubt, but it was not sufficient to allow her case to go to a hearing. The independent consultant, to whom she had been referred, gave an ambiguous report because he did not have the notes of her operation. That is a sort of defensive medicine, too—we do not like to have our notes revealed to other consultants.
As a result, my constituent was annoyed about the consultant's approach and wrote a letter setting out her anxieties. His response was that she had made a number of libellous statements. The big hammer of the profession came down on a patient seeking her rights.
In a letter of 7 March 1990 I was informed by the medical administrator of the hospital—to whom I had written to try to find out some information to help me when representing her, and to discover what was going on and why there were delays—that he could not reply because a writ of summons had been issued on 6 September 1989.
My constituent died in the late autumn of 1990. She was 56 years old. I knew her from my early days as an assistant minister in a congregation. I knew her family and knew what calibre of person she was. Even during her illness she spent any time that she could supporting others who were in need and on research for medical provision. She was not depressive, but was being depressed by the medical profession, as it was defending itself instead of helping a person in need. Therefore, I support the Bill.
11.7 am
Sir Michael McNair-Wilson: I congratulate the hon. Member for Greenwich (Mrs. Barnes) on her success in the ballot for private Members' Bills and on bringing forward such a potentially important measure. I also thank her for asking me to be one of the supporters, even though I had not seen the Bill when I accepted. She knows of my interest in the subject and I was grateful for her acknowledgement of it.

1243
My interest in this subject dates back to a visit by a constituent soon after I became the Member of Parliament for Newbury. He told me about an operation for a cleft palate on his baby son, which went wrong. When he went to collect his son he collected a baby with only one foot. He came to see me because the lawyers representing the health authority were contesting a payment of compensation for a mistake made by the anaesthetist. The letter that they sent my constituent was unbelievably high handed and it was only due to my personal intervention on his behalf that we persuaded the health authority that if there was a case for compensation, this was it. I am glad to say that he got compensation.
That case left a mark on me and subsequently, during long spells in hospital, I had some personal experience of medical mishaps, which perhaps merely served to strengthen my view that all is not well with the present system of compensating for negligence.
I have referred to the measure before us as a potentially important Bill because, as it is drafted, I am not sure that it could be a proper alternative to the present system, where proof of medical negligence produces compensation. Certainly the victims of a medical accident should receive compensation speedily.
I am afraid that I do not agree with the hon. Member for Greenwich that the no-fault route is the right one to take. There has to be accountability. One cannot talk about accidents in which no one is to blame. That is not the real world. The hon. Lady told us that she envisaged safeguards in respect of what she described as reprehensible behaviour. I wish that she would spell that out. I must tell her that I shall have some difficulty in supporting the Bill today if she pursues the concept of no fault. The medical profession has no more right than any other profession to expect to be exempted from explaining its actions.
Mrs. Rosie Barnes: Let me make it absolutely clear that I feel that accountability is vital. It is true that I maintain that there may be genuine accidents in which there has been no fault but in respect of which someone may be compensated; I am sure that the haemophiliacs who have been compensated fall into that category. But wherever there is evidence of behaviour that is inappropriate, careless, reprehensible or whatever, I would certainly intend the appropriate measures and follow-up to be undertaken.
I have given a great deal of thought to accountability. I am sure that the hon. Gentleman knows that it is a difficult area, because there is a debate about whether the matter should fall within the ambit of the compensation board or should be handled separately. I felt it necessary to include the no-fault provision because it is not properly addressed anywhere else, but I assure the hon. Gentleman that I take the matter very seriously.
Sir Michael McNair-Wilson: I am grateful to the hon. Lady.
Clause 1 is so widely drafted as apparently to provide compensation for any injury suffered due to mishaps during national health service treatment, although I admit that clause 2 qualifies clause 1 in its definitions of a mishap and of an injury. However, I am not easy with either. I am not a lawyer, so I do not know the legal significance of the words in clause 2:
"a person suffers 'injury', where as a result of a mishap in National Health Service care and not as a foreseeable and
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reasonable result of that care or the person's pre-existing condition, he … requires in-patient hospital treatment for 10 or more days; or … is prevented from engaging in normal activities"
—whatever they may be—
"for 28 or more days; …or suffers a reduction in his life expectancy."
Perhaps each of those reasons for claiming compensation would not be a matter for considerable legal argument, but it does not strike me that way. For example, can anybody say with any certainty how long any of us is likely to live?
If the Bill reaches its Committee stage, clauses I and 2 will need to be discussed and, in my view, heavily amended if we are to have in legislative form a real alternative to what is currently in place.
Mr. James Couchman: Did my hon. Friend make a Freudian slip in omitting to mention clause 2(5)(d), which refers to a person who suffers "significant pain, disability, harm" and so on? That is the provision which worries me most because
"significant pain, disability, harm, or distress or significant loss of amenity"
are perhaps the "injuries" that are most ill-defined and most difficult to define.
Sir Michael McNair-Wilson: I was trying to use shorthand for the various reasons, but I entirely accept my hon. Friend's point and could talk about it from personal experience.
I wish that the hon. Member for Greenwich had gone for a tighter definition than the one that she has chosen. I commend to her the Finnish Patient Injury Act 1986, which set out three grounds on which compensation would be paid:

"1. that an injury probably has arisen as a consequence of examination, treatment or any similar action, or neglect of the same.

2. has been caused by infection or circumstances connected with inflammation which probably has originated in the examination, treatment, or similar action.

3. has been caused by an accident (a) connected with examination, treatment or similar action, (b) occurred during ambulance transportation or in connection with fire or other damage to treatment premises or treatment equipment, or (c) resulting from a defect in medical equipment or in a medical care device."

The clearer that we make the possible grounds for compensation, the less disappointment there will be for those seeking it, and the simpler will be the task of those charged with deciding whether compensation should be paid. The fact that approximately 60 per cent. of those hoping for compensation under the Swedish and Finnish patient injury legislation actually get it shows how easy it is for people to assume that a compensation scheme covers every mishap. It cannot and it will not because being an in-patient in hospital is a hazardous business: hospitals are inevitably repositories of infection and disease and their hygiene and services are not always what they should be. I am not sure that I would want to be treated by a junior doctor at the end of his 90-hour shift. A recent survey carried out by Liverpool university showed that one person in 10 admitted to NHS hospitals acquired an infection unrelated to the reason for admission. As someone who has had to have three ribs removed as a result of septicaemia contracted in hospital, I am aware of the risk, although at present neither I nor any of the patients who pick up infections are eligible for compensation.

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Another report, this time by specialists, pointed out that about 2,000 people injured in road crashes and other accidents die every year because of mistakes, misjudgments and inadequacies in hospitals. That is an appalling number and shows that medical accidents are rather more commonplace than most of us care to admit.
Perhaps this is the point at which I should explain what I mean by a medical accident rather than negligence. I choose two definitions. The first, given in the House of Lords in 1904, defines an accident as an unlooked for mishap or untoward event which is not expected or designed. The second says that an error of judgment is not necessarily negligence. Negligence occurs when a professional person falls below the standard that can reasonably be expected of him. Thus, if we rely on negligence as the sole reason for providing compensation, many people who have suffered medical accidents will lose out. That must call into question the Government's attitude to compensation as we know it.
As I said, I commend the hon. Member for Greenwich, because, like a number of us on both sides of the House, she has recognised that the present system for compensating the victims of medical accidents is unfair, discriminatory, unreasonably expensive and unconscionably long winded. What is more, far from guaranteeing that every NHS patient can pursue a claim for compensation if he or she feels that he or she has been a victim of a medical accident, we have constructed a system for the use of the very rich, who can afford legal fees, and the very poor, who can get legal aid, but which is too expensive for the majority of us to pursue through the courts. That is the first and overriding reason why we need a change.
The second need is to speed up a process that may suit lawyers, because of its protracted and expensive nature, but which does nothing to enhance the idea that, under the national health service, compensation should be available speedily for those who have suffered medical injury as a result of inadequate treatment.
The hon. Member for Greenwich has encapsulated her solution to the problem in the Bill. I support the spirit of what she is trying to do, even if I do not support everything in the Bill. A new compensation scheme would need a compensation body to decide who gets what. For some time, however, I have held the view that, before a claim goes before a medical injury compensation board, it should be passed by some clearing house, such as the national health service ombudsman, as being a prima facie case for compensation. I know that at present the ombudsman is not allowed to investigate clinical complaints. I have always thought of that as a restriction which has made his job much less valuable than it should be. I would give the ombudsman a larger staff and the task of being the clearing house for the board.
Can we seriously contemplate a compensation scheme under which no attempt is made to discover whether that for which we are providing compensation was the result of negligence or simple human error? As I have said, I do not think so. By all means, let us pay the victim of a medical accident whatever compensation the board judges to be fair—and let us compensate quickly, not five to seven years after the event, as happens at present. But let us not walk away from the need to discover what went wrong and
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whether anybody was to blame. To allow that to happen would be to place the medical profession in a favoured and unreal position in which it was in no sense accountable for what it did.
That would do nothing to improve standards. After all, as well as speeding up compensation, any new scheme should seek to make doctors and hospitals more willing to be open about the way in which they work. If compensation is to be paid as of right, the question of accountability will no longer embrace the question of liability. That would be a considerable gain and it could end the wall of silence that currently prevents hospitals from offering an explanation of what has happened to a patient or commenting on a case, for fear of admitting liability. As the hon. Member for Greenwich said, an explanation would be much appreciated by so many people who just want to know what happened.
I ask my right hon. Friend the Secretary of State whether, if the Government are as opposed to the Bill as they appear to be, they agree that the present system has serious shortcomings—they were graphically illustrated in a number of programmes on BBC 2 last autumn which were aptly entitled "Raw Deal"—which must be remedied. Are they aware of the increasingly vocal worries that are being expressed not only by those who cannot afford to seek compensation, but by professional medical bodies such as the Royal College of Physicians and the BMA, that the accountability of the NHS and those who work in it to those whom they look after is governed by the cost of lawyers' fees, despite the fact that the NHS is a service free to everyone at point of delivery?
In the light of that concern and the concern expressed in letters to hon. Members from bodies such as the National Spinal Association, the National Cancer Council, Mencap and the Haemophilia Society, what proposals do the Government have to improve matters? I know that they argue that in 1978 the Pearson report came out against a full-blown compensation scheme, but that was 12 years ago, when such schemes were in their infancy. Is not it time that the subject was recognised in the light of experience? Is not it time for a fresh inquiry to consider the subject of medical negligence and accidents and whether, if the present system stays in place, it will be able to meet the needs of those who may be victims of mishaps?
Quite apart from the intention of the Bill, which has all-party support, is not there a new EC directive that will become effective in 1993 and will place the onus on the doctor to prove that he has not been negligent, so upsetting the present approach? That could lead to defensive medicine and increased cost.
I know that the Government are worried that a new compensation scheme would be enormously expensive, and much more so than the present system. I can understand their worry and I find the King's Fund estimated that it might cost about £235 million a year more convincing than the BMA's £100 million. It will depend on the cost of setting up the scheme and on the size and number of awards that the compensation board makes.
I would not envisage compensation being given as huge lump sum payments, as at present, but as annual payments where a chronic condition is being compensated and modest lump sum payments for one-off accidents. Surely what matters is that we have a demonstrably fair and workable compensation scheme for the statistically small number of people who are the victims of medical accidents

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within the national health service and who currently miss out because we rely on the outmoded civil law of tort to provide compensation.
I recently heard my right hon. Friend the Secretary of State talking of his child's treatment by the national health service and of his attitude to that treatment. He agreed that when it is one's own child, the NHS does not lend itself to becoming a health service that should be constrained solely within business disciplines. I agree with him. I add only that when one has been the victim of a massive drug rash, septacoemia or some other mishap that has forced an unwanted and unexpected hospital stay, imposed problems on one's family and possibly jeopardised one's employment, one is inclined to expect a measure of compensation by right as well as statutory sick pay and sickness and invalidity benefits.
I have referred to the statistically small number of people who are victims of medical accidents. I think that I am correct in that statement, but one of the more curious features of the subject is that the Department of Health does not collect figures centrally, so none of us can be certain how many claims there may be. When I wrote to the chief medical officer asking for guidance, he replied:
"The only relevant figures which we collect centrally for the hospital and community health services provided by health authorities are the numbers of formal written complaints whether or not they are wholly or partly clinical."
That is a strange admission and it makes the Government's hostility to the Bill even harder to understand, unless there is a principle involved that has not yet been stated. It certainly makes it impossible to know the statistical basis for their estimated cost of setting up a compensation scheme. I hope that they will give proper consideration to the Bill's suggestion for a national database so that those figures can be made available.
We hear that the Government intend to have an approved list of solicitors who specialise in negligence, who it is hoped will speed up the present legal process. We know that the Lord Chancellor has brought forward proposals for a no-win, no-payment approach to these cases. That has merit if one wins, but if one loses who pays the defence costs if the case is not fought on legal aid?
I do not deny that reducing the time within which compensation cases come to court would be helpful, but what of their cost? Under NHS indemnity, there seems to have been a saving in medical protection insurance premiums because the health authority bears the whole cost of any litigation and if it loses it pays out of its annual regional budget. That system must make the life of a regional chairman even more difficult than it has always been, because a big award may mean that he has to cut expenditure on new drugs—I am thinking particularly of Erythropoetin for kidney patients—or even close wards to balance the books. Surely that should not be the price that every other patient must pay for the negligent behaviour of a small number of his medical staff.
Is not it time that consideration was given to the make-up of compensation awards? If a lump sum is being provided, should it contain a figure for loss of earnings as well as a theoretical multiplier? These are matters for a fresh inquiry.
I must repeat that NHS indemnity does not sound like a satisfactory long-term approach to the problem, and I shall give just one illustration. Recently, I heard of a case in Oxford where the authority settled out of court because it was advised that it might not win and that, if it did not,
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costs would be awarded against it, which would have made the case far more expensive than settling out of court in the first place. That is not a good precedent. All these measures seem to be tinkering with a system that is less and less able to meet the needs of patients for whom the NHS has been a personal tragedy. The haemophiliacs illustrate that.
That is why I believe that a new approach is needed and why I support the principle behind the Bill, even if I have reservations about its detail. If the Government will not allow it to go further, at least let them recognise that it represents a genuine concern that patient rights have not been given proper attention in the past and that in a reformed national health service the clamour for more consideration to be given to the users of the service will not go away.
11.37 am
Mr. Tom Clarke: The whole House will have welcomed the return to our proceedings of the hon. Member for Newbury (Sir M. McNair-Wilson) and the particularly robust speech that he made.
I should like to think that the whole House would welcome what I regard as a splendid Bill, presented by the hon. Member for Greenwich (Mrs. Barnes) in an excellent speech. I cannot recall a speech—the House will understand that I have followed private Member's Bills carefully in recent years—that had been more methodically researched. The hon. Lady was able to reassure hon. Members who wanted to be reassured about points that they raised.
The hon. Lady said that the Bill's aims are modest, but none the less it will be a major step forward for people who should benefit from it. I thought that the House would welcome her response to the hon. Member for Newbury, when she made it quite clear that the issue of compensation did not remove the need for accountability. If, for example, criminal acts take place within the health service, the law takes its course. If there are other procedures responding to other matters within the health service, issues will still be dealt with as they are now even if we introduce the issue of compensation.
Some of the arguments so far, either in interventions or in speeches from some Conservative Members, disappoint me in the extreme. Hon. Members may have some criticisms of the Bill. I have one or two very mild criticisms, as the hon. Member for Greenwich will appreciate. However, the procedures in this House and in another place should mean that if we accept the principle—and there seems to be overwhelming support for the principles in the country—in due course we can, in Standing Committee and elsewhere, address ourselves to some of the issues. If that is not the intention of some hon. Members, they are nit picking, which is most unworthy in terms of some of the injustices in the national health service today.
Mr. Gale: No speech this morning suggested that the present system is entirely or in any way satisfactory. I doubt whether any hon. Member here does not agree that the hon. Member for Greenwich (Mrs. Barnes) has done a tremendous service in promoting the Bill. However, some of us believe that the long and short titles of the Bill do not permit the necessary changes and that is why we look to

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our right hon. Friend the Secretary of State to tell us later this morning that the Government will examine the matter and will bring forward the right legislation.
Mr. Clarke: The short and long titles of the Bill give considerable scope to the House. I have heard no interventions with which we could not deal in a reasonable debate in Committee. The hon. Gentleman's argument for voting against a Second Reading is bogus, unacceptable and unconvincing to the British people.
One argument that is produced time after time when we attempt to make progress in the House is that bureaucracy may take over. My heavens, the present system is riddled with bureaucracy, but it is not a bureaucracy that helps us to remove injustice or to make patients, their families and friends feel that if something goes wrong, which may be the result of a mistake, it will be put right or that reasonable compensation will be considered.
The issue of no fault is important. If we continue to relate disability benefits to whether the disability arises from birth or from an accident at home or at work, and if we have different systems for responding to individual needs, causation must be identified. I cannot think of a better way to do that than to have the board that the hon. Member for Greenwich proposes in her admirable Bill. The suggestion that such a scheme would cost a great deal of money and would be so expensive that the Government could not deal with it assumes that the Government are far more naive than their record suggests. They did not let the social fund run riot. They had cash limits and regulations, and they knew exactly what they were doing. I cannot imagine for a second that if the hon. Member for Greenwich manages to get the Bill through, as she deserves, the Government will act nonchalantly in seeking to deal with problems that may arise.
I said earlier that I have some very mild—and I emphasise that—criticisms of the Bill. They can, of course, be corrected in due course. If I have a criticism at all, it is simply that the Bill does not go far enough. However, I wish the hon. Member for Greenwich well and I know how difficult it is to get a Bill through the House. In many ways, it is the Government who should have accepted the responsibility that the hon. Lady has nobly accepted after being given her opportunity in the ballot.
One of my criticisms is that the Bill does not have an element of retrospection. That is rather sad especially in the light of the two constituency cases that I want to mention. I mention them because all of us are influenced by what people tell us in constituency correspondence and at our surgeries. We learn a great deal from people who present themselves on cold Saturday mornings to tell us of individual cases that relate to them, and which are relevant to existing legislation and to legislation that should exist.
I do not want to weary the House and I know that several hon. Members still wish to speak. The first case was featured recently in the Glasgow Evening Times. My constituent, Mr. Brian Smith, came to see me at my surgery in the mining village of Moodiesburn, but for greater ease of reference, I will simply report what the Glasgow Evening Times said. The article stated:
"A heartbroken husband pleaded today: 'Tell me why my wife died'. Amy Smith (35)"—
this happened last October—
"was admitted to hospital 16 days ago suffering from depression.
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Husband Brian (35) said he made continuous anxious complaints to medical staff about her deteriorating condition.
But on Sunday the mother-of-three died …
Amy was admitted to Gartnavel General Hospital at the end of September. Brian, of Bridgeburn Drive, Moodiesburn, Lanarkshire, watched in horror as Amy deteriorated rapidly. He claimed doctors had doubled the dose of her medication.
And on Sunday he sat outside her room as medical staff called for ventilators and rushed consultants to her bedside.
'All week I tried to see someone and it was impossible. No one was ever available and no one listened to me. Then two hours before she died, there were crowds of people around her bed. But they told me nothing. I don't know whether she died peacefully, whether she was frightened or conscious or whether she even asked for me.'"
Even today, Brian and the three children do not know the cause of Amy's death. Her father died last February and she suffered from depression. Her family understood that she was being admitted to hospital for that reason. If we do not have a mechanism for dealing with such complaints, we have a great cause for worry. All of us have enormous faith in the national health service, but, if things go wrong, we want people to know exactly what happened and we want a mechanism for putting it right.
A second constituency case has caused me great concern. Michael Starrs is now 53. In 1958, Michael was given a grade A1 as a result of the examination for entering the forces. He appeared to be a healthy young man and he served in Northern Ireland in the King's Royal Hussars. He completed an apprenticeship as a moulder, left the Army in 1960 and married in 1961. In 1964, he developed a duodenal ulcer and on 25 March 1965, a crucial day in his life as he has explained several times, most recently last Sunday, he entered Hairmyres hospital in East Kilbride and was presented for an operation. As Micheal told me on Sunday:
"That was the day I lost my two most precious possessions, my health and my ability to earn the shilling."
I would, of course, have preferred a full inquiry to have taken place; my requests for one, however, have met with no success. The hon. Member for Greenwich has cited the problems of recollection experienced by someone who, at the time of the incident concerned, who under medication and preparing for an operation. Michael remembers being given a pre-med, but does not remember an anaesthetic being administered. He recalls being aware of being surrounded by people wearing masks who held him down forcibly; and he recalls part of his stomach hanging out.
Many years have passed since Michael's operation, during which I have engaged in a good deal of correspondence and a good many ministerial meetings. When I asked the Scottish Office health Minister, the hon. Member for Stirling (Mr. Forsyth) to instigate an inquiry, he told me that the only person in that operating theatre who is now still alive is Michael Starrs himself.
Surely that is an argument not for necessarily trying to apportion blame, but for accepting that something went badly wrong and that there is a valid case for compensation. Michael Starrs has suffered agony over the years, undergoing operation after operation—the most recent being major surgery to remove his gall bladder in 1988. He is unable to walk properly; he is very weak, and his digestive system has been almost totally ruined.
At present, the NHS has no mechanism to deal with cases such as those of Michael Starrs and Amy Smith. I am sure that other hon. Members can give examples from their constituencies. It is clearly time that something was done; so far the Government have not come up with any proposals, and I hope that, despite all the rumours that we

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have heard, the Secretary of State will at least allow the House to consider the merits or otherwise of what I consider an admirable Bill.
It cannot be without significance that organisations such as the British Medical Association and other professional bodies, as well as consumers, have welcomed the Bill. As a Labour Member, I consider the role of the consumer very important. I see no inconsistency with the principles in which my hon. Friends and I believe; Robert Owen and the co-operative movement had a considerable influence on Labour thinking.
I have no wish to stigmatise the medical profession or to cause its members years of worry, but why should not those who use the NHS, and their family and friends, have recourse to help when things go wrong? I visited America recently and I know that the medical profession dislikes the thought of litigation hanging over it for years. The Bill would prevent many such instances. The Secretary of State indicates dissent; I hope that, when he winds up the debate, he will give us his reasons, but he must know that his views run counter to those of the professional organisations mentioned by the hon. Member for Greenwich.
Magnificent though I believe the NHS to be, in recent years the very strains and stresses experienced by the service have given us all the more reason to exercise vigilance in defending the rights of patients and their families. It would be positively uncaring for the Government not to allow us even to consider the Bill. It will be deplorable if the payroll vote turns up to oppose even its Second Reading. I consider the Bill laudable and worthy of debate and support. I wish the hon. Lady well, and hope that the Bill receives the backing that it deserves.
11.44 am
Mrs. Edwina Currie: Let me join other hon. Members in congratulating the hon. Member for Greenwich (Mrs. Barnes) both on winning the ballot and on the excellent way in which she presented the Bill.
As I am sure the hon. Lady will agree, under a no-fault compensation scheme there would be no need to prove negligence. There is no doubt that, as several hon. Members have pointed out, considerable problems are involved in proving negligence. Given the legal costs and the uncertainty, the present system is open only to the very poor and the very rich. There is also the difficulty of obtaining evidence, especially from medical records and from a profession that still tends to protect its own. The delay can be extraordinary: on average, three and a half years pass before action is even started in obstetric cases. The average duration of such cases is 6·7 years, and it frequently takes 10 or 11 years to bring them to a conclusion. Such delays are contrary to natural justice. People die before cases are concluded, witnesses are not available, records prove to be lost and, very often, witnesses simply cannot remember what happened.
One result of all that is that there are relatively few cases of medical compensation in this country—about 4,500 new cases a year, at a cost of about £75 million. Only about one case in three succeeds and it is widely considered unfair that only the most persistent litigant does so.
There are also the public-health and public-interest considerations, outlined by such people as the chief medical officer, Sir Raymond Hoffenberg, the Royal College of Physicians and the British Medical Association.
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They would say that the existing system destroys the patient-doctor relationship. Writing in The Independent on 8 January, Dr. Tobias, one of the consultants at University College hospital, makes the interesting observation that it is all a
"wretched business, with patients and doctors forced into confrontation by the adversarial methods of the British courts."
There are increasing worries about litigation, with the top awards now amounting to more than £1 million a case; there are also worries about defensive medicine and the system is widely regarded as unfair to doctors, who are seen as being on trial in court cases, even when they have taken reasonable risks.
Let me say to my right hon. Friend the Secretary of State that many of those problems are genuine, as I think every hon. Member who has spoken—and many who have yet to speak—would agree. One or two problems are not genuine or are already being addressed, and some have better solutions; but most will need my right hon. Friend's active and vigorous intervention if improvements are to be made to the current system.
I say to the hon. Member for Greenwich, with the best will in the world, that I do not think that her Bill will solve the problems—and, indeed, it could make life considerably more difficult for some of those whom she is trying to assist.
Some of the problems that have been outlined are either in the process of being eased or likely to be eased shortly. Legal costs are an example. The most tragic cases involve brain-damaged babies, but, as from 1 April last year, it is now possible for a minor to apply to the courts for legal aid on the basis of its own income. Most children, of course, have no income and, as a result, far more such cases can be brought to court with the full protection of legal aid. In the first six months after that change in the rule, the number of such cases brought to the notification of the authorities trebled. It therefore follows that those children will be able to obtain justice much more easily in future.
The hon. Lady mentioned that the Access to Health Records Act 1990, the result of a private Member's Bill presented by the hon. Member for Newcastle upon Tyne, North (Mr. Henderson) with the support of the Department of Health, provides for patients to have access to medical records from November this year. The hon. Lady cited that as a reason for our needing the Bill; I cite it as a reason for our not needing it. One of the key problems, that of obtaining access to medical records, will diminish and, one hopes, disappear. Given the effort to which I went to improve access when I was at the Department, the change in attitude in both the Department and the BMA is most commendable.
My right hon. Friend should address the important issue of delay. In Sweden 60 per cent. of all claims are settled within two months, and 93 per cent. within six months; here, as I have said, it can take many years. A quarter of obstetric claims do not come to the attention of the hospitals until more than seven years after the births. The system in Britain is very different. The Bill refers to a timespan of six months. That would be very tight particularly in many of the most tragic cases. Mr. Brian Capstick, a lawyer writing in the British Medical Journal on 26 January, suggested a period of 18 months. The

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Limitation Act 1980 refers to three years in the case of a death. It should be possible to make an effective time limit on some cases.
Much of the delay in payment is due not to the way in which the law works, but to the way in which health authorities work. I stood at the Dispatch Box in 1988 and admitted liability for cases in Exeter in which patients had been excessively irradiated by equipment that had been faultily calibrated. It took another year before the health authority admitted liability. Two years on, many of those cases have not been settled. That is absolutely scandalous. The cases involving the largest pay-outs, the most spectacular cases about which the public hear, are often those in which health authorities offer a financial settlement perhaps three days before the cases go to court. That might be years after the event. That could be corrected easily through the assistance and at the insistence of the Secretary of State.
Mr. Nicholls: My hon. Friend has made a valuable point. Does she agree that, in practice, when the defendant is effectively an insurance company which knows that it is being opposed by someone who does not have legal aid, it will keep the case going to the last minute to try to grind that person down? As a lawyer, I have acted for both plaintiffs and defendants and have used that tactic. The way out of that problem is to have particular classes of action, such as actions in respect of medical negligence, in which the case is assessed only on its merit with regard to legal aid. It is not assessed on account of means. At a stroke, that would take care of the kind of case that my hon. Friend has rightly put to the House.
Mrs. Currie: I suspect that my hon. Friend's profession will do well whether or not this Bill receives a Second Reading today. Although insurance cases are not covered by the Bill, it is worth pointing out that nine out of 10 insurance claims for motor accidents are paid out eventually one way or another. The certainty that people will receive a payment is a big help. With regard to compensation for compulsory purchase cases in which there may be a dispute about the value of a property, the local authority is obliged to pay out very quickly 90 per cent. of the expected amount. The relatively minor amount can then be disputed. However, the individual in such a case benefits.
The Bill could create difficulties and if we were to follow the path proposed today, we would live to regret it. The Bill does not avoid people having to go to court. The compensation board proposed in clause 4(9) would be able to initiate legal cases. As a result, there would be many more cases.
Mrs. Rosie Barnes: Does the hon. Lady agree that it would be inappropriate for the board to make large settlements on the part of third parties with no attempt to recoup them? One of the intentions of the Bill is to remove patients from the on-going proceedings, but not for the state to pick up the Bill that should naturally be the responsibility of the appropriate company or authority.
Mrs. Currie: I can see why that provision is included in the Bill. It is an improvement on the proposal in the Bill presented by the hon. Member for Peckham (Ms. Harman) last year which would have removed people's
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rights and, in that sense, was, I believe, iniquitous. Most people who are interested in this matter believe that a no-fault compensation scheme will avoid the need for all those terrible court cases. However, it will not. There will be just as many terrible court cases. Indeed, there will be a lot more of them.
Mrs. Rosie Barnes: Does not the hon. Lady accept that in cases such as Thalidomide or Opren there would be one court case between the board and the company instead of the hundreds or thousands that are going on at the moment? That would be a great improvement for everyone involved.
Mrs. Currie: It is worth pointing out that well over 2,000 of the Opren claimants have been paid. It was shown yesterday that some of those claimants had failed to make a claim within the reasonable time limit, which is six times the limit suggested in the Bill.
We should not abrogate people's legal rights. However, the introduction of a no-fault compensation scheme in which the board could initiate action may well result—in fact, I am certain that it would result—in more such cases and not fewer.
The Bill also does not avoid people having to prove fault. To make a successful case under the no-fault compensation scheme suggested in the Bill a patient would need three things: a problem; a medical event; and a proven link between the two. Without those requirements, spurious claims would be paid. Even in New Zealand where the pay-out is based on accidents, people still have to show that the problem was caused by an accident and did not have a natural cause.
Mr. Jim Lester: Surely it is one thing to prove fault, but another to prove negligence. So many of us feel strongly about the need to prove negligence, not fault.
Mrs. Currie: The process of proving fault is similar to the process of proving that someone caused that fault. In practice the evidence must still be obtained.
Ms. Harriet Harman: The difference in the Bill is not the difference between proving fault and proving negligence—this is a no-fault Bill. The difference in the Bill is that instead of having to produce causal links and negligence, one need only prove the causal links. The hon. Member for Derbyshire, South (Mrs. Currie) has not understood that. She certainly is not addressing that point.
Mrs. Currie: It is very difficult to prove fault. For example, 1,500 babies a year are born with cerebral palsy —[Interruption.] The hon. Member for Peckham is not listening so she will not understand what I am saying.
It is extremely difficult in most of the cases involving those babies born with cerebral palsy to prove that that condition is anyone's fault. It is in the nature of medical events that most of what happens is caused by the nature of the disease or the risk associated with the treatment or by some natural process. Most cerebral palsy is caused by congenital problems. The tragedy is that when people try to prove fault, they must still go through a similar process. Although it may not be so complete as pinning it on an individual, they must still show fault.
Mr. Kenneth Hind: Will my hon. Friend give way?
Mrs. Currie: If my hon. Friend will forgive me, I will not give way. I have already given way more than any other speaker and it might be helpful if I make progress.
If the Bill or something like it is enacted, there will be a serious danger that if we do not try to prove negligence, bad doctors might get off. What is so terrible about proving fault and negligence? I can understand that the British Medical Association and our doctors might think that it was terrible, but we must bear in mind the confidential enquiry into peri-operative deaths—CEPOD —which showed that 21 per cent. of deaths within 30 days of surgery were caused by anaesthetists and surgeons. There are obviously a lot of serious medical faults around. That confidential inquiry was produced only after a battle was waged; many doctors refused to co-operate with it. Of course, doctors want a no-fault compensation scheme because some of them do not want their fault to be identified.
Doctor Tobias at University College hospital has stated:
"in cases of minor head injury, it is increasingly felt unwise for a clinician to discharge a patient from hospital after clinical examination has revealed no apparent damage. Instead there is a growing reliance on skull X-rays and even brain scans, since these provide 'hard evidence' should the patient later become unwell, sue the hospital and the case be brought to court."
If I had had a bang on the head, I would want the brain scan and the X-rays not because I might sue, but because I might die or suffer brain damage otherwise. If defensive medicine leads to better medicine, I am all in favour of it.
My right hon. Friend the Secretary of State should consider research in Florida that Was reported in the British Medical Journal on 29 September 1990. It was found that, in the medical group, 85 per cent. of pay-outs on medical negligence cases were sustained on behalf of only 3 per cent. of doctors. When those doctors' history was checked, it was found that the high payment group had had a large number of complaints against them, particularly in the period four to five years previously. We put up with bad practice far too much. Bad doctors should be tackled. That job is partly for my right hon. Friend the Secretary of State and the General Medical Council, and it is a jolly good job that the British Medical Association may like to take it on board.
I now refer to the point about patient-doctor relationships suffering in the existing system. I am not sure about that. A patient who thinks the world of his doctor does not sue. The patient-doctor relationship has broken down before anybody starts to make a complaint, and the usual problem is precisely that. All the cases that were described so movingly this morning have evolved not from there being a need for no-fault compensation but from the need for better communication between patients and their doctors. In that sense, the new consent form, which was brought in recently and which is so bitterly resented by some doctors, is a step in the right direction towards getting informed consent.
The main problem is costs. The hon. Member for Greenwich has suggested a figure, the BMA has suggested a figure—everyone has suggested a figure. Again, the British Medical Journal, on 29 September 1990 made an effort. One in 25 patients in this country admitted to hospital experiences harm as a result of their stay in hospital. A fifth of all deaths in hospitals may be caused by something going wrong. We know that that is true of surgery. About 300,000 patients in the United Kingdom a
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year therefore might experience harm, and 45,000 deaths may be caused by that harm, and that would give rise to 75,000 potential cases of negligence from hospital admissions alone. That does not count out-patients attending for surgery—it would be many times that number—and it does not count attendances for general practice.
If we had 75,000 cases at the current average pay-out rate, which is about £17,000, we would be talking not about a couple of hundred million, but about £1·2 billion. That is not far-fetched. The New Zealand scheme costs more than £300 million a year, and that is 1·4 per cent. of their gross national product. In this country we would be talking about several billion pounds for an equivalent figure. If hon. Members think that £1 billion might be far-fetched, let me remind them that, in 1979, we thought that it would be a wonderful idea to give substantial social security payments to old people living in private residential care. The cost in 1979 was 10 million quid. The cost last year was £1·1 billion. We are talking about a potentially enormous amount of money. An effective scheme would cost the earth, and the money would be better spent on improving health care.
Therefore, I do not feel that we should be aiming to introduce no-fault compensation. We should be aiming at fewer faults. We should be aiming at having fewer cases that might lead to such complaints, and we should be indulging in a vigorous pursuit of those at fault and of improvements to reduce the damage that potentially they can do. That would be a lot easier if we were not spending enormous sums of money on thousands of relatively modest claims.
12.3 pm
Mr. Frank Doran: I listened carefully to the hon. Member for Derbyshire, South (Mrs. Currie). She seemed to have some difficulty in appreciating the difference between fault and negligence. That is at the root of the system of tort in England and Wales and delict in Scotland—the requirement to prove negligence and the causal link between the incident and the harm.
As a practising solicitor, I have come across many cases in which fault has been alleged, but it has been impossible to prove negligence. There is a real sense of grievance and injustice on the part of an individual in that situation, particularly when he or she has had to go through the hoops and hurdles of the legal system before a case can get into court. Most people find it necessary to apply for legal aid. There is difficulty in receiving legal aid. Also, a prior test is required and, thereafter, there are long delays before cases come to court.
The biggest problem for people who must go through that process after an injury has been caused to them and the change that inevitably occurs to their lives is the complete uncertainty in the system and what it means to them. They can be recovering from the trauma of physical damage but be left with the stress and strain of uncertainty for many years while cases work through our legal system. It is not uncommon for cases to take seven, eight or more years to be heard before the original incident is dealt with. For that and many other reasons, I have long been a supporter of a no-fault liability scheme, not just in cases of medical evidence but for other matters covered by, for example, the New Zealand scheme or the Canadian and Saskatchewan schemes, which were pioneers.

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The hon. Member for Derbyshire, South made much of the cost of the New Zealand scheme. She omitted to mention that it covers not only medical negligence but a range of insurance matters, including road traffic liability and third-party liability under their traffic legislation. Of course it is expensive—so would ours be if all those matters were lumped together.
When I read the Bill, I was struck by the compromises that would have to be made if we set up a no-fault scheme. Clearly, many aspects are left out of the Bill, but they should be an essential part of any scheme. One point that worries me is protection for patients. Legal assistance for patients who have to present cases should be provided. Other hon. Members have mentioned the problem of full access to medical records and assistance in understanding and interpreting them. We should also consider how to deal with the problem of assessing the damages required to be paid. The board that would be set up by the Bill would be a self-perpetuating body which would require some outside influence in determining what damages should be paid. If it had a monopoly, how would it make such an assessment? What comparisons would it make? There are gaps in the Bill. Again, that is part of the inevitable compromise.
There is opposition across a broad range of the establishment, not just on Conservative Benches—I know that it exists on my side of the House also—to the principle of no-fault compensation. One thing that strikes me most is that the Bill focuses on the national health service. In many respects, that service is in a unique position because it is a public body and is directly answerable to the Secretary of State for Health. There are many advantages of the scheme, particularly for the national health service.
We have heard about the potential cost of the scheme. The hon. Member for Derbyshire, South gave grossly inflated figures concerning the likely consequences. Not every incident will result in a claim and not every incident that results in a claim will result in a claim worth the average figure of £17,000. That is certainly not the experience of the Criminal Injuries Compensation Board.
Dr. Norman A. Godman: According to a parliamentary question that was answered by the Scottish Minister with responsibility for health, the sum paid out last year in Scotland in cases of compensation amounted to £1·364 million. That was based on an average claim, including claimant's costs, of £17,000. For our country we are not talking about a great deal of money, are we?
Mr. Doran: My hon. Friend makes his point very well, and I shall develop it. What is not included in the costing of the scheme is the court time involved, legal aid costs, which are all costs to the state, the problems within the health service that are created by any litigation, and the cost of running legal services. I have already mentioned the legal costs across the board.
The distraction of the staff is also important. The involvement of any member of staff in a legal claim is a fairly major event for that individual. A whole department may be involved in a claim. I was involved in a complaint brought by one of my constituents recently. It will not result in a claim against the health service, but there appeared to have been negligence. For many months the
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staff of one department in my local hospital were caught up and distracted. Many of them were worried and stressed by the implications of that complaint. The cost of such stress is never assessed and taken into account when we examine the cost of the present system.
The present system results in several costs both within and outside the system. One is the worry and stress on individuals who are the subject of the fault or negligence claim. That in itself can create costs for the state such as extra industrial injuries benefit or social security benefits for someone who cannot return to work quickly or may suffer illness brought about by the stress and strain of the legal process which they must pursue.
As I said, the NHS is in a unique position because it is a public body through and through. Opposition Members, who support the NHS, want to see it continue to be a public body through and through. The Government are worried about the cost of insurance against negligence and brought in the system of Crown indemnity. That is a step in the right direction because it has taken central control, at least through the various health boards, of health service insurance. The service is becoming self-insured. I have some experience of that because I worked in public bodies—one nationalised industry and a local authority—which made exactly the same decision in respect of their insurance claims. They discovered that they were paying an enormous amount in insurance premiums and that the return from them did not make economic sense. So they decided to become self-insured. They spent the £50,000 premium on setting up their own insurance.
It is common practice now throughout the public sector to pay the equivalent of the insurance premium into a fund that slowly builds up and allows bodies to meet all their insurance claims. I am not sure whether there is a similar practice in the health service. The practice means that bodies can carry their own insurance and keep control of it. They are not in the hands of an insurance company when deciding whether a claim should be settled. They can meet claims or fight them if they decide that they want to do so. They can make decisions on a case-by-case basis.
Administrative costs were cut dramatically by adopting that practice. With on-going payments into the fund, bodies have control of a substantial fund to meet all their liabilities. There is no reason why something similar should not be introduced into the health service. As we heard earlier, the health service spends about £75 million on direct payments of costs. My hon. Friend the Member for Greenock and Port Glasgow (Dr. Godman) gave us the example from Scotland. That is an enormous amount of money and I am sure that there is scope for making savings.
The Health Secretary could examine how the system of Crown indemnity might be extended. It would not necessarily require legislation. It could be done administratively. Why not consider the possibility of an experiment in one health board and see what could be done?
The Criminal Injuries Compensation Board was introduced administratively and has operated for 20-odd years. It is subject to delays and there are real criticisms about the way in which it operates, but at least it provides compensation in an area where no compensation was previously available in practice although technically it was always available. There is no reason why the same could not be done in the health service.

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The Secretary of State could introduce a scheme whereby an area board did away with the concept of legal challenges and assessed claims on their merits, not necessarily, in the first instance, on the basis of fault, but on the usual legal basis of legal liability for damage caused by negligence. The Secretary of State could experiment and see what effect that scheme had on the area. I am convinced that there would be practical savings which would be extended to the patients making the claims. It would remove from them the uncertainty and fear of the legal process, which I mentioned earlier. Such an experiment would be a valuable test of whether such a scheme could be extended beyond the area of the experiment.
No matter what hon. Members on both sides of the House say about the Bill—we know that the Government have called in the troops to vote against the Bill, so we know their position—there is great anxiety about the way in which compensation claims are dealt with in the health service. It is not good enough to bat down the measure and say that it is inappropriate. Clearly, such measures will be introduced regularly in the House. We want to hear something from the Government about what they propose and how they see the way forward. Shall we be stuck with the rigidities, inequities and inconsistencies of the present system, or does the Secretary of State have some practical proposals to put to the House to show us the way ahead and give us something against which we can test the present system? I do not expect an immediate answer on my idea of an experiment, but I should like the Secretary of State to consider whether it is possible to introduce a scheme administratively as an experiment somewhere in the country.
12.16 pm
The Secretary of State for Health (Mr. William Waldegrave): I found the speech of the hon. Member for Aberdeen, South (Mr. Doran) interesting. I shall come back to some of his suggestions for improving the present position by administrative means. There are some ways of doing that and I have one suggestion which I hope will interest the House later. However, we should be a little careful about analogies with the Criminal Injuries Compensation Board because it has the advantage of having settled beyond peradventure all questions of fault. Criminal liability has been established. It settles the causation in pretty well all cases. It establishes only a small amount of damages. Although it is a useful board, one must be careful with the analogy the health service. It is certainly not analogous with the type of board proposed by the hon. Member for Greenwich (Mrs. Barnes).
Dr. Kim Howells: I remind the Secretary of State that some industries have similar boards which have dealt well with complicated cases where bitterness may arise out of the board's decision. For example, in the coal industry a large number of cases is dealt with. The greatest hardship is taken out of the compensation case before the case comes to court. In certain cases the company is taken to court, but not in all cases, and therefore the courts are not clogged up.
Mr. Waldegrave: There may be arrangements to deal with certain categories of cases in comparable ways, but I shall come back to the matter.
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I thank the hon. Member for Greenwich for bringing the House back to an important, interesting and difficult subject. It is not a party subject as such. I have no doubt that the hon. Member for Peckham (Ms. Harman), with her usual skill, will attempt to make it so. The begetter of the no-fault compensation lobby, which goes back to the 1950s, was the late lamented Member and great friend of mine, Sir John Foster, who badgered me when I was in the civil service long ago in the 1970s on no-fault compensation schemes. He found a Government more susceptible than ours to his arguments in New Zealand. I am not sure that the New Zealand Government are universally pleased that they allowed themselves to be so badgered by Sir John.
There are supporters and opponents on both sides of the House of the principle of a no-fault compensation scheme. So far in the debate few people have been willing to say that the operation of the law is satisfactory in respect of medical negligence cases and the definition of who is responsible for what at present. I count myself among that consensus, and therefore I shall try to meet some of the points made by my hon. Friends and by the hon. Member for Greenwich.
I repeat that although this is not a party matter, it is a matter on which no Government can stand back and simply allow things to fall out where they may. Immensely important issues are involved. We are being asked to change the relationship between the victim of harm and the person who caused it. That relationship has developed over many years in common law. I believe that the first claims against doctors go back 600 years.
There is nothing to say that the House should not, from time to time, have a go at overturning long-established principles, and we do. However, we must have a strong case to prove that our actions are right.
If we were to overturn the present relationship between someone whose damage is caused by the fault of a doctor in the NHS—it is important to remember that we are talking about only one sector of the medical profession—there would be major implications for such relationships in many other sectors. I must warn the House about that. However much it is legitimate for the hon. Member for Greenwich to say that she cannot solve all the problems at once in one Bill, it is also the duty of the House, and certainly the Government, to consider the implications of the Bill across the board.
Dr. Godman: I know that it is no answer to the problems suffered by someone who experiences massive negligence at the hands of a consultant during an operation, but would not it put the mind of the public at ease slightly if the Government introduced a more efficient disciplinary procedure for the conduct of consultants?
Mr. Waldegrave: Some important comments have been made on that matter today. My hon. Friend the Member for Derbyshire, South (Mrs. Currie), in her characteristically robust style, drew the attention of the General Medical Council to the unease that still exists, although I accept it has addressed some of the problems. We all share that feeling. I remind the hon. Member for Greenock and Port Glasgow (Dr. Godman) that, with the support of the House and the leaders of the medical profession, various things have been done in terms of a peer-group review of the skills of doctors—a medical audit. In common with all self-governing professions, the GMC has a tremendous

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duty to relieve public unease by ensuring that the inevitable solidarity that exists in the profession does not overpower the need for justice and accountability. Accountability is an important theme and I am not sure that we heard enough about it in the lead-up to the Bill, although important comments have been made about it today.
We should make such a fundamental change in an important area of our public life only if we have before us a most compelling and coherent case. Preferably we should be able to study exemplars from abroad to see how to do it. We should make that change only when there has been a clear and practical exposition of not just the principle in the broadest sense, but of how it will work. That is what a Second Reading debate is for. Some hon. Members have suggested that we can push the Bill into Committee to sort out the details, but we need to know whether the majority of the House has agreed on a clear principle on which the Committee and experts in my Department can work to make practical.
People have gathered round the no-fault compensation banner for many years, but it is a banner with many different emblems. I read the accounts of the press conference of the hon. Member for Greenwich and I have read the letters from organisations expressing support for the Bill's principle. It is noticeable how differently they render that principle and how few of those organisations are willing to say that they are in favour of a Bill—be it the one introduced today by the hon. Member for Greenwich or that introduced by the hon. Member for Peckham. At that point the House has the right to ask whether those differences exist because it is not easy to produce a Bill embodying that principle which works. I do not believe that the Bill's ability to embody that principle has been demonstrated today and I shall try to explain why.
Mr. Chris Mullin: No one is suggesting that it is easy, but we believe that what is proposed is better than what has gone before. Unless the Minister has any better suggestions—we should have heard them before this debate and they should not be tagged on to the end of his speech—he should allow the Bill its Second Reading.
Mr. Waldegrave: Although it was put in the hon. Gentleman's characteristically emollient way, his point is fair. I believe that I shall be able to demonstrate that the desire for change would not be met by the Bill and that, in a number of crucial respects, the Bill would make things worse. That also goes for all the other Bills that have attempted to embody the principle of no-fault compensation. Perhaps the principle is easy to state in the highest level of generality, but not so easy to carry into law. As a result of the Second Reading the House must know that it is submitting to the Committee something that can be made into reasonable law that will improve matters.
The hon. Member for Greenwich listed the criteria that the Bill is designed to meet and we are all agreed on those criteria. The hon. Lady is seeking to improve on the unfairness of the present system and I agree that, in many respects, the present arrangements are perceived as unfair. There is a basic perception that such compensation claims are a lottery. The family of one baby who has suffered may receive £1 million, but another baby with a similar injury
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may get nothing or only social security support. The new system will involve major changes to principles that have existed in law for many years and we must be certain that it will produce a better system with less unfairness.
We all respect the concern that the right hon. Member for Stoke-on-Trent, South (Mr. Ashley) has expressed on this matter, and on other similar matters, but it is no good saying that it is disgraceful of me to oppose something if the origin of my opposition is my belief that the Bill will make matters worse. I must try to persuade the right hon. Gentleman of that.
Would we have less unfairness as a result of the Bill? Clearly not. We would still have negligence claims—I plead with hon. Members to remember that. The hon. Lady played down the fact that people may not like the compensation offered by the board—the hon. Lady and the hon. Member for Peckham have rightly said that such compensation must be cash limited and the hon. Member for Peckham has reiterated that the Labour party is committed to cash-limiting the health service—because the awards will not be very big. Comparison has been made with the Criminal Injuries Compensation Board—we should not follow that comparison too far—but it deals only in awards of between £2,000 and £3,000.
Under the most analogous foreign systems—although none of them approximates closely to the system that we would obtain under the Bill—the sums awarded would be between £10,000 and £20,000. On the advice of their lawyers many people will refuse such awards, thinking that they will get more by suing for negligence and damages through the courts. So many of the most heart-rending cases will continue. The hon. Member for Greenwich offered a most moving example in her speech today and at her press conference—of a woman who took her case through all the courts and finally lost, on the issue of causation I believe. Costs were awarded against her and the whole episode was a terrible disaster. Her solicitor, who was also present at the press conference, said, as I understand it, that this Bill would make no difference to such cases: the woman would have been likely to pursue her case in any event. So this is one category of unfairness that would persist under the Bill—
Mrs. Rosie Barnes: The lady in question has made her case well known and she has made it clear that she pursued the case through the courts in the first place to get to the bottom of what happened and to be given a proper explanation. She is, of course, devastated by the £150,000 costs awarded against her, but she is less worried about having lost her award. It must be forcibly stated that the courts are sometimes used to get explanations that are otherwise unobtainable.
Mr. Waldegrave: That is a fair point, but the solicitor, Mr. Body, said that since the woman ultimately lost on causation she would not have got compensation from the board either—so her case would not have been helped at all.
Miss Emma Nicholson: Does my right hon. Friend agree that the Access to Health Records Act 1990 was drafted a little more narrowly than it should have been and that the way to get increased access to medical information for patients might lie in re-examining that Act and perhaps other measures of that nature, instead of following the proposal of the hon. Member for Greenwich (Mrs. Barnes)?
Mr. Waldegrave: The hon. Member for Newscastle upon Tyne, North (Mr. Henderson) greatly assisted the progress that we have made on medical records, although the Act has not yet come into force and we must see how it works when it does.
There would be new unfairnesses under the Bill. In the past few days large compensation claims have been paid to children involved in tragic car accidents. Clear fault was established and I expect that the insurance companies ultimately paid the people involved. Such cases will also persist. Similar cases involving brain-damaged children and damage done by other public services will be settled with no change from the present system. No one could claim that that would be fairer than what happens now. If a person is hit by a British Rail train and full negligence is not shown, that person will receive no compensation; but people who are the subject of accidents in the health service will have an automatic right to some compensation. Of course, the hon. Member for Greenwich says that she cannot deal with everything at once, but she is pushing us in the direction of what happens in New Zealand, although everyone, including the hon. Members for Peckham and for Greenwich, now agrees that the New Zealand system is cracking up. It does not work and New Zealanders are backing away from it. The hon. Member for Peckham may say that the Labour party is committed to introducing such a Bill; if so, she is committing her party to another £300 million or £400 million of expenditure. She should talk to some of the lawyers in her party—they may not be as keen as she is. We do not want to land ourselves in a frightful muddle.
Mr. Terence L. Higgins: Does my right hon. Friend agree that in all the cases that have been mentioned it is probably possible to obtain redress through the courts, but that the group who have been really unfairly treated are the nuclear test veterans who cannot take action through the courts?
Mr. Waldegrave: That runs well outside my departmental responsibilities, but I agree with the first part of my right hon. Friend's intervention.
Yet another extraordinary unfairness would arise under the Bill. Let us imagine that the board pays compensation in a case but then comes to the conclusion that it should take the case forward for negligence, even though the person involved has not, possibly because he is satisfied by the quicker process. The board might win its case for compensation and, having awarded the victim £50,000, win £1 million. In that case the person concerned would get no more money; other claimants with less good cases would get it, because it would spread among other cases under the regime of the Bill. That would not be right. People would claim strongly that the money that had been won was theirs. Perhaps that anomaly could be removed in Committee, but there are signs that the problem has not been thought through.
Mr. Doran: The board's claim would be limited to its own loss. It is not a case of the injured person's loss being transmitted and that being the test. The test is what the board has paid out.
Mr. Waldegrave: If the board fought a negligence case, it would gain what the individual would have received if the case had been fought by that individual. The individual would have won, just as the board had won. The
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individual would then receive compensation on the usual basis. The hon. Gentleman cannot escape from that conclusion.
The procedure involves acute unfairness to doctors. There is a double jeopardy. The doctor is asked to co-operate with the board. He is asked to apologise. Dubious causation is established. Then a negligence claim is made by the board against him. I do not believe that a doctor should be put in that position.
Mrs. Rosie Barnes: It is not intended that the boa rd should enter into negligence actions against NHS employees, including doctors. The intention is to take action against third parties—NHS suppliers whose products may have caused a problem through being faulty. The intention is to recoup that money. We do not intend to pursue the doctors through the courts. We want to refer to the appropiate authority only matters that are not being dealt with.
Mr. Waldegrave: This is a new and fundamental principle—that only one category of negligence claims is to be pursued by the board. Such a new idea would be difficult to uphold. There would be cases under the criteria set out by the hon. Lady where it would be right for the board to sue a doctor for negligence. If the intention is to sue only Eli Lilly, which, rather to my astonishment, is in alliance with the right hon. Member for Stoke-on-Trent, South because it is in favour of the Bill, I am told by one of my hon. Friends—it must be the first time in history that that particular alliance has been forged—that would be a new source of unfairness. Only one form of negligence case would be pursued, not others. That is why I am willing to debate with the right hon. Member for Stoke-on-Trent, South my view that my opposition is not inhuman; I am just trying to find out whether the Bill would improve the position. I believe that it does not do away with unfairness. It introduces much more unfairness.
The second criticism of the present system relates to accountability. The hon. Member for Greenwich made the point at her press conference that if the case is settled out of court there will be little accountability. The Bill does nothing about that. The best negligence cases that the hon. Lady's Bill will not exclude—although the Bill introduced by the hon. Member for Peckham would have excluded them—will continue to be settled out of court, just as they are now. Therefore, the Bill provides no help in that direction. However, together with the presidents of the royal colleges, we should try to draw explicit lessons from court cases. I shall return to the point made by my hon. Friend the Member for Newbury (Sir. M. McNair-Wilson) about gathering information centrally to draw lessons that can be fed into our growing means of improving medical standards, audits and so on, based on existing cases.
Difficulty over access to the ordinary court system often prevents an explanation of and the disentangling of tragic events. Above all, in my constituency experience, people want to know whether negligence could have been avoided. We want people to be able to gain quicker arid better access to the courts.
Unusually for a Secretary of State standing at the Dispatch Box, I have to say that I am alarmed by the degree of power that is given to me and my successors by the Bill. At two crucial points in it, important matters are left to the Secretary of State for his guidance. Causation,

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which could often be proved before the board only with great difficulty, will not accord with the usual legal definition, because I am to make my definition
"having regard to the difficulties in establishing causation in law."
My new definition, which will be more intelligent and sensitive than that developed over hundreds of years by lawyers, will be compared with the definition used by the courts when dealing with the same case. That would be extremely odd. The board may pursue a case in the High Court and a verdict may be reached according to the normal definitions of law, but that will be compared with a wholly different definition used by me. If there is no difference, what is the point of a new definition? If I establish a new definition, it will create a fresh set of problems and conflict with the existing legal system.
The Bill would also allow me, under schedule 2, to do all sorts of unnamed things in relation to disciplinary bodies. That is not something that should be sorted out later in Committee. If I were to come to the House and ask for such powers, I would be met with a good deal of uproar from the Opposition, and certainly my hon. Friend the Member for Tiverton (Mr. Maxwell-Hyslop) would find such a proposal intolerable.
The pig in the poke that we are being asked to buy will, by its very nature, diminish accountability. That is the nature of no-fault schemes—and part of their merits in the eyes of their proponents. They do not seek to lay blame. If one wants to do that, there is no escape from the much-maligned adversarial court system. If one wants to put the blame on someone, that individual must be allowed to defend himself—and will therefore place himself in an adversarial position, of the sort that I find myself adopting towards the hon. Gentleman to whom I give way.
Mr. Tom Clarke: The Secretary of State introduces a new dimension that runs counter to an argument that the Minister for Health, who is seated next to the right hon. Gentleman, will recall from the Committee debates in 1989 on the National Health Service and Community Care Bill. Then, the right hon. Gentleman's predecessor took upon himself power upon power, without as much as an apology or a blush. Is the Secretary of State announcing a policy change? If he is worried about the time taken by courts to deal with cases, do his calculations about bureaucracy and costs take into account the abuse of the existing system? Will not the Bill give the right hon. Gentleman an opportunity to do something about that?
Mr. Waldegrave: A private Member's Bill comes to the House with the major and difficult issues left for the Secretary of State to address. On Second Reading, we should be debating matters such as the nature of causation and the sort of no-fault concept that we have in mind.
I refer to the point about double jeopardy made by the hon. Member for Peckham. Schedule 2(6) states:
"Where the Board pursues any legal claim which it has passed to it, the value of that claim shall not be restricted to the level of compensation that the Board has paid to the claimant, but shall be assessed by reference to the damages that would have been awarded to the claimant had he pursued the legal claim himself."
I thought that my earlier remarks were correct, so it seems that the hon. Member for Peckham has not read to the end
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of the Bill. I only argue with the hon. Lady because she has been making inflammatory remarks from a sedentary position and occasionally I must be allowed to strike back.
There is a consensus in the House that cases should be dealt with by the courts more quickly and in a fairer way. However, there is the danger of litigiousness and a horror of the sort of cases that arise in America. The hon. Member for Sunderland, South (Mr. Mullin) is bound to be in favour of this revolutionary change, on principle. [HON. MEMBERS: "He is a reformer."] Yes, he is a genuine reformer. However, would the dramatic reform that we are being asked to consider limit litigiousness? That is a prefectly reasonable question for the hon. Member for Greenwich, as it is one of the reforms which she claims for her Bill. It will not do so, for the following reasons. There would be bound to be more cases against the NHS under this proposal, because a lower level of proof would be required to get compensation, as no fault is involved. If I am allowed the powers granted in the Bill there will be a lower test of causation than the reasonable test that the courts use at present which will result in many more cases. There would be more claims against the national health service than against any other service, because claims against other services would still be dealt with using the recognised legal concept of causation.
With all respect to my hon. Friends and to Opposition Members who are lawyers, the legal profession will not turn down the chance of a whole new industry of bringing cases against the NHS. One sees advertisements for solicitors in newspapers now. I saw such an advert in a Hampshire paper last week which said, "Do you feel you have a negligence claim against the NHS?" I suppose that that is fair enough, and that solicitors should be able to publicise, but the Bill would result in a great deal of pressure to bring cases because of the lower criteria required.
American litigiousness has produced a new phenomenon called defensive medicine, although there is more anecdote than proof of it. As a result of this Bill there will be a new form of defensive medicine. The present form —if it exists and whether or not it is a bad thing—would remain and ordinary negligence cases would continue as at present. The Bill does not exclude that. However, a new form of defensive medicine would emerge.
All medicine has risks attached to it. As a result of the Bill, doctors would not only take steps to avoid pressure from negligence claims—although sometimes those steps are a good thing and we should take more of them—but would move away from any medical practice which has risk attached. All medicine involves some risk, but doctors would not wish to go before the board or to be constantly involved in inquiries, and so would decide to move away from any medicine with a slightly higher risk factor. That would be wrong, partly because no medical practice is entirely without risk, and partly because medical decisions should be made as a result of proper clinical judgments and should not be influenced by other considerations such as boards.
Mr. Couchman: Does my right hon. Friend agree that the Bill will also militate against innovative procedures and treatment?
Mr. Waldegrave: That is probably so. If a doctor followed that route he would probably end up before the board.

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Defensive medicine is a serious matter, which must be considered. There is a lot of loose talk on the subject and as I said earlier, some defensive medicine can be a good thing. For example, the King's Fund report of 1988 showed that much defensive medicine in the United States was concerned with closer monitoring of patients and better record-keeping. I believe that one of the midwives at the press conference given by the hon. Member for Greenwich gave an example of unsatisfactory defensive medicine—the electronic foetal monitor. I was jolly pleased that there was electronic foetal monitoring for all four of my children and I would not wish to do anything to diminish that modern good practice.
I am trying to persuade the hon. Member for Stoke-on-Trent, South that the Bill will not make things better. It might do away with existing defensive medicine —whether that is good or bad—and it would introduce a new type.
Mr. Ashley: I appreciate what the Secretary of State is saying and although I do not agree with his objections to the Bill, I know that he puts them forward in good faith. What are his alternatives to the present scandalous situation?
Mr. Waldegrave: Hon. Members will be united in pressing me on that. First, let me finish my explanation of why I think the Bill does not help and why we must therefore look to some other proposals.
My last objection is on grounds of cost. At present, most cases—about 95 per cent—are settled below £100,000, although some headline cases, usually involving children, result in much higher settlements. Surely it is naive to think that if the Bill is enacted, there will not be a very large increase in the number of claims. Unless the awards are extremely small—at the level of criminal injuries compensation type awards of £2,000 or £3,000—most people are bound to go for negligence and, if they are not, the cost will be very great. The BMA says £100 million; the King's Fund used to say £300 million to £400 million and is now saying about £230 million. At any rate, considerable sums will be involved. Nobody really knows, but there would be rapid expansion.
Sir Michael McNair-Wilson: Is not it the case that although people in Sweden and Finland have the right to use the courts, an extremely small percentage exercise that right, and that most are satisfied with what the compensation board offers?
Mr. Waldegrave: I know more about Sweden than about Finland, although I suspect that the arrangements are rather similar. The trouble with an analogy with Sweden is that the scheme represents a small top-up to a very generous disability system, which would be the delight of many hon. Members on both sides of the House if we could afford it. I fear that that is the answer to my hon. Friend's question and we looked into the matter to see why that was so.
Sir Barney Hayhoe: The Secretary of State is about to explain what he thinks could be put in place of the proposals in the Bill. Many of us who have studied the subject carefully do not accept that just because the present situation is bad—we all accept that it is—we should necessarily adopt the proposals of the hon. Member for Greenwich (Mrs. Barnes). Many of us agree with my right hon. Friend's case, which is that those
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proposals would make matters worse. I want to make that absolutely clear before we reach what I hope will be my right hon. Friend's constructive proposals for improving the present arrangements.
Mr. Waldegrave: That is the structure of my argument and I am grateful for my right hon. Friend's endorsement of it.
We have problems with each of the matters that the Member for Greenwich and the supporters of the Bill, have, honestly and straightforwardly, sought to address, but which I argue are not addressed effectively in her approach. First, we have a problem with access to health records—a point to which hon. Members have referred. The Access to Health Records Act 1990, introduced by the hon. Member for Newcastle upon Tyne, North, comes into action on 1 November and will be of considerable help in terms of enabling justified cases to be brought.
A whole battery of matters—described by the hon. Member for Peckham as a smokescreen, which they are not—arise from the civil justice review started by Lord Hailsham in 1985. Some of the most distinguished experts in the field—for example, Roger Pannone and Lord Griffiths—took part in that review and a large number of the 91 recommendations are either in train or about to be set in train. I shall mention them because, if we are criticising the tort system, we should know what is being done to make it better.
The review looked into three main areas—matching cases to judges, what the lawyers call the cards-on-thetable approach, and changes to reduce delay. New arrangements for the allocation of business between the High Court and the county court will ensure that cases are heard by the appropriate level of judge. Smaller value cases will be heard, for the most part, in the county courts, thereby reserving the High Court for the cases in which it should properly be involved. To achieve that, county courts will be given unlimited jurisdiction and all personal injury claims involving amounts below £50,000 will be required to start in the county court. All cases set down to trial will be scrutinised and decisions will be made on the appropriate forum for trial based on the criteria of substance—the value of the claim and the importance and the complexity of the case. District judges' trial jurisdiction will be increased to £5,000 in line with that of circuit judges and the limit for the automatic reference to arbitration will be increased from £500 to £1,000.
Then there is the so-called cards-on-the-table approach. The aim is for parties to provide each other with information at an early stage of the proceedings to clarify the issues, encourage settlements and shorten trials.
Since last June, a plaintiff with a personal injury claim has been required to provide a medical report and statement quantifying the losses he has suffered, or continues to suffer as a result of his injuries, with his particulars of claim. A further rule change requires the defendant to inform the plaintiff of any facts on which he intends to rely to contest the damages claim. Those rules give each party important information at the outset of proceedings rather than closer to the trial.
From July—this has not been introduced in the debate —parties in defended actions will be required to exchange the statements of witnesses on whose evidence they intend to rely. That will lead to better-informed settlement at an earlier stage of the action. Where a case goes to trial, the

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length of the hearing should be shortened as issues will have been identified and the need for oral evidence reduced.
Changes to reduce delay have been introduced. A period for serving a writ or any other originating process has been reduced from 12 to four months. A defendant will therefore have speedier notice of an action being taken against him and the overall period between issue and trial should be reduced accordingly.
Courts now have more power to split trials—to say that a question of liability be heard in advance of an assessment of damages. Previously, an order for split trials could be made only on application by one of the parties. A further change is the introduction of automatic directions in the county court which provides parties with a timetable of standard directions leading to trial. That means that the parties need not go to the High Court for such a direction.
A county court can now order provisional damages in similar circumstances to the High Court. That allows a plaintiff to receive damages while maintaining his right to claim further damages if his injuries deteriorate.
Since 1985, a number of county court trial centres have been established that can offer continuous hearings. There are 74 such centres and a further four are planned. The Lord Chancellor will next consider steps to allow courts to adopt an interventionist role in ensuring that cases progress.
The House will be aware that, as I have shifted to a legal brief, I am, in a sense, speaking with the permission of the Lord Chancellor. This important battery of changes and reforms are aimed exactly at the target that we should be aiming at.
Mrs. Currie: Is my right hon. Friend aware that, following my visit to Sweden in 1987, my right hon. Friend the Member for Braintree (Mr. Newton) and I, who were then serving at the Department, instead of accepting a no-fault compensation scheme decided to recommend certain changes to the Lord Chancellor's criminal law review committee? I must place it on record that I am delighted to hear the changes that he has announced, particularly the improvement in the county court procedure, which will help all the claims of which he has spoken today.
Mr. Waldegrave: I am delighted that my hon. Friend was involved in the conception of these matters with the Lord Chancellor.
Mr. Lester: Surely all these improvements, which are welcome and which we appreciate, do not help where negligence must be proved but where, as a result of advice that it cannot be proved, the person is not given legal aid. All these improvements will not bring the cases that concern many of us to fruition.
Mr. Waldegrave: My hon. Friend makes the point that if one has no case in law one will not get legal aid. That is, indeed, the truth. I have attempted to argue that the no-fault scheme does not solve that, but causes the range of separate problems that I have tried to describe.
Mr. Nicholls: Will my right hon. Friend give way?
Mr. Waldegrave: I must press on. The hon. Member for Greenock and Port Glasgow is rightly pointing at the clock.
I have something new to put before the House which may be of some interest. The Pearson commission discussed arbitration procedures. More recently, Lord Griffiths proposed that we should offer an arbitration procedure for cases in which negligence must be proven. He suggested a panel of two doctors and a lawyer agreeable to either side. They would work entirely on paper and would have full access to case notes and hospital records. There would be no appeal. The panel would apply the normal principle of negligence under common law.
I am aware that there may be many cases—I am trying to meet a point made by the hon. Member for Greenwich —in which speed and simplicity of solution may be acceptable to the claimant in exchange for losing the ultimate right to bigger damages. I am willing to examine that, although I am not committing the Government today. However, we should have discussions with those who are interested.
One benefit of the debate started by the hon. Member for Greenwich is that attention is now focused on the issues and people are now thinking about them. I should be willing to discuss with groups who are concerned whether such an arbitration prodecure, which we could offer administratively in the national health service and which would not need primary legislation, could provide a second string to the general court bow. The key objective would be to provide quicker, cheaper and simpler avenues for the informal resolution of disputes. I put that suggestion to the House in good faith, but without final commitment. The suggestion needs to be discussed, costed—
Mr. Peter Griffiths: Will my right hon. Friend give way on that point?
Mr. Waldegrave: I must proceed. I apologise to my hon. Friend.
Mr. Peter Griffiths: On that point.
Mr. Waldegrave: I will give way, but this really is the last time.
Mr. Peter Griffiths: If I heard my right hon. Friend correctly, he was foreshadowing the composition of an arbitration tribunal as being one lawyer and two doctors. Is not it rather difficult to conceive of a decision having to be reached on the legal concept of what constitutes negligence when the majority representation on the panel would not consist of lawyers?
Mr. Waldegrave: I do not think that we should now debate that point, suggested by Lord Griffiths. If it is thought to be acceptable by those who are interested, we should consult on it.
We need to know a little more about defensive medicine. We have heard anecdotes and we have seen the study by the King's Fund which seemed to suggest that, in one sense, defensive medicine may be good. We have also seen the evidence published in a recent edition of the British Medical Journal which shows that the number of American claims is falling. When we talk about America in the House, we are often out of date about what is happening. There is now a distinct downward turn about which we need to know.

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I agree with my hon. Friend the Member for Newbury that it is odd that we do not have proper central information about the matter. We should review the incidence of medical accidents and carry out a proper analysis of claims so that we know what we are talking about. Two research projects are needed before we launch ourselves into uncharted territory. What do we mean by defensive medicine? Is it a good or a bad thing? We must investigate that, as I propose to do with the help of the presidents of the royal colleges. We should have proper evidence about the extent of existing cases.
The hon. Member for Greenwich said—and I have some sympathy with this—that there is something odd about enormous lump sums claims that are based on the principle that the person in question will have the most expensive Harley street treatment. The Bill simply reverses that and says that damages should be awarded on the basis that people have to have NHS treatment. That is not right either. The reason why Aneurin Bevan put such a provision in the original legislation was that he accepted the civil liberties case that one cannot compel someone to have national health service treatment. People must have the option to go elsewhere, especially if they have been damaged by NHS treatment. However, it seems wrong that a person can be given damages on the basis that he will use extensive private medicine, but may not actually do so.
We have discussed the level of damages in relation to the lifetime of the patient concerned. The damages may be too low because, as the hon. Member for Greenwich said, there has been medical progress, or they may be too high. I have had discussions with my noble friend the Lord Chancellor. He has authorised me to tell the House that he has been discussing with the Law Commission the possibility of instituting a new inquiry into personal injury damages which would consider, among other matters, the issue of so-called "structured payments". That is right.
I must advise the House that, even with such measures, the Bill would involve considerable costs for the national health service. The most charitable and positive way to put the matter is to say that the argument that the new principles that we are being asked to endorse are either practical or would improve the position is not proven. I must ask the House to vote against the Bill on Second Reading.
1.4 pm
Ms. Harriet Harman: I welcome the Bill. The hon. Member for Greenwich (Mrs. Barnes) has taken up the cudgel in a worthy cause, which has long been the subject of campaigns by my right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) and numerous others on both sides of the House. The Labour party supports no-fault compensation and I will certainly vote for the Bill's Second Reading.
I agree with everything that was said by the hon. Member for Greenwich, who set out the arguments extremely well. A service must be judged by what happens when things go wrong as well as what happens when they go well. Although the Government pay lip service to patients' rights, patients are treated shamefully when problems arise. The current compensation system adds insult to injury: it is a cruel lottery, in which a very few people receive large sums and most receive nothing—not even an explanation or an apology.
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The Secretary of State spoke of a "perception" of unfairness. Patients do not "perceive" that the system is unfair; it is indeed monstrously unfair and the right hon. Gentleman's response completely failed to recognise the scale of the injustice that we shall continue to allow unless we make changes. Even those who win compensation must fight in the courts for up to eight years before they are given their entitlement, and justice delayed is justice denied. That is certainly true for the parents of a child who, having gone into hospital for a routine operation, comes out brain-damaged: those parents must spend eight years of their child's life struggling on the bread line. They need the money at the time when they must give up their jobs and move house, not eight years later, after experiencing all the risks and stress of a legal struggle to prove negligence.
When things go wrong, the odds are stacked against the victim. There will be no compensation at all unless the victim can show that someone was at fault. That is the key point of the Bill, which removes the need to prove negligence and fault. It is very hard to prove that a doctor was negligent. The hon. Member for Northampton, South (Mr. Morris) was right in saying that medicine was an inexact science. It is not just a question of the difficulty of proving fault; it is also difficult to know whether someone was at fault. But we can all tell when something has gone badly wrong. We want a system that compensates people when things have gone badly wrong, without the need to prove negligence.
Mr. Michael Stern: I am listening to the hon. Lady with interest. Does she believe that, if the need to prove negligence were removed, the result would be more or fewer cases in which negligence was identified for the protection of other patients of a practitioner who might be negligent again? I accept that the Bill would remove the delay involved in proving negligence, but what about those other patients?
Ms. Harman: I intend to deal with questions of accountability and discipline later.
No one would deny that something went badly wrong for the AIDS haemophiliacs who were victims of a terrible mishap. The Secretary of State, who has come here to defend the current legal system, says that it would give them no compensation. That is one of the best arguments for changing the current system of compensation. If the Government's legal advice is right—if, had there been no publicity campaign and if the Government had not used their discretion, those haemophiliacs would have been left with nothing—the system is clearly all wrong.
Mr. Waldegrave: It is rather difficult to show how this Bill would make a difference. The haemophiliacs were offered sums equivalent to the amounts likely to come from the proposed compensation board. They were offered about £28,000 and they refused it as they were free to, just as they would have refused an offer made by the compensation board. They then pursued their case in the courts and they would have a similar right to do that under the Bill. The Bill would make no difference to the haemophiliacs.
Ms. Harman: That is not the case [HON. MEMBERS: "Why?"] The Government had to make a special discretionary award in response to public pressure. That shows why the system must be changed. Although the

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haemophiliacs were able to mobilise public pressure to bear on the Government, there are thousands of individuals who, because they are alone in suffering the consequences of a particular accident, receive nothing, despite the fact that their personal tragedies may be as grave as that of the haemophiliacs.
What about people who contracted HIV as a result of infected blood transfusions, but who are not haemophiliacs? The haemophiliacs have organised themselves and have been offered compensation because of their pressure on the Government. However, women who contracted HIV when they were given a blood transfusion after child birth do not get compensation. How can we possibly defend a system that allows that to happen?
Mr. Robert G. Hughes: The Bill would not change that.
Ms. Harman: Yes it would. As that woman had entered hospital expecting to have a baby, but came out HIV positive, the Bill would ensure that she was entitled to compensation. At the moment she cannot receive that compensation unless she can go to court, live long enough to see the case come to court and finally prove negligence.
Somone cannot begin the battle for compensation through that court unless he or she is poor enough to qualify for legal aid. The Secretary of State did not consider the fact that only 55 per cent. of the population qualifies for legal aid. People cannot begin to go to court and take advantage of the so-called speeded-up procedures, which, by the way, have yet to materialise, unless they are poor enough to qualify for legal aid or rich enough to risk the thousands of pounds involved in legal costs in order to prove negligence.
Mr. Nicholls: Will the hon. Lady give way?
Ms. Harman: No, I will not give way. My experience of the interventions that I have allowed is that I was about to reach the point raised in the intervention and to demolish it. It is not worth giving way.
No system of compensation can be fair when it rules out from the outset most people who should be entitled to compensation and prevents them from even making a claim. How can we justify a system under which more than half the population cannot even begin to make a claim? The Bill's opponents who support the current system should tell us how they can justify that. They have not justified such a system so far.
Most people who claim against the NHS for negligence receive legal aid. However, that does not mean that the only people who suffer accidents in the NHS are those who fall below the legal aid eligibility limit. It simply shows that hardly anyone else can afford to sue. The only people who benefit from the current system are the lawyers. How can we tolerate a system in which for every £100 awarded by the court, £50 to £70 is swallowed up in legal fees? The Secretary of State referred to speeding up the process. I welcome those proposals, but we should bear it in mind that speeding up the process will not change the enormous amount of resources that are diverted away from compensation and into lawyers' pockets. The money will simply end up in their pockets sooner.
Mr. Nicholls: Will the hon. Lady give way?
Ms. Harman: I give way to the hon. Gentleman who is a lawyer.
Mr. Nicholls: The hon. Lady is making a better point than she realises. As one lawyer to another, I assure her that if the Bill is enacted, we will still do okay, if not better. What the hon. Lady says about legal aid is absolutely right. It must have been her experience, as it has been mine, that once an insurance company backing a defendant realises that the plaintiff does not have legal aid, it simply uses its superior financial position to launch a war of attrition against that plaintiff. The Government may not accept it, but the way of dealing with that within the context of the present system is to do something about legal aid. That would be an intelligent point to put to my right hon. Friend the Secretary of State, though he might not agree to it. However, we do not need this edifice of a Bill which does not begin to identify the real problems.
Ms. Harman: Obviously, I should welcome an announcement by the Secretary of State for Health that we are to have a comprehensive legal aid system, but, even if we had one, and there is no whisper of a suggestion, we would still have the problem of proving negligence.
The Secretary of State argued against the Bill on the ground of cost, but he does not know the cost of the current system. I have repeatedly tabled parliamentary questions to successive Secretaries of State, asking how much is paid in court orders and out-of-court settlements, how much legal fees cost health authorities and how much it costs in legal aid and court time. The Government have not begun to add up the different items of expenditure that lead our present system to be not only terribly unfair but terribly expensive. The Secretary of State says, "Let us not have this scheme because it is more expensive than the current scheme," when he does not know the cost of the current scheme and has not proposed a tariff on the future no-fault scheme. That is pathetic. He should come up with a few answers. He knows that, for years, we have been asking about the cost of the current scheme. He has not done his homework, but he asks us to reject the Bill. We know that the current system is expensive and unfair. Arguments about cost are spurious.
Mr. Higgins: The hon. Lady has announced that the Bill is official Labour party policy. She has, therefore, presumably discussed with the shadow Chancellor an estimate of the cost of the Bill. Will she confirm that he has agreed to her undertaking?
Ms. Harman: We should like a system that takes the resources that are currently wasted in court time and lawyers' fees and devotes them to the victims. That is the whole point of a no-fault scheme. Before we even start talking about whether the scheme is based on no change in resources or whether resources will be added, the current system is monstrously structurally unfair.
Mr. Waldegrave: The hon. Lady is making an important new commitment. She is saying that the present money, which I suspect is about £70 million, is now to be spread among no-fault compensation claimants. Of course, the hon. Lady will end up with tiny claims for each one.
Ms. Harman: It is a bit much for the Secretary of State to say that, when he has not provided information that his own Department should be able to obtain. We should have

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information about how much the current system is costing. It is no good the Secretary of State saying that the problem is that the money would be spread too thinly. He does not even know how much is in the pot. However, we know the percentage in the lawyers' pot and how much is wasted on court time.
Some opponents of the Bill argue that it does not address disciplining the medical profession. The Secretary of State mentioned accountability of the medical profession and giving the patient an explanation or apology. Those issues must be considered. However, the Bill is principally about compensation. For heaven's sake, compensation is also important. It is not fair to say, "Let's not talk about money—people want somebody to say sorry." They want both. Let us not undermine the case for compensation by saying that we can smooth matters with an explanation and by everybody being sorry. Both compensation and an explanation are important.
To reject the Bill because it does not include other measures that we also want would be to cut off our noses to spite our faces. Those who argue in that way do not understand that the adversarial system does not provide accountability, contrary to the Secretary of State's suggestion. The adversarial system is one of the main reasons why everyone clams up and the patient cannot get an explanation or apology.
Mr. Waldegrave: The proposed scheme is still adversarial.
Ms. Harman: The Secretary of State says that the system proposed in the Bill is still adversarial. It is not; it is a no-fault scheme.
Mr. Waldegrave: But negligence continues.
Ms. Harman: I shall not be distracted by the Secretary of State's sedentary interventions. If we remove the need to prove negligence, we shall go a long way to removing the need for a cover-up.
Let us quickly run through the Secretary of State's arguments against the Bill. First, he said that the current system has operated for 600 years, although he acknowledged that that is not a terribly good argument. Secondly, he said that it would be the thin end of the wedge and that we would end up in the same position as New Zealand. That is an odd argument. We are dealing with whether we should have no-fault compensation in the NHS. To say that the system will get out of control and that we shall end up covering other matters such as road traffic accidents and goodness knows what else is not a creditable argument.
Thirdly, the Secretary of State said that we need to have a coherent case set before us. We have a coherent case set before us and, what is more, the public support the change. There is no public support for the current system. The case is made outside, even if the Government cannot recognise it.
Fourthly, the Secretary of State said that we needed exemplars and we could not take a leap in the dark. But why did he not offer, as my hon. Friend the Member for Aberdeen, South (Mr. Doran) suggested, to set up a no-fault compensation scheme in one regional health authority? People who claim that there has been a mishap could choose whether they wish to go to the board or to court. They could make a contractual agreement to choose the path of no-fault compensation or go to the courts. If
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the Secretary of State believes that the scheme would not work, why did he not offer to set up an example? We have had no such suggestions. All we have had is, "No, let us chuck the whole thing out."
The Secretary of State said as a criticism—[Interruption.] I wish that the hon. Member for Harrow, West (Mr. Hughes) would listen to this point.
Mr. Deputy Speaker (Mr. Harold Walker): Order. The Secretary of State was given a fair hearing. I hope that hon. Members will give an equally fair hearing to the Opposition Front Bench speaker.
Mr. Robert G. Hughes: It is not a fair speech.
Ms. Harman: The hon. Member for Harrow, West might care to note that I have avoided the cheap party political points which, unfortunately, the Secretary of State directed at my hon. Friend the Member for Sunderland, South (Mr. Mullin). I intend to continue to do so.
The Secretary of State said that the problem with the Bill was that it would not exclude negligence claims. But that is not the point of the Bill. It does not seek as its principal objective to exclude negligence claims. We seek not to exclude people who cannot prove negligence. The evil is not the negligence claim itself. The evil and the injustice is that people who cannot prove negligence cannot go to court.
The Secretary of State also said that the board would get more money than the victim and that that would be unfair. That is a Committee point on clause 4(8). It is not a point of substance. He also talked about double jeopardy, but all the professions are well used to the idea of civil jeopardy running alongside professional disciplinary action.
The Secretary of State also said that doctors would avoid high-risk areas. It is exactly the other way round.
Mr. Waldegrave: Will the hon. Lady give way?
Ms. Harman: No. I shall press on.
Mr. Nicholls: On a point of order, Mr. Deputy Speaker. I have been in the House only seven years but in that time I have never witnessed the Opposition Front-Bench spokesman refuse to give way to the Government Front-Bench spokesman. Is it in order to do that?
Mr. Deputy Speaker: It is one of the conventions of the House, but to whom the hon. Member who has the Floor gives way is entirely a matter for that Member.
Ms. Harman: The Secretary of State spoke for more than half an hour. He has had his opportunity to make his case. I am trying to put my case as quickly as possible.
The Secretary of State said that doctors would avoid high-risk medicine if we introduced a no-fault compensation scheme, but the opposite is true. If one has a fuelled-up, litigation-based system, doctors will get out of high-risk medicine. The same goes for the right hon. Gentleman's argument that such a scheme would militate against innovative medicine. The lesson from the United States and Sweden is that it is the adversarial system which militates against innovative medicine.
The right hon. Gentleman made the interesting suggestion that he should offer some sort of administrative procedure, but that procedure must be on a no-fault basis. If it is not, it hardly takes us any further forward than the

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current system, which requires proof of negligence. The right hon. Gentleman also went through the proposals of his right hon. and learned Friends the Lord Chancellor and the Attorney-General to speed up civil litigation. Such a change would be welcomed for civil claims, but that does not deal with those who do not qualify for legal aid or who cannot prove negligence.
The beneficial effects of more litigation need to be questioned. The assumption is that, to right the wrong, we should simply have more litigation and cases of patients suing doctors. Consider what has happened in the United States where access to the courts is easier. The Secretary of State said that we should not consider the example of America too hard because things have changed. His assumption was based on anecdotal evidence from friends and such who have been there. We do not need to base our judgment on such evidence, as there is good evidence to prove that the litigious climate under which the doctor in America operates undermines the quality of the medical care available in the United States.
Mr. Waldegrave: The hon. Lady has given a rather poor performance and she has misrepresented virtually everything I have said. My comments on America were based on evidence produced in the British Medical Journal that suggests that the type of practice she has described is declining. We should find out about that.
Ms. Harman: It is absolutely clear—there is no evidence to contradict it—that a high rate of litigation leads to defensive medicine; defensive of the doctor not the patient.
The best way for a doctor to defend himself is to do everything imaginable, tests and treatment, even if that is not in the patient's interest. If he does that, he can say in court that he tried everything. Why risk a normal delivery of a baby when one can perform a caesarean and say that one did everything possible? Why risk a lumpectomy, when one can do a mastectomy and thus tell the court that one at least performed radical surgery? Why wait to see how a problem develops when one can open up a patient to see inside?
The hon. Member for Derbyshire, South (Mrs. Currie) is completely wrong—defensive medicine is bad medicine. She is wrong to argue that it leads to better medicine. The hon. Member for Reading, East (Sir G. Vaughan) is right to argue that defensive medicine is bad medicine.
When a doctor decides on a course of treatment we want that decision to be based on medical grounds, not legal ones and not in terms of what courts he or she might face in future. Medicine is a sophisticated and yet inexact science—we do not want a doctor's judgment clouded by thoughts of future litigation.
There is no evidence from America to suggest that doctors are now any more open with their patients, accountable to them or ready with explanations or apologies. They are just as ready to send out a battery of legal letters and to batten down the hatches. If we followed the American example we would encourage a flurry of litigation, which would be disastrous.
Today is a watershed in terms of compensation of the victims of medical negligence. Three choices are available to us. We could keep going with the current system, which is monstrously and cruelly unfair and should not continue. We could encourage more litigation, which would put
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patients at risk from defensive medicine and pour money into lawyers' pockets. The final option is to change to a no-fault scheme. No-fault compensation is an idea whose time has come. We can sort out the details in Committee; but for the sake of all who are made worse, not better, by the NHS, I hope that the Bill will be given a Second Reading today.
1.30 pm
Mrs. Ann Winterton: I am grateful for this opportunity to contribute briefly to the debate as a co-sponsor of the Bill. I congratulate the hon. Member for Greenwich (Mrs. Barnes) on introducing it so well. Extremely courageously, she has introduced a measure which touches on complex and sensitive issues, and she should be flattered to note that her speech attracted the presence of the Secretary of State and of the Minister for Health.
As the debate has unfolded, a certain amount of common ground has emerged between those who support the principle behind the Bill and those who do not. The consensus is that our present system, in which negligence must be proved, is expensive, risky and full of unacceptable delays. The victim of a medical accident takes on a considerable financial burden when pursuing his case through the courts if he does not qualify for legal aid. There is no certainty about the outcome and the fear always haunts the litigant that he may end up far worse off than if he had not begun the action in the first place.
I believe that many victims would be prepared to settle for far less money if their cases could be settled within a reasonable time and if they could be assured that they did not have to face the trauma of our present tort-based system. Accidents and mishaps will occur even in good health care systems such as the one that we enjoy. Patients who are injured in some way may well settle in some instances for a full explanation of what went wrong if they are satisfied that their cases have been fully investigated.
Legal action has been taken when many patients have been affected. Numbers bring strength and raise public awareness. Pressure mounts in support and eventually common sense prevails, as it did in the case of HIV-infected haemophiliacs. By settling out of court the Government have implicitly accepted the principle of no-fault compensation. What is just for one large group of people is surely just for individuals.
We are fortunate to live at a time when the pharmaceutical industry has produced drugs and medication that have successfully treated many conditions and dramatically improved the length and quality of life of patients. However, we must also recognise that the more straightforward health problems have already been tackled, leaving those which are more complex and difficult to solve—I refer, among others, to various forms of cancer, to arthritis and to Alzheimer's disease. It is obvious to me that, in spite of the best endeavours to develop safe therapeutic treatments and cures, there will be patients who will react adversely and who will suffer as a result of such treatments. There may be a few hard cases who merit compensation even when the risks of possible side effects have been fully explained before treatment. The medical injuries compensation board, recommended as a possible vehicle for such cases, could be used. If the board's decision were rejected, litigation, with all its warts, could still go ahead—people would still have that option.

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The two most tricky issues in the context of a no-fault scheme to have emerged during the debate are causation and cost. Although, under the Bill, it would not be necessary to prove that a negligent act or omission was the cause of an injury, it would be necessary to prove a link and that would be extremely difficult in some cases. However, just because it is difficult does not mean that it should not be attempted. At present, the only way forward for the injured party is through the courts. The Bill at least proposes an alternative, which is to be welcomed.
The thorny problem of cost, or possible cost, is no doubt the driving motive behind the Government's positive reaction against the introduction of the Bill. Its provisions do not necessitate any new public money, but, rather, that some of what is already spent on administration and litigation costs should be diverted more constructively to those who have suffered while undergoing NHS treatment. One result that may ensue is that the level of compensation offered by the board will be far too low. The Secretary of State picked up that point. In that case, public pressure will build up once again to improve funding.
We recognise also that growing expectations of what can be achieved will lead to further pressure for additional funding. That should come from the taxpayer who funds the national health service. Other ways, however, could be introduced. For example, the pharmaceutical industry might be encouraged to play a part and to enter into a partnership scheme with the Government. That opportunity should be explored.
I have discussed no-fault compensation with the pharmaceutical companies, in particular with ICI whose pharmaceutical research base is located at Alderley Park in the constituency of my hon. Friend the Member for Macclesfield (Mr. Winterton). I received a letter from ICI yesterday in which it said:
"The pharmaceutical industry recognises the inadequacies of the present system and welcomes moves to make it possible for claimants to seek compensation without incurring considerable expense or financial risks. The need to improve the speed at which claims are dealt with is also accepted. We welcome moves to increase the speed of the court process and to assist in the funding of 'class actions' and other initiatives to facilitate greater access to the courts. The Bill highlights most of the concerns expressed by actual or would-be claimants and presents an excellent opportunity for debating this important matter. However, deeper consideration of all the aspects is required."
Many hon. Members will agree with those conclusions.
The problem of a just solution to the really thorny problem of compensation for accidents in the NHS will not disappear in these days of consumerism, when society is more sophisticated and people are more aware of their rights and, I believe, have strong feelings about natural justice.
The Government will eventually have to take action further than that which has been announced this morning. I hope that they do so before they are backed into a corner and forced to act. The Bill has provided an important opportunity for a full debate of this important issue, a debate which I welcome and which will undoubtedly result in instigating progress.
1.37 pm
Dr. Norman A. Godman: I agree with everything that the hon. Member for Congleton (Mrs. Winterton) said in her closing remarks.
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She is absolutely right. At the very least, this fine Bill has provided us with the opportunity to debate at considerable length important and deeply worrying matters.
I have a great deal of sympathy for the Bill and its objectives. I am a little diffident about criticising surgeons, given the fact that I face surgery in the very near future. However, I am assured by my wife and friends that Mr. Imrie and his team at Glasgow royal infirmary are pretty good. I can only hope that that is the case. I should not want to inflict a by-election on right hon. and hon. Members.
The quality and nature of the doctor-patient relationship is in many respects utterly unlike any other client-practitioner relationship. It is very different from that which exists, for example, between a lawyer and his or her client. The uniqueness of the doctor-patient relationship was brilliantly illustrated in Dr. TalcottParson's essay, written fully 45 years ago. Given the degree of trust that a patient must place in his or her doctor's competence and commitment—be he a general practitioner, consultant surgeon or consultant psychiatrist —the doctor must be subject to a strong degree of accountablility. In all instances, the patient is in a peculiarly vulnerable position, but the same cannot be said of the client of an architect or lawyer.
Despite my remarks about my own future, the accountability of doctors and surgeons is masked by the high degree of conservatism that pervades the medical profession and numerous defence mechanisms. Whereas some claim that lawyers are the most conservative profession in the United Kingdom, at least an equal case could be made for the innate conservatism of the medical profession.
My hon. Friend the Member for Monklands, West (Mr. Clarke) mentioned a number of distressing cases that had been brought to his attention. I want to cite the experience of a lady in my constituency who underwent a bilateral mastectomy. Because of the trust she placed in her surgeon, she agreed to undergo an operation that is viewed by others in the medical profession as being quite unneeded. That lady's husband wrote to me:
"The effects that this has had on my family could never be explained in a letter. The result of this terrible ordeal was that my wife has never left the house again, and she has got so bad with nerves and depression that I was forced to give up my employment, which was a very good staff position."
He was compelled to take that action so that he could look after his clinically distressed wife. His letter continues:
"The reason that I set out to try to gain compensation for my wife was through a chance conversation that my wife's sister had with a surgeon in Canada. On hearing what had been done to my wife, he was absolutely shocked. He said that the statement regarding the high cancer risk was wrong, and also that the manner in which she was treated at Conniesburn hospital was a disgrace."
He goes on to say that his wife's lawyer
"has been trying to establish a case for her, for a period of two years now, and all we have to show for our effort is the medical report from a Professor who is recognised as an expert in that field, in which he states that there was no medical reason why Bylateral Mastectomy should have taken place."
Finally he says:
"My wife has been a prisoner in her own home for ten years now, it would make you cry to hear her say that she would love to walk in the rain … No amount of compensation could replace what they have destroyed, but it would at least improve the quality of her life."

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When people seek compensation they are not out for vengeance but for the means to improve the quality of a life that has been damaged.
I do not necessarily blame the surgeon in my constituent's case, but I blame the obduracy and stubbornness of officials of the Argyll and Clyde health board in prolonging the distress of this couple and of their family. I have been told that in such cases the doctors' medical insurance representatives and health board officials—in the Scottish experience—engage in discussions about areas of responsibility, which prolongs matters to a needless and distressing degree. That is totally unacceptable.
I listened closely to what the Secretary of State said earlier when he promised that such cases would be speeded up in England and Wales. Presumably identical procedures will be introduced in Scotland.
As the hon. Member for Congleton stressed a few moments ago, when people have suffered terrible injuries whether physical or psychological, as in the case of my constituent, we need to distinguish between the sad but unintended consequences of justifiable risk-taking by surgeons, and injuries which are inflicted by careless, incompetent surgeons.
I have had a number of conversations with my hon. Friend the Member for Strathkelvin and Bearsden (Mr. Galbraith), who was perhaps one of the foremost neurosurgeons in western Europe before he came to the House. He told me that, especially in the field of neurosurgery, one is engaged in risk-taking when undertaking certain operations. He referred to the case of a young motor cyclist who had suffered brain damage in a traffic accident, and he told me that neurosurgeons have to take risks. I suggest that surgeons who work in such an incredibly complicated field must be allowed to take justifiable risks.
These days some people talk about "just" wars and in the context of this debate—which I welcome, as did the hon. Member for Congleton—we can talk about "just" operations and justifiable risks which surgeons must be encouraged to take. I do not want our surgery to be affected by the litigiousness that now affects American surgery. Last Christmas my wife met a Scot who now works in New York as a geriatrician. His insurance for working with the elderly in a geriatric hospital there is $2·5 million. Neurosurgeons and other doctors working in delicate fields have to be allowed to take justifiable risks. Having said that, we need a system under which the careless and incompetent surgeon can be disciplined.
Mr. Couchman: The hon. Gentleman is on the wrong track if he regards the Bill as a way of protecting patients against the careless and the incompetent. Whatever happens, the Bill must not become a charlatans' charter.
Dr. Godman: I hope that the hon. Gentleman knows me well enough to know that I would not in any way—directly or indirectly—support a charlatans' charter. In his usual courteous way, the hon. Gentleman has been listening intently to what I have said. He will remember that I said earlier that if nothing else, the fine Bill introduced by the hon. Member for Greenwich (Mrs. Barnes) has enabled us to debate these matters, although I hope that the Bill goes further and I shall be voting for it this afternoon.
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I have some reservations, however, We must somehow distinguish between the unintended but sad consequences of justifiable risk-taking and the sloppy theatre behaviour of the careless or incompetent surgeon. Careless or incompetent surgeons who have inflicted injury on people should be disciplined. The Argyll and Clyde health board recently dismissed a surgeon for alleged incompetence, which had led, in the view of the sheriff conducting the fatal accident inquiry, to the death of a constituent of mine.
The Secretary of State may challenge me on this, but in my view the United Kingdom has sloppy disciplinary procedures for dealing with such cases of incompetence. I am not a medical man; I have an authentic doctorate. But it seems to me that consultants who are suspended from the national health service can continue to practise privately. Is not that the case? Moreover, such consultants may be suspended on full salary for what may seem to be many months.
To ensure accountability, we must have a fair and humane disciplinary procedure which at the same time protects the decent surgeon, as opposed to the one who is guilty—or is found guilty by his peers—of incompetence or careless surgery. If we can do that, the trust that is the cornerstone of the unique client-practitioner relationship will be enhanced to a considerable extent.
The Government have a responsibility. It is right that we should leave the establishment of disciplinary procedures to the professions. In Scotland, we have a Law Society—presumably there is one south of the border—which can discipline its members by way of its disciplinary committees. Nevertheless, the Government have a role to play in ensuring that such effective disciplinary procedures are established in the near future.
As I said, I have some reservations about the Bill itself. I am worried that it may persuade some surgeons to go in for safe surgery—some have used the term "defensive surgery". Surgeons may be unwilling to take risks and that would be a great shame. It is certainly worth giving the Bill its Second Reading. Some of the problems in its structure can then be eliminated in Committee. I suspect that that is a forlorn hope, but we ought, now and again, to debate these important matters in the House.
1.54 pm
Mr. James Couchman: I am pleased to have caught your eye, Mr. Deputy Speaker, in this important debate.
I should declare an interest. The Register of Members' Interests shows that I advise a pharmaceutical company in Kent. I have not spoken to it about the Bill, and it may be one of the companies that the hon. Member for Greenwich (Mrs. Barnes) said support her Bill, or at least the concept of it.
I congratulate the hon. Member on introducing the Bill. It has given us a good opportunity to discuss a highly controversial subject. There seems to be a growing swell of opinion in favour of no-fault compensation schemes, probably principally because of the haemophiliacs and the contaminated blood products, about which we all know and which I congratulate my right hon. Friend the Secretary of State on settling so honourably.
Whenever there is clinical treatment that involves invasion of the body by surgery or by medication, there is a risk. Inevitably, there are risks that are not always

1283
foreseeable. The risk of post-operative problems from surgery or adverse side-effects from medication is brought to the attention of the patient by a responsible doctor prior to commencing the treatment. Generally, the patient will accept that risk.
Not all side-effects are known or predictable. The hon. Member for Greenwich was less than forthcoming about the fact that novel procedures can have quite unexpected side-effects. One patient's side-effect is another patient's mishap. The more serious the disease, the more heroic the intervention is likely to be and the more unpredictable the outcome.
I am worried about clause 2(5)(d), which refers to the suffering of significant pain, disability, harm or distress. I do not believe that that is drawn tightly enough. My wife suffered two episodes of cancer, one of which resulted in unpleasant surgery, from which she has been left in significant pain. The alternatives to undergoing that surgery are known to all of us. The pain would undoubtedly fall within the definition in clause 2, but I would not think of pursuing that, because everything was done to help my wife recover from the condition from which she was suffering.
My primary concern is that the Bill will militate against medical advance. We have seen enormous progress in recent years. The hon. Member for Greenock and Port Glasgow (Dr. Godman) rightly instanced neurosurgery, and I would add the magic of microsurgery, laser treatment and the chemotherapy treatment of leukaemia. Not all patients survived or benefited from the development of those novel treatments, but the alternatives were usually grave or fatal. One need only review the transplant programme, from which my hon. Friend the Member for Newbury (Sir M. McNair-Wilson) benefited so recently, to appreciate that the prognosis for early transplantees was poor indeed, partly due to their grave condition when they underwent their operation and partly due to the as yet imperfect techniques that were used to treat them. Many of those people or their relatives might have had a case under the Bill. The Bill would lead to safe surgery, safe medicine and safe treatment.
A further worry is that the Bill could act as a substantial block to the research and development programmes of pharmaceutical companies. I am sure that no hon. Member would wish to see them cease to probe the frontiers of their science and to try to develop treatments for the more intractable diseases that are left untreated, as my hon. Friend the Member for Congleton (Mrs. Winterton) suggested.
One of the weaknesses of the Bill is that the board might pursue a claim—having compensated the patient whose treatment has been adjudged to be unsatisfactory—against a pharmaceutical company or against another supplier to the national health service. The hon. Member for Greenwich was incorrect to suggest that the Bill was not intended to enable the board to pursue a claim against those working in the national health service. Part II of schedule 2 refers to
"pursuing any legal claim which has passed to the Board (whether that claim is against the National Health Service or any part of it, or against a supplier to or for the National Health Service or to or for any part of it)".
The Bill allows for the possibility of the board following up a negligence case against an employee of the NHS.
My principal objection to the Bill and the reason why I will vote against it is that it would be detrimental to
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patients because it would lead to a diminution in innovation and in the techniques and procedures that are at the frontiers of the skills of the people treating us.
2 pm
Mr. Chris Mullin: I congratulate the hon. Member for Greenwich (Mrs. Barnes) on the Bill, which contains an idea whose time has come. The correct principle is that one must first help the victims and then argue at leisure about who is to blame.
The present position cannot be allowed to continue. I have heard the reservations of many Conservative Members and of the Secretary of State. I agree that the medical profession must be accountable, like any other profession, for its mistakes. However, it is not accountable under the existing system in most cases. The person who is responsible may be dead, may have retired or may have moved before he has been called to account. In the case that I am about to relate, he had moved to Saudi Arabia. With all due respect to the Secretary of State, who comes from the merciful wing of his party, as I come from the reforming wing of mine, I heard nothing in his speech that would cause me to change my mind about the Bill.
The case that came to my surgery some years ago and caused me to feel strongly on the issue involved a gentleman called Kenneth Stanness. In May 1983, he went into hospital for a minor operation on his back and emerged seriously brain damaged. That had a devastating effect on his wife and family who have been caring for him since.
In November 1987, four years after the event, I wrote to the chief executive of the health authority. I said:
"I am shocked to learn that 4 years after the event the Health Authority is stoutly refusing to admit liability or to make any offer that would help to relieve the burden … for this unfortunate woman."
I received a wholly unsatisfactory reply. The district general manager said:
"I have reviewed the file and discussed the situation with the Authority's Solicitors, and I regret that it is not possible at this stage to add very much .… The legal process is taking its course."
Indeed, it was—at a snail's pace.
A year later, another case within the same health authority came to my attention. It involved a gentleman called Mr. Blackburn who, after a long and tortuous legal process which lasted for 12 years, received damages of £491,000, despite the fact that his original solicitors—he had to change his solicitors three times, solicitors' incompetence being a common feature of such cases—had initially advised him to accept £2,000. That case seemed relevant to the case of Mr. Stanness because the award of the damages from the same health authority was accompanied by expressions of regret about how terrible it was that 12 years had elapsed before jusice had been done and how we must find some way—which was unspecified —of avoiding that happening again.
Stimulated by that response and thinking that it might cause the health authority to get a move on in the case of Mr. Stanness, I wrote to the district general manager of the health authority on 8 August 1988:
"I am prompted to write to you again following reports in last week's newspapers of an award made to Mr. Keith Blackburn who suffered a similar accident to that of Mr. Stanness, 12 years ago in Newcastle General Hospital. You will also have seen in last week's newspapers expressions of surprise and regret that it took 12 years before the Health Authority was obliged to face up to its responsibilities.

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My purpose in again raising with you the case of Mr. Stanness is to suggest that you ought to review his case in the light of the award to Mr. Blackburn. The alternative seems to be that the Stanness case will be allowed to drift on at the cost of continuing distress to Mrs. Stanness and the spending of large sums of public money on lawyers' fees, which would be better directed towards alleviating the catastrophe that has overtaken Mr. and Mrs. Stanness. If you thought it would be worthwhile I would be glad to meet and discuss the matter".
After a bit of prompting, I received another bland letter:
"Whilst I appreciate your concern about this case, I am afraid that in view of the legal position, I am not in a position to provide any information beyond that already forwarded to you, and I would find myself unable to discuss the case with you either, for reasons which I am sure you will understand … I am sorry that I cannot be more helpful".
Another year or so went by; there was another change of lawyers—the third, I believe—and, five years after the event, the health authority finally admitted liability. As it was obvious to everyone concerned that it was liable, it might as well have done so many years earlier. A further six or seven months elapsed before, some time last year, the first preliminary offer of damages was made. Believe it or not, the case is still being contested: I believe that it will go to court in March 1991, eight years after the event. During those eight years that woman has been through hell, while no regret has been expressed or assistance offered by those who, for whatever reason and regardless of whether negligence occurred, brought disaster on her husband.
That is the case that set the issue so forcefully at the forefront of my mind. I shall support the Second Reading because I have heard nothing from those who object to the Bill that suggests that there is a better way of dealing with the problem. I accept that the way suggested in the Bill may be imperfect, but I have heard no serious alternative that might have brought relief to Mrs. Stanness.
2.6 pm
Mr. Anthony Coombs: We are coming to the end of a long and interesting debate. I join other hon. Members in expressing my appreciation to the hon. Member for Greenwich (Mrs. Barnes), who has raised an important subject and dealt with it with great sensitivity. It is, in fact, a very sensitive issue. About four of my constituents have been involved in medical accidents and I have noticed the blight cast on not only their lives but those of their relatives, especially when fatalities have been involved.
I think that everyone agrees that the present position is unsatisfactory. I agree with the hon. Member for Greenock and Port Glasgow (Dr. Godman), who argued that, because of the patient-doctor relationship, many patients would find a confrontation extremely difficult to deal with, even if it was a possibility. It is also entirely wrong that legal costs should amount to between 50 and 70 per cent. of claims.
The position is not assisted by the medical profession's unique unwillingness to accept the modern demands of accountability imposed on them by patients. The Daily Telegraph told us yesterday:
"The Medical Profession has been defensive to the point of obstructiveness."
The Association of Victims of Medical Accidents, for which I have considerable regard, says that members of the
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profession try to surround themselves with an aura of inviolability, and we have heard what the Pearson commission had to say about the current methods of redressing wrongs in such instances.
I was pleased to hear from the Secretary of State about the reforms that the Government have introduced in regard to access to medical records, specialist solicitors' lists, medical audit, inquiry on structural costs and, perhaps most important, a survey of the incidence of medical accidents: the AVMA has been asking for such a survey for a long time.
It is not entirely satisfactory to rely on the courts for the resolution of those disputes. As has been said, some people are not eligible for legal aid and they miss out on the opportunity to go to court. I dislike the idea of having the legal aid board as the effective arbiter in many medical disputes which, in effect, is the position.
However, I believe that there is a semi-contractual relationship between the taxpayer and the medical profession. The taxpayer seems to be saying more and more that the medical profession should be responsible for its actions. That lack of accountability in no-fault compensation causes me problems with regard to the Bill.
There is little doubt that the present system of accountability is completely inadequate. Professor Margaret Stacey, emeritus professor of sociology at Warwick university and author of "The Patient Voice and the GMC" has said:
"The profession's leaders operate and support a system of regulation which neither ensures the continuing competence of practitioners nor adequately disciplines the incompetent."
It is obvious that the statutory procedures for taking action against incompetent doctors, whether through the General Medical Council, the family health services authorities or the general practitioner complaints procedures are not sufficient.
I asked the FHSA in my county how it had dealt with cases involving death since 1988. I discovered that there had been 13 cases dealing with death since 1988, only two of which were withdrawn by the complainants. In all those cases only one doctor was severely reprimanded. No action was taken in the other cases. It is clear that the present system of accountability is unacceptable.
Unfortunately I believe that the no-fault compensation scheme leaves effectively unanswered all the questions about the accountability of the medical profession. I am not saying that the patients are not interested in compensation. Rather, they want to know why things have gone wrong and who is responsible. They want an apology and an explanation. The code of practice, which the proposed board will draw up, will take an enormous amount on trust. A cast-iron case has not been made that that code of practice will ensure that investigations are sufficiently rigorous to ensure that proper investigations are carried out under the Bill.
Clause 3 does not define mishap and causation is too vague. Both those issues are vital in distinguishing between legitimate clinical judgment and negligence and incompetence.
For some time the BMA has been calling for a compensation fund to be accompanied by some form of independent medical inspectorate. It is curious that we have a health and safety inspectorate for our factories and an independent education inspectorate to monitor the way in which our children are taught. We have a social services inspectorate to deal with many of the life-and-death issues

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in which the social services departments are involved. We also have a police inspectorate, but we do not have a similar body to maintain standards of competence in what is possibly the most delicate area—the national health service.
A national health inspectorate would be one way of ensuring that many of the complaints that are presently ignored or have to proceed through an exceptionally expensive, long and perhaps ultimately unsuccessful legal procedure are adequately dealt with. If the Government can move their thinking towards an independent inspectorate that will absorb many of the existing methods of redressing complaints within the national health service, we would do the cause of the victims of medical accidents a great deal of good.
2.14 pm
Mrs. Rosie Barnes rose—
Mr. Deputy Speaker: Does the hon. Lady have the leave of the House to speak again?
Hon. Members: Aye.
Mrs. Barnes: All hon. Members will agree that this has been a stimulating and sensitively handled debate. It is an issue to which there are no easy answers and I did not think that I had solved every problem. I am reassured by the genuine and deep-rooted acceptance that the current position is seriously flawed and that something radical must be done about it. I am reassured also by the consensus that, in an ideal world, all those with needs or disabilities of any kind would be adequately compensated without having to demonstrate cause of negligence. However, as I made abundantly clear, my Bill restricts itself to the national health service and does not tackle other issues that may cause similar problems in other aspects of our community. That is quite deliberate. That national health service, as I said, accounts for 15 per cent. of public sector expenditure—£27 billion. It is our duty to make sure that that money is properly spent and that those who receive the benefits of the national health service are receiving the right protections and safeguards.
Mr. Thurnham: The hon. Lady mentioned the amount that is spent on the national health service. Perhaps she will draw attention to the amount that is spent through social security on the disabled, which is currently about £8·3 billion. If we are not to have some of the measures that she is advocating the alternative is more money for social security so that the safety net for those who get nothing will be raised.
Mrs. Barnes: I accept that point, but I shall not be led down that path at the moment.
I listened with care to what the Secretary of State said as he poured scorn on several aspects of my Bill. I waited with growing interest to see whether his alternative proposals would offer a much more radical, long-lasting and, perhaps, better solution to the problems than my Bill can. I was disappointed. I welcomed the measures that he made known to the House—they can only help. However, I am confident that in one, two or three years' time, the House will have to face this issue again. The Secretary of State's measures will not address the severity of the problems that we are facing and they will do nothing to
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address some of the major cases, such as that of the haemophiliacs, which have brought the attention of hon. Members and others to this matter.
Several hon. Members have said that, under my proposals, the haemophiliacs would not have received such a settlement. That is entirely due to the Secretary of State. If he considered it appropriate, in such exceptional circumstances he could make additional moneys available to the board because a terrible wrong had been done to innocent people. That would be entirely within his power. The same public clamour that forced the Government to make that settlement without a no-fault scheme would force a Government with a no-fault scheme to consider such a case.
I was concerned to hear the Secretary of State say that many of the credible and creditable organisations and bodies that have put forward the principle of no-fault compensation have not been able to agree on any one scheme—that perhaps it is inherently flawed, perhaps there is no right scheme and perhaps there is something wrong. I take serious issue with that. In recent weeks, I have listened with great care to all the bodies that expressed an interest in this matter and I have been convinced of their sincerity. Many of them have worked in this area for several years and have become committed to a particular type of no-fault compensation scheme that they believe is right for their side of the argument. The Association for Victims of Medical Accidents sees the matter entirely from the patients' view. It has a degree of what I describe as the punitive approach to the medical profession. In some of its documents it implies that compensation is less important than obtaining explanations and, perhaps, making retribution.
I have not dodged the issue of accountability, but I have also listened to people on the other side of the argument such as the doctors, represented by the British Medical Association and the Royal College of Physicians, and the obstetricians and gynaecologists who are at the sharp end of the argument. They have difficult decisions to make. They should not have to do so constantly looking over their shoulders at what may happen in a court of law. They wish to build a trusting relationship and most of them are entirely honourable. It would be inappropriate to introduce a measure that could bring a medllcal practitioner to his knees through one error in an exemplary career.
My Bill is an attempt to walk the tightrope between the various interested bodies that have rightly addressed the matter for many more years that I have. I sincerely hoped that if I did not get the Bill quite right and improvements could have been made, the House, with its long experience and many hon. Members who have been involved in the matter for many years, would be given the opportunity to improve the Bill in Committee. I was asking for the opportunity to take a stage further the principle of no-fault compensation. All the various bodies involved tend to agree that that should be done. Some have been of that opinion for many years, while others have come to that conclusion only recently in the face of the changing pattern and level of litigation in this country.
There is a growing consensus among almost all the royal colleges, many patients' and consumers' groups and many legal bodies that the current position is becoming almost unworkable. I was no less surprised than other hon. Members that my proposals drew less hostility than

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expected from the drug companies, which recognise that the current procedure is not working well and perhaps does them more harm than good.
I ask the House seriously to consider its decision today. We are talking about a system which involves miserable lengths of time, large sums of money for those who are able to obtain compensation—because they are either entitled to legal aid or are wealthy—and confrontation. Although I accept that the Secretary of State made a genuine attempt to address some of those issues within the legal system, I believe that he will do little to make matters substantially better. There may be some trimming here and there, but the increased number of cases entering the system will overtake any such measures.
When I drew up the Bill I had regard to the Bill previously presented to the House by the hon. Member for Peckham (Ms. Harman). I discussed with her some of the pitfalls in her Bill and deliberately avoided them. In her Bill many of the details on which the House could have argued long and hard were spelt out, such as whether someone who had a catheter in place for two years should be eligible for compensation and how infections should be treated. In the limited time available to me to draw up a Bill that would give the House an opportunity to take the debate further, I felt that I should concentrate on the basic principles. I thought that it was appropriate to allow the board, to which we would give great power and in which we would put great trust, to lay down some of the detailed regulations that would come back to the Secretary of State and the House for approval. After all, the board would include experts. I see this Bill as an enabling one. I did not intend to dot every "i" and to cross every "t". Obviously such matters can be finalised and decided on in Committee.
If we turn our back on this issue today and say no to the possibility of no-fault compensation, we shall persist with the court-based approach. Therefore, the misery of many individuals, about whom we shall never know except as individual constituents, will continue. The next scandal that rocks the House will leave us answering our constituents' question, "Why did you not do something about it last time?"
We have seen the misery caused by Thalidomide and Opren and the problems of the haemophiliacs. There will be similar cases and whatever improvements may result from the Secretary of State's proposals, they will not tackle that. We will be back to the public clamour and the media campaign and people will be forced to take action after deaths have occurred and widespread misery has been caused.
A no-fault compensation scheme may be forced on the House in the future following European legislation. The Secretary of State argued that there are no foreign examples on which we can base our scheme, but if we cannot be innovators and lead the world on this vital issue, it is deplorable.
There are compensation schemes in Sweden, although admittedly they are built upon much more generous social security benefits as it is a wealthier country than the United Kingdom. There are also schemes in some American states —for example, Virginia, where schemes specifically relate to maternity claims. There must be a solution for this
1290
country. It is not enough to say that no one else has got it right or that no one body has the right formula, so we should set it to one side.
I strongly urge the House not to turn its back on this opportunity to tackle medical negligence in an entirely different, non-confrontational, fair and affordable way.
Question put, That the Bill be now read a Second time:—
The House divided: Ayes 81, Noes 193.

Division No. 56]

[2.27 pm

AYES

Allen, Graham

McCrindle, Sir Robert

Archer, Rt Hon Peter

McKay, Allen (Barnsley West)

Ashley, Rt Hon Jack

McKelvey, William

Barnes, Harry (Derbyshire NE)

McNamara, Kevin

Barnes, Mrs Rosie (Greenwich)

Madden, Max

Barron, Kevin

Marek, Dr John

Battle, John

Michael, Alun

Beggs, Roy

Mitchell, Austin (G't Grimsby)

Bermingham, Gerald

Morris, Rt Hon A. (W'shawe)

Blair, Tony

Morris, M (N'hampton S)

Body, Sir Richard

Mullin, Chris

Brown, Ron (Edinburgh Leith)

Murphy, Paul

Campbell-Savours, D. N.

Owen, Rt Hon Dr David

Canavan, Dennis

Page, Richard

Cartwright, John

Richardson, Jo

Clwyd, Mrs Ann

Rogers, Allan

Cohen, Harry

Ross, Ernie (Dundee W)

Cook, Robin (Livingston)

Ruddock, Joan

Corbett, Robin

Sedgemore, Brian

Corbyn, Jeremy

Shore, Rt Hon Peter

Cousins, Jim

Short, Clare

Cox, Tom

Sillars, Jim

Cryer, Bob

Skinner, Dennis

Davis, Terry (B'ham Hodge H'I)

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

Dobson, Frank

Smyth, Rev Martin (Belfast S)

Doran, Frank

Soley, Clive

Dunwoody, Hon Mrs Gwyneth

Spearing, Nigel

Field, Frank (Birkenhead)

Steel, Rt Hon Sir David

Foster, Derek

Thomas, Dr Datydd Elis

Fraser, John

Watson, Mike (Glasgow, C)

Godman, Dr Norman A.

Welsh, Andrew (Angus E)

Griffiths, Win (Bridgend)

Williams, Rt Hon Alan

Grocott, Bruce

Williams, Alan W. (Carm'then)

Harman, Ms Harriet

Wilson, Brian

Hoey, Ms Kate (Vauxhall)

Winnick, David

Howells, Dr. Kim (Pontypridd)

Winterton, Nicholas

Hoyle, Doug

Wise, Mrs Audrey

Hughes, Simon (Southwark)

Worthington, Tony

Kennedy, Charles

Lester, Jim (Broxtowe)

Tellers for the Ayes:

Lestor, Joan (Eccles)

Mrs. Ann Winterton and

Livingstone, Ken

Mr. Tom Clarke.

McCrea, Rev William

NOES

Alexander, Richard

Bowis, John

Alison, Rt Hon Michael

Brazier, Julian

Amess, David

Bright, Graham

Arbuthnot, James

Brown, Michael (Brigg & Cl't's)

Arnold, Jacques (Gravesham)

Buck, Sir Antony

Arnold, Sir Thomas

Burns, Simon

Ashby, David

Carlisle, John, (Luton N)

Baker, Rt Hon K. (Mole Valley)

Carlisle, Kenneth (Lincoln)

Baker, Nicholas (Dorset N)

Carrington, Matthew

Baldry, Tony

Carttiss, Michael

Banks, Robert (Harrogate)

Cash, William

Batiste, Spencer

Chapman, Sydney

Bendall, Vivian

Chope, Christopher

Bennett, Nicholas (Pembroke)

Clark, Rt Hon Sir William

Biffen, Rt Hon John

Clarke, Rt Hon K. (Rushcliffe)

Blaker, Rt Hon Sir Peter

Colvin, Michael

Bonsor, Sir Nicholas

Conway, Derek

Boscawen, Hon Robert

Coombs, Anthony (Wyre F'rest)

Boswell, Tim

Coombs, Simon (Swindon)

Bottomley, Peter

Couchman, James

Bottomley, Mrs Virginia

Cran, James

Bowden, Gerald (Dulwich)

Currie, Mrs Edwina

1291

Curry, David

Lyell, Rt Hon Sir Nicholas

Davies, Q. (Stamf'd & Spald'g)

Macfarlane, Sir Neil

Davis, David (Boothferry)

MacGregor, Rt Hon John

Day, Stephen

MacKay, Andrew (E Berkshire)

Dorrell, Stephen

McLoughlin, Patrick

Durant, Sir Anthony

Mans, Keith

Dykes, Hugh

Maples, John

Eggar, Tim

Marland, Paul

Evans, David (Welwyn Hatf'd)

Marshall, John (Hendon S)

Fallon, Michael

Martin, David (Portsmouth S)

Favell, Tony

Mates, Michael

Forman, Nigel

Maude, Hon Francis

Forsyth, Michael (Stirling)

May hew, Rt Hon Sir Patrick

Forth, Eric

Mellor, Rt Hon David

Fox, Sir Marcus

Meyer, Sir Anthony

Freeman, Roger

Montgomery, Sir Fergus

Fry, Peter

Moore, Rt Hon John

Gale, Roger

Morrison, Sir Charles

Garel-Jones, Tristan

Moss, Malcolm

Goodhart, Sir Philip

Moynihan, Hon Colin

Goodlad, Alastair

Needham, Richard

Gorst, John

Neubert, Sir Michael

Greenway, Harry (Ealing N)

Newton, Rt Hon Tony

Gregory, Conal

Nicholls, Patrick

Ground, Patrick

Nicholson, David (Taunton)

Gummer, Rt Hon John Selwyn

Norris, Steve

Hamilton, Neil (Tatton)

Onslow, Rt Hon Cranley

Hampson, Dr Keith

Paice, James

Hanley, Jeremy

Patnick, Irvine

Hargreaves, Ken (Hyndburn)

Patten, Rt Hon Chris (Bath)

Hayhoe, Rt Hon Sir Barney

Pattie, Rt Hon Sir Geoffrey

Hayward, Robert

Powell, William (Corby)

Heathcoat-Amory, David

Raison, Rt Hon Sir Timothy

Higgins, Rt Hon Terence L.

Redwood, John

Hind, Kenneth

Rhodes James, Robert

Hogg, Hon Douglas (Gr'th'm)

Riddick, Graham

Holt, Richard

Ridsdale, Sir Julian

Howard, Rt Hon Michael

Roberts, Sir Wyn (Conwy)

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

Roe, Mrs Marion

Howarth, G. (Cannock & B'wd)

Rumbold, Rt Hon Mrs Angela

Hunt, Rt Hon David (Wirral W)

Ryder, Rt Hon Richard

Hunter, Andrew

Sackville, Hon Tom

Irvine, Michael

Sainsbury, Hon Tim

Jack, Michael

Sayeed, Jonathan

Jackson, Robert

Scott, Rt Hon Nicholas

Janman, Tim

Shaw, David (Dover)

Jones, Robert B (Herts W)

Shaw, Sir Giles (Pudsey)

Key, Robert

Shephard, Mrs G. (Norfolk SW)

King, Roger (B'ham N'thfield)

Shepherd, Colin (Hereford)

King, Rt Hon Tom (Bridgwater)

Shersby, Michael

Kirkhope, Timothy

Sims, Roger

Knapman, Roger

Skeet, Sir Trevor

Knight, Greg (Derby North)

Smith, Tim (Beaconsfield)

Knowles, Michael

Soames, Hon Nicholas

Knox, David

Spicer, Sir Jim (Dorset W)

Lamont, Rt Hon Norman

Spicer, Michael (S Worcs]

Lang, Rt Hon Ian

Squire, Robin

Latham, Michael

Stanbrook, Ivor

Lennox-Boyd, Hon Mark

Stern, Michael

Lloyd, Peter (Fareham)

Stevens, Lewis

1292

Stewart, Andy (Sherwood)

Waldegrave, Rt Hon William

Stewart, Rt Hon Ian (Herts N)

Walker, Bill (T'side North)

Summerson, Hugo

Walker, Rt Hon P. (W'cester)

Taylor, Ian (Esher)

Waller, Gary

Taylor, John M (Solihull)

Wardle, Charles (Bexhill)

Tebbit, Rt Hon Norman

Watts, John

Temple-Morris, Peter

Wheeler, Sir John

Thompson, Patrick (Norwich N)

Widdecombe, Ann

Thurnham, Peter

Wilshire, David

Townsend, Cyril D. (B'heath)

Wood, Timothy

Tracey, Richard

Yeo, Tim

Tredinnick, David

Young, Sir George (Acton)

Trippier, David

Twinn, Dr Ian

Tellers for the Noes:

Vaughan, Sir Gerard

Mr. Robert G. Hughes and

Viggers, Peter

Mr. Andrew Mitchell.

Wakeham, Rt Hon John

Question accordingly negatived.

LOCAL GOVERNMENT FINANCE (PUBLICITY FOR AUDITORS' REPORTS) BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday 8 February.

AIRCRAFT (NOISE RESTRICTION) BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday 1 March.

ROAD TRAFFIC (RANDOM BREATH TESTING) BILL
Order for Second Reading read.
Mr. Deputy Speaker (Mr. Harold Walker): Not printed.
Second Reading deferred till Friday 8 February.

DOMESTIC SMOKE ALARMS BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday 8 February.

NORTHERN IRELAND (EMERGENCY PROVISIONS) BILL
Motion made,
That it be an Instruction to Standing Committee B that it have power to amend the Northern Ireland (Emergency Provisions) Bill so as to make, in relation to the whole of the United Kingdom, provision for and in connection with the exercise of investigation powers by persons other than constables.—[Mr. Nicholas Baker.]
Hon. Members: Object.

Take-away Food Shops
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Nicholas Baker.]
2.40 pm
Mr. Cyril D. Townsend: I am grateful for this opportunity to raise the subject of planning controls over hot food take-away shops, with particular reference to Welling—which is the second largest town in my south-east London constituency.
I appreciate that such shops meet an obvious demand and are certainly popular with many people—particularly younger persons and parents of small children. My own two sons hold them in high regard. They are well suited to the pace of modern life, and create wealth and employment locally.
However, as many right hon. and hon. Members know from constituency experience, there is a downside. In the words of Bexleyheath's chief superintendent:
"A number of such establishments in this borough have in the past attracted police attention for the following reasons. Complaints of noise by local residents. A cause of litter in the immediate vicinity. Obstruction to footways outside by groups of youths. Complaints of rowdyism, particularly in the late evening. Obstruction of vehicles parked outside."
The Government are well aware of the litter problem, which reached unacceptable levels years ago. Some types of commercial operation, such as take-away restaurants, generate a disproportionate volume of litter. Firms such as McDonalds are well aware of their public responsibilities. Their experienced managers do their best, but the litter problem remains.
Although the town of Bexleyheath has benefited from a vast new shopping centre, there is local concern, which I share, about the future of Welling. It must hold on to the attractiveness and vitality of a prime shopping area.
In past years, Bexley borough council was slow to recognise that too many hot-food shops were opening in the Welling area. Local people became increasingly vocal and I began to receive a large number of letters and complaints. I pay tribute to Darwin and Faraday residents association, which for many years has carried out a classic campaign to alert those in authority to an ever-increasing problem.
Bexley council—with all-party support, which is not easy to achieve at a local level—started doing what it could within existing planning controls, but it hit a major snag. I quote from my letter dated 15 November 1989 to my right hon. Friend the former Secretary of State for the Environment:
"I wrote in July 1988 to the then Minister of Housing and Planning concerning the approach being adopted by the Department of the Environment towards local planning decisions. I regret to say that since then the position in my own constituency has gone from bad to worse.
I refer in particular to the almost regular practice of the Department to overthrow the decisions of our local planning authority—decisions they make as elected representatives of my constituents and normally with the whole-hearted support of my constituents. Of course I understand that the Government rightly wishes to reduce the amount of bureaucracy in the planning system and allow more firms and individuals to do what they want, but we both know a proper balance needs to be struck and regretfully the evidence in Bexley is that this is not happening."
There are now 21 hot food take-away shops in Welling which seems to me, as a layman, to be an extraordinarily large number for one comparatively small town. Of those, three were allowed on appeal in 1985, 1989 and last year.
1294
My correspondence with the Department became increasingly frustrating. Bureaucratic replies, laced with planning jargon become meaningless at constituency level, as we all know. Junior Ministers were insensitive to what was becoming a major local issue for me.
On 8 December 1989 I received a letter signed by the then Parliamentary Under-Secretary, my hon. Friend the Member for Lewisham, East (Mr. Moynihan). The nub of that letter was that the question whether any service is sufficiently represented in a locality is a matter of commercial judgment, and is not a matter for planning consideration and that the planning system should not be used to regulate the supply and demand for commercial services.
I submit that that approach is barmy. I like to think that under the Department's new and distinguished management it has been or is being altered. Frankly, I have no idea what the market for hot food take-away shops is in an area like Welling. South-east London has a high population density and a highly mobile and comparatively wealthy population. Welling is on a major road and there are plenty of bus stops. Would that market take 30 or 40 of these shops before some started falling off? It would be ridiculous to allow more shops to try their hand and to fight for their share of that crowded market, while the whole area continues to suffer in the process.
I stress to my hon. Friend the Minister that this matter should not be left solely to market forces. Proper planning by the local elected authority should be encouraged in the interests of the inhabitants of my constituency and the local environment. I look forward to hearing exactly what a local authority can do in such circumstances to meet the strongly expressed feelings of the local residents. At present many of my constituents are losing faith in the planning system. They see Whitehall overruling Bexley far too often.
I am proud of what we have achieved as a country in terms of local planning to protect and improve our surroundings. Whenever I go to the United States I am appalled at the unchecked linear development that has been allowed to take place, and I am grateful to Britain's far-sighted post-war planners. Ministers tell me that when they deal with appeals, the inspectors are concerned that what is proposed is in the public interest. That entails weighing the legitimate worries of local residents about the possible effects of development on their environment, against arguments in favour of proposals. My constituents do not agree that their interests are being properly looked after and they do not believe that the proper balance is being achieved. They have appealed to me, as their local Member of Parliament, and I have therefore initiated this brief debate. I appeal to the Under-Secretary of State for the Environment for his support.
Mr. Deputy Speaker (Mr. Harold Walker): The hon. Member for Bolsover (Mr. Skinner) and his hon. Friends appear to be holding a committee meeting. Perhaps they would prefer to do so outside the Chamber.
Mr. Dennis Skinner: On a point of order, Mr. Deputy Speaker. I find it odd that you should make such remarks about my hon. Friends and me, given that about 10 Conservative Members persisted in interrupting the speech of my hon. Friend the Member for Peckham (Ms. Harman) on the important Bill dealing with no-fault compensation, which the Tories have just ransacked.
Mr. Deputy Speaker: Order. The hon. Gentleman is taking up the valuable time of the hon. Member who has the Adjournment debate.
Mr. Skinner: You started it.
Mr. Deputy Speaker: Order. The hon. Gentleman knows that he ought not to engage in sedentary conversations—
Mr. Skinner rose—
Mr. Deputy Speaker: Order. I hope that the hon. Gentleman will respond to the request of the Chair.
2.50 pm
The Parliamentary Under-Secretary of State for the Environment (Mr. Tim Yeo): I congratulate my hon. Friend the Member for Bexleyheath (Mr. Townsend) on winning the opportunity to raise this important subject. He is a strong and effective champion of the interests of his constituents and I hope that he will remain their champion and representative for many years to come.
I regret any insensitivity that may have been shown by any of my predecessors—of whom there have been quite a large number in the past few months—in the wording of replies to my hon. Friend. We shall certainly renew and redouble our efforts to avoid recourse to bureaucratic jargon, which may, indeed, be incomprehensible by the time it reaches Welling.
Hot food take-away shops have been around in a variety of guises for generations. Perhaps the most familiar are fish and chip shops. My hon. Friend acknowledged that most of us patronise such outlets from time to time, and those of us with families no doubt visit them rather more frequently than we might if the choice were left entirely to us. Nevertheless, proposals to establish new outlets can still generate local controversy. The Government's planning policies in respect of such establishments are sometimes misunderstood and I am pleased to have the oportunity to set them out in a way that I hope will be unambiguous.
I entirely understand why individual establishments and proposals for additional establishments give rise to concern such as that expressed by my hon. Friend on behalf of his constituents. It is most important that the operators of such outlets should ensure that they minimise any problems of litter, noise or disturbance, and those are all factors which local planning authorities can take into account in deciding whether to grant planning permission. I am encouraged by the fact that many operators are adopting very responsible policies towards the communities in which they function.
For more than 40 years, the development control system has distinguished between the use of land for catering establishments such as restaurants and takeaways, and other uses of land for outlets such as shops. There is a world of difference, in both a cultural and a culinary sense, between a traditional pie-and-mash or tripe shop, and a modern fast-food restaurant. But there is less difference in land-use planning terms. I refer, for example, to the effects on local amenities and the environment and to the pedestrian and vehicular traffic that they generate. At present, the planning system allows changes of use as between most catering trade uses to take place without planning permission, but planning permission must be
1296
obtained before a catering use can be introduced for the first time. I believe that that is the right basis for planning control.
The Town and Country Planning (Use Classes) Order 1987 is often regarded as the present-day villain of the piece as regards take-aways. Nevertheless, it has considerable merits as a piece of deregulation in relation to planning matters. My hon. Friend seemed ready to acknowledge that there is a great deal of concern about the fact that the planning process involves considerable delays for people making applications and for people involved in appeals. Of the very large number of applications dealt with each year, almost 30,000 go to appeal. The order performs a helpful service in reducing what, if it were not in force, would be an additional burden of extra appeals. It means that more manpower resources are available to deal with other aspects of the planning system, including enforcement.
For the first time, the order groups together restaurants, take-aways, cafes and other catering trade uses in a single food and drink use class. In the order, that use class is known as A3. It frees from planning control changes between those uses. It broke new ground and it was always likely, therefore, to be regarded with mistrust and suspicion in some quarters.
The approach adopted in the order, however, was pragmatic as well as deregulatory. It recognised that the catering trade has undergone a transformation in the past decade. The traditional demarcation between public houses and restaurants and between restaurants and take-aways has become blurred. The order allows the catering trade to adapt to changing trends and demands with greater speed and certainty, in premises where potential environmental nuisances such as smell, traffic and parking have already been accepted. It also relieves local planning authorities of the burden of determining whether planning permission would be required for a change of use from a public house to a wine bar or from a bistro to a brasserie.
I should stress that the order did not remove or reduce local planning authorities' power to control the proliferation of premises used by the catering trade. Planning permission is still invariably required to erect new premises, or to change the use of existing non-A3 premises to A3 uses. Each such application must be decided on its merits by the local planning authority, according to a time-honoured formula of
"having regard to the provisions of the development plan and to any other material considerations."
Let us suppose that an area is already well served or, as my hon. Friend and his constituents might claim, over-supplied—21 seems quite a large number for a town the size that he mentioned—with restaurants and take-aways, possibly for historical reasons. Let us further suppose that, individually or collectively, the establishments are creating environmental difficulties. It will be difficult for a local authority to secure a reduction in their overall number under planning legislation other than by granting planning permission for suitable alternative uses as and when the opportunity arises.
There are powers for local authorities to make orders to discontinue particular uses of land, but such orders can involve the local planning authority in a liability to pay compensation for the losss of existing use rights. I recognise, therefore, that the use of such powers will be

1297
contemplated only in exceptional circumstances. Nevertheless, local authorities have discretion to refuse planning permission for any additional take-away outlets.
Local authorities also have several options available outside the scope of planning control to alleviate some of the problems associated with restaurants and take-ways. These include the introduction of parking restrictions and, in Greater London, the power to require hot-food shops to close at midnight. Those powers will be augmented by the street litter control notice provisions of the Environmental Protection Act 1990, under which a local authority will be able to place a duty on the proprietors of premises such as take-aways to keep their frontages litter free.
To safeguard against planning refusals being overturned on appeal, local planning authorities must buttress their decisions with sound reasons based on criteria that are relevant to the land use planning system. Typically, such reasons will relate to the anticipated adverse effects on the local environment and amenity. Such effects can include an increase in traffic and parking, noise and disturbance, particularly if this seems likely to take place in the evening or to affect a residential area.
My hon. Friend will understand that I cannot comment on or discuss the merits of individual decisions, but I assure him that appeals are decided only after the most careful assessment of all material factors. My hon. Friend said that three of the 21 establishments had resulted from appeal.
An additional way in which a local planning authority can defend a refusal of planning permission on appeal is by basing its decision on a relevant policy in an adopted local plan. This leads me to another issue that appears to have caused some misunderstanding. In 1985—before the introduction of the A3 use class—my Department issued guidance on "Service Uses in Shopping Areas" in development control policy note 11. That document made it clear that, in land-use planning terms, the adoption by local planning authorities of policies designed to maintain or to strengthen the retail element of shopping areas can be justified. Indeed, I understand that the London borough of Bexley included such a policy in the Bexley borough plan, which was adopted in February 1985. This means that it is acceptable for local planning authorities, in the light of local circumstances, to decide whether they should resist changes to the mix of retail and non-retail uses in a particular shopping area. Thus, if the conversion of a shop to a take-away were proposed in an area in which such a policy applied, the desirability of giving effect to such a policy could provide an important pillar for a refusal of planning permission.
However, what the Government could not support in the context of such a policy would be decisions that discriminated against a particular form of non-retail use. I cannot accept that local authorities' power to regulate development should go so far as to set ceilings for the
1298
number of particular outlets in a particular area. This does not mean that we are simply content to allow a completely market-led free-for-all. I recognise the force of my hon. Friend's point. It means that we are committed to a development control system in which each decision is considered carefully on its own merits. Such decisions will be based on an assessment of the likely effect that the development proposal will have on the locality and will not be arbitrarily pre-ordained on the basis of a rigid system of rationing for specific forms of development.
I am sure that my hon. Friend and others will agree that it would be inappropriate for Bexley council—or my Department—simply to set a limit for the number of pizza parlours or burger bars that could become established in Welling. I am sure that those of my hon. Friend's constitutents who patronise such establishments would not wish to have their choice curtailed in such a way. Equally, I hope that they will accept that if the continued viability of a retail shopping area or the amenity of a locality were judged to be issues raised by any proposal to create a new A3 outlet, the council has a duty to ensure in the wider public interest that such considerations are taken into account in determining whether planning permission should be granted for that outlet. The same duty would apply to the Secretary of State and to his inspectors when deciding appeals.
If, in reaching its decision, the local planning authority judges that a particular use or uses within the A3 use class would have adverse effects on the environment or on amenity, not susceptible to other control, it need not necessarily refuse planning permission outright. An alternative approach would be to grant planning permission subject to a condition restricting future changes of use which, by virtue of the Use Classes Order 1987, would not otherwise require a further grant of planning permission.
Independent research has recently been carried out on behalf of my Department into the effects of the Use Classes Order 1987. That research has revealed that local planning authorities' use of such conditions is relatively commonplace when granting planning permission for A3 uses. The Government are still considering the implications of the researchers' findings and we will announce our conclusions in due course. However, the apparent willingness of local authorities to grant conditional planning permission for A3 uses seems to demonstrate that applications from the catering trade represent a demand that should be met, where that can be achieved without compromising those areas of concern that the development control system is designed to safeguard, and about which my hon. Friend has spoken.
I hope that I have been able to provide some enlightenment and encouragement to my hon. Friend on the Government's planning policies in this sometimes contentious area.
Question put and agreed to.
Adjourned accordingly at four minutes past Three o'clock.

EDUCATION AND SCIENCE

  Political Science
  Mrs. Dunwoody
  To ask the Secretary of State for Education and Science if he will include contemporary political issues in the syllabus for 14 to 16-year-olds.

  Mr. Eggar
  There is nothing to stop schools dealing with contemporary political issues subject to their legal duty to avoid political indoctrination and ensure that any political issues raised are given a balanced treatment of opposing views.

  Special Purpose Grants
  Mr. Fatchett
  To ask the Secretary of State for Education and Science if he will set out, for the year 1991–92, the value per child(a) in each maintained sector school of the grants for education, support and training and (b) in each grant-maintained school for the special purpose grant (development).

  Mr. Eggar
  In 1991–92, the grant payable to local authorities under the grants for education support and training programme will represent nationally an average of some £28 per pupil in local education authority maintained schools. Special purpose grant (development) of some £41 per pupil will be available to grant-maintained schools.

  Mr. Fatchett
  To ask the Secretary of State for Education and Science how much grant-maintained schools have been allocated for special purpose grant for staff redundancy; how many teaching and non-teaching posts have been removed; and how many teaching and non-teaching staff have been made redundant or taken early retirement.

  Mr. Eggar
  Up to 31 December 1990 approval had been given for special purpose grant for restructuring (SPG(R)) to be paid in respect of 52 teachers at grant-maintained schools. No approvals have been given in respect of non-teaching staff. Of the 52 teachers three received redundancy payments at a total cost of £29,800. A further three received voluntary severance terms at a total cost of £25,900. The remaining 46 teachers and the three receiving redundancy payments have received or will be receiving premature retirement compensation.

  Cash Limits
  Mr. Gill
  To ask the Secretary of State for Education and Science if he has any changes to announce to cash limits on votes within his responsibility for 1990–91; and whether there are any proposals to amend his Department's running cost limit for 1990–91.

  Mr. Kenneth Clarke
  Subject to parliamentary approval to the necessary supplementary estimates, the cash limits 642
  for class XI, vote 1, schools, research and miscellaneous services, and class XI, vote 2, higher and further education will be amended. The Department's running cost limit on class XI, vote 4 will also be increased. The cash limit changes are as follows:

  Class and vote

  Current cash limit £

  Change £

  Revised cash limit £

  XI.1

  657,650,000

  -1,500,000

  656,150,000

  XI.2

  3,115,983,000

  +1,500,000

  3,117,483,000

  The decrease on class XI, vote 1 results from slippage of certain projects in connection with research, development and implementation of the national curriculum. The token supplementary estimate also takes account of a transfer of provision for grant-in-aid to the Sports Council from the Department of the Environment to my Department.

  The increase on class XI, vote 2 is needed to offset reduced receipts to be appropriated in aid of the vote from the Channel Islands and Isle of Man for students attending higher education institutions in the United Kingdom; from the sale of property owned by the Royal College of Art to be reinvested in the college's redevelopment scheme; and from a decline in the proportion of Open university students from Northern Ireland. It also provides additional recurrent funds for the Royal College of Art to pay the rent on temporary accommodation for the school of painting following its move from a building owned by the Victoria and Albert museum.

  My Department's running cost limit will be increased by £193,000 from £80,686,000 to £80,879,000.

  These changes are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

OVERSEAS DEVELOPMENT

  Know-how Funds
  Mr. Allen
  To ask the Secretary of State for Foreign and Commonwealth Affairs when he expects to reply to the letter from the hon. Member for Nottingham, North regarding access to the know-how fund for local education authorities.

  Mrs. Chalker
  I replied to the hon. Gentleman's letter of 17 January on 31 January.

  Mr. Allen
  To ask the Secretary of State for Foreign and Commonwealth Affairs when the joint assistance unit expects to meet the British Council to discuss the Brackenhurst college submission for support from the know-how fund.

  Mrs. Chalker
  I am writing to the hon. Member about this case.

  Mr. Tom Clarke
  To ask the Secretary of State for Foreign and Commonwealth Affairs if he will list in full the current disbursements under the Polish know-how fund.

  Mrs. Chalker
  The list of activities and their estimated expenditure which are being supported in 1990–91 from the Poland know-how fund is as follows:
  643

  Know-How Fund, Poland: Projects being funded 1990/91

  Aid Vote Projects

  Anticipated Expenditure

  £'000

  Banking and Finance

  Foreign Investment Agency

  357·0

  Privatisation Consultancies

  1,690·0

  Privatisation Foundation

  112·0

  Gdansk Research Centre

  32·0

  Gdansk Economic Foundation

  4·0

  Export Development Bank

  200·0

  Advanced Corporate Finance

  15·0

  Diagnostic Studies for Banks

  200·0

  Conference on Demonopolisation

  11·3

  Financial Seminars

  4·0

  New Banks - Unity Trust plc

  30·0

  National Banks of Poland - Lawyers

  2·0

  Insurance Regulators

  6·0

  Insurance Seminar

  10·0

  Insurance Consultancy

  300·0

  Assets and Liabilities

  30·0

  Stock Exchange Training

  70·0

  Total

  3073·3

  Management and Accountancy

  Accountancy Project Identification Mission (PIM)

  14·3

  Accountancy Training Project

  109·0

  Assistance with Auditing

  250·0

  Management Project Identification

  42·0

  Industrial Attachments

  300·0

  Management Educators

  25·0

  Regional Management Centres

  170·0

  Shipping Management

  20·0

  Total

  930·3

  Macroeconomic advice

  Computer Education

  8·0

  Ministry of Planning—Initial

  27·0

  Ministry of Planning—Follow-up

  70·0

  Industrial Competitiveness Research

  27·0

  Advice to Ministry of Finance

  202·0

  Total

  334·0

  Natural resources

  Section Project Identification Mission (PIM)

  5·0

  PIM Follow-up

  15·0

  Agros Vegetable Study

  55·0

  Krakow Vets Training

  42·0

  Seeds Sector Training

  55·0

  Total

  172·0

  Industry

  Vehicle Productivity Study—Phase I

  44·3

  Phase II

  123·4

  UNIDO Projects

  200·0

  National Business Services

  9·0

  Company Doctor Training

  431·0

  Industrial Restructuring

  122·0

  Industrial Competitiveness

  27·0

  Total

  956·7

  Energy

  Electric Utility

  403·0

  UNDP/World Bank Studies

  Hard Coal

  339·0

  Oil and Gas

  339·0

  Lignite and Electricity

  409·0

  Gas Pricing

  156·0

  Coal Industry Training (United Kingdom)

  130·0

  Pilot Course (Poland)

  10·5

  644

  £'000

  Coal Industry Training (Poland)

  45·0

  Total

  1,831·5

  Education and ELT

  Distance Education

  23·6

  Access to English

  319·2

  English for Management

  300·0

  VSO Teachers (English Language Lecturers)

  154·0

  Equipment for Education Ministry

  50·0

  Academic Links Programme

  185·0

  Training Awards Programme

  118·0

  Study Tour (Technical Education)

  15·0

  Book Sector Study

  29·0

  Total

  1,193·8

  Environment

  Assistance to Ministry of Environment

  20·0

  Carlisle/Slupsk-River Pollution Advice

  30·0

  Total

  50·0

  Local Government

  Equipment Supply

  20·0

  Department of Environment Mission

  8·0

  Training of Trainers

  186·0

  Foundation for local Democracy

  7·0

  Local Government Seminars

  12·0

  Training Needs Analysis

  5·0

  Total

  238·0

  Employment

  Employment: Sector PIM

  5·0

  Health and Safety

  Employment Services

  125·0

  Training

  Small Firms

  Total

  130·0

  Planning

  Urban Planning

  30·0

  Aid Co-ordination Adviser

  17·5

  Ministry of Physical Planning

  26·8

  Total

  74·3

  Telecommunications

  Telecommunications

  40·0

  Total

  40·0

  Railways

  Polish Railways Management

  150·0

  Railways Signalling Training

  15·8

  Total

  165·8

  Tourism

  Cracow Tourism Study

  20·5

  Total

  20·5

  Health

  Blood Plasma Study

  49·0

  Healthcare

  17·0

  645

  £'000

  AIDS Education

  47·6

  Pharmacy Training

  4·2

  Eurohealth Conference—Wroclaw

  11·0

  Total

  128·8

  Police

  Police Training

  30·0

  Total

  30·0

  Joint Ventures

  British Airports Authority

  41·0

  Simon Storage Gp Ltd·

  12·5

  COMTEC

  3·0

  Pilotweld

  21·0

  Total

  77·5

  BESO

  Fact Finding Mission

  3·0

  Total

  3·0

  AID Vote Total

  8,563·8

  Political Legal and Other

  British/Polish Legal Seminars

  30·0

  British/Polish Round Table

  10·0

  Placement of Polish Lawyers

  40·0

  British/Polish Commercial Law

  31·5

  Book Industry Training—Stage I

  70·0

  Book Industry Training—Stage II

  51·0

  Journalists—British Council/Thomson Foundation

  120·0

  Customs Assistance

  3·0

  Western Press

  20·0

  Tweedale Press Group

  20·0

  Photography—Delta Images

  2·8

  Trade Union Trading—Gdansk

  2·7

  Financial Journalists

  15·0

  OECD Contribution

  125·0

  Civics Education

  1·0

  Police

  4·5

  Ealing Language Courses

  45·0

  Restructuring Polish TV

  3·0

  World Service/Media

  190·0

  Cambridge University Seminar

  1·2

  Association of Countryside Rangers

  10·0

  Lecture Tour (Legal)

  1·0

  Warsaw School of Planning (Books)

  5·0

  Broadcasting

  2·0

  Jagiellonian Trust Seminars

  16·0

  Social Security Advice

  3·0

  Training Polish Diplomats

  53·2

  Information and Printing Technology Seminars

  8·0

  Polish Publishing House

  15·0

  Education for Democracy Textbook

  4·0

  Publishing Sales and Marketing Consultancy

  5·7

  Political Legal and other Total

  908·6

  GRAND TOTAL

  9,472·4

  Cash Limits
  Mr. Lester
  To ask the Secretary of Strate for Foreign and Commonwealth Affairs what changes have been made in the 1990–91 cash limit for expenditure by the Overseas Development Administration.

  Mrs. Chalker
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit on the 646
  overseas aid vote (class II, vote 5) will be increased by £1,444,000 from £1,477,509,000 to £1,478,953,000. The increase reflects adjustments to the aid programme including a contribution from the Scottish Office to the costs of the St. Helena ship. The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Commonwealth Foundation
  Mr. Tom Clarke
  To ask the Secretary of State for Foreign and Commonwealth Affairs what discussions he has had with the Commonwealth Foundation on its activities for 1991; and if he will make a statement.

  Mrs. Chalker
  My right hon. Friend the Secretary of State is represented on the board of governors of the Commonwealth Foundation by the British governor, Dr. John Wood. The board meets regularly to establish the foundation's policy and future activities.

  Reforming European Economies
  Mr. Tom Clarke
  To ask the Secretary of State for Foreign and Commonwealth Affairs what is his overall strategic approach to aid and assistance to the reforming east European and central European economies.

  Mrs. Chalker
  The main strategic aid is to help in the establishment of a plural democracy and to facilitate the transition from a centrally planned to a free market economy. The know-how fund is our main bilateral instrument for achieving these overall aims. Assistance under the know-how fund is concentrated on help in the financial sector, particularly privatisation, banking arid accountancy; in the employment sector; in the development of small businesses; in management training; and in assistance to parliamentarians, the media and legal structures.

ENERGY

  Mine Workings
  Mr. Barron
  To ask the Secretary of State for Energy what were the findings of the Government-commissioned Harris research survey into attitudes to British Coal's arrangements for the notification of past and proposed mine workings; and if he will place a copy in the Library.

  Mr. Heathcoat-Amory
  I refer the hon. Member to the answer given to my hon.Friend the Member for Sherwood (Mr. Stewart), on 20 April 1990 at column 1035.

  British Coal intends to introduce on a voluntary basis in February a pilot scheme for individually notifying householders that their property might be affected by subsidence damage as a result of underground mining operations. The intention is that these arrangements will be introduced nationally from June. The recently published Coal Mining Subsidence Bill, once enacted, will make the individual notification of householders a statutory requirement.

  Cash Limits
  Mr. Burns
  To ask the Secretary of State for Energy whether any changes will be made to his Department's cash limits for 1990–91; and if he will make a statement.
  647
  Mr. Wakeham
  Subject to parliamentary approval of the necessary supplementary estimates, the following changes will be made.

  The cash limit for class V, vote 2 will be increased by £27,033,000 from £298,562,000 to £325,595,000. This extra provision sought includes £27,141,000 for UKAEA programmes mainly for additional requirements on decommissioning and radioactive waste management operations, together with restructuring costs related to the thermal reactor safety programme and to the closure of the Winfrith reactor. Extra provision of £3,700,000 to meet an increased contribution towards British Coal's topping cycle project and £34,000 to cover residual Oil Pipelines Agency costs is also required. The increases sought will be partially offset by savings of £3,842,000 on class V, vote 2.

  The cash limit for class V, vote 3 will be increased by £586,000 from £40,117,000 to £40,703,000. This extra provision is sought to meet an increase of £655,000 on the running costs limit (from £41,970,000 to £42,625,000), including additional costs arising from the implementation of the report of the public inquiry into the Piper Alpha disaster; £81,000 for additional information technology requirements; and £20,000 for increased costs in connection with the Ocean Odyssey fatal acccident inquiry. The increases sought will be partially offset by savings of £120,000 together with an increase of £50,000 in appropriations in aid on class V, vote 3.

  The increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Geothermal Hot Dry Rock Technology
  Mr. Hind
  To ask the Secretary of State for Energy whether he intends to end the research programme into geothermal hot dry rock technology.

  Mr. Moynihan
  No, the current phase of work on hot dry rock technology is due to be completed in September 1991. My Department has undertaken a thorough review of the technology with substantial input from the contractors for the present programme, Camborne school of mines (CSM), the RTZ Consultants Limited (RTZC). This has shown that very substantial uncertainties remain about the practicality of extracting energy from hot dry rocks within the United Kingdom and, although the economics are very uncertain, the technology seems unlikely to be competitive with conventional means of generation in the short to medium term.

  In the light of this I have concluded that a new direction rather than closure of the programme is needed. The next phase of work (expected to be carried out by CSM and its associates, and RTZC), for which £3·3 million will be provided over the period 1 October 1991 to 31 March 1994, will concentrate less on research in Cornwall and involve greater collaboration with a European programme now under way involving France, Germany and the European Commission. In this way the substantial expertise developed in the United Kingdom can be exploited in a European context and opportunities pursued for transferring the technology to industry. A decision on further major investment in an experimental prototype will be taken in about two years when feasibility work on the different European sites has been completed.

WALES

  Births
  Mr. Geraint Howells
  To ask the Secretary of State for Wales how many babies were born in Wales in 1990; and what were the corresponding figures for the last 10 years.

  Mr. Nicholas Bennett
  Information for 1990 is not yet available. The available information is given in the following table:

  Babies Born in NHS Hospitals in Wales (Live and Still Births)

  Year

  Number

  1979

  34,636

  1980

  35,741

  1981

  34,445

  1982

  34,019

  1983

  33,998

  1984

  34,528

  1985

  35,302

  1986

  35,552

  1987

  36,338

  1988

  37,376

  1989

  36,713

  Welsh Food
  Mrs. Ray Michie
  To ask the Secretary of State for Wales if he will list the reasons for his decision to set up the Welsh food promotion to begin operation on 1 April; and if he will make a statement.

  Mr. David Hunt
  While many organisations are involved in the marketing of Welsh food, I was concerned that no single body was in a position to assume a clear lead role and to co-ordinate our efforts.

  Mrs. Ray Michie
  To ask the Secretary of State for Wales what plans he has to promote Welsh food abroad; and if he will make a statement.

  Mr. David Hunt
  One of the objectives of Welsh Food Promotions Ltd. will be to co-ordinate marketing efforts at home and abroad. I expect the company to work closely with Food From Britain and with other bodies that are engaged in that task.

  Mrs. Ray Michie
  To ask the Secretary of State for Wales how many people are employed in the manufacture of Welsh food; and if he will make a statement.

  Mr. David Hunt
  Estimates obtained from the 1987 census of employment indicate that, in Wales, there were 18·4 thousand employees employed in the manufacture of food (standard industrial classification 1980 groups 411 to 423).

  Cash Limits
  Mr. Gwilym Jones
  To ask the Secretary of State for Wales if he proposes to make any changes to his Department's cash limits for 1990–91.

  Mr. David Hunt
  Yes. The cash limit for class XVI, vote 2 is to be reduced by £1,400,000 from £98,998,000 to £97,598,000. This reduction takes account of lower than expected demand for regional enterprise grants and will offset the spring supplementary estimate being sought for class XVI, vote 1 in respect of agricultural grants.
  649
  The cash limit for class XVI, vote 5 is to be reduced by £2,987,000 from £325,411,000 to £322,424,000, to offset the following increases:

  The WO/UA cash limit will be increased by £2 million from £69,904,000 to £71,904,000 in respect of additional provision for Cardiff Bay development corporation to facilitate additional land acquisition and relocation costs.

  Subject to parliamentary approval of the necessary supplementary estimate, there will be an increase of £145,000 in the provision for class XVI, vote 12 in respect of rate rebates for the disabled.

  A sum of £842,000 is being transferred to the Office of Arts and Libraries to cover a payment of that amount to the Welsh National Opera company.

  All these changes are within the forecast outturn for the overall planning total published today in the statistical supplement to the autumn statement.

TRADE AND INDUSTRY

  Continuous Stationery plc
  Mr. Austin Mitchell
  To ask the Secretary of State for Trade and Industry whether he will investigate the compliance by Continuous Stationery plc with paragraphs 50(2) and 50(4) of schedules 4 and 5 of the Companies Act 1985, concerning contingent liabilities, in respect of its most recent published accounts.

  Mr. Redwood
  If the hon. Member cares to write to me with details of the reasons why he believes the accounts in question warrant investigation, I shall be pleased to consider the matter.

  Lyons Maid
  Mr. Martlew
  To ask the Secretary of State for Trade and Industry if he will make it his policy to refer any takeover bid for Lyons Maid by Unilever to the Monopolies and Mergers Commission.

  Mr. Redwood
  If such an offer is made it will be considered by the Director General of Fair Trading under the merger control provisions of the Fair Trading Act 1973 to determine whether it qualifies for reference to the Monopolies and Mergers Commission. If it does qualify the Director General will advise my right hon. Friend the Secretary of State on the question of reference. Each case is considered by the Director General and my right hon. Friend on its merits. The main criterion for my right hon. Friend in deciding whether or not to make a reference remains the possible effect of a merger on competition in the United Kingdom.

  Cash Limits
  Mr. Tracey
  To ask the Secretary of State for Trade and Industry whether any changes will be made to his Department's cash and running cost limits for 1990–91.

  Mr. Lilley
  The cash limit for class IV, vote 2 (support for industry, international trade, statutory and regulatory work, consumer protection, and administration) will be reduced by £11,308,000 from £801,681,000 to £790,373,000. The running costs limit for the Department of Trade and Industry will be reduced by £3,024,000 from £303,764,000 to £300,740,000.

  The reduction in the cash limit covers a reduction of £7,958,000 in grant-in-aid external finance provision for
  650
  the English Industrial Estates Corporation from £24,758,000 to £16,800,000 reflecting current conditions in the property market, and a reduction of £350,000 for the Government's contribution to a rent subsidy for the International Sugar and Wheat Organisation following the transfer of responsibility to the Ministry of Agriculture, Fisheries and Food (class III, vote 4).

  The reduction in the running cost limit is due principally to lower-than-expected costs for the restructuring of the National Engineering Laboratory. It also reflects some savings resulting from the reorganisation of certain headquarters divisions announced by my predecessor to the House of Commons on 21 February 1990, Official Report, columns 791–92, and £24,000 in respect of the transfer of some functions from gross running cost control areas to those exempt from gross running cost control.

  Crown Suppliers
  Mr. Battle
  To ask the Secretary of State for Trade and Industry how much stock will be put into the public auction of the Crown Suppliers' ex-stock; and if it will include office and domestic furniture.

  Mr. Yeo
  I have been asked to reply.

  All remaining stock, including new office furniture and fitments, domestic and commercial furniture and household goods.

  Mr. Battle
  To ask the Secretary of State for Trade and Industry on what date a public auction of the Crown Suppliers' ex-stock will be held in the current year.

  Mr. Yeo
  I have been asked to reply.

  The dates are 14 and 15 February 1991.

  Mr. Battle
  To ask the Secretary of State for Trade and Industry what is the estimated value of the Crown Suppliers' ex-stock to be put into a forthcoming public auction.

  Mr. Yeo
  I have been asked to reply.

  The figure is between £3 million and £3·5 million at cost price.

  Personal Debt
  Mr. Alton
  To ask the Secretary of State for Trade and Industry what are the latest estimates of serious personal over-indebtedness; and if he will make a statement.

  Mr. Leigh
  There is no generally agreed definition of "serious personal over-indebtedness". However, the Policy Studies Institute in its report "Credit and Debt in Britain" which was published in February 1990 estimated that about 3 per cent. of all households (560,000) had serious debts.

  Enterprise Initiative
  Mr. Peter Griffiths
  To ask the Secretary of State for Trade and Industry (1) if he will list in the Official Report those measures of assistance to firms under the enterprise initiative which are directed on a regional basis and the regions in which they are currently available;

  (2) if he will list in the Official Report those criteria by which firms in the south-east region of England are excluded from measures of assistance under the enterprise initiative;
  651
  (3) if he will consider making all measures of assistance to firms under the enterprise initiative available throughout the United Kingdom without regional distinction.

  Mr. Leigh
  [holding answer 30 January 1991]: Under the enterprise initiative, there are three measures of assistance which are directed on a regional basis:
  Regional selective assistance—available in the assisted areas of Great Britain;
  Regional enterprise grants—available in development areas of Great Britain and the intermediate areas of South Yorkshire, Derbyshire, Plymouth and Fife;
  The consultancy initiatives—available throughout Great Britain but at a higher rate in assisted areas and urban programme areas.

  The only forms of help under the enterprise initiative not available anywhere in the south-east are regional selective assistance and regional enterprise grants. In urban programme areas in the south-east firms can benefit from higher rates of support under the consultancy initiatives.

  A wide range of criteria were used in drawing up the current assisted areas map, including unemployment, long-term unemployment, industrial and occupational structure, population density and remoteness from main markets. No areas in the south-east were judged to warrant assisted area status. The designation of urban programme areas is a matter for my right hon. Friend, the Secretary of State for the Environment.

  We have no intention of extending to the whole of the United Kingdom the additional help available regionally. The Government seek to promote enterprise and growth throughout the country as a whole but within this framework, extra help is needed in certain areas.

ATTORNEY-GENERAL

  Mining Subsidence
  Mr. Barron
  To ask the Attorney-General how many cases in respect of mining subsidence damage were referred to the Lands Tribunal in each of the last five years; and how long each took to be resolved.

  The Attorney-General
  The number of cases in respect of mining subsidence damage referred to the Lands Tribunal in each of the last five years is given in the table.

  Year

  Number of cases

  1986

  23

  1987

  68

  1988

  34

  1989

  26

  1990

  8

  The Lord Chancellor's Department does not keep detailed statistics on the length of time taken to resolve mining subsidence damage cases, but it is estimated that cases are resolved within 12 to 18 months, depending on the length of time it takes the parties to prepare for the hearing.

  Entry Clearance Officers
  Mr. Gorst
  To ask the Attorney-General what qualifications or training(a) entry clearance officers and (b) adjudicators have in order to qualify them for the
  652
  work they carry out in the Indian sub-continent; how many entry clearance officers and adjudicators are employed; what is the average number of applications dealt with by an entry clearance officer or an adjudicator each month; and to whom they are answerable for the manner in which they perform their duties.

  The Attorney-General
  The training of entry clearance officers is a matter for my right hon. Friend the Secretary of State for Foreign and Commonwealth Affairs. I understand that entry clearance officers on the Indian sub-continent undergo a three-and-a-half week training course in which they are instructed in all areas of the immigration rules. On arrival at post they are given a further period of training varying between two and eight weeks depending on their location. All aspects of their work are closely monitored by line managers, to whom they are immediately answerable. Their ultimate responsibility is to their head of post. There are 82 entry clearance officers on the Indian sub-continent, who each process an average of 320 applications per month.

  Adjudicators are appointed by the Lord Chancellor from among lawyers of not less than seven years' standing. Upon appointment, adjudicators are required to attend a two to three-day induction course, to pay visits to officials of the immigration service at ports of entry in the United Kingdom, and to officials of the United Kingdom Immigrants Advisory Service, which represents 50 per cent. of appellants before the adjudicators. Once the adjudicators take up their duties they are required to attend training seminars, which are held on a regular basis.

  The number of adjudicators currently sitting at nine hearing centres throughout the United Kingdom is as follows:

  1 Chief Adjudicator

  11 Full-time Adjudicators

  71 Part-time Adjudicators

  There are no details of the number of cases from the Indian sub-continent disposed of by individual adjudicators, but in 1990 the average number of cases disposed of each month was 1,377.

  Adjudicators are answerable to the chief adjudicator and the Lord Chancellor for their conduct. Appellants dissatisfied with a judicial decision of an adjudicator may appeal on a point of law to the immigration appeal tribunal.

  Mr. Gorst
  To ask the Attorney-General what discretion is available to Ministers to bring forward the timing of the hearing of an appeal against the refusal of an entry permit by an entry clearance officer in the Indian sub-continent; and whether he has discretion to intervene in cases where evidence of an unsound refusal is made available to him.

  The Attorney-General
  Ministers have no discretion to being forward the timing of immigration appeal hearings by the adjudicators. That is a matter for the immigration appellate authorities, which are independent of Ministers, although responsibility for their administration rests with the Lord Chancellor.

  Where further evidence clearly indicates that a decision to refuse entry is unsound, the correspondence unit in the migration and visa department of the Foreign Office will refer the case back to the entry clearance officer for reconsideration.

  Mr. Gorst
  To ask the Attorney-General what is the average time in the Indian sub-continent that elapses
  653
  between the lodging of an appeal against the decision of an entry clearance officer to grant an entry permit and the hearing of that appeal by an adjudicator; and what are the minimum and maximum times recorded during the past two years.

  The Attorney-General
  The immigration appellate authorities (IAA) do not record details of the minimum and maximum times for appeals from an Indian sub-continent to be determined by adjudicators. However, it is possible to provide an estimate of the average time taken by the IAA to deal with appeals at each stage of the proceedings, as follows:

  (a) From the date of receipt of the notice of appeal and explanatory statement at the IAA's headquarters in London, to the date the case papers are despatched to the parties representatives in this country: 10 to 12 weeks;

  (b) From the date on which both parties indicate readiness to proceed to a hearing, to the date of the hearing: two to three months;

  (c) From the date of the hearing to the date the Adjudicator's determination is despatched to the parties representatives in this country: one month.

  Thus the current estimate of the average time taken by an Adjudicator to deal with a case is five and a half to seven months, to which must be added the time taken by the parties' representatives in the United Kingdom to indicate readiness to proceed after receipt of the case papers from the IAA. This latter period can vary considerably but the current estimate is from two to six months.

  In addition, an appeal from a determination by an adjudicator to the immigration appeal tribunal is estimated to take four to six months.

  Cash Limits
  Mr. Ian Bruce
  To ask the Attorney-General whether any changes will be made to the Lord Chancellor's Department's cash limit and running costs limit for 1990–91.

  The Attorney-General
  Yes, subject to parliamentary approval of the necessary supplementary estimate, the cash limit for the Lord Chancellor's Department, class X, vote 1 will he increased by £2,716,000 from £321,132,000 to £323,848,000.

  The supplementary estimate gives effect to an increase of £2,472,000 in the Department's provision for the 1990–91 accommodation charge. The increase arises from the introduction of value added tax on commercial rents.

  The supplementary estimate also gives effect to an increase of £254,000 in the Department's provision for estate management which arises from the introduction of value added tax on commercial use of fuel and utilities.

  The increase to appropriations in aid of £10,000 is required to give effect to receipts in respect of nursery facilities.

  The running costs limit for class X, vote I will be increased by £2,726,000 from £280,982,000 to £283,708,000.

  The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Mr. Ian Bruce
  To ask the Attorney-General whether any changes will be made to the Crown prosecution service's cash limit and running costs limit for 1990–91.
  654
  The Attorney-General
  Yes. Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class x, vote 5 will be increased by £3,000,000 from £130,668,000 to £133,668,000. Within this total the Department's running costs limit will be increased by £4,000,000 from £125,107,000 to £129,107,000.

  Additional provision is required to enable the Crown prosecution service to meet increased accommodation costs, mostly caused by rent reviews and essential office moves, and the costs of agency support staff to compensate for shortfalls in recruitment particularly in the south-east. The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Mr. Ian Bruce
  To ask the Attorney-General whether any changes will be made to the Treasury Solicitor's Department's cash limit and running costs limit for 1990–91.

  The Attorney-General
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class X, vote 9 will be increased by £249,000 from £15,862,000 to £16,111,000. The additional provision is required for capital expenditure for new office accommodation in Taunton and a similar sum will he deducted from the provision allocated for 1991–92.

  The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Mr. Ian Bruce
  To ask the Attorney-General whether any changes will be made to the Serious Fraud Office's cash limit and running costs limit for 1990–91.

  The Attorney-General
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class X, vote 7 will be increased by £60,000 from £6,567,000 to £6,627,000. The Department's running costs limit will be increased by £60,000 from £6,367,000 to £6,427,000. This increase will enable the Serious Fraud Office to meet additional costs arising from a restructuring of its senior management.

  The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

HOME DEPARTMENT

  Prisoners (Police Cells)
  Mr. Vaz
  To ask the Secretary of State for the Home Department what is the cost of holding people in police cells, giving(a) the daily rate and (b) by police authority.

  Mr. Peter Lloyd
  The information requested is not held centrally and could be obtained only at disproportionate cost.

  Dogs
  Mr. Geraint Howells
  To ask the Secretary of State for the Home Department what assessment he has made of the effectiveness of present legislation to control killer dogs; and if he will make a statement.

  Mrs. Rumbold
  The Dangerous Dogs Act 1989 increased the powers of the courts under the Dogs Act
  655
  1871, particularly as regards the destruction of dangerous dogs. The courts have already used these new powers. Last summer, the Government's consultation paper, "The Control of Dogs", reviewed the legislation on dangerous dogs and set out a number of proposals for further action. We are now considering the responses to this paper.

  Glen Parva Remand Centre
  Mr. Ashley
  To ask the Secretary of State for the Home Department if he will hold an inquiry into the conditions in Glen Parva remand centre.

  Mrs. Rumbold
  As part of his normal programme, Her Majesty's chief inspector of prisons will be conducting an inspection of Her Majesty's young offender institution Glen Parva in October this year, but I see no reason for an inquiry.

  Arab People (Racist Attacks)
  Mr. Wray
  To ask the Secretary of State for the Home Department what role he is playing in co-ordinating special measures to protect Arab and Muslim people from racist attacks.

  Mr. Peter Lloyd
  My right hon. Friend is in close touch with representatives of different Muslim communities and with the police service. They and other agencies with responsibilities for dealing with attacks against law-abiding citizens and their homes and institutions in this country are clear about the priority such incidents deserve.

  Cash Limits
  Mr. Hayes
  To ask the Secretary of State for the Home Department whether he intends to make any changes to the 1990–91 cash limits within his responsibilities and to his Department's running costs' limit.

  Mr. Kenneth Baker
  [pursuant to my reply, 8 November 1990, column 13]: Subject to parliamentary approval of the necessary supplementary estimates, the cash limit on class IX, vote 2, prisons, England and Wales, will be increased by £50,000,000 from £1,294,715,000 to £1,344,715,000. The additional provision is needed to meet the costs of accommodating prisoners in police cells made necessary as a result of the serious prison disorders which occurred in April 1990 and because of industrial action by prison officers. The cash limit on class IX, vote 3, Home Office administration, immigration and police support services, England and Wales, will be increased by £36,523,000 from £758,668,000 to £795,191,000. The additional provision is necessary mainly to fund grants under section 11 of the Local Government Act 1966 to local authorities which have to make special provision for the needs of their ethnic minority population and also to meet higher than expected costs of Home Office accommodation.

  The Home Office running costs limit will be increased by £18,984,000 from £1,012,417,000 to £1,031,401,0001

  The increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Furthermore, subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class IX, vote 5 (the Charity Commission) will be increased by £221,000 from £14,302,000 to £14,523,000 and the running
  656
  cost limit will be increased by £419,000 from £13,414,000 to £13,833,000. These increases are to meet the costs of the inquiry under section 6 of the Charities Act 1960 into the charity War on Want. The costs of the inquiry are being met partly by savings in capital expenditure. The increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  1This is needed mainly for the greater than expected increase in the cost of accommodation, principally in the rents of offices in London.

ENVIRONMENT

  Southampton Buildings, Holborn
  Mr. Campbell-Savours
  To ask the Secretary of State for the Environment when the cladding removed in 1986 from the east wing of Southampton buildings, Holborn will be replaced.

  Mr. Yeo
  The cladding was removed in 1986 because of serious deterioration following storm damage in that year. Re-cladding was planned to start in December 1989, but this had to be postponed because of funding difficulties and other maintenance priorities. It is unlikely that the position will change during 1991–92, but I can assure the hon. Member that there has been no significant deterioration to the fabric of the building. Periodic inspections will be carried out and the position kept under review.

  Mr. Campbell-Savours
  To ask the Secretary of State for the Environment what proposals exist for Southampton buildings, Holborn, when the Patent Office and British Library vacate the buildings; and if there are any plans to develop the site.

  Mr. Yeo
  The Patent Office now occupies only a small part of Southampton buildings, having vacated most of its accommodation there in September 1989. The building is expected to be occupied by British Library and others until the mid- 1990s, when the opportunity may occur for refurbishment or redevelopment. It is too early to say which option might be adopted.

  Disused Barns
  Mr. David Nicholson
  To ask the Secretary of State for the Environment what is the latest guidance provided by his Department to local authorities over planning permission for the conversion of disused barns into(a) dwellings and (b) workshops or other use.

  Mr. Yeo
  DOE circular 8/87, "Historic Buildings and Conservation Areas—Policy and Procedures", states that, finding new uses for buildings such as barns which play an important part in the history and appearance of the countryside, all possible solutions should be explored. It points out that they can make a contribution to the rural economy by providing employment. My Department also provided guidance on the re-use of redundant rural buildings in 1988 in planning policy guidance note 7 (PPG7) on "Rural Enterprise and Development" and PPG2 on "Green Belts". A draft revision of PPG7 was issued for public consultation in December 1989.

  Land Compensation Act 1973
  Mr. Bellotti
  To ask the Secretary of State for the Environment if he has any plans to review the Land Compensation Act 1973; and if he will make a statement.

  Mr. Yeo
  The Planning and Compensation Bill, introduced in another place, contains a number of major proposals for change to land compensation legislation. These include in particular a substantial widening of eligibility for home loss payments under the 1973 Act and an increase in the level of such payments for owner-occupiers.

  Urban Development Corporations
  Mr. Blunkett
  To ask the Secretary of State for the Environment if he will publish a table indicating the number of jobs created in each urban development corporation area.

  Mr. Portillo
  The totals of permanent jobs created or attracted, net of losses, are given in the table:

  UDC

  Net gain in jobs to March 1990

  Black Country

  5,734

  Bristol

  0

  Central Manchester

  285

  Leeds

  5,241

  London Docklands

  29,000

  Merseyside

  4,200

  Sheffield

  40

  Teesside

  2,741

  Trafford Park

  2,450

  Tyne and Wear

  1,630

  Total

  51,321

  Mr. O'Brien
  To ask the Secretary of State for the Environment if he will give details of financial resources allocated to(a) the urban programme, (b) urban development corporations and (c) grants for urban development for each of the past five years; and if he will make a statement.

  Mr. Portillo
  [holding answer 31 January 1991]: The breakdown of central Government expenditure on the urban programme, urban development corporations and city grant (including urban development grant and urban regeneration grant) for 1986–87 to 1990–91 is as follows:

  1991-92 Standard spending assessments

  31 October figure for total SSA

  Final figure for total SSA

  Percentage change in total SSA

  Change in total SSA

  Change in capital financing SSA element

  Change in flood defence SSA element

  Change in all other SSA elements

  £ million

  £ million

  per cent.

  £ million

  £ million

  £ million

  £ million

  Bristol

  40·872

  41·098

  0·6

  0·226

  0·089

  0·132

  0·004

  Nottingham

  37·162

  37·138

  -0·1

  -0·024

  -0·035

  —

  0·011

  Kingston upon Hull

  31·210

  31·419

  0·7

  0·210

  0·206

  -0·002

  0·006

  Plymouth

  28·678

  28·666

  0·0

  -0·012

  -0·012

  -0·030

  0·006

  Portsmouth

  24·505

  24·729

  0·9

  0·223

  0·236

  -0·018

  0·005

  Stoke-on-Trent

  24·880

  24·470

  -1·6

  -0·410

  -0·407

  -0·008

  0·005

  Derby

  24365

  24·313

  -0·2

  -0·051

  -0·056

  0·000

  0·005

  Southampton

  23·370

  23·351

  -0·1

  -0·020

  -0·024

  —

  0·005

  Luton

  22·175

  22·230

  0·2

  0·055

  0·051

  —

  0·004

  658

  £ million

  1986–87 outturn

  1987–88 outturn

  1988–89 outturn

  1989–90 outturn

  1990–91 forecast outturn

  Urban Programme1

  236·7

  245·6

  229·0

  226·0

  232·6

  Urban Development

  Corporations (EFLs)

  89·3

  133·5

  234·4

  436·0

  553·9

  City Grants

  23·9

  26·8

  27·8

  39·1

  50·6

  1 Includes contributions from DH, DES and DTp but excludes contributions for District Health Authorities.

  Mr. O'Brien
  To ask the Secretary of State for the Environment if he has any plans to increase the number of schemes in any urban programme operating at the present time; and if he will make a statement.

  Mr. Portillo
  [holding answer 31 January 1991]: Local authorities decide on the number of schemes in their annual urban programmes, according to local priority. The Secretary of State has no present plans to review the list of urban programme authorities.

  Mr. O'Brien
  To ask the Secretary of State for the Environment what are his current priorities in urban regeneration.

  Mr. Portillo
  [holding answer 31 January 1991]: Good progress has already been made on improving the quality of life for people in our inner cities: we aim now to build on that success, working with local government and the private and voluntary sectors.

  Local Government Finance
  Mr. Ashley
  To ask the Secretary of State for the Environment if he will list the standard spending assessment for Stoke-on-Trent and the 10 district authorities closest to it in size, giving figures for five larger ones and five smaller ones, together with the estimated assessment for each, and the percentage increase or decrease in the final figure compared with the estimate for each; and if he will list the criteria which led to changes in the original estimates.

  Mr. Portillo
  The table lists the standard spending assessment (SSA) for Stoke-on-Trent and the 10 districts closest in size in terms of 1991–92 SSA in £m. The main reasons for change between the provisional figures for 1991–92 SSAs announced on 31 October and the final settlement figures are: that later estimates of credit approvals have been used; that later data on flood defence expenditure have been incorporated; and there have been a number of other small changes to data and service control totals. These effects are shown in columns 5, 6 a:nd 7 respectively of the table.
  659

  31 October figure for total SSA

  Final figure for total SSA

  Percentage change in total SSA

  Change in total SSA

  Change in capital financing SSA element

  Change in flood defence SSA element

  Change in all other SSA elements

  £ million

  £ million

  per cent.

  £ million

  £ million

  £ million

  £ million

  Blackburn

  19·100

  19·183

  0·4

  0·083

  0·080

  0·000

  0·003

  Brighton

  18·215

  18·329

  0·6

  0·114

  0·113

  —

  0·001

  Mr. Battle
  To ask the Secretary of State for the Environment how much it would cost to exempt all those people on income support from paying 20 per cent. of the poll tax.

  Miss Widdecombe
  I have been asked to reply.

  Income-related benefit levels were adjusted in April 1989 to include help towards the 20 per cent. contribution to the community charge at an estimated cost of £500 million.

  Assuming that these benefit levels are not reduced, exempting all those on income support from paying the 20 per cent. contribution would cost an estimated £300 million in community charge benefit, at current benefit levels.

  Source: Modelled using data drawn from the 1985–86–87 Family Expenditure Surveys.

  ID Investment Development AG
  Mr. Campbell-Savours
  To ask the Secretary of State for the Environment, pursuant to his reply on 28 January, what information he has on the connections between ID Investment Development AG to which Heveningham hall was sold and representatives of the Iraqi Government.

  Sir George Young
  My right hon. Friend has no evidence that any such connections exist.

  Employment (Ethnic Minorities)
  Mr. Terry Davis
  To ask the Secretary of State for the Environment whether he has received the final report of the research project by Victor Hausner and Associates into the use of the urban programme in creating employment opportunities for black and ethnic minority communities in the inner cities; and whether he will put a copy of this report in the Libary.

  Mr. Portillo
  My right hon. Friend has not yet received the final report of this research project.

  Cash Limits
  Mr. Favell
  To ask the Secretary of State for the Environment if there are any proposals to change the 1990–91 running costs limit for Ordnance Survey.

  Mr. Baldry
  Subject to parliamentary approval of the necessary token spring supplementary estimate, the running costs limit for Ordnance Survey will be increased by £650,000 from £57,193,000 to £57,843,000. The increase is needed to fund additional expenditure in a number of areas.

  Miss Emma Nicholson
  To ask the Secretary of State for the Environment whether he has any changes to announce to his Department's cash limits and running costs limits for 1990–91.

  Mr. Heseltine
  Yes. Subject to parliamentary approval of the necessary supplementary estimates, the following changes will be made:660

  (i) The cash limit for class VIII, vote 5 (central environmental services, etc.) will be reduced by £145,000 from £366,400,000 to £366,255,000. There will be a corresponding increase on class VIII, vote 8 (Department of the Environment: administration) to provide for administrative expenditure incurred in setting up the Nature Conservancy Council (England).

  (ii) The cash limit for class VIII, vote 8 (Department of the Environment: administration) will be increased by £52,000 from £157,750,000 to £157,802,000. This includes a transfer of £145,000 from class VIII, vote 5 (central environmental services) for expenditure incurred in setting up the Nature Conservancy Council (England). A transfer of £13,000 is being made to the Department of Transport to support a review of first aid arrangements. Further income of £80,000 will accrue to the Building Research Establishment as a result of Property Holdings being charged the full economic cost of services provided to it.

  (iii) The cash limit for class VIII, vote 2 (miscellaneous housing administration and grants) will be reduced by £1,000,000 from £110,217,000 to £109,217,000, to reflect a reduction in the level of claims by local authorities for reimbursement of costs incurred on the rent officer service, and a small reduction to the provision for grants for tenant participation schemes.

  (iv) The non-voted cash limit for DOE/UA (urban aid and derelict land reclamation) will be increased by £3,675,000 from £904,666,000 to £908,341,000. This is to cover increased grant-in-aid of £3,675,000 to the Bristol development corporation for land acquisitions in connection with the Bristol spine road. This will be offset by a corresponding reduction in the Department of Transport's cash limit for class VII, vote 1. Teesside development corporation will receive further provision of £4,800,000 fully offset by a corresponding decrease in grant-in-aid to Trafford Park development corporation. The provision for the city grant has also been increased by £1,122,000 to meet the higher-than-expected level of claims. There are offsetting savings of £500,000 from the recovery of derelict land grant and £622,000 from a reduction in expected claims for urban development grant.

  (v) The non-voted cash limit for DOE/LACAP (local authority capital grants and credit approvals) will be reduced by £27,890,000 from £2,813,060,000 to £2,785,170,000. This provides offsetting savings for spending on specified housing grants not at present included in the cash limit, a transfer of resources to the Department of Social Security and to cover an increase in new towns housing subsidy.

  (vi) the running costs limit for the Department of the Environment will be reduced by £13,000 from £157,754,000 to £157,741,000.

  (vii) These changes are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Sir Michael Neubert
  To ask the Secretary of State for the Environment if he proposes to make any changes to the cash limit on the Property Services Agency services vote in 1990–91.

  Mr. Yeo
  Yes, subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class VIII, vote 13 will be increased by £15,548,000 from £29,658,000 to £45,206,000. This increase is required to
  661
  finance additional expenditure on severance payments to surplus staff as a result of the restructuring of PSA Services into a viable commercial proposition, and to finance additional and unforseen expenditure on the dilapidation costs relating to the early surrender of a leased property no longer required for use by Government Departments. The increase is within the forecast outturn for the planning total published today in the statistical supplement to the autumn statement.

  Inner-city Decay
  Mr. O'Brien
  To ask the Secretary of State for the Environment what is the amount of expenditure by his Department to tackle inner-city decay for each year since 1988; and if he will make a statement.

  Mr. Portillo
  [holding answer 31 January 1991]: My Department supports a wide range of programmes within the Government's current initiatives for the inner cities. Resources for these programmes totalled some £1.3 billion in 1988–89 and £1.4 billion in 1989–90; expenditure during 1990–91 is expected to exceed £1.5 billion.

  Global Warming
  Mr. Cryer
  To ask the Secretary of State for the Environment if he has received a copy of the report of the German parliamentary commission on preventive measures to protect the earth's atmosphere chaired by Bernd

  Estimated Population

  Local authority

  1985

  1986

  1987

  1988

  1989

  Antrim

  45,900

  45,900

  46,600

  47,700

  48,100

  Ards

  62,200

  63,000

  63,600

  64,000

  64,500

  Armagh

  50,400

  51,200

  50,700

  49,200

  49,000

  Ballymena

  55,800

  55,800

  56,100

  56,900

  57,200

  Ballymoney

  23,800

  23,800

  23,800

  23,900

  23,900

  Banbridge

  31,600

  31,700

  32,000

  31,900

  31,900

  Belfast

  301,600

  303,600

  303,800

  299,600

  296,900

  Carrickfergus

  28,400

  29,000

  29,300

  30,000

  30,400

  Castlereagh

  58,400

  58,000

  57,900

  58,000

  58,000

  Coleraine

  47,300

  47,600

  47,700

  48,100

  48,500

  Cookstown

  27,900

  27,800

  27.700

  27,600

  27,600

  Craigavon

  75,300

  76,100

  76,600

  77,200

  77,700

  Derry

  95,300

  95,700

  97,500

  98,700

  99,500

  Down

  55,400

  55,800

  56,400

  57,000

  57,200

  Dungannon

  43,900

  43,800

  43,900

  43,700

  43,700

  Fermanagh

  51,400

  51,000

  50,300

  50,000

  50,400

  Lame

  28,600

  28,600

  28,700

  29,000

  29,100

  Limavady

  28,900

  29,100

  29,600

  30,000

  29,800

  Lisburn

  90,900

  91,900

  92,900

  95,500

  97,400

  Magherafelt

  33,000

  33,200

  33,300

  33,100

  32,900

  Moyle

  15,000

  15,100

  15,200

  15,200

  15,100

  ewry and Mourne

  84,700

  86,100

  87,100

  87,800

  88,900

  Newtownabbey

  72,100

  72,200

  72,300

  72,800

  72,900

  North Down

  69,300

  69,800

  70,700

  71,100

  71,900

  Omagh

  44,900

  54,100

  45,800

  44,900

  44,900

  Strabane

  35,800

  35,900

  35,700

  35,200

  35,600

  Totals

  1,557,800

  1,566,800

  1,575,200

  1,578,100

  1,583,000

  Figures for 1990 will not be available until mid-1991.

  Estimated Electorate

  Local Authority

  1986

  1987

  1988

  1989

  1990

  Antrim

  27,131

  27,572

  27,834

  29,054

  29,669

  Ards

  44,288

  45,266

  45,669

  46,571

  47,697

  Armagh

  34,979

  35,417

  35,181

  35,195

  35,776

  Ballymena

  39,020

  39,304

  39,611

  40,769

  41,619

  Ballymoney

  16,499

  16,685

  16,665

  17,072

  17,396

  Banbridge

  23,322

  23,600

  23,782

  24,080

  24,537

  Belfast

  216,772

  220,326

  218,611

  214,065

  214,158

  Carrickfergus

  21,073

  21,627

  21,858

  22,816

  23,554

  662
  Schmidbaver in 1987 to 1989; and what arrangements are in place to obtain for his Department copies of reports produced by Parliaments of European Community member states on global warming and greenhouse gas emissions.

  Mr. Trippier
  [holding answer 31 January 1991]: Copies of the German parliamentary commission's report have been obtained by the Department. We receive such reports through British embassies in other member states and through direct contacts with the Governments of member states.

NORTHERN IRELAND

  Local Authority Statistics
  Mr. John D. Taylor
  To ask the Secretary of State for Northern Ireland was was(a) the estimated population, (b) the estimated electorate and (c) the estimated total net valuation in each of the past five years for each of the 26 local authorities in Northern Ireland.

  Dr. Mawhinney
  The information requested is set out in the tables.
  663

  Local Authority

  1986

  1987

  1988

  1989

  1990

  Castlereagh

  45,580

  46,005

  46,052

  46,739

  47,435

  Coleraine

  33,960

  34,623

  34,897

  35,697

  36,717

  Cookstown

  20,433

  20,551

  20,757

  20,830

  21,254

  Craigavon

  51,293

  51,716

  51,552

  52,764

  53,657

  Derry

  57,809

  58,310

  59,862

  60,423

  61,999

  Down

  36,867

  37,269

  37,735

  38,697

  39,440

  Dungannon

  30,906

  30,991

  31,269

  31,270

  31,919

  Fermanagh

  38,052

  37,868

  37,495

  37,300

  38,615

  Lame

  20,926

  21,295

  21,303

  21,794

  22,184

  Limavady

  17,292

  17,514

  18,369

  18,534

  18,739

  Lisburn

  60,660

  61,551

  62,627

  65,490

  67,825

  Magherafelt

  23,867

  24,378

  24,662

  24,664

  25,028

  Moyle

  10,135

  10,210

  10,289

  10,404

  10,546

  Newry and Mourne

  53,542

  54,709

  54,763

  55,980

  57,387

  Newtownabbey

  52,249

  52,718

  52,751

  53,674

  54,577

  North Down

  49,299

  50,089

  50,833

  51,660

  53,224

  Omagh

  29,550

  29,884

  29,992

  29,933

  30,410

  Strabane

  23,578

  24,023

  24,062

  23,975

  25,233

  TOTALS

  1,079,082

  1,093,501

  1,098,481

  1,109,450

  1,130,595

  Total non-exempt net annual value

  Local authority

  1985–86 (£)

  1986–87 (£)

  1987–88 (£)

  1988–89 (£)

  1989–90 (£)

  Antrim

  5,830,012

  5,994,112

  6,187,649

  6,513,335

  6,570,755

  Ards

  6,763,974

  6,924,571

  7,005,564

  7,180,240

  7,321,190

  Armagh

  4,271,435

  4,488,904

  4,563,290

  4,677,142

  4,747,395

  Ballymena

  7,039,259

  7,228,749

  7,379,867

  7,534,520

  7,684,498

  Ballymoney

  2,198,716

  2,275,208

  2,341,678

  2,396,412

  2,427,267

  Banbridge

  3,018,341

  3,147,404

  3,222,734

  3,316,300

  3,390,459

  Belfast

  48,306,943

  49,953,444

  50,605,570

  51,043,470

  51,732,828

  Carrickfergus

  4,119,067

  4,258,133

  4,357,282

  4.535,074

  4,684,614

  Castlereagh

  6,946,923

  7,139,971

  7,294,741

  7,408,177

  7,649,732

  Coleraine

  6,715,965

  6,886,587

  7,015,869

  7.213.131

  7,385,174

  Cookstown

  2,588,584

  2,674,125

  2,766,598

  2.X35.745

  2,905,501

  Craigavon

  9,128,023

  9,636,690

  9,753,690

  9,903,051

  10,035,007

  Derry

  10,292,053

  10,496,041

  10,713,397

  10,910,232

  11,126,709

  Down

  5,033,246

  5,133,055

  5,256,985

  5,420,047

  5,588,768

  Dungannon

  3,760,555

  3,917,281

  4,026,362

  4,153,398

  4,240,870

  Fermanagh

  4,308,166

  4,544,234

  4,667,363

  4,770,953

  4,938,799

  Lame

  3,515,785

  3,608,122

  3,637,364

  3,699,924

  3,815,754

  Limavady

  2,436,042

  2,496,315

  2,565,414

  2,611,704

  2,661,796

  Lisburn

  10,977,484

  11,360,776

  11,563,568

  11,997,608

  12,422,095

  Magherafelt

  2,849,759

  2,974,285

  3,028,959

  3,127,147

  3,243,890

  Moyle

  1,255,239

  1,303,200

  1,324,525

  1,355,398

  1,381,285

  Newry & Mourne

  6,577,276

  6,851,324

  7,121,027

  7,432,529

  7,673,345

  Newtonabbey

  10,115,650

  10,377,191

  10,515,650

  10,639,684

  10,585,369

  North Down

  8,207,959

  8,422,604

  8,537,887

  8,687,086

  8,835,188

  Omagh

  3,561,677

  3,741,905

  3,886,309

  4,013,140

  4,121,208

  Strabane

  2,555,439

  2,656,999

  2,725,852

  2,818,197

  2,978,889

  Totals

  182,373,572

  188,491,230

  192,065,194

  196,193,644

  200,148,385

  Cash Limits
  Mr. Beaumont-Dark
  To ask the Secretary of State for Northern Ireland if he will make a statement on cash and running cost limits for Northern Ireland departmental services and the Northern Ireland Office in 1990–91.

  Dr. Mawhinney
  Subject to parliamentary approval of the necessary associated supplementary estimates, it is proposed that the cash limit for the Northern Ireland Office (NIO1) will be increased by £16.5 million from £683.5 million to £700.0 million.

  The cash limit for Northern Ireland departmental services (NID1) for 1990–91 will be decreased by £27·8 million from £2,949·3 million to £2,921·5 million. This change reflects increases in respect of VAT compensation (£1·9 million) and running costs carried over from 1989–90 under end-year flexibility arrangements (£2·2 million). It also reflects decreases in respect of transfers to the
  664
  Northern Ireland Office of some £16 million and technical changes of some £16 million, the majority of which were transfers to non cash-limited areas within Northern Ireland Departments.

  The running cost limit for Northern Ireland Office and Northern Ireland Departments will be increased by £3,818,000 from £592,597,000 to £596,415,000 primarily reflecting the take-up of end-year flexibility entitlement of £2,697,000, as announced by the Chief Secretary to the Treasury on 25 July 1990, Official Report, column 235–40, and a transfer of £1,079,000 from the Department of Social Security in respect of services operated on an agency basis by the Departments of Health and Social Services. The revised running cost provision is £150,614,000 for the Northern Ireland Office and £445,801,000 for Northern Ireland Departments.

  Paymaster General's Office (Cash Limits)
  Mr. Paice
  To ask the Secretary of State for Northern Ireland what changes are proposed to the cash and running costs limits for 1990–91 in respect of the Paymaster General's Office.

  Mr. Hanley
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for the Paymaster General's Office (class XVIII, vote 12) will be increased by £170,000 from £19,120,000 to £19,290,000 and the running cost limit by £85,000 from £17,573,000 to £17,658,000. The increases in running costs mainly reflects an increase in postal charges. The increase in cash limit also includes a reduction in receipts from the national insurance fund.

  These increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

PRIME MINISTER

  Katyn Massacre
  Mr. Pawsey
  To ask the Prime Minister if he will place in the Library, copies of all official statements made or published by members of the Government on the Katyn massacre since I January 1961.

  The Prime Minister
  The information is not readily available and coud be provided only at disproportionate cost. Ministers have answered many questions in the House about the Katyn massacre. I refer my hon. Friend to the replies given by my hon. Friend the Minister of State, Foreign and Commonwealth Office to him on 23 and 30 November.

  "The Times" Article
  Mr. Sillars
  To ask the Prime Minister if the article written by the Secretary of State for Foreign and Commonwealth Affairs for The Times on 17 January represented Government policy.

  The Prime Minister
  Yes.

  Conscription Forms
  Mr. Dalyell
  To ask the Prime Minister what steps have been taken by Her Majesty's Government to print conscription forms.

  The Prime Minister
  None.

  Gulf Oil Slick
  Mr. Dalyell
  To ask the Prime Minister if he will make a statement on the co-ordinating arrangements with the Gulf states for dealing with the Gulf oil slick.

  The Prime Minister
  The United Kingdom is maintaining close touch through diplomatic channels with the Gulf states affected, who are leading the response to the environmental damage that Iraq is inflicting on the region. The Government have responded promptly and positively to requests received from the Saudi Arabian Government for expert advice on oil pollution control and on the care of oiled birds and stand ready to respond to 666
  any further requests. The Government have stated their readiness to help to contribute to the response of the international community through such bodies as the European Communities and the United Nations Environment Programme and have called successfully in the OECD for commitment to action to improve the world's common response for the future to events of this kind.

  Cabinet Office (Cash Limits)
  Mr. Roger King
  To ask the Prime Minister, if there are any proposals to change the 1990–91 running costs limit or cash limit for the Cabinet Office: other services.

  The Prime Minister
  The running costs limit for the Cabinet Office: other services will be increased by £622,000 from £18,074,000 to £18,696,000. This increase is offset by reductions in the running costs limits of £510,000 for the Foreign and Commonwealth Office, £38,000 for the Department of Trade and Industry and £74,000 for Her Majesty's Treasury and reflects the transfer of the responsibility for certain administrative functions. At the same time the cash limit for the Cabinet Office: other services will be reduced by £728,000 from £21,256,000 to £20,528,000. This reflects the reprofiling of the timetable of a major capital project. Expenditure will now fall in later years.

THE ARTS

  Cash Limits
  Mr. Robert G. Hughes
  To ask the Minister for the Arts if he will give details of any proposed changes to the cash limits of his Department's votes in 1990–91.

  Mr. Renton
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit of class XIII, vote 2, is being increased from £199,025,000 to £199,867,000 to facilitate the additional provision of £842,000 to the Arts Council of Great Britain. The increase will be met by a corresponding saving on class XVI, vote 5, which is accounted for by the Welsh Office.

  This change is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

CIVIL SERVICE

  Executive Agencies
  Mr. Hind
  To ask the Minister for the Civil Service if he will list the "next steps" agencies created since 1 January 1990; and if he will make a statement.

  Mr. Renton
  Since 1 January 1990, 24 "next steps" agencies have been established and these are listed in the table. In total 34 agencies have been set up covering some 80,000 staff. The project is continuing to make excellent progress: we expect there to be about 50 agencies by this summer and by the end of the year we expect that "next steps" will apply to about half the civil service.
  667

  Agencies established since 1 January 1990

  Executive agencies

  Staff number

  Building Research Establishment

  690

  Central Office of Information

  730

  Central Veterinary Laboratory

  580

  Driver and Vehicle Licensing Agency

  5,450

  Driving Standards Agency

  2,200

  Employment Service

  33,500

  Hydrographic Office1

  880

  Information Technology Services Agency

  3,350

  Insolvency Service

  1,450

  Intervention Board

  910

  Land Registry

  10,400

  Meteorological Office

  2,250

  National Engineering Laboratory

  430

  National Physical Laboratory

  820

  Natural Resources Institute

  90

  Occupational Health Service

  100

  Ordnance Survey

  2,500

  Patent Office

  150

  Radiocommunications Agency

  500

  Registers of Scotland

  1,100

  Royal Mint

  1,050

  Training and Employment Agency2

  1,700

  Vehicle Certification Agency

  90

  Veterinary Medicines Directorate

  70

  Total of 24 in number

  72,290

  1 Defence Support Agency. Figure does not include service personnel.

  2 Northern Ireland Civil Service.

  Figures based on Staff in Post as at 1 October 1990.

  Cash Limits
  Mr. Stevens
  To ask the Minister for the Civil Service if there are any proposals to change the 1990–91 running costs limit for the office of the Minister for the Civil Service.

  Mr. Renton
  Subject to parliamentary approval of the necessary supplementary estimate, the running costs limit for the Office of the Minister for the Civil Service (class XIX, vote 1) will be increased by £155,000 from £33,864,000 to £34,019,000. The increase will be offset by increased appropriations in aid.

  The increase is required to meet increased demand for training and occupational health services provided by the Civil Service college and civil service occupational health service, respectively. The supplementary estimate includes a transfer of provision from the Foreign and Commonwealth Office to reflect the transfer of responsibility for purchasing certain press summaries.

  In addition, the amounts listed in the table will be transferred to the Departments and agencies shown to meet part of the cost of increased management development training under the challenge funding scheme initiated by my Department. This will be met from existing but unallocated public expenditure provision.

  £'000

  Ministry of Defence

  37

  Department of Employment

  452

  Inland Revenue

  182

  Northern Ireland Civil Service

  31

  Northern Ireland Office

  21

  Department of Social Security

  60

  Department of Transport

  5

  Vehicle Inspectorate

  2

  TOTAL

  790

SOCIAL SECURITY

  Disability Working Allowance
  Mr. Hannam
  To ask the Secretary of State for Social Security if receipt of disability working allowance will entitle a recipient to national insurance credits if their earnings are below the national insurance lower earnings limit.

  Mr. Scott
  We have given consideration to the representations that we received and have decided, exceptionally, that disability working allowance claimants will be awarded national insurance credits for periods when earnings fall below their lower earnings limit.

  Child Benefit
  Mr. Nicholas Brown
  To ask the Secretary of State for Social Security if he will estimate the change in Exchequer income during the 1991–92 financial year resulting from restoring child benefit, for all children, to its April 1987 value in real terms.

  Mr. Jack
  It is estimated that benefit expenditure in 1991–92 would increase by about £775 million if the level of child benefit reflected the movements in the index of retail prices which applied to the annual uprating of benefits generally from April 1988.

  Income Support Deductions
  Mr. Meacher
  To ask the Secretary of State for Social Security if he will update his answer to the hon. Member for Coventry, South-East (Mr. Nellist) on 22 October 1990,Official Report, column 78, on income support deductions.

  Miss Widdecombe
  The latest count showed that 85 offices had income support cases with a deduction to clear community charge arrears. The number of deductions for each office is shown in the table.

  Local office

  Number of deductions

  Scotland

  Aberdeen (N)

  1

  Airdrie

  229

  Ayr

  383

  Bathgate

  67

  Bellshill

  887

  Campbeltown

  7

  Clydebank

  248

  Coatbridge

  634

  Cowdenbeath

  274

  Cumbernauld

  969

  Dumbarton

  511

  Dumfries

  1

  Dundee (E)

  29

  Dunfermline

  246

  East Kilbride

  154

  Falkirk

  824

  Galashiels

  493

  Glasgow Anniesland

  517

  Glasgow Bridgeton

  470

  Glasgow City

  245

  Glasgow Cranstonhill

  1

  Glasgow Craigton

  968

  Glasgow Laurieston

  733

  Glasgow Maryhill

  375

  Glasgow Partick

  264

  Glasgow Provan

  640

  Glasgow Shettleston

  786

  669

  Local office

  Number of deductions

  Glasgow Southside

  764

  Glasgow Springburn

  1,006

  Greenock

  486

  Hamilton

  418

  Irvine

  131

  Johnstone

  15

  Kilmamock

  536

  Kirkaldy

  229

  Leven

  39

  Motherwell

  839

  Oban

  12

  Paisley

  481

  Perth

  12

  Port Glasgow

  241

  Stirling

  1,391

  Sub Total

  17,556

  England and Wales

  Crewe

  21

  Liverpool Belle-Vale

  119

  Liverpool Crosby

  11

  Liverpool Kirkby

  896

  Manchester Cheetham

  17

  St. Helens

  35

  Warrington

  6

  Berwick

  IS

  Chester le Street

  145

  Gateshead

  550

  Goole

  137

  Hull (W)

  28

  Newcastle (W)

  1

  Pontefract

  1

  South Shields

  64

  Stanley

  86

  Stockton

  1

  Sunderland (N)

  1

  York

  3

  Birmingham South Yardley

  21

  Boston

  56

  Coventry (W)

  32

  Hereford

  9

  Rugby

  5

  Shrewsbury

  2

  Aberdare

  17

  Barry

  32

  Bournemouth

  1

  Cardiff Central

  4

  Cardiff (E)

  1

  Chippenham

  12

  Poole

  5

  Porthmadog/Dolgellau

  15

  Salisbury

  4

  Tonypandy

  6

  Torbay

  43

  Diss

  2

  Ashford

  2

  Gravesend

  1

  Year

  Payments

  Payments

  £ cash value

  £ real value at 1990–91 price

  A

  Nottingham B

  Nationally C

  Nottingham D

  Nationally E

  Nottingham F

  Nationally G

  1980–81

  280,000

  1

  3,600,000

  Nil

  6,600,000

  Nil

  1981–82

  Nil

  Nil

  Nil

  Nil

  Nil

  Nil

  1982–83

  Nil

  Nil

  Nil

  Nil

  Nil

  Nil

  1983–84

  Nil

  Nil

  Nil

  Nil

  Nil

  Nil

  1984–85

  170,000

  2,108

  1,700,000

  19,794·25

  2,400,000

  20,857·80

  1985–86

  450,000

  4,143

  11,600,000

  96,668·45

  15,600,000

  129,948·50

  1986–87

  2,000,000

  20,247

  10,200,000

  101,23500

  13,300,000

  131,589·50

  1987–88

  99,000

  Nil

  500,000

  Nil

  600,000

  Nil

  1988–89

  502

  Nil

  2,510

  Nil

  2,884

  Nil

  1989–90

  44,448

  Nil

  406,481

  Nil

  438,999

  Nil

  1 No information available.

  670

  Local office

  Number of deductions

  Hastings

  9

  Isle of Wight

  8

  Kingston

  3

  New Forest

  1

  New Maiden

  24

  Tunbridge Wells

  6

  Sub Total

  2,458

  TOTAL

  20,014

  Disability Living Allowance
  Mr. Hannam
  To ask the Secretary of State for Social Security what representations he has received with regard to good cause backdated claiming within prescribed time for claims of the attendance or mobility component of the disability living allowance.

  Mr. Scott
  We received a large number of comments on the consultation document on disability living allowance of which only a handful commented on the issue of backdating the mobillity and care components of disability living allowance.

  Severe Weather Payments
  Mr. Allen
  To ask the Secretary of State for Social Security if he will list the temperatures used to trigger severe weather payments recorded in each of the stations relevant to the city of Nottingham for each day during the last two weeks of 1990 and those weeks in 1991 for which figures are available.

  Mr. Scott
  A weather station will trigger if there has been a period of seven consecutive days, during which the average mean daily temperature is 0 deg C or less.

  Watnall weather station, which covers the city of Nottingham, did not trigger on any day during the last two weeks of 1990, nor at any time during 1991 to date.

  Full details of average mean daily temperatures recorded at all the weather stations can be found in the Library.

  Mr. Allen
  To ask the Secretary of State for Social Security if he will list in table form for Nottingham and for the United Kingdom(a) the total number of recipients and (b) the total values of the payments in (i) cash and (ii) constant terms, under the exceptionally severe weather payments in each year from 1980–81 to 1990–91 under the social fund exceptionally cold weather payments.

  Mr. Scott
  The information is as follows:
  671
  Note:

  The variations in numbers of annual payments made can be attributed to the mild weather experienced in certain years rather than changes in criteria and legislation.

  Columns B and C relate to payments made and not to the number of recipients.

  Benefits
  Mr. Allen
  To ask the Secretary of State for Social Security if he will publish in table form his Department's policy in respect of recovery of overpayment of benefit in the case of each benefit for which his Department is responsible.

  Mr. Jack
  Section 53 of the Social Security Act 1986 applies a common test to the recovery of overpaid social security benefits. The statutory test is whether the overpayment results from"misrepresentation or failure to disclose a material fact".

  The independent adjudicating authorities administer this test, deciding whether an overpayment has occurred and whether it is recoverable. If an overpayment is determined to be recoverable the Department on behalf of the Secretary of State is entitled to seek recovery.

  Freephone Lines
  Mr. Allen
  To ask the Secretary of State for Social Security how many freephone lines are operated by his Department; what trends are evident in the level of provision and use; and if he will make a statement.

  Miss Widdecombe
  The freeline social security service provides general benefits information on 125 lines at 10 centres throughout Great Britain. The service is provided in Punjabi, Urdu and Welsh as well as English. The following specialist freeline services are also provided: social security advice line for employers; family credit freeline; Gulf crisis freeline; benefit advice line for people with disabilities.

  The Department's freeline services have been regularly expanded and modernised since their 1984 launch and altogether are now taking more than 2 million calls per year. They are important and successful parts of the Department's information and advice service.

  Gulf Crisis
  Mr. Allen
  To ask the Secretary of State for Social Security if he will list the differences in benefits that would be payable to those involved or affected by the conflict in the Gulf if the claim arose during(a) an officially declared war or (b) in an engagement in hostilities.

  Miss Widdecombe
  Entitlement to war pensions and social security benefits administered by the Department is not affected by whether a claim arose during an officially declared war or in an engagement in hostilities.

  Severe Disablement Premium
  Mr. Hinchliffe
  To ask the Secretary of State for Social Security what assessment he has made of the implications of the introduction of the severe disablement premium for the financial circumstances of carers who are precluded from claiming invalid care allowance.

  Miss Widdecombe
  The severe disability premium is intended to focus extra help on those severely disabled people who are most likely to need to buy in care, because they live alone and do not have a carer who is receiving invalid care allowance. A person receiving the severe 672
  disability premium who has a carer who is, for whatever reason, precluded from claiming invalid care allowance is, as a result of this premium, in a better position to make some payment to the carer.

  Mr. Hinchliffe
  To ask the Secretary of State for Social Security what is his estimate of the number of carers who are precluded from claiming invalid care allowance because the person they are caring for is in receipt of severe disablement premium.

  Miss Widdecombe
  None. The receipt of the severe disability premium by a disabled person does not preclude his carer from claiming invalid care allowance.

  Cash Limits
  Mr. Nicholls
  To ask the Secretary of State for Social Security whether there have been any changes in the cash limits or running costs limit of his Department for 1990–91.

  Mr. Scott
  Subject to parliamentary approval of the necessary supplementary estimate the cash limit for class XIV, vote 7 (administration and miscellaneous services) will be increased by £59,013,000 from £1,706,375,000 to £1,765,388,000. The revision takes account of the transfer of industrial injury benefit from the national insurance fund to the consolidated fund, as provided for in the Social Security Act 1990 (£59,000,000). In addition, running cost changes result from a transfer from the Office of the Minister for the Civil Service (class XIX, vote 1), £60,000, a transfer to Scottish Office administration (class XV, vote 21) £42,000, and a transfer to Department of Health (class XIII, vote 3) £5,000. There is also an increase of £23,999,000 to take account of expenditure previously classified as capital now being regarded as running costs. The increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  As a result of these changes the running costs limit of the Department of Social Security is increased by £24,012,000 from £1,931,176,000 to £1,955,188,000.

NATIONAL FINANCE

  Income Tax
  Mr. Squire
  To ask the Chancellor of the Exchequer if he will publish a table which sets out, for a two-child family on(a) half, (b) three quarters, (c) full, (d) one and a half times, (e) twice, (f) five times and (g) ten times average earnings, the increase in net income to be derived from (i) a one pence cut in the standard rate of income tax in the 1991–92 financial year, (ii) an increase in personal allowances, over the above indexation, which incurred the same cost as a one pence cut in the standard rate income tax, (iii) an increase in child benefit which incurred the same cost as a one pence cut in standard rate income tax, both assuming and not assuming similar increases in the income support and family credit children's rates separately and (iv) the introduction of reduced rate tax bands of (1) 20 per cent. and (2) 15 per cent. at the same

  673
  cost as a one pence cut in standard rate income tax, showing what band of income the reduced rate would cover.

  Mr. Maude
  The effects of the various changes to income tax and child benefit on a married man with two

  Increase in income after tax1 (£ per week) compared with indexation in 1991–92 for a married man2 with two children

  Mulitiple of average earnings3

  ½

  ¾

  1

  1½

  2

  5

  10

  (i)Increase derived from 1p cut in basic rate

  0·67

  1·50

  2·34

  4·01

  4·41

  4·41

  4·41

  (ii) Increase in main income tax allowances

  1·68

  1·68

  1·68

  1·68

  2·70

  2·70

  2·70

  (iii) Increase in child benefit

  (a) £4·30 per week per child4

  2·26

  8·60

  8·60

  8·60

  8·60

  8·60

  8·60

  (b) £3·07 per week per child5

  6·14

  6·14

  6·14

  6·14

  6·14

  6·14

  6·14

  (iv) Reduced rate band of 20 per cent, on first £1,600 of

  taxable income

  1·54

  1·54

  1·54

  1·54

  1·54

  1·54

  1·54

  (v) Reduced rate band of 15 per cent, on first £750 of

  taxable income

  1·44

  1·44

  1·44

  1·44

  1·44

  1·44

  1·44

  Notes:

  1 Disregarding any change to entitlement to social security income-related benefits except in item (iii)(b).

  2 Assumed to have no reliefs and allowances other than the personal allowance and the married couple's allowance.

  3 Average earnings assumed to be £334.1 per week.

  4 Assuming no change in income support and family credit children's rates.

  5 Assuming corresponding changes in income support and family credit children's rates.

  Holiday Homes
  Mr. Simon Coombs
  To ask the Chancellor of the Exchequer what consultations took place with representatives of the tourism industry before the decision was taken to impose value added tax on the purchase of holiday homes.

  Mrs. Gillian Shephard
  The change in VAT liability referred to was one of a number of VAT coverage changes made in the Finance Act 1989. The position was made clear to the main trade association concerned in May 1989. The provision imposing the standard rate on holiday homes was subsequently found to be defective in a recent decision in a VAT tribunal. The statutory instrument was designed to return the legal position largely to what was intended in 1989. Before it was debated by the Standing Committee, I met representatives of the British Holiday and Home Parks Association and explained to them that, as tourist services, with the exception of public transport, are liable to VAT I saw no compelling case for a special relief for new, restricted occupancy holiday homes.

  VAT (Animals)
  Sir Eldon Griffiths
  To ask the Chancellor of the Exchequer (1) what value added tax rate is payable on the sale of(a) pedigree cattle, (b) pigs, (c) goats, (d) rabbits and (e) shire, show and draught horses;

  (2) what rate of value added tax applies to (a) bloodstock race horses and (b) other types of horse.

  Mrs. Gillian Shephard
  Live animals of a kind generally used as, or yielding or producing food for human consumption, including cattle, pigs, goats and rabbits, are zero-rated for VAT. Other animals, including horses of all types, are taxable at the standard rate of 15 per cent.

  Unitary Taxation
  Sir John Stanley
  To ask the Chancellor of the Exchequer whether the Government's review of the situation on unitary taxation with the United States 674
  children are shown in the table. In a full year each of the changes would cost about £1·95 billion which is the cost of a 1 p cut in the basic rate of income tax. Estimates are based on projections of the 1988–89 survey of personal incomes in line with forecasts in the autumn statement.

  Treasury referred to by the then Financial Secretary to the Treasury on 18 December 1989 at column 176, has now been completed; and if he will make a statement.

  Mr. Lamont
  The review has been extended to take account of the outcome of the case of Barclays Bank International Ltd.v. Franchise Tax Board of the State of California in the Californian appeal court. A decision has now been given in this case and it is hoped to complete the report in the near future.

  Endangered Species
  Mr. Tony Banks
  To ask the Chancellor of the Exchequer if he will give details of articles relating to rare and endangered species seized by Her Majesty's Customs and Excise in the last complete year for which statistics are held.

  Mrs. Gillian Shephard
  In the year to 31 March 1990 Customs seized 1,546 live animals and birds, 188 plants and 7,148 parts and derivatives (such as elephant tusks, stuffed animals and birds and goods made from ivory or reptile leather) because their importation or exportation contravened the restrictions imposed by the Endangered Species (Import and Export) Act 1976 or Council regulation No. 3626/82.

  Cigarettes
  Mr. Pendry
  To ask the Chancellor of the Exchequer what has been the increase in the tax take on cigarettes in real terms since 1987.

  Mrs. Gillian Shephard
  In the year to September 1990 estimated real receipts from excise duty and value added tax on cigarettes were 8 per cent. lower than in 1987.

  Cash Limits
  Mr. David Martin
  To ask the Chancellor of the Exchequer what changes are proposed in the cash limit and running cost limit for 1990–91 for Customs and Excise.

  Mrs. Gillian Shephard
  Subject to parliamentary approval of the necessary supplementary estimate, the
  675
  cash limit for class XVIII, vote 6 will be increased by £23,438,000 from £647,862,000 to £671,300,000 and the running costs limit by £1,380,000 from £575,799,000 to £577,179,000. The increase in the running costs limit arises from the need to enforce sanctions against trade with Iraq and for extra costs associated with a survey for the Central Statistical Office and a centrally organised telecommunications system project. The increase in the cash limit otherwise is almost wholly accounted for by the need to pay interest on large refunds of VAT being made as a result of recent legal decisions in both United Kingdom and European Community courts. There is also a predicted shortfall in receipts due mainly to a lower-than-expected number of requests by traders for out of hours attendance by officers.

  The increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Mr. Hannam
  To ask the Chancellor of the Exchequer whether any changes are proposed in the cash limit and running cost limit for 1990–91 for the Inland Revenue.

  Mr. Maude
  Subject to parliamentary approval of the necessary supplementary estimate the cash limit for class XVIII, vote 7 will be increased by £4,167,000 from £1,403,945,000 to £1,408,112,000 and the Department's running cost limit by £182,000 from £1,327,395,000 to £1,327,577,000. The change in the running costs limit arises from a transfer from the Cabinet Office (Office of the Minister for the Civil Service) for challenge funding (class XX, vote 1). The change in cash limit also includes the full take-up of the capital end-year flexibility entitlement announced by the Chief Secretary to the Treasury on 25 July 1990. The increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Mr. Moate
  To ask the Chancellor of the Exchequer whether there will be any changes to the Treasury's cash and running costs limits in 1990–91.

  Mr. Mellor
  Subject to parliamentary approval of the necessary supplementary estimates, the cash limit for class XVIII, vote 1 will be increased by £407,000 from £77,531,000 to £77,938,000.

  The cash limit increase reflects the take-up of £509,000 of the entitlement to carry forward capital underspends announced by my predecessor on 25 July 1990, Official Report, columns 235–38, offset by a net reduction of £102,000 in provision for running costs expenditure in the light of reduced requirements. The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  A token supplementary estimate will be sought for class XVIII, vote 3, reflecting higher running costs and other expenditure by the Civil Service Catering Organisation in the light of increased trading activity fully offset by an increase in receipts from their customers. The increase in running costs expenditure partly reflects the take-up of the full entitlement of £377,000 to carry forward running costs underspends announced on 25 July 1990.

  As a result of these changes, the running costs limit of Her Majesty's Treasury will be increased by £1,988,000 from £83,147,000 to £85,135,000.

  Mr. Moss
  To ask the Chancellor of the Exchequer whether he is proposing any change to the Central Statistical Office's running cost limit for 1990–91.
  676
  Mr. Maples
  Subject to parliamentary approval of the necessary token supplementary estimate, the running cost limit for class XVIII, vote 13 will be increased by £26,000 from £22,457,000 to £22,483,000. The increase reflects the measures planned, in response to the 34th report, Session 1989–90, of the Committee of Public Accounts (Cmnd 1323), to improve the quality of price collection for the retail prices index. The increase in provision for these measures is offset by savings in the capital provision on the same vote.

  Mr. Hind
  To ask the Chancellor of the Exchequer what changes he proposes to make to the cash and running cost limits for 1990–91 for the National Investment and Loans Office.

  Mr. Maples
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XVIII, vote 11 will be increased by £249,000 from £1,000 to £250,000. The additional provision is required to cover a shortfall in fees payable on loans to local authorities. The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement. The running costs limit will be reduced by £169,000 from £1,369,000 to £1,200,000.

  Economic and Finance Council
  Mr. Bowis
  To ask the Chancellor of the Exchequer if he will make a statement on the outcome of the latest meeting of the European Community's Economic and Finance Council.

  Mr. Norman Lamont
  The ECOFIN Council met in Brussels on 28 January. The inter-governmental conference on economic and monetary union met later the same day. I represented the United Kingdom at both meetings.

  The meeting began with a discussion of the economic situation in member states as part of the multilateral surveillance under stage 1 of economic and monetary union. It was generally agreed that strict monetary policy was essential, and that structural improvements were needed, particularly in the employment market and that saving and investment needed to be increased and budget deficits reduced.

  The presidency introduced its work programme on VAT and excise questions which was endorsed by the Council. I also made a statement emphasising the importance of the recent report on export refunds by the European Court of Auditors, which highlighted the need for improvements in the management of this significant area of the Community budget, in part to reduce the risk of fraud. It was agreed that progress in meeting the court's recommendations should be carefully monitored.

  On the basis of a report that the Commission had received pledges of $500 million from non EC members of the G24 and others for a loan to Czechoslovakia, the Council agreed that the Community would contribute a further $500 million and that the necessary legal texts should be adopted as soon as possible. The Council also agreed that the Community would pledge a 50 per cent. contribution, up to $250 million, to a loan by the G24 to Hungary.

  Over lunch, I also raised the question of burden-sharing by other countries for the costs of the war in the Gulf, and emphasised the substantial contribution being made to the allied operations by the United Kingdom.
  677
  A balance of payments loan to Greece of the order of 2·2 billion ecu (about £1½ billion) was agreed in principle. The first tranche will consist of the order of 1 billion ecu, but the release of further tranches will be decided by the Commission in consultation with the Council in the light of the Greek Government's performance in implementing its programme of economic reform. The formal decision will set out the precise conditions for the granting of this loan and will be taken at the next meeting of the Council on 25 February.

  The meeting of the intergovernmental conference focused on procedure, endorsing a proposal by the Presidency that the IGC should concentrate on drafting treaty texts and agreeing, in broad terms the work programme of the next meetings of the IGC. France and Spain introduced proposals on economic and monetary union. The next meeting of the IGC at ministerial level will be on 25 February.

HEALTH

  Psychiatric Patients
  Mr. Robin Cook
  To ask the Secretary of State for Health what information he has on the number of patients from psychiatric institutions who were released into the community and who have been readmitted to psychiatric institutions over the last 10 years.

  Mr. Dorrell
  This information is not collected centrally.

  Baby Care Units
  Mrs. Ray Michie
  To ask the Secretary of State for Health how much funding was provided for special care baby units for each year since 1979; and if he will make a statement.

  Mr. Dorrell
  This information is not held centrally.

  Medicine Labelling
  Mr. Cummings
  To ask the Secretary of State for Health if he will introduce legislation for the mandatory labelling of medicines in large print and braille; and if he will make a statement.

  Mrs. Virginia Bottomley
  There are no plans to do so.

  All medicines labelling has to be clearly printed but the provision of braille labelling presents technical difficulties, not least being the lack of space available in which to carry the information required. I understand that some work has been done on this and that the Royal Pharmaceutical Society is having discussions with industry.

  Prescription Charges
  Mr. Viggers
  To ask the Secretary of State for Health whether leukaemia sufferers are exempted from prescription charges.

  Mrs. Virginia Bottomley
  Leukaemia sufferers are not automatically entitled to free NHS prescriptions. Those in financial need will qualify for help. There are extensive general exemption arrangements designed to protect those who are likely to have difficulty in paying. Prescription pre-payment certificates are also available for anyone who does not qualify for exemption but who needs a lot of 678
  medication, and these can lead to considerable savings. As a result of the present exemption arrangements and pre-payment certificate scheme, a prescription charge is paid on less than one item in five dispensed.

  OPCS Cash Limits
  Mr. Paice
  To ask the Secretary of State for Health if he has any changes to the cash limits for the Office of Population Censuses and Surveys for 1990–91.

  Mr. Dorrell
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XIII, vote 6 (Office of Population Censuses and Surveys) will be increased by £220,000 from £48,878,000 to £49,098,000. This reflects an increase of £220,000 in capital provision towards the fitting out of the 1991 census regional processing office at Hillington in Glasgow (this represents a timing change within the overall 1991 census expenditure); an increase of £272,000 in the social survey area exempt from gross running cost control for development work on the enlarged labour force survey. This latter cost will be met from within the existing resource of the Department of Employment (class VI, vote 2) and will be financed by an equivalent increase in appropriations in aid. The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Myalgic Encephalomyelitis
  Mr. John Greenway
  To ask the Secretary of State for Health what is his Department's current spending on research into myalgic encephalomyelitis; and whether he has plans to increase this in the next financial year.

  Mr. Dorrell
  I refer my hon. Friend to the replies I gave to the hon. member for Kingston upon Hull, North (Mr. McNamara) on 15 October 1990 at column 659.

  Census
  Mrs. Maureen Hicks
  To ask the Secretary of State for Health how he has decided to obtain independent advice on the confidentiality arrangements for samples of anonymised records from the 1991 census.

  Mr. Dorrell
  The president of the Royal Statistical Society, having been consulted about the best procedure, has nominated Professor D. Holt, deputy vice chancellor of the University of Southampton, as technical assessor. I am pleased to be able to announce that Professor Holt has agreed to act in this capacity. He will consider I he confidentiality arrangements for the samples of anonymised records (SARs) requested from the 1991 census of Great Britain by the Economic and Social Research Council (ESRC), and will assess whether or not the arrangements ensure that any risk of inadvertent disclosure of census information about identifiable individuals is minimised. He will advise the registrars general both on the confidentiality measures included in draft specifications of the SARs and on the proposals for their subsequent use. Once the draft specifications have been revised (if appropriate) as a result of his advice, he will prepare a report for Ministers on the proposed confidentiality arrangements. That report will be considered before any final approval is given for the production and supply of the SARs.

  Cash Limits
  Mr. Favell
  To ask the Secretary of State for Health whether any changes will be made to the cash limits and running cost limits of his Department in 1990–91.

  Mrs. Virginia Bottomley
  Subject to parliamentary approval of the necessary supplementary estimates, the following changes will be made:The cash limit for class XIII, vote 1 (Hospital and community health services, family health services (part) and other services, England) will be reduced by £1,250,000 from £14,194,789,000 to £14,193,539,000. This reduction represents a transfer to class XIII, vote 3.
  The cash limits for class XIII, vote 3 (Department of Health administration, miscellaneous health services and personal social services, England) will be increased by £43,255,000 from £691,253,000 to £734,508,000. This provides an additional £42,000,000 for grants to haemophiliacs infected with HIV; £1,250,000 transferred from class XIII, vote 1 following a reapportionment of family health service funds and £5,000 from class XIV, vote 7 for revised manpower costs. The Department's running cost limit is reduced by £4,356,000 from £202,049,000 to £197,693,000.

  The increase is within the forecast outturn for the planning total published in the statistical supplement to the 1990 autumn statement.

  Wakefield Health Authority
  Mr. Hinchliffe
  To ask the Secretary of State for Health (1) on how many occasions over the last five years the finances of Wakefield health authority have been examined by his Department's director of audit;

  (2) if he will direct the Audit Commission to conduct an inquiry into the financial management of Wakefield health authority;

  (3) on how many occasions over the past five years his Department's director of audit has drawn matters of concern regarding the financial management of Wakefield health authority to the attention of (a) the Yorkshire regional health authority, (b) the Wakefield health authority and (c) other bodies; and what were the matters in question in each instance.

  Mr. Dorrell
  [holding answer 31 January 1991]: In common with the arrangements for all health authorities, staff of the Department's director of audit will have made the necessary visits to Wakefield health authority in order to carry out the statutory audit of its annual accounts entailing related examination of its financial systems and procedures.

  Matters arising from audits are routinely raised with local management although auditors at their discretion may include subjects in their audit reports which are directed to the Secretary of State for Health but on which resolution is delegated to regional health authorities, who are expected to ensure that remedial action is taken in liaison with the Department.

  During the last five years the audit reports on the Wakefield health authority included one such item recommending the complete vacation and disposal of a hospital site which had already been closed for patient care. The Yorkshire regional health authority was involved in resolving this matter.

  Responsibility for the statutory audit of the national health service now lies with the Audit Commission. It is for the Audit Commission itself to decide what inquiries are appropriate.

  Health Authority Functions
  Mr. Hinchliffe
  To ask the Secretary of State for Health if he will list the functions which have been passed from health authorities to local authorities since 1979.

  Mrs. Virginia Bottomley
  [holding answer 24 January 1991]: The development and growth of community care over the last 12 years has reshaped the boundary between health and social care, not least by the reduction in the number of children and adults permanently resident in hospital. There has, however, been no transfer of statutory functions in this period.

SCOTLAND

  Local Enterprise Companies
  Mr. Graham
  To ask the Secretary of State for Scotland (1) if he will give the date of incorporation and the operational commencement date for the local enterprise company for Argyll, Arran and the Cumbraes;

  (2) if he will list (a) the dates of incorporation and (b) the operational commencement dates of each local enterprise company operating in the area formerly covered by the Scottish Development Agency in 1991–92.

  Mr. Allan Stewart
  The local enterprise company for Argyll, Bute, Arran and the Cumbraes was incorporated on 6 August 1990; the remainder of the information requested about incorporation dates is set out in the table.

  Local enterprise company

  Date of incorporation

  Borders

  30 July 1990

  Central

  25 May 1990

  Grampian

  16 May 1989

  Lanarkshire

  27 April 1990

  Lothian

  30 April 1990

  Moray, Badenoch and Strathspey1

  1 March 1990

  Tayside

  22 August 1990

  1 Straddles the Scottish Enterprise and Highlands and Islands Enterprise boundaries.

  Operational commencement is not readily linked to a single date. Local enterprise companies' operations have commenced in all cases, with the business planning process, and they are increasingly involved in operational decisions both about individual projects and about matters such as the agreement of new contracts with training providers. The next stage will be for detailed operational contracts to be awarded to companies by Scottish Enterprise and Highlands and Islands Enterprise. In general, these contracts will be awarded over the next few weeks and will result in local enterprise companies becoming fully operational on 1 April, the same date as Scottish Enterprise and Highlands and Islands Enterprise take over full operational responsibility from their predecessor bodies.

  Cash limits
  Mr. Bill Walker
  To ask the Secretary of State for Scotland if he proposes to make any changes to the cash limits for 1990–91 within his responsibility.

  Mr. Lang
  Yes, I intend to make changes to eight of the cash limits within my responsibility as follows.
  681
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XV, vote 3, regional and general industrial support, will be increased by £10,460,000 from £140,716,000 to £151,176,000. The increase is to provide for a special payment of grant in aid to the Scottish Development Agency to extinguish the residual public dividend capital and national loans fund debt prior to the establishment of Scottish Enterprise; this has no net effect on public expenditure.

  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XV, vote 8, housing, Scotland will be increased by £8,957,000 from £316,364,000 to £325,321,000. The increase to Scottish Homes grant in aid will provide for the acquisition of stock from local authorities and new towns and for publicising the extension of the rents to mortgages scheme. The increases are partially offset by a reduced requirement for housing support grant due to lower interest rates.

  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XV, vote 11, administration of justice, Scotland will be increased by £659,000 from £42,790,000 to £43,449,000. This increase reflects a partial take up of capital end year flexibility entitlement announced by the Chief Secretary to the Treasury on 25 July 1990 to meet expenditure on Aberdeen sheriff court delayed from last year.

  The cash limit for class XV, vote 15, education, arts, libraries and social work, Scotland will be reduced by £900,000 from £233,975,000 to £233,075,000. This reduction will partially offset the requirement for increased expenditure of £1,517,149 on the St. Helena ship being provided by the Overseas Development Administration. The remainder will be offset by further cash limits reductions of £617,149 to be announced in due course.

  The cash limit for class XV, vote 19, general register office for Scotland will be reduced by £200,000 from £7,621,000 to £7,421,000 and the running costs limit reduced by £200,000 from £8,391,000 to £8,191,000.

  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XV, vote 20, Department of the Registers of Scotland will be increased by £1,560,000 from £1,000 to £1,561,000 to cover

  Estimated period of gestation (weeks)

  Year of Termination

  1980

  1981

  1982

  1983

  1984

  1985

  1986

  1987

  1988

  1989

  20–23

  92

  84

  69

  65

  51

  41

  51

  53

  44

  26

  24–27

  10

  6

  5

  6

  7

  5

  5

  6

  5

  3

  28 +

  —

  1

  1

  —

  —

  —

  —

  —

  —

  —

  Roodlands Hospital, Haddington
  Mr. Home Robertson
  To ask the Secretary of State for Scotland (1) if the announcement by his predecessor, the right hon. and learned Member for Edinburgh, Pentlands (Mr. Rifkind), of 6 September 1990, concerning the provision of a 24-hour treatment service at the casualty unit at Roodlands hospital, Haddington, remains Government policy;

  (2) whether a 24-hour treatment service is provided at the casualty unit at Roodlands hospital, Haddington; when he intends to reply to the letter from the hon. Member for East Lothian dated 21 December 1990 on that subject; and if he will make a statement.
  682
  a shortfall in receipts. In addition, funds available for surrender to the consolidated fund as extra receipts will be reduced from £372,000 to zero. These changes will be partially offset by further cash limit reductions totalling £414,851 to be announced in due course.

  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XV, vote 21, Scottish Office administration will be increased by £217,000 from £130,152,000 to £130,369,000. Increased provision is required to reduce the backlog of regional medical service reference work and to meet extraordinary legal expenses. The additional expenditure will, however, be partially offset by a reduction in the cash limits for class XIV, vote 7. Increased provision is also required for expenditure on outward seconded staff but this will be offset by a corresponding increase in receipts. As a result of changes relating to the regional medical service and the running costs provision within class XV, vote 14 the running costs limit for the Scottish Office will be increased by £442,000 from £222,597,000 to £223,039,000.

  The non-voted cash limit SOLA2 will be reduced by £10,510,000 from £347,987,000 to £337,468,000. This is required to provide for the acquisition of stock by Scottish Homes from local authorities and new town development corporations.

  These changes are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Abortions
  Dr. Godman
  To ask the Secretary of State for Scotland what was the number of abortions performed in(a) Scotland and (b) each of the health board areas in each of the past 10 years; what percentage they represent of all categories; and how many of the abortions were carried out after (i) 20 weeks, (ii) 24 weeks and (iii) 28 weeks.

  Mr. Michael Forsyth
  Information about abortions in Scotland by health board of treatment and area of residence, and the statutory grounds under which they were carried out, is published annually in "Scottish Health Statistics", a copy of which is in the Library. The following table shows the numbers of abortions by gestational age for the period 1980–89.

  Mr. Michael Forsyth
  I replied on 28 January to the letter of 21 December. My letter explained the full circumstances of the 24-hour casualty service which Lothian health board is providing in Haddington.

  Scottish Food
  Mrs. Ray Michie
  To ask the Secretary of State for Scotland how many people are employed in the manufacture of Scottish food; and if he will make a statement.

  Mr. Allan Stewart
  There were an estimated 43,200 people employed in firms employing more than 10 workers in Scotland in 1989 in the manufacture of food. The food
  683
  manufacturing industry remains an important industry in Scotland employing more than one in 10 of all manufacturing employees.

  Mrs. Ray Michie
  To ask the Secretary of State for Scotland (1) what plans he has to promote Scottish food abroad; and if he will make a statement;

  (2) what were the reasons for the withdrawal of funds from Scottish Food Promotion; who will carry out its functions in future; and if he will make a statement.

  Mr. Michael Forsyth
  Scottish Food Promotion Ltd. was established in 1987 with support from the Scottish milk marketing board, Scottish salmon board, Scotch Quality Beef and Lamb Association, and the Scottish Development Agency and Highlands and Islands development board. Support from the two development agencies was made on a reducing basis over a three-year period, with the expectation that funding from the private sector would eventually replace public support.

  I understand that the SFP board decided to wind up the company when it was unable to attract funding for its new business plan. The promotion of sales by Scottish food and drink companies is primarily a matter for the companies themselves. The Government do provide support through Food From Britain and the Department of Trade and Industry. I understand that the SDA is considering what further public support is needed for Scottish companies and that it will maintain a Scottish presence at major food and drink trade shows.

  Registers (Financial Control)
  Mr. Bill Walker
  To ask the Secretary of State for Scotland if he will make a statement about the financial control arrangements for the registers of Scotland.

  Lord James Douglas-Hamilton
  The registers of Scotland (ROS) was approved for exemption from gross running costs control from 1989–90 on the basis of meeting certain management, performance and financial targets, in particular that it should recover the full costs of its services each year. ROS has been unable to meet the cost recovery target this year and will require supplementary substantive provision for 1990–91.

  Exemption has therefore been suspended for the remainder of 1990–91 with the result that changes in ROS gross expenditure and its funding have been subject to full Treasury scrutiny.

  Net control (the successor to exemption) will resume from April 1991, subject to ROS making good the shortfall in income for 1990–91 in 1991–92.

  Crown Office (Cash limits)
  Mr. Bill Walker
  To ask the Secretary of State for Scotland whether the Lord Advocate proposes any changes to the Crown Office's cash and running costs limits for 1990–91.

  Lord James Douglas-Hamilton
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class X, vote 13, will be increased by £1,365,000 from £28,369,000 to £29,734,000. The Department's running costs limit will be increased by £1,378,000 from £21,701,000 to £23,079,000. This increase will enable the Crown Office to meet additional costs relating to an increase in staff numbers, higher than 684
  expected salary increases and the costs of a high level review of the Department recommended by the Public Accounts Committee. The increase is within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Grant-aided Colleges
  Mr. Bill Walker
  To ask the Secretary of State for Scotland whether he has determined the allocations of grant-in-aid for recurrent expenditure to grant-aided colleges in Scotland; and if he will make a statement.

  Mr. Michael Forsyth
  The allocations are as follows:

  Offer 1991–92 £m

  Craigie College of Education

  1·198

  Duncan of Jordanstone College of Art

  3·419

  Dundee Institute of Technology

  6·540

  Edinburgh College of Art

  3·126

  Glasgow Polytechnic

  14·525

  Glasgow School of Art

  2·993

  Jordanhill College of Education

  8·301

  Moray House College of Education

  6·259

  Napier Polytechnic of Edinburgh

  17·799

  Northern College of Education

  4·618

  Paisley College of Technology

  9·757

  Queen's College, Glasgow

  3·918

  Queen Margaret College

  4·413

  Robert Gordon Institute of Technology

  11·154

  RSAMD

  2·314

  St· Andrew's College of Education

  2·914

  Scottish College of Textiles

  2·107

  The offers, which are conditional on parliamentary approval of the supply estimates, take account of the substantial increases in the tuition fees which colleges will receive for undergraduate students under the student awards system.

  The system of determining grant-in-aid allocations distributes the funds available by reference to a funded number of students for each college, weighted by subject group. Some modifications in the funding system have been made for 1991–92 following consultation with the colleges, notably to transfer from grant-in-aid into aggregate external finance for local authorities most of the resources for in-service training of teachers at colleges of education; and also to reflect more closely colleges' past performance in attracting and retaining students. In addition there are substantial inward transfers from other providers of courses in professions allied to medicine and the built environment. Not counting these transfers, the number of students for whom grant-in-aid provision has been made has been increased by about 7 per cent. in 1991–92 in recognition of the success of the sector in attracting additional students.

  The grant allocations take account of the further substantial increases in the level of the publicly-funded undergraduate tuition fees to be paid to colleges as from September 1991 and, after adjusting for transfers, the allocations .represent an increase in Government funding of about £20 million; or 14 per cent. compared with the current year if colleges achieve their funded student enrolments. The table shows how grant-in-aid plus estimated tuition fees for funded students will change for individual colleges.
  685

  Year-on-year comparison of grant-in-aid and tuition fees

  Grant-in-aid plus estimated tuition fees for funded students (£ million)

  1990–91

  1991–92

  Change Per cent.

  Craigie College of Education

  1·634

  1·850

  +13·2

  Duncan of Jordanstone

  4·994

  5·797

  +16·1

  Dundee Institute of Technology

  9·472

  10469

  +10·5

  Edinburgh College of Art

  5·045

  5·494

  +8·9

  Glasgow Polytechnic

  16·659

  20·105

  +20·7

  Glasgow School of Art

  4·532

  5·005

  +10·4

  Jordanhill College of Education

  10·765

  11·892

  +10 5

  Moray House College of Education

  8·059

  9·119

  +13·2

  Napier Polytechnic of Edinburgh

  23·783

  27·251

  + 14·6

  Northern College of Education

  6·070

  6·833

  +12·6

  Paisley College of Technology

  13·751

  15·611

  +135

  Queen's College, Glasgow

  4·113

  4·782

  +16·3

  Queen Margaret College

  6·061

  71·09

  +17·3

  Robert Gordon Institute of Technology

  15·360

  17·814

  +16·0

  RSAMD

  2·924

  3·100

  +6·0

  St· Andrew's College of Education

  3·759

  4·460

  +18·6

  Scottish College of Textiles

  3·117

  3·363

  +7·9

  All colleges

  140·098

  160·054

  +14·2

  Note: The inward transfers of resources for building courses and courses for professions allied to medicine from other sectors, and outward transfers of resources for in-service training of teachers are excluded from the figures.

  The allocations reflect the high priority which the Government are continuing to give to higher education. The funding levels will adequately cover cost increases and will also enable the colleges to continue to contribute to the rising participation in higher education of recent years. Colleges are free to recruit students above the levels on which grant-in-aid is based and can thus benefit from the increased tuition fee levels to be paid from public funds for those students who are entitled to students' awards.

EMPLOYMENT

  Labour Statistics
  Mr. Blunkett
  To ask the Secretary of State for Employment if he will publish a table indicating current unemployment levels in each urban development corporation area.

  Mr. Jackson
  Urban development corporation (UDC) boundaries do not correspond to areas for which unemployment figures are available. Unemployment figures for the travel-to-work areas which include the UDCs, for December 1990, are contained in the following table.

  Urban development corporation

  TTWA

  Total unemployed

  1Rate

  London Docklands

  London

  230,694

  5·8

  Black Country

  Walsall

  12,307

  7·3

  Wolverhampton

  12,994

  8·7

  Dudley and Sandwell

  21,115

  7·3

  Merseyside

  Liverpool

  63,743

  12·6

  Tyne and Wear

  South Tyneside

  9,020

  15·5

  686

  Urban development corporation

  TTWA

  Total unemployed

  1Rate

  Sunderland

  20,253

  11·0

  Teeside

  Stockton on Tees

  8,357

  10·7

  Hartlepool

  5,207

  13·3

  Middlesbrough

  16,147

  11·5

  Cardiff Bay

  Cardiff

  16,497

  7·1

  Leeds

  Leeds

  23,325

  6·4

  Central Manchester

  Manchester

  62,138

  7·3

  Trafford Park

  Sheffield

  Sheffield

  25,609

  8·9

  Bristol

  Bristol

  20,548

  5·5

  1 Per cent. of workforce.

  Sheltered Placement Scheme
  Mr. Soley
  To ask the Secretary of State for Employment if he will make a statement regarding his decision to stop the expansion of the sheltered placement scheme in 1990–91.

  Mr. Jackson
  [holding answer 31 January 1991]: The sheltered placement scheme (SPS) is part of my Department's sheltered employment programme. Since 1985 the scheme has been extremely successful in offering people with severe disabilities a wide choice of employment opportunities.

  In 1990–91 my Department is making available to local authorities and voluntary organisations £4·2 million more than the previous year to support jobs for people wiih severe disabilities. Our first priority in using this additional money has been to help maintain the jobs of existing SPS workers by increasing the grants paid to sponsors to assist in meeting their rising wage bills and administrative costs. In 1990–91 the scheme will support an average of 6,700 sheltered placement jobs throughout the country at an estimated cost of £15·7 million. Whilst there has been no increase in the number of SPS places in 1990–91, previous patterns of turnover indicate that some 1,000 existing places nationally are likely to become vacant to allow new entrants to join the scheme.

  Cash Limits
  Mr. Waller
  To ask the Secretary of State for Employment whether any change will be made to his Department's cash limits or running costs limits for 1990–91.

  Mr. Jackson
  [pursuant to his reply, 8 November 1990, c. 10]: Subject to parliamentary approval of the necessary supplementary estimates, the following further changes will be made:

  The cash limit for class VI, vote 1 (training and enterprise programmes) will be reduced by £152,233,000 from £2,452,338,000 to £2,300,105,000. Of this reduction, £145,000,000 will be transferred to class VI, vote 2 to offset a £132,400,000 increase in European social fund payments to third parties and a number of other minor changes. In addition £4,217,000 is transferred to class VI, vote 5 for the sale of the STA. Further transfers result in a net decrease of £3,016,000.
  687
  The cash limit for class VI, vote 2 (other programmes and central services), will be increased by £10,830,000 from £214,197,000 to £225,027,000. This increase is offset by a reduction on the class VI, vote I cash limit.

  The cash limit for class VI, vote 3 (employment service), will be increased by £24,000 from £415,304,000 to £415,328,000. This increase is offset by reductions on class VI, vote 1. The changes include the transfer of £658,000 from class VI, vote 1 in connection with the transfer of the employment rehabilitation service and increased provision of £93,000 for additional statistical work on the RPI. These increases are partly offset by receipts from the CSO and increased receipts as a result of the employment service revenue generation scheme.

  The cash limit for class VI, vote 4 (Health and Safety Commission and Advisory, Conciliation and Arbitration Service), will increase by £1,242,000 from £137,211,000 to £138,453,000. This increase is offset by a reduction of the cash limit on class VI, vote 1. The main changes relate to a transfer of £1,500,000 from class VI, vote 1 to pay for higher staff relocation costs and the effects of the transfer of the railway inspectorate. These increases are partly offset by higher receipts.

  The cash limit for class VI, vote 5 (Sale of Skills Training Agency), will increase by £4,217,000 from a token £1,000 to £4,218,000. This increase is offset by reductions in the cash limit on class VI, vote 1. The increase is to fund the main sale expenditure of the Skills Training Agency, and to reflect a reduction in receipts due to delays in the sale of properties and leases.

  As a result of these changes, the DE group cash limits will fall by £135,920,000. However, public expenditure will reduce by only £3,520,000 because the £132,400,000 increase in ESF payments to third parties shown on class VI, vote 2 is due to its receipts which do not score in DE's cash limits but are included in public expenditure totals.

  The running costs limit for the Department of Employment (Votes 1,2,3 and 5) will be increased by £25,726,000 from £916,267,000 to £941,993,000.

  The running costs limit for the Health and Safety Commission will increase by £1,680,000 from £100,621,000 to £102,301,000.

  These increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

DEFENCE

  Gulf War (Pay)
  Sir Nicholas Fairbairn
  To ask the Secretary of State for Defence if he will list the comparative rates of pay of reservist troops and regular troops, by rank, serving in the Gulf.

  Mr. Archie Hamilton
  All regulars and reservists serving in the Gulf receive the same basic rates of pay. However, reservists are entitled to a taxable supplement of up to 20 per cent. of service pay (and more in special cases) to help make up any loss of civilian earnings up to a maximum total ceiling, including service pay, of £55,000.

  Territorial Army Reservists
  Mr. Redmond
  To ask the Secretary of State for Defence, pursuant to his reply of 16 November to the hon. Member for Don Valley,Official Report, column 228, if he will make it his practice to keep central records of individual casualties among Territorial Army reservists.

  Mr. Archie Hamilton
  My noble Friend the Under-Secretary of State for the Armed Forces will write to the hon. Member.

  Gulf War (Costs)
  Mr. Tony Banks
  To ask the Secretary of State for Defence what is the current estimated daily cost of the British presence in the Gulf arising from the invasion of Kuwait.

  Mr. Archie Hamilton
  The current full daily operating cost of the British presence in the Gulf arising from the invasion of Kuwait is estimated to be over £4 million per day.

  Gulf Oil Spills
  Mr. Dalyell
  To ask the Secretary of State for Defence what protection is available to the United Nations Environment Programme global environment monitoring system studying oil spills in the Gulf.

  Mr. Archie Hamilton
  The United Kingdom has received no request for any form of protection for UNEP global environment monitoring system personnel in the Gulf.

  Prisoners of War
  Mr. Dalyell
  To ask the Secretary of State for Defence what information he has on the areas of Iraq that are sufficiently far from military action to constitute safe areas for prisoners of war under article 14 of the Geneva convention.

  Mr. Archie Hamilton
  The targets being attacked by the coalition are sites which could pose a threat to allied forces or facilities supporting Iraq's occupation of Kuwait. Article 23 of the third Geneva convention states that no prisoner of war may at any time be sent to, or detained in areas where he may be exposed to the fire of the combat zone, nor may his presence be used to render certain points or areas immune from military operations. Iraq has not yet provided any information to the International Committee of the Red Cross on the personnel being held or their location, nor permitted the ICRC to satisfy itself that they are being held in accordance with Iraq's obligations.

  Cash Limits
  Mr. Conway
  To ask the Secretary of State for Defence if there are any changes to the defence cash limits and running costs limits for 1990–91.

  Mr. Tom King
  Subject to parliamentary approval of the necessary spring supplementary estimates, the following changes will be made:
  689

  (1) Defence Cash Limits

  £'000s

  Class and Vote

  Current Cash Limit

  Change

  Revised Cash Limit

  I, 1

  9,108,295

  + 100,000

  9,208,295

  I, 2

  8,944,597

  + 196,728

  9,141,325

  I, 3

  1,407,570

  +10,975

  1,418,545

  I, 4

  1,930,960

  -87,901

  1,843,059

  I, 5

  494,027

  + 40,000

  534,027

  These changes, which increase the block Defence cash limit by £259,802,000 from £21,885,449,000 to £22,145,251,000, are principally to cover costs arising from the deployments of British forces to the Gulf area. The changes also take account of a number of minor transfers between the Ministry of Defence and other Government Departments. They are consistent with the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  (2) Running Costs Limit

  Within the block Defence cash limit the running costs limit for the Department will be increased by £66,011,000 from £5,362,678,000 to £5,428,689,000. This is mainly for additional running costs being incurred on the Defence budget as a result of the crisis in the Gulf area.

AGRICULTURE, FISHERIES AND FOOD

  Environmental Protection
  Mr. Ron Davies
  To ask the Minister of Agriculture, Fisheries and Food what representations he made to Commissioner Ray MacSharry to seek to ensure that environmental protection measures are linked closely with production and budgetary reforms to the common agricultural policy being discussed by European Commissioners.

  Mr. Curry
  As my right hon. Friend the Minister made clear in his reply to the hon. Member for Bosworth on 23 January at column 247, we did not have the opportunity at the last meeting of the Agricultural Council to give our views on the EC Commission's ideas for reforming the common agricultural policy, but at next week's Council we intend to argue for the closer integration of agricultural and environmental policies.

  Tourism
  Mr. Simon Coombs
  To ask the Minister of Agriculture, Fisheries and Food what consultations took place with representatives of the tourism industry before the abolition of capital grants for the provision of tourist accommodation under the farm diversification scheme.

  Mr. Curry
  In reaching a decision the Ministry took into account a range of views and considerations including those of the tourism industry.

  Environmentally Sensitive Areas
  Mr. Ron Davies
  To ask the Minister of Agriculture, Fisheries and Food what representations he has made to the European Commission to raise the levels of reimbursement for payments made in environmentally sensitive areas in objective 1 and 5b areas of the United Kingdom.
  690
  Mr. Curry
  None, since any increase would be bound to apply to other member states. A general rise would increase the overall cost of existing schemes to the United Kingdom Exchequer without any direct benefit to United Kingdom farmers.

  Hill Livestock Compensatory Allowances
  Mr. Ron Davies
  To ask the Minister of Agriculture, Fisheries and Food when he expects to publish a consultation paper on reforms to bring about more explicit environmental benefits from the hill livestock compensatory allowances system.

  Mr. Curry
  I plan to consult interested parties as soon as we have specific proposals to present on how the existing environmental benefits afforded by hill livestock compensatory allowances might be made more specific.

  Drift-net Fishing
  Mr. Tony Banks
  To ask the Minister of Agriculture, Fisheries and Food what steps are being taken to protect fish stocks in waters for which Britain is responsible from the activities of drift-net fishing.

  Mr. Curry
  The small-scale drift net fisheries found in United Kingdom waters are considered to be relatively selective in operation, targeting certain fish species reasonably effectively. Various restrictions including minimum mesh size controls may be applied in these fisheries, and those for salmon and trout in particular are tightly regulated.

  Food From Britain
  Mrs. Ray Michie
  To ask the Minister of Agriculture, Fisheries and Food (1) what percentage of funding through Food From Britain was spent promoting Scottish food; and if he will make a statement;

  (2) what percentage of funding through Food From Britain was spent promoting Welsh food; and if he will make a statement.

  Mr. Curry
  The information is not available in the form requested. Food From Britain has the task of promoting British foodstuffs from all parts of the United Kingdom, and offers services to food companies without regard to their geographical location.

  Mrs. Ray Michie
  To ask the Minister of Agriculture, Fisheries and Food what plans he has to promote(a) English food abroad and (b) British food abroad; and if he will make a statement.

  Mr. Curry
  The Government are fully committed to the promotion of food from the United Kingdom both at home and abroad. We provide substantial financial support to the national food marketing organisation, Food From Britain, so that its resources and expertise can be drawn upon by British food producers, manufacturers and traders in increasing the sales of British food to the consumers of the world.

  Cash Limits
  Mr. Gill
  To ask the Minister of Agriculture, Fisheries and Food whether he intends to make any changes to his Department's cash limits for 1990–91.
  691
  Mr. Gummer
  Yes. The non-voted cash limit MAFF/LACAP (supplementary credit approvals for flood defence and coast protection) will be increased by £2,300,000 from £13,230,000 to £15,530,000, to enable local authorities to devote additional resources to coast protection work following the severe winter storms at the beginning of 1990.

  The cash limit for class III, vote 5 (departmental research, advisory services and administration) will be reduced by £2,000,000, from £285,096,000 to £283,096,000, reflecting a predicted shortfall in spending on capital works.

  The net increase is within the forecast outturn for the planning total published today in the statistical supplement to the autumn statement.

FOREIGN AND COMMONWEALTH AFFAIRS

  Missile Technology Control Regime
  Mr. Flynn
  To ask the Secretary of State for Foreign and Commonwealth Affairs if he will list the countries that are currently members of the missile technology control regime and the date on which they became members.

  Mr. Douglas Hogg
  The missile technology control regime was established in 1987 by Canada, France, the FRG, Italy, Japan, the United Kingdom and the United States. In 1989 Spain also adhered to the MTCR guidelines. In 1990 six further countries, Australia, Belgium, Denmark, Luxembourg, the Netherlands, New Zealand and Norway, also announced their adherence to the MTCR.

  Weapons
  Mr. Sillars
  To ask the Secretary of State for Foreign and Commonwealth Affairs what is the latest list of weapons outlawed by international law; and what efforts the United Kingdom is making to extend that list.

  Mr. Douglas Hogg
  There is no international agreed list of outlawed weapons. However, restrictions on certain types of weapon are included in a variety of international agreements. Such restrictions apply only to countries which are parties to the agreement.

  Iraq (Muslim Holy Sites)
  Mr. Dalyell
  To ask the Secretary of State for Foreign and Commonwealth Affairs if he will publish in the Official Report his letter of 28 January to the hon. Member for Linlithgow concerning damage to Muslim holy sites in Iraq.

  Mr. Hurd
  I am arranging for a copy of my letter of 28 January to the hon. Member to be placed in the Library of the House.

  Council of Ministers
  Mr. Moss
  To ask the Secretary of State for Foreign and Commonwealth Affairs if he will publish in the Official Report a statement of forthcoming business in the European Community Council of Ministers.

  Mr. Garel-Jones
  The Foreign Affairs Council will meet on 4 and 5 February. Ministers will discuss the situation in 692
  the Soviet Union and the consequences of events in the Baltic states for the EC's aid proposals. They will also discuss food aid for Romania and Bulgaria and the extension of European Investment bank lending to Czechoslovakia, Romania and Bulgaria. The Council may review progress towards the resumption of negotiations on GATT, and will consider EC/United States trade in aircraft. Political co-operation issues will also be discussed. The ministerial meeting of the intergovernmental Conference on political union on 4 February will consider progress made by Ministers' personal representatives.

  The Agriculture Council will meet on 4 and 5 February and will discuss the development of the common agriculture policy, the agriculture aspect of the GATT Uruguay round and EC quality standards for fresh and frozen sheep carcases.

  The Economic and Finance Council will meet on 25 February to consider financial assistance to central and eastern Europe and aid to the USSR. The abolition of fiscal frontiers appears on the agenda but no substantive discussion is expected. The ministerial meeting of the inter-governmental conference on economic and monetary union on 25 February will hold a general discussion on progress made to date by Ministers' personal representatives.

  Prisoners of War
  Mr. Trotter
  To ask the Secretary of State for Foreign and Commonwealth Affairs what steps are being taken by the United Kingdom and other countries to ensure that prisoners of war held by Iraq are being treated in accordance with the Geneva convention; and if he will make a statement.

  Mr. Douglas Hogg
  I refer my hon. Friend to the answer I gave to the hon. Member for Southport (Mr. Fearn) on 31 January at column 605.

  Falkland Islands (Fishing)
  Mr. Tony Banks
  To ask the Secretary of State for Foreign and Commonwealth Affairs what information he has on Japanese drift-net fishing in the vicinity of the Falkland Islands.

  Mr. Garel-Jones
  The Falkland Islands Government, who manage the Falkland Islands interim conservation and management zone and the Falklands outer conservation zone, are not aware of any drift net fishing in the vicinity of the Falkland Islands.

  Taiwan
  Mr. Tony Banks
  To ask the Secretary of State for Foreign and Commonwealth Affairs what representations have been made to the Taiwanese authorities regarding drift-net fishing; and if he will make it his policy to ban all Taiwanese fishing in waters for which Britain is responsible until the Taiwanese end the use of drift-nets.

  Mr. Lennox-Boyd
  We have no dealings with the authorities in Taiwan. We welcomed the decision of the authorities in Taiwan in September last year to comply in principle with the resolution on large-scale pelagic drift net fishing adopted by the 44th General Assembly of the United Nations. We also welcomed the additional
  693
  measures undertaken by the authorities in Taiwan such as a ban on the building of new drift net vessels and a ban on the operation of drift net fishing in the Atlantic. We do not propose to take action against Taiwan fishing vessels.

  British Overseas Territories (Fishing)
  Mr. Tony Banks
  To ask the Secretary of State for Foreign and Commonwealth Affairs to which countries licences have been granted for fishing operations in the economic exclusion zone waters of British overseas territories.

  Mr. Garel-Jones
  Dependent territories of the United Kingdom do not have exclusive economic zones, but a number of them have fisheries jurisdictions. Licences have been issued to vessels and associations from a number of countries; it is not normal practice to enter into licence agreements with foreign Governments.

  Cash Limits
  Mr. Arbuthnot
  To ask the Secretary of State for Foreign and Commonwealth Affairs if he proposes to make any changes in his Department's diplomatic wing cash limits and running costs limits for 1990–91.

  Mr. Lennox-Boyd
  Subject to parliamentary approval of the necessary supplementary estimates, the following changes will be made: The cash limit for class II, vote 1 (overseas representation) will be increased by £18,058,000 from £534,722,000 to £552,780,000. In addition, the running costs limit on vote 1 will be increased by £14,986,000 from £477,103,000 to £492,089,000. These changes reflect increased costs due to the Gulf crisis; construction of buildings and adverse effect of overseas price movements.

  The cash limit for class II, vote 2 (other external relations) will increase by £11,402,000 from £176,019,000 to £187,421,000. This takes account of increased costs on Vietnamese boat people; international conferences; FCO scholarships; military assistance; consular expenditure in the middle east as a result of the Gulf crisis and higher than forecast expenditure on our contributions to international organisations due to the adverse effect of overseas price movements.

  The cash limit for class II, vote 3 (external broadcasting and monitoring) will increase by £4,760,000 from £142,685,000 to £147,445,000 to take account of increased rental for Bush house and increased costs as a result of the Gulf crisis.

  The cash limit for class II, vote 4 (the British Council) will increase by £2,076,000 from £76,233,000 to £78,309,000 to take account of the adverse effect of overseas price movements. These increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  Saudi Arabia
  Sir David Steel
  To ask the Secretary of Stale for Foreign and Commonwealth Affairs what assistance is being given to British nationals to leave Saudi Arabia following the cessation of civilian flights.

  Mr. Douglas Hogg
  We have arranged for British nationals to leave Saudi Arabia on Kuwait Airways flights 694
  from Dhahran. Only about 230 British nationals have taken up this opportunity. The last of these flights left on 30 January.

  Saudia Airlines is operating a service of three flights a week between Jedda and the United Kingdom and a daily shuttle service between Jedda and Riyadh. British Airways will provide a similar service between London and Jedda from 31 January. It continues to be possible to travel without difficulty by road between Dhahran, Riyadh and Jedda.

  The American military have also offered seats on their aircraft to British nationals.

TRANSPORT

  Boom Equipment
  Mr. Macdonald
  To ask the Secretary of State for Transport what consultation has taken place, and what advice has been received, from local authorities as to the adequacy of the scale, type and amount of boom equipment stationed in Scotland for use in an oil pollution incident.

  Mr. McLoughlin
  The Department's marine pollution control unit (MPCU) keeps local authorities fully informed of the content of its stockpiles of beach protection and cleaning equipment and is always ready to consider any suggestion they might make about the amount or type of equipment it keeps. However, there have been no formal consultations with, or advice from, local authorities as to the adequacy of the scale, type and amount of boom equipment stationed in Scotland for use in an oil spill incident.

  As I explained in my answer of 4 July at col. 563 the MPCU's stocks of highly mobile resources, including booms, are on short notice stand-by at various locations around the United Kingdom from where they can be quickly deployed to the west coast of Scotland, or any other part of the United Kingdom which may be threatened by a major oil spill.

  The adequacy of these resources is kept under constant review and following the Rosebay incident off the south Devon coast in May of last year, the MPCU has taken steps to enhance substantially its stockpiles, including the one at Cambusbarron in Scotland, by improving its stocks of booms, shoreline barriers, skimmers and other equipment.

  Prestwick Airport
  Mr. McAvoy
  To ask the Secretary of State for Transport what plans he has to encourage an increase in freight and passenger traffic using Prestwick airport; and if he will make a statement.

  Mr. McLoughlin
  It is for airlines to decide whether they wish to mount services using Prestwick, and for BAA plc, as the owner of the airport, to encourage them to do so. Proposals put forward for new services by foreign airlines will be considered as quickly as possible within the framework of the appropriate air service agreements, and account will be taken of the Government's wish to see effective use of Prestwick.

  Rail Electrification
  Mr. Galbraith
  To ask the Secretary of State for Transport if he will give, for Great Britain as a whole and for Scotland, the total rail route length, and the percentage which is electrified, including projects approved or under construction.

  Mr. Freeman
  At 31 March 1990 British Rail had 10,307 route miles in Great Britain of which some 28 per cent. are electrified or will be electrified by projects approved or under construction. British Rail has some 1,700 route miles in Scotland, 10 per cent. of which are or will be electrified.

  Rail Crossings
  Mr. Andrew F. Bennett
  To ask the Secretary of State for Transport whether the railway inspectorate's review of footpath crossings announced in his answer to the hon. Member for West Bromwich, East (Mr. Snape) on 9 July at column 96 has been completed; and if he intends to place a copy of the review's findings in the Library when it is completed.

  Mr. McLoughlin
  The Health and Safety Executive's railway inspectorate is reviewing the warning and layout arrangements at footpath and bridleway crossings and the criteria for their application. Its findings will be published in due course as an additional chapter to the railway construction and operation requirements for level crossings. A copy will be placed in the Library at that time.

  Mr. Andrew F. Bennett
  To ask the Secretary of State for Transport if he will place in the Library a copy of British Rail's review of all the footpath and bridleway crossings of the east coast main line and proposals for bridges or underpasses at, or stopping-up or diversion of, those crossings.

  Mr. McLoughlin
  This is a matter for British Rail. Proposals to stop up certain level crossings on the east coast main line railway are contained in British Rail's East Coast Main Line (Safety) Bill. If this Bill is given a Second Reading, it will be for the Committee appointed to consider it to take evidence on the case for British Rail's proposals.

  Disabled People
  Mr. Hannam
  To ask the Secretary of State for Transport what guidance his Department issues to local authorities with regard to the reinstatement of existing provision for disabled people, such as dropped kerbs and tactile pavements when roads are being repaired and reinstated.

  Mr. Freeman
  Highway authorities are required under the Disabled Persons Act 1981 to have regard to disabled persons when considering the provisions of ramps at appropriate places between carriageways and footpaths. The Department of Transport's advice on these provisions, including such features as dropped kerbs and tactile pavements, is contained in departmental advice notes TA 52/87 "Design Considerations for Pelican and Zebra Crossings" and TA 57/87 "Roadside Features", and in the Department's disability unit circular 1/86. Where provisions are in place we would recommend that they are retained when roads are repaired and reinstated.

  Cycling Accidents
  Mr. Ron Davies
  To ask the Secretary of State for Transport if he will list, in descending order by borough, the number of cycling accidents in each London borough in the last three years.

  Mr. Chope
  The information requested is as follows.

  Number

  1987

  Westminster

  266

  Wandsworth

  200

  Camden

  191

  Lambeth

  190

  South wark

  180

  Islington

  180

  Hounslow

  168

  Richmond

  160

  Eating

  1S9

  Hillingdon

  154

  Kingston

  139

  Bromley

  137

  Croydon

  136

  Kensington and Chelsea

  129

  Lewisham

  117

  Hammersmith and Fulham

  110

  Barnet

  107

  Enfield

  105

  Hackney

  104

  Tower Hamlets

  100

  Havering

  97

  Bexley

  96

  Greenwich

  94

  Brent

  89

  Merton

  87

  Sutton

  86

  Waltham Forest

  82

  Newham

  81

  Redbridge

  75

  Haringey

  69

  Barking and Dagenham

  62

  Harrow

  60

  City of London

  32

  1988

  Westminster

  323

  Lambeth

  233

  South wark

  195

  Camden

  189

  Wandsworthk

  186

  Islington

  179

  Ealing

  161

  Hounslow

  155

  Kensington and Chelsea

  151

  Kingston

  146

  Hammersmith and Fulham

  141

  Bromley

  137

  Hillingdon

  137

  Croydon

  134

  Richmond

  132

  Hackney

  131

  Lewisham

  111

  Enfield

  107

  Barnet

  102

  Newham

  93

  Waltham Forest

  91

  Brent

  90

  Tower Hamlets

  90

  Havering

  88

  Merton

  83

  Greenwich

  83

  Barking and Dagenham

  77

  Haringey

  73

  Redbridge

  69

  Harrow

  68

  Sutton

  68

  Bexley

  66

  City of London

  38

  697

  Number

  1989

  Westminster

  461

  Lambeth

  322

  South wark

  245

  Camden

  233

  Wandsworth

  228

  Islington

  219

  Kensington and Chelsea

  208

  Ealing

  201

  Hounslow

  194

  Hammersmith and Fulham

  173

  Hillingdon

  173

  Richmond

  170

  Croydon

  153

  Barnet

  151

  Bromley

  150

  Tower Hamlets

  145

  Kingston

  138

  Hackney

  127

  Lewisham

  123

  Enfield

  121

  Greenwich

  119

  Havering

  118

  Waltham Forest

  112

  Brent

  111

  Haringey

  111

  Newham

  105

  Redbridge

  96

  Merton

  94

  Sutton

  91

  Bexley

  74

  Harrow

  73

  Barking and Dagenham

  66

  City of London

  58

  Source: London Accident Analysis Unit fact sheets 18 and 33.

  Cycling
  Mr. Ron Davies
  To ask the Secretary of State for Transport if he will make a statement on the progress towards implementing the 1,000-mile cycle lane network in London.

  Mr. Chope
  In 1990 the London planning advisory committee consulted all London highway authorities on the proposals for a 1,000-mile strategic cycle network. Replies are being co-ordinated by the London Cycling Forum. Results are expected later this year.

  Mr. Ron Davies
  To ask the Secretary of State for Transport if he will make a statement on the availability of finance to local authorities for the provision of cycling facilities.

  Mr. Chope
  Transport supplementary grant (TSG) and credit approvals for local authority capital expenditure on highways are allocated in the light of information included in authorities' annual transport policies and programme (TPP) submissions.

  The Department's circular inviting TPP submissions for 1991–92 said that expenditure on provision for cyclists will be considered for TSG where it is integral to a highway or traffic management scheme which meets the criteria for TSG accepted expenditure. Specific cycling schemes, in addition to those which form or are part of a local safety scheme, can also qualify for TSG support if they are intended to reduce accidents on roads of more than local importance. This can involve not only the construction of facilities on main roads (such as cycle lanes and cycle
  698
  crossings) but also the development of cycle routes on minor roads which attract significant numbers of cyclists away from roads of more than local importance.

  Most expenditure on cycling facilities is likely to take the form of "minor works" for which authorities are given a block allocation of accepted expenditure. Other expenditure on cycling, as on all other categories of expenditure, may be funded from within authorities, approved levels of borrowing, from capital receipts or from revenue.

  There is no predetermined share of the total resources available reserved for cycling facilities, and it is for individual authorities to decide how much of their overall allocations to devote to them.

  Child Safety Belts
  Mrs. Dunwoody
  To ask the Secretary of State for Transport whether he can now announce the date at which rear seat belts for children in cars will become mandatory.

  Mr. Chope
  Regulations requiring children under 14 years of age to be restrained when travelling in the rear seats of cars, where appropriate restraints exist and are available, came into force on 1 September 1989.

  The European Commission is currently discussing a proposal for a directive on child restraint construction which is expected to include requirements on installation involving both restraint and vehicle manufacturers.

  Road Repairs
  Mr. Steinberg
  To ask the Secretary of State for Transport if he will give an estimate of the cost of maintenance and repairs for motorways and roads for 1990.

  Mr. Chope
  The latest forecast of expenditure on maintenance of motorways and trunk roads in England in 1990–91 is £543·8 million.

  This includes £419·5 million of capital expenditure on the renewal of roads and the renewal and strengthening of bridges (including the Severn bridge) and £124·3 million of current expenditure on roads and bridges.

  A19 Improvement Study
  Mr. Cummings
  To ask the Secretary of State for Transport if he will make available sufficient funding to enable the recommendations contained within the A19 improvement study prepared by consultants Bullen and Partners on behalf of the northern regional office of the Department of Transport to be implemented in full.

  Mr. Chope
  The consultant's report listed recommendations for improvements to the A19 in an order of priority. The scheme with top priority, Testo's roundabout improvement, is currently under way.

  The other improvements recommended will be processed within the annual programmes of regional improvements as funds permit.

  Departmental Expenditure
  Mr. Brazier
  To ask the Secretary of State for Transport what changes he proposes to make to the cash limit and running costs limit for his Department.

  Mr. Rifkind
  Subject to parliamentary approval of the necessary supplementary estimate, the cash limits in class VII will be changed as follows:
  699

  Class and Vote

  Current cash limit

  Changes

  £ thousand revised cash limit

  VII

  1

  1,798,862

  14,027

  1,802,889

  2

  259,693

  29,037

  268,730

  4

  135,796

  313,500

  149,296

  5

  267,519

  41

  267,520

  1 Take up in part of entitlement to end year flexibility announced by the Chief Secretary to the Treasury on 25 July 1990 (Official Report, cols. 235–40). There is a transfer of £100,000 from the Department of Environment (class VIII, vote 6) consequent upon the decision to pay grant direct to English Heritage and a token provision to enable certain payments in respect of the construction and maintenance of roads.

  2 There are increases of £8,900,000 transferred from class VII, vote 1, for the relocation of part of my Department and for additional accommodation costs and capital equipment, £20,000 in respect of first aid work and OMCS challenge funding allocations and £288,000 shortfall in appropriations in aid offset by a reduction of £171,000 resulting from the transfer of railways inspectorate to the Department of Employment (class VI, vote 4).

  3 Increases to cover shortfall in appropriations in aid of £13,500,000 in respect of the sale of marks scheme.

  4 Token.Provision has been made to enable increased expenditure on urban traffic control which will be recovered from local authorities.

  The running costs limit of the Department of Transport has been increased by £2,847,000 from £322,416,000 to £325,263,000 as a consequence of running costs increases on two Votes. The bulk of this increase comprises the transfer of £2,700,000 from programme expenditure on class VII vote 4.

  The increases are within the forecast outturn for the planning total published today in the statistical supplement to the 1990 autumn statement.

  The Gulf (Pollution Control)
  Mr. Dalyell
  To ask the Secretary of State for Transport what response he has made to the Saudi Government's request for the loan of small numbers of skilled pollution control experts and advisers.

  Mr. McLoughlin
  Two pollution control experts, one from the Department's marine pollution control unit and the other from the DTI's Warren Spring laboratory, arrived in the Gulf yesterday.

  Both have considerable experience in dealing with pollution arising from oil spills dating back to the Torrey Canyon incident off the Scilly isles in 1969 and both have been involved in clean-up operations in the Gulf on previous occasions.

  Their role will be to advise the Saudi Government on response techniques and any possible needs for additional equipment.

  Mr. Dalyell
  To ask the Secretary of State for Transport if he will make a statement on his meeting with EEC colleagues on 29 January about the standing task force of national experts on oil pollution going to the Gulf; and if he will give a breakdown of the numbers and experience of such a task force.

  Mr. McLoughlin
  The meeting held on 29 January at official level was of a technical nature aimed at assessing the situation in the light of available knowledge, considering possible response strategies and determining the extent to which the Community might be able to help if requested to do so by the Saudi Government.
  700
  Member states expressed a willingness to help and it is clear that much equipment and expertise is available if required. However, I am also aware that considerable counter-pollution resources already exist in the Gulf area as a result of existing contingency plans to deal with spillages of oil from tanker casualties and other sources. It is important therefore not to mobilise European resources until it is clear that they would be needed and not simply hinder the operation.

  The EC task force has no specific number of personnel. It is drawn from member states in response to specific requests to the EC for assistance and its composition will vary from incident to incident depending on the type of help and advice being sought.

  Rail Technology
  Mr. Gwilym Jones
  To ask the Secretary of State for Transport what plans he has to examine the new European rail technology being developed by Powell Duffryn Standard Limited.

  Mr. Freeman
  BR plans to use low-platform wagon technology for channel tunnel freight services, and I am taking a close interest in the development of this new rolling stock. My hon. Friend the Member for Derbyshire, West (Mr. McLoughlin) visited Powell Duffryn in Cardiff last September, and I hope to visit their recently acquired French operation in April.

  Dartford Tunnel
  Mr. Evennett
  To ask the Secretary of State for Transport if he will make a statement on forthcoming closures of the Dartford tunnels for carriageway repairs.

  Mr. Chope
  [holding answer 31 January 1991]: Investigations into the condition of the existing tunnels at Dartford are continuing. Until they are complete and have been evaluated, no forecast can be given of the extent and timing of any closures. If closure of one of the tunnels does become necessary, it will not happen until some time after the opening of the new bridge at the end of this summer. The increased capacity would then provide three lanes of traffic in each direction during any closure, 50 per cent. more than at present.

  Speed Limits (Essex)
  Mr. Burns
  To ask the Secretary of State for Transport, pursuant to his answer on 7 December 1990,Official Report, column 254, if he has determined Essex county council's highway committee's application of October 1988 to extend the 30 mph and 40 mph speed limit zone in Dembury; and if he will make a statement.

  Mr. Chope
  [holding answer 31 January 1991]: Approval in principle was given to Essex county council on 27 December 1990. I now await their application for confirmation of this order. I understand this is likely to be submitted sometime early in March.

  Road Links
  Mr. Robert Hicks
  To ask the Secretary of State for Transport what are the names of the consultants appointed by his Department to examine a possible new road link between Exeter and Plymouth and a second
  701
  Tamar road bridge; what was the date they were appointed; what is the proposed timetable and their terms of reference; and what are the organisations from whom evidence will be taken.

  Mr. Chope
  [holding answer 25 January 1991]: Consultants have still to be appointed for the assessment of the needs of the A38 between Exeter and Plymouth which was announced in "Roads for Prosperity". The assessment is likely to take about 12 months.
  702
  The proposal for a second Tamar crossing was one of the six projects on which the private sector were invited to express views on the suitability for private finance in June 1990. The responses are under consideration and an announcement will be made as soon as possible.

  The Department is joining with the local authorities in a traffic study of Plymouth and its environs; this should be complete by the end of 1991.