Sitting of 7 January 2004

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

  LONDON LOCAL AUTHORITIES BILL [Lords]
  Motion made,
  That the promoters of the London Local Authorities Bill [Lords] may. notwithstanding anything in the Standing Orders or practice of this House, proceed with the Bill in the present Session; and the Petition for the Bill shall be deemed to have been deposited and all Standing Orders applicable to it shall be deemed to have been complied with;
  That, if the Bill is brought from the Lords in the present Session, a declaration signed by the agent shall be deposited in the Private Bill Office, stating that the Bill is the same in every respect as the Bill brought from the Lords in the last Session;
  That the Clerk in the Private Bill Office shall lay upon the Table of the House a certificate, that such a declaration has been deposited;
  That in the present session the Bill shall be deemed to have passed through every stage through which it passed in the last Session, and shall be recorded in the Journal of the House as having passed those stages;
  That no further fees shall be charged to such stages.—[The Chairman of Ways and Means.]
  Hon. Members: Object.
  To be considered on Wednesday 14 January.

Oral Answers to Questions
  The Deputy Prime Minister was asked—
  DEPUTY PRIME MINISTER

    Social Housing Chief Executives
    Dr. Brian Iddon: Which housing association or registered social landlord chief executive receives the highest remuneration; and how much they will receive in 2003—04. [145884]
    The Parliamentary Under-Secretary of State, Office of the Deputy Prime Minister (Yvette Cooper): Figures for this year will be published in housing associations' annual accounts. Survey results for last year show that the average salary for the chief executives of the main RSLs was £88,000, but that the highest remuneration was £213,000 for the chief executive of Sanctuary. We are concerned that housing associations should not be promoting excessive and unjustifiable pay and severance packages, and my right hon. Friend the Deputy Prime Minister has written to the Housing Corporation to ask for further work on this issue.
    Dr. Iddon: I hope that my hon. Friend is aware that some former directors of housing are receiving considerable increases in salary, following stock transfer. I am aware of one who was earning about £70,000 as a director of housing, who is now earning double that figure—more than £140,000. Does my hon. Friend agree that, in the same way that some chief executives of private enterprises are now being held accountable to their shareholders, chief executives of housing associations should be held accountable by their tenants?
    Yvette Cooper: My hon. Friend is right to suggest that RSLs need to justify chief executives' salaries to tenants, who arc entitled to question some of the remuneration packages, and particularly some of the severance payments, that have been agreed. Taking those decisions is a matter for the RSL boards—housing associations are independent organizations—but there should be tenants on the boards and those tenants should be fully informed of the implications not simply for that RSL, but for the whole sector if irresponsible decisions are taken.
    Sir Nicholas Winterton: May I say from the Opposition Benches that I fully support the concern that has just been expressed by the hon. Member for Bolton, South-East (Dr. Iddon)? May I add that I am deeply concerned that many local authorities, district borough councils, are being forced—I use that word intentionally—to transfer their housing stock to social housing landlords, bearing in mind that many councillors and many, many tenants are opposed to that for the very sort of reason that the hon. Gentleman has expressed so clearly to the House? May we have further assurances from the Government that local authorities will not be forced to transfer because of the way that the Government are allocating resources?
    Yvette Cooper: The hon. Gentleman is completely wrong. Local authorities are not being forced to do

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    anything of the sort. The matter is up to a vote of local tenants, and that is as it should be. Local tenants should have the vote. Local tenants should have the say in what they think should happen to their local social housing because we must ensure that social housing is provided in the best interests of those tenants.
    Mr. Ken Purchase: But is not the whole gambit of transferring stock bound to lead to the payment of inflated salaries to the very people who are currently administering our housing stock, who will be in charge of our rented housing stock in that new situation? Do we not already have in place the necessary checks and balances? Councillors are elected by council tenants and ratepayers, creating the checks and balances required to keep those things in order.
    Yvette Cooper: My hon. Friend will know that there have been concerns about increases in the pay of local authority chief executives, on which my right hon. Friend the Deputy Prime Minister has expressed his views very clearly, so we must recognise that all sectors—whether the not-for-profit sector, the private sector or the public sector—need to exercise restraint and responsibility in setting pay settlements, and they certainly need to do so with senior salaries because they are the ones that set the example for the entire sector and that can have implications right across the sector. Particularly when we are talking about social housing, where the income comes from the rents of those who are on a low income, we must ensure that those services are provided in the interests of tenants, not of the providers.

    Telecommunications Masts
    Mr. Laurence Robertson: If he will introduce legislation to require public utilities to obtain planning permission before erecting masts; and if he will make a statement. [145885]
    The Minister for Housing and Planning (Keith Hill): In most cases, mobile phone operators' masts are subject to full planning permission or prior approval procedures. Other utilities have a range of so-called permitted development rights, which we are now reviewing as part of our planning reform agenda.
    Mr. Robertson: I thank the Minister for that mildly encouraging response. In my constituency, Network Rail planned to build a 33 m mast in the village of Churchdown, but it withdrew its proposals when all the residents formed a group to oppose them. May I suggest that organisations such as Network Rail invest in investigating what alternative and, indeed, more advanced technology might be available to avoid siting masts where they are clearly not wanted and where they are clearly inappropriate? It might also be better if a formal consultation were required, so that residents had the right to prevent such things from happening in the first place.
    Keith Hill: I am somewhat sympathetic to the points that the hon. Gentleman makes. He will be aware that there is a general height restriction of 15 m on water, gas and electricity undertakings, but there is no current
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    restriction, as he says, on Network Rail. However, a report by the Lichfield consortium has been completed, which recommends similar restrictions on railway undertakers for mast installations in sensitive areas, so we are moving in that direction.
    David Taylor: On the website of the Office of the Deputy Prime Minister, it says that the Government attach considerable importance to keeping the number of radio and telecoms masts and sites to a minimum. There seems to be some evidence that various telecoms companies are still developing their networks in parallel rather than sharing masts and sites. What are the Government doing that is tangible to minimise the number of such installations?
    Keith Hill: If that is the case, my hon. Friend is absolutely right to say that that is not in the spirit of the undertaking made by the mobile phone operators. We expect them to synchronise and link together their masts. If there is evidence of the unreasonable proliferation of such masts, we will, of course, want to have a look at that. As a matter of principle I, as the Minister with responsibility for planning, have regular meetings with the mobile phone operators and I will certainly take up the matter with them when we next meet.
    Mr. Crispin Blunt: From my experience in my constituency, I am absolutely convinced that Network Rail and its predecessors have been abusing their permitted development rights to gain a commercial advantage from the fact that they are able to put up such masts without planning permission. Will the Minister tell the House exactly when the Government will implement the welcome recommendations of the Lichfield consortium to limit Network Rail in the way in which other public utilities are limited?
    Keith Hill: We intend to issue a consultation paper on the report produced by Nathaniel Lichfield and Partners, which I mentioned earlier, in the early summer of this year. We obviously want to take the representations of all interested parties into account before we contemplate possible legislation on the matter.
    Mr. Geoffrey Clifton-Brown: I wish the Minister a happy new year and hope that he will make the correct decision on telephone masts. I am sure that he will be aware that Network Rail intends to put up several thousand masts. Many of the masts will be over 15 m and would normally require planning permission but will be exempt from that under the Town and Country Planning (General Permitted Development) Order 1995. Will he urgently review the matter, because Network Rail will put up the masts at a huge rate until the 1995 order is stopped?
    Keith Hill: It is indeed 1995. I take the point that the hon. Gentleman makes. I recognise that there is extraordinary sensitivity in some circumstances about the proposed location of such masts and we will keep a close eye on the matter. In general terms, we have the matter very much under review.

    Council Tax
    Mr Andrew Mackay: If he will make a statement on the level of council tax in 2003–04. [145886]
    The Minister for Local Government, Regional Governance and Fire (Mr. Nick Raynsford): In 2003–04 all councils had an above-inflation grant increase for the first time ever. Given this, we were very disappointed that local authorities chose to raise council tax so substantially with an average increase of 12.9 per cent. That trend in council tax rises is not sustainable and we have made it clear that we expect councils to budget prudently in the coming year with a view to council tax increases in low single figures. We have also made it clear that we will use our capping powers if local authorities persist in unreasonable council tax increases.
    Mr. Mackay: What does the Minister say to my hard-pressed council tax payers in Bracknell who face a council tax increase next year that will be many times the level of inflation? Does he appreciate that even though an extra £700,000 has been granted as an additional payment because the Government realised that the passporting of money to schools was far too high, there will still be many other costs that Bracknell Forest borough council will have to meet? Those costs, which the Government force on the council, will not allow it to restrict its council tax increase to a modest amount. What is he going to do about that?
    Mr. Raynsford: I have spoken to the leader of the right hon. Gentleman's council, and made it clear that I expect it to budget prudently and introduce a modest council tax increase. That is entirely possible, because Bracknell Forest borough council has received a grant increase in the current year of 5.7 per cent., which is double the rate of inflation, and will receive in the coming year, following our provisional announcement, an increase of 7 per cent., which is three times the rate of inflation. We expect it to budget prudently.
    Mr. Bill O'Brien: Does my right hon. Friend accept that the majority of local authorities appreciate the way in which the Government have helped local authorities with council tax and benefits? The formula that was recently introduced has helped local authorities considerably, and will he agree to continue to meet SIGOMA—the special interest group of municipal authorities, of which I am chairman in the House of Commons—to discuss further policies and progress on the formula? We do not want to return to the problems of the poll tax, which was introduced in the early days of the Tory Government.
    Mr. Raynsford: I thank my hon. Friend for his kind remarks about the grant distribution formula. I had an enjoyable visit to his local authority just before Christmas, and was impressed by the steps taken by the new management team and the leader of the council to ensure improved services for people in the area and, indeed, prudent budgeting. I assure him that there is absolutely no question that the Government will go back to the nonsense of the previous Government, particularly the poll tax.
    Mr. David Curry: Whatever the size of this year's settlement, the Minister will be aware that the Government are still incapable of managing change competently. Is he aware that for many district councils the change in the method of paying rent allowance and council tax benefits, which is now done entirely by grant, and the removal of the population-based revenue support element mean that almost the entire increase in Government grant is swallowed up by the loss of revenue associated with those benefits? A council such as Harrogate will get the princely increase of 35p per inhabitant next year to cover all its additional costs. Does the right hon. Gentleman therefore accept that the safety net proposed by the Department for Work and Pensions is inadequate, and will he strengthen it before councils set their budget? Will he draw the lesson that, yet again, the Government cannot manage change and are simply incapable of joined-up government?
    Mr. Raynsford: That is somewhat rich coming from the right hon. Gentleman, whose Government had a remarkable record on change in local government finance. I need say no more but, on his specific point, the change from the current framework, whereby local authorities are reimbursed for costs incurred in paying council tax grant and housing benefit, is complex. There are two separate elements, but it is generally accepted that it is sensible to have a single element, and the reform is broadly welcomed by local government. The right hon. Gentleman understands these matters, so he will appreciate that any process of change involves transitional difficulties. The Department for Work and Pensions has proposed a transitional framework, which it is continuing to discuss. I hope that representations from his authority and other authorities with concerns wilm be taken into account—I am sure that they will.
    Mr. Curry: Last year, the Greater London authority precept was increased by 29 per cent. Given the strictures that the Minister has just repeated about the need to limit increases in council taxes and precepts, and given the fact that he has capping powers over precepts, what figure has he given Mr. Livingstone, his new party friend, for the maximum permitted increase in the GLA precept?
    Mr. Raynsford: We have told all local authority leaders, including the Mayor of London and the leaders of all London authorities, that we expect them to budget prudently and introduce increases in low single figures. As the right hon. Gentleman knows only too well, we have said that we will use our capping powers if necessary, and intend to do so if authorities are not responsible or prudent. That applies to all authorities, and I remind him that the largest increase in London last year was in the Conservative-controlled London borough of Wandsworth, which increased its council tax by a staggering 57 per cent.
    Dr. Nick Palmer: Does my right hon. Friend accept that despite the help in the pre-Budget report, shire boroughs are still having some difficulty because of the changes in the formula? Does he also accept that much of the public resentment related to local government spending is linked to the fact that the

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    council tax is not sufficiently progressive, and that widening the range of bands that councils can impose would be a useful step forward, which many councils would welcome?
    Mr. Raynsford: First, for the second year running, all district councils in the country are guaranteed an above-inflation grant increase. This is the first time that it has happened, and despite the concerns raised by my hon. Friend and by the right hon. Member for Skipton and Ripon (Mr. Curry) in relation to the transitional arrangements for support for housing and council tax benefit grant, I believe it will be possible for district councils to budget prudently. I am sure they will. Secondly, with regard to the wider issue—the banding system—this is one of the issues that we are considering in the context of the balance of funding review that is currently taking place.
    Mr. Edward Davey: In the light of his answer to the right hon. Member for Skipton and Ripon (Mr. Curry), the Minister will know that the Deputy Prime Minister's newly rediscovered friend has published his draft budget, which proposes an increase of 12 per cent. in council tax band D for the GLA precept. Will that level be capped?
    Mr. Raynsford: I am sure the hon. Gentleman will recall his days on the Standing Committee of what became the Greater London Authority Act 1999, which created the Greater London authority. He knows that the budget is a complex process whereby the Mayor may propose a budget but it is subject to the approval of the assembly. The assembly has not yet discussed the Mayor's proposals. I am sure that its members will want to examine them very closely indeed, and I hope that they will ask searching questions about an increase that certainly does not meet our expectation of low single figures.

    Antisocial Behaviour
    Mr. Adrian Bailey: What steps his Department is taking to tackle antisocial behaviour. [145887]
    Helen Southworth: What action his Department is taking to tackle antisocial behaviour. [145890]
    The Deputy Prime Minister (Mr. John Prescott): My Office is tackling the root causes of antisocial behaviour though our sustainable communities plan, which will create thriving communities where people feel safe and want to live. We are also tackling the symptoms of antisocial behaviour by introducing a raft of measures in the Anti-social Behaviour Act 2003 and the Housing Bill, and through ongoing programmes such as that for neighbourhood wardens, with encouraging results.
    Mr. Bailey: My local authority, Sandwell, is engaged in a consultation process to identify areas in the borough where public drinking is a nuisance. Given the importance of local authorities, the Government and the police working together to curb antisocial
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    behaviour, can my right hon. Friend assure me that examples of local authority best practice will be promoted by the Government throughout the country?
    The Deputy Prime Minister: Yes, I can give my hon. Friend that assurance. He will know that that is the responsibility of my right hon. Friend the Secretary of State for Culture, Media and Sport, and she is issuing guidance for parliamentary consideration, which we will consider in the House. It will bring about more uniform practice in respect of licensing and contribute to dealing with antisocial behaviour connected with drink.
    Helen Southworth: Will my right hon. Friend monitor progress on the new local authority licensing powers, particularly the new responsibility that local authorities will have to order the temporary suspension of licences, so that pubs and clubs that allow under-age drinking, binge drinking and antisocial behaviour will get a swift penalty?
    The Deputy Prime Minister: I certainly see the sense of that recommendation. Indeed, guidance from another Department will be issued shortly and the House will have to make a judgment as to whether it thinks that it is adequate. I shall pass on my hon. Friend's comments to my right hon. Friend the Secretary of State for Culture, Media and Sport.
    Mr. Robert Key: Does the Deputy Prime Minister agree that one of the acts of antisocial behaviour that gravely disfigures our country, in every town and street, is the spitting and spreading of chewing-gum? I know that the Government have introduced some initiatives, but will the issue be covered by the Anti-social Behaviour Act 2003, as we really have to do something about chewing-gum?
    The Deputy Prime Minister: There used to be a song about sticking chewing-gum on the bedpost at the end of the day. This is a very important issue, however. Anyone going into any of the regeneration areas can see the disfigurement caused by the casting away of chewing-gum. It is a deplorable practice—I know that it is controversial to say that—and we are looking at a number of measures that we can take to clear up the problem, which disfigures some very good developments and regeneration areas.
    Shona Mclsaac: Can my right hon. Friend tell me what his Department intends to do to persuade certain local authorities that are reluctant to use the new powers that they are about to be given in the Anti-social Behaviour Act 2003? What is his Department going to do to give them a kick up the rear end?
    The Deputy Prime Minister: Well, I would not want to be associated with such violent action, but I think that we are making it very clear to local authorities what new powers in the legislation will allow them to do. Many authorities complain that they do not have the powers that they need or that they are not clear enough. The new Housing Bill and antisocial behaviour legislation will make an awful lot of improvements, and I expect all

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    local authorities to play an important part. I do not know of any constituency in this country where people are not demanding that we deal with antisocial activity.
    Mr. Roy Beggs: Is the Deputy Prime Minister sufficiently confident about the improvements that will be brought about by the new legislation on antisocial behaviour here in Great Britain to give an undertaking to us from Northern Ireland that his Government will seek to make the legislation available for use in Northern Ireland as quickly as possible?
    The Deputy Prime Minister: I am convinced that the legislation will work. In fact, I think that there is a great deal of encouraging evidence about how such measures have affected antisocial areas in a number of countries. We think that the new framework will work. I am a little unsure about the last part of the hon. Gentleman's question and whether the measures apply to Northern Ireland. I take it from his indication that they do not do so, but he has raised an issue, I do not know the answer and I shall write to him about it.[Interruption.]
    Mr. Speaker: Order. I call the House to order; it is far too noisy. [HON. MEMBERS: "Hear, hear."] Perhaps those who are cheering me will agree to come to order.
    Mr. Clive Betts: Does my right hon. Friend accept that in many areas, including my constituency, the police and local authorities are working together to use the new powers that they have been given? One of the problems, however, is that at the end of the process of eviction, tenants are all too often rehoused in another local authority house or end up in the private rented sector, where the landlords can be just as irresponsible as the tenants. Will he therefore give guidance to local authorities saying that we should not create a merry-go-round for antisocial tenants whereby they are simply moved from one property to another? There should also be a requirement for private landlords to assume wider responsibility for the antisocial behaviour of their tenants.
    The Deputy Prime Minister: Security of tenure and the sanctions used need careful handling. The new Housing Bill that we will introduce to the House, I think on Monday next week, will cover some of the issues involved. However, this matter is not only about public housing and social landlords, but about licensing private landlords. We get a lot of difficulties in that regard, and we are now taking the powers to deal with the problem.

    Council Performance Assessments
    Mr. David Cameron: How much best value and comprehensive performance assessments have cost (a) district and (b) county councils in the last year; and if he will make a statement. [145888]
    The Parliamentary Under-Secretary of State, Office of the Deputy Prime Minister (Phil Hope): We do not gather information about the costs incurred by local government on best value or comprehensive performance assessments. To do so would be an
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    additional burden on local authorities. However, recent findings from independent research show that best value reviews are helping authorities to deliver improved services. The second year of comprehensive performance assessment results announced by the Audit Commission show real improvement in councils' performance.
    Mr. Cameron: Is the Minister aware that, in West Oxfordshire, best value and CPA have cost the council £600,000, the equivalent of £13 on a band D council tax bill? That compares with the £60 at which the authority set the total council tax—the second lowest level in the country. Does he agree that every council should find out the cost of these things and put them on the front of a council tax bill so that everyone can see how much they are paying for centrally imposed red tape and bureaucracy?
    Phil Hope: I think that we have all seen the latest Tory list of meaningless platitudes about bureaucracy, and what people remember is the Tory record of Tory cuts—the Tory poll tax and Tory attacks on local councils. Oxfordshire has had an increase of 7.3 per cent. for next year, and we expect it to budget prudently and to keep its council tax down next year.
    Mr. Ronnie Campbell: Has the Minister been informed that only this morning Northumberland county council in my area announced the closure of all its local authority old people's homes? Is that best value or Labour's best value?
    Phil Hope: I understand my hon. Friend's concerns. It is important that local councils make a considered judgment about the way in which to provide the best services for local people. It is up to those authorities, in consultation with local people, to decide on the right way forward. If my hon. Friend has particular concerns about his constituency, I am happy to write to him about them. I can tell him, however, that local councils are providing better services to older people than they have ever had in previous generations, particularly under the Tories, who imposed cuts and compulsory competitive tendering on every council in the country.

  The Prime Minister was asked—
  PRIME MINISTER

    Engagements
    Ql. [145899] Mr. Ben Chapman: If he will list his official engagements for Wednesday 7 January.
    The Prime Minister (Mr. Tony Blair): This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I will have further such meetings later today.
    Mr. Chapman: My right hon. Friend will be aware that unemployment in my constituency has gone down by 60 per cent. since 1997. That is, of course, good news, but it still means that 770 people are claiming jobseeker's allowance. Major manufacturing firms have

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    suffered from problems such as the costs of doing business with the eurozone, the relative exchange rate during 2003 and increased costs in other areas, and we lost a major manufacturing plant—[Horn. MEMBERS: "Question!"] Can my right hon. Friend tell me what his plans are to ensure that small firms are allowed to trade unfettered and large manufacturing firms are allowed to prosper, so that Wirral, South can continue to be part of the strong economy during 2004?
    The Prime Minister: The best thing that we can do for small and large firms alike is to run the economy in a stable way. As my hon. Friend acknowledges, the fact that we have the lowest interest rates, lowest inflation and lowest unemployment for decades is good news for business, big and small alike. However, we still have a particular problem with those who are claiming jobseeker's allowance, and we want to see them back in work. My hon. Friend is right to say that there have been huge falls in unemployment in his constituency—and in other constituencies throughout the country—but the way that we will get those remaining people off the dole and into work is by continuing programmes such as the new deal for the unemployed, which has given opportunity to hundreds of thousands of people. That is why we will continue it, not abolish it, as the Conservative party would.
    Mr. Michael Howard
    Mr. Speaker: Order. The House must come to order. I call the Leader of the Opposition.
    Mr. Howard: On 22 July, the Prime Minister was asked:
    "Did you authorise anyone in Downing Street or in the MOD to release David Kelly's name?"
    He replied:
    "Emphatically not. I did not authorise the leaking of the name of David Kelly."
    Does he stand by that statement today?
    The Prime Minister: I suggest first of all that the right hon. and learned Gentleman look at the totality of what I said, but I stand exactly by what I said then. However, the Hutton inquiry will look at all these issues and will make its report. I suggest to him and to Conservative Members that rather than trying to prejudge the report, they actually wait for it.
    Mr. Howard: We are not going to take any lectures from the Prime Minister on prejudging the inquiry. The statement that he made, and that I just put to him, was made after he set up that inquiry. He was also asked at that time:
    "Why did you authorise the naming of David Kelly?"
    He replied:
    that is completely untrue."
    Does the Prime Minister also stand by that statement?
    The Prime Minister: I have already said, and I repeat, that the right hon. and learned Gentleman should consider the totality of my remarks. However, the
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    inquiry will determine all those issues, and I suggest that he wait until the report is published to make his points. However, it is obvious from his questions today that the Conservative party has already made up its mind. Frankly, we know what Conservative Members will say, whatever the report says.
    Mr. Howard: The Prime Minister did not answer the question, as the whole country will see, so let me give him another opportunity. He was asked:
    "Why did you authorise the naming of David Kelly?"
    He replied:
    "that is completely untrue."
    Does the Prime Minister stand by that statement?
    The Prime Minister: I have already made it clear in answer to the right hon. and learned Gentleman's first question that I stand by the totality of what I said, but in relation to the issues that he raises, and all the others, the Hutton inquiry will report shortly and I suggest that he wait for that. It is obvious from comments that he and his colleagues have made in the past few days that it does not matter what the inquiry concludes; he has already made up his mind. However, I suggest that the rest of the House wait for the report.
    Mr. Howard: But the permanent secretary at the Ministry of Defence has said that the decision to authorise the disclosure of Dr. Kelly's name was taken at a meeting chaired by the Prime Minister. Is not it clear that either the permanent secretary or the Prime Minister is not telling the truth?
    The Prime Minister: No, it is not—as I believe that we will show when the inquiry report is published. Rather than our having a debate about the evidence now, which strikes me as rather absurd, given that we are about to have the report published, and rather than the right hon. and learned Gentleman cross-examining me now, he can do that on the day the report is published—according to what it says, not according to what he says.
    Mr. Howard: I can assure the Prime Minister that I am looking forward to that.
    The Prime Minister has said that Ministers in a Government that he leads should resign if they lie to Parliament. Does that apply to the Prime Minister?
    The Prime Minister: Of course it applies to me, as it applies to all Ministers. However, since we are about to have a report that will decide whether people have or have not lied to Parliament, is it not sensible to wait for it rather than having an absurd preliminary now? As for the right hon. and learned Gentleman's relish in examining me on the report, it is equalled by mine in rebutting some of the rubbish that he has been saying in the past few weeks.
    Anne Picking: Is my right hon. Friend aware that the Accommodation and Works Committee has asked the equivalent Committee in the other place to reconsider where to put the statue of Sylvia Pankhurst? Although I understand that that is a House matter, does he agree that Sylvia Pankhurst did wonderful things to help the struggles of working-class

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    women? As we honour men who run about a field kicking balls, can we not commemorate someone who had some?
    The Prime Minister: I am looking for the Sylvia Pankhurst brief, but it does not appear to be with me. We have nothing against men kicking balls around a field—we are completely in favour of them, especially when they win the world cup for England.
    Mr. Patrick McLoughlin: That was rugby.
    The Prime Minister: The hon. Gentleman might have noticed that they kick the ball on the rugby field as well. Anything that happens to a statue of Sylvia Pankhurst is a matter for the House. Obviously, I should like her to be honoured; she was a tremendous champion of women's rights and women's suffrage—but the details should not be for me but for the House authorities.
    Mr. Charles Kennedy: Does the Prime Minister anticipate that Labour's endorsement of Ken Livingstone as candidate for London Mayor will prove more successful than Ken Livingstone's endorsement of Labour during the Brent, East by-election?
    The Prime Minister: The electorate will decide that, and we look forward to joining battle with the right hon. Gentleman and his candidate in the election.
    Mr. Kennedy: Is not the fact of the matter that yesterday's dodgy deal between the two of them means that, together, they have sold their souls? We all know that Ken Livingstone disagrees with the Prime Minister on everything from the London tube to top-up fees to Iraq. They are united in their mutual complete and utter chicanery, and the voters are going to see through that.
    The Prime Minister: Talking of chicanery, I thought that at our first Prime Minister's questions after we came back after the recess, we were going to have a discussion about the right hon. Gentleman's spending plans. It is a pity that we are not going to do so, because I have quite a lot to say on the subject. I will say it the next time he asks me about it, because there have been a few interesting developments. As for the mayoral election, we shall all have our candidates, we shall fight the election, and let us see who wins.
    Jim Sheridan: This Government have made good progress on introducing effective employment legislation, particularly with the introduction of the national minimum wage, which was either opposed by or lacked the support of some of the Opposition parties. Will my right hon. Friend continue the good work by extending the provisions and the principle of the national minimum wage to many of the youngsters in our communities who are currently excluded from it, and are therefore subject to potential exploitation by unscrupulous employers?
    The Prime Minister: We await a report from the Low Pay Commission on the possibility of extending the
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    national minimum wage to 16 and 17-year-olds. I know that my hon. Friend would accept that the introduction of the minimum wage has benefited about 1.3 million workers to an enormous extent. It is worth pointing out that all those people who warned that its introduction would damage British jobs and competitiveness have been comprehensively proved wrong. However, the reason why we did not initially introduce it for 16 and 17-year-olds was that we feared that it might have an impact on youth unemployment. We need to examine that idea carefully again in the light of what the Low Pay Commission recommends. We will study those recommendations very carefully. As ever, we must strike a balance between what we want to do to improve people's living standards, and ensuring that we do not harm job prospects.
    Mr. Bill Wiggin:
    "A person who calls for"—
    the Chancellor—
    "to be sacked and whose economic politics do not stand up has a total disregard for sensible, mature politics."
    That is what the Prime Minister said about Ken Livingstone four years ago, when he used to denounce people who called for the Chancellor to be sacked. Why has he chosen to support them now?
    The Prime Minister: Let me give the hon. Gentleman an example of why I think it is important that we back the policies of the London Mayor in relation to London. Those policies include a commitment to increase the number of police officers. The number of police officers in London has risen to record levels—there are now 3,000 more of them—and some of us remember who was Home Secretary when police numbers in London were actually cut.
    Shona Mclsaac: The industries on the Humber bank represent one of Britain's major manufacturing areas, but is my right hon. Friend aware that 475 jobs were lost in the Grimsby area in the last year? What are the Government going to do to assist areas such as Grimsby and Cleethorpes to help to regenerate them and to encourage manufacturing, particularly in view of our peripheral geography?
    The Prime Minister: There are three things that we can do to help those seaside towns. As my hon. Friend acknowledges, unemployment has fallen in those areas, but we still have some distance to go. The first thing is to use the neighbourhood renewal fund; the second is to use European Union structural funds; the third is to ensure that we get the right resources from the new deal for the unemployed into seaside towns where there are pockets of endemic unemployment. It is in part as a result of doing those things that the long-term unemployment in my hon. Friend's constituency has fallen by more than 90 per cent. I believe that if we continue with the policies of sound economic management and the new deal for the unemployed, we will reduce the numbers of unemployed still further.
    Mr. Richard Shepherd: Surely it is not the responsibility of Lord Hutton to

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    reconcile the Prime Minister's statements on the release of the name of Dr. Kelly. Surely it is the duty of the Prime Minister to reconcile his statements on this matter, which comes within his responsibility both to the House and to the country.
    The Prime Minister: Of course it is, but what I am saying to the hon. Gentleman and the Conservative party is, let us wait and deal with these issues in the light of the Hutton report, which will make the specific findings on all these questions. Surely it is more important to debate those issues on the basis of what the report actually says, rather than on the basis of speculation as to what it might say.
    Valerie Davey: Does my right hon. Friend consider that the case for action by the coalition in defence of human rights would be strengthened if justice were seen to be done for all 660 detainees at Guantanamo Bay?
    The Prime Minister: I agree that it is important. Talks are continuing on the issue. Not much has happened over the Christmas period, for obvious reasons, but I hope that we will shortly be able to tell the House how the issue will be handled, particularly in relation to the British detainees at Guantanamo Bay. I return to the point that I have made on many occasions, however, which is particularly important to emphasise when there is still, rightly, a lot of concern about possible terrorist activity: some of the information that we have had from those detained at Guantanamo Bay has been of immense importance.
    Sir Patrick Cormack: As the Prime Minister has rightly indicated that he wants to do everything possible to help the police in their battle against rural crime, will he give the House an undertaking today that he will do nothing this year to criminalise the activities of one of the most law-abiding sections of the rural community?
    The Prime Minister: If the hon. Gentleman is referring to the hunting issue, it is, as I have said previously, subject to a free vote, and a matter for the House.
    Phil Sawford: In the pre-Budget statement, the Chancellor announced additional funding for local authorities. Obviously, local authorities in my Kettering constituency, which were systematically underfunded by the previous Government, welcome that additional money. Police authorities, however, were not given any additional funds. Will my right hon. Friend look at funding for police authorities to ensure that they receive funding in line with the formula in future years?
    The Prime Minister: I know that this is an issue for my hon. Friend, and he has made many representations on it. Northamptonshire, like other police authorities, was given a significant increase in funding. We are looking all the time at what more we can do, however. I simply point out that we now have record numbers of police officers in this country: I think that we have in the region of 9,000 more police officers than we had in 1997. It is important that we recognise that that is also now being
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    boosted by thousands of community support officers. The Conservative party opposed both the investment in record numbers of police and the community support officers.
    Mrs. Patsy Calton: Can the Prime Minister tell us whether he is content to preside over a country in which the results of post office consultations on closure are ignored 99 times out of 100?
    The Prime Minister: As I have said previously on this issue, a steady stream of post office closures has occurred for a number of years. We are putting several hundred million pounds into supporting rural post offices. As a result, significant support has been given to those post offices. It lies on the shoulders of anyone who says that they would prevent any post office closures to say how they could fund such a thing. If we were to give that commitment, it would run into hundreds of millions of pounds, and we cannot afford to make it.
    Andy King: When the aviation White Paper was published last month, the people of Coventry and Warwickshire in particular heaved a huge sigh of relief. The peace of the people in my constituency and in neighbouring constituencies, however, is about to be shattered by the irresponsible behaviour of Coventry airport, which has done a shabby deal with Thomsonfly without any consultation, and without any regard for safety or for the implications of night flying for its neighbours. Will my right hon. Friend do everything that he can to ensure that any changes in Coventry are well within the constraints of the White Paper?
    The Prime Minister: Let me say first that I was not aware of the specific issue raised by my hon. Friend. He will know that we do not support the option of a new airport between Coventry and Rugby. We have published a comprehensive White Paper, and I can assure him that we will make sure that any developments that occur are within the proper principles and guidelines set out in that White Paper. Certainly, I shall examine the issue that he has raised.
    Dr. Vincent Cable: As the Prime Minister confirmed on Monday that British troops will be in Iraq for at least two more years, can he confirm the estimate that by that time, the cost to the British taxpayer of occupation and reconstruction will be at least £7 billion? In view of the vast costs involved, what success has he had in persuading friendly countries to defer the costs that the UK incurred in the first Gulf war?
    The Prime Minister: I would not confirm the figure that the hon. Gentleman has just given—and as for what commitment we make to Iraq in terms of troops in years to come, I simply cannot be sure of that. Again, contrary to some reports, I have not said that thousands of British troops will be there for years. I do not know at this time, but what I do know is that the reconstruction of Iraq is important not just for that country, but for the stability of the region and of the wider world. Some 30 countries are helping us in Iraq at the moment—it is not just the US and the UK—and I think it very important

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    that we make sure that that reconstruction succeeds. What it will cost at this stage we cannot say, but I do believe that it is an investment in the future stability and security of that region and of the world, and I welcome it.
    Mr. David Stewart: Does my right hon. Friend share my view that the joint strike fighter will provide tremendous improvement in the capability of the Royal Air Force, and does he accept that, for British manufacturing to be able to upgrade and improve the JSF, we need technological transfer from the United States? What steps does he plan to take in order to gain that technological transfer from the US Government?
    The Prime Minister: My hon. Friend's point is very important, because participation in the joint strike fighter programme will mean that we guarantee, and expand on, thousands of jobs in the UK. At the moment we are working with the US in respect of the technology. That technology will have applications that go beyond the JSF programme, so it is important that we make sure that we get the right access to it. The discussions with the US are going well, and I very much hope that they will have a positive result.
    People sometimes ask what are the benefits, apart from security, of this country's relationship with the United States. We should recognise that in terms of defence co-operation, for example, which has a spin-off into all sorts of areas, our alliance with the US is of enormous importance, not least to British industry.
    Mr. Henry Bellingham: Does the Prime Minister recall that five years ago, he promised to crack down on school truancy to help end social exclusion? Is he aware that despite a 700 per cent. increase in spending on anti-truancy schemes, truancy has gone up by a staggering 40 per cent.? Is this not yet one more example of his Government increasing public expenditure but totally failing to deliver any improvements?
    The Prime Minister: No, it is not, because the figures that the hon. Gentleman gives are wrong. The number of children in school has increased significantly, so that has to be taken into account when assessing the percentage levels of truancy. Those levels are at their lowest, and school attendance is at its highest level. I can assure him about what would happen if we were not making this investment. For example, a lot of this money is being spent on pupil referral units. That is contrary to the position that we found when we took office, whereby pupils excluded from school were getting a couple of hours' schooling a week, and were otherwise simply roaming the streets. As a result of that extra money, such pupils are now in full-time lessons five days a week, actually being taught something. That is where the money is going, and it is money well spent.
    Dr. Ian Gibson: My right hon. Friend will be aware that a very innovative exercise has been carried out called "GM nation", through which the public were asked for the
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    first time ever on a widespread basis about their views on genetically modified food. What difference might that exercise make to Government policy on GM foods?
    The Prime Minister: It gives us the opportunity to discriminate between various different types of GM technology, and it allows us to say that in certain circumstances there may be reasons—because of problems of biodiversity, for example—why we would not want to develop certain GM foods. On the other hand, in respect of certain crops it may be in our interests to do so. In terms of GM, it is also important—[Interruption.] Contrary to the Conservative party. I happen to believe it important that these measures be dealt with on the basis of science, because the biotech industry is of huge importance to this country. GM technology has a huge application not just in relation to food, but particularly in relation to medicine. Yes, it is vital that we proceed by public consultation, but also on the basis of the evidence about the science of GM, because its potential is enormous for the future of our country and of the world.
    Sir Peter Tapsell: Is the Prime Minister still able to remember that he led this country into war with the specific and categoric statement that in the spring of last year, Iraq possessed weapons of mass destruction that threatened Britain? As it is now becoming increasingly clear that that statement was a conspiratorial pretext for the war, why does he believe that it is honourable for him to continue in office?
    The Prime Minister: Because I believe that it is absolutely clear that Saddam Hussein both developed and used weapons of mass destruction. We put the information to the House on the basis of the intelligence that we received. Incidentally, I still believe that that intelligence was correct and I believe that, had I ignored that intelligence and decided not to take action in respect of the threat that was perceived, I would have been failing in my duty to this country. I would also point out to Opposition Members that it should be possible to have a debate about the rights and wrongs of the conflict in Iraq—I happen to believe passionately that it was the right thing to do—without attempting to attack each other's integrity.
    Mr. Nigel Beard: Will my right hon. Friend consider making an appeal to all universities and research laboratories to ensure that where work relates to public health and welfare, it is properly reviewed by peers working in the same field? Does he agree that if that had been done in respect of the work of Dr. Wakefield, which purported to link the MMR vaccine to autism but was never corroborated, a great deal of parental anxiety and a dangerous reduction in child vaccinations could have been avoided?
    The Prime Minister: My hon. Friend is right to suggest that the controversy over MMR is a good example of people's fears being raised quite unnecessarily, because the evidence is very clear. He will know that my right hon. Friend the Secretary of State

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    for Education and Skills has certain proposals about changing research funding, to which I refer my hon. Friend. I agree that it is important for funding to be awarded on the basis of good scientific research.
    Mr. Nick Gibb: Who determines education policy in this country—the profession or Ministers? The Labour manifesto of 1997 promised more setting in schools, but in a parliamentary answer to me last year, the Prime Minister said that that was a flatter for heads and teachers. If he believes that setting is right, and given that parents want it and that it appeared in the manifesto, why do 62 per cent. of lessons in comprehensive schools today take place in mixed-ability classes?
    The Prime Minister: I am not sure about the figure that the hon. Gentleman gave, and I would like to check it before accepting it. However, there is a balance to be struck between the Government saying that setting is something that we want to encourage in the right circumstances, and specifically telling schools that they have to operate in a specific way. Surely it is the case that setting in schools should be done where it is appropriate, but we do not believe that it is right for the central Government to dictate to schools and say that setting has to be done in all circumstances. I would point out, however, that the majority of comprehensive schools that I know about do engage in setting where they think it appropriate.
    David Winnick: Should the Government not act on an issue in respect of which the vast majority of Labour MPs and people in the country agree—that hunting with dogs should be banned, that the Parliament Act should be used and that on that matter, the Lords majority should be told where to get off? I suggest that the Prime Minister act on the issue, because it is right to end that barbaric sport once and for all.
    The Prime Minister: As I have said before, we are committed to resolving the issue in this Parliament and we will do so.
    Matthew Green: Does the Prime Minister envisage any circumstances in which his Government would scrap council tax and introduce local income tax?
    The Prime Minister: It is not our policy to scrap council tax and introduce local income tax. I have to say to the hon. Gentleman and the Lib Dems that whatever system of taxation is introduced, the money still has to be raised. I personally think that it would be difficult to persuade people of the wisdom of allowing local authorities to tax people's income.
    Mr. Michael Connarty: The Prime Minister will be aware that the European Parliament has rejected a proposal from the European Commission to put value added tax on postal services. However, the matter can be referred back to the Commission and then brought forward to the Council of Ministers. Can we have an assurance that the Government will oppose the imposition of VAT on postal services, as that, of course, would cause Royal Mail prices to rise?
    The Prime Minister: The promises that we have made on VAT, and other promises, will of course be kept.
    Mrs. Iris Robinson: Will the Prime Minister involve himself urgently and personally in resolving the very real concerns felt by Northern Ireland prison officers in response to the threats made to them and their homes? Will he ensure that all necessary security is provided, thus avoiding threatened strike action across the UK?
    The Prime Minister: Obviously, we are looking at the concerns of prison officers in Northern Ireland, and at what we can do to ensure that they are given proper protection. It is obviously to their advantage, and to the advantage of other people, that a more peaceful situation be brought about in Northern Ireland. However, I know that the dispute is at present subject to discussions between the officers' union and the Northern Ireland Office. If the hon. Lady will forgive me, I think that I will leave them to take those discussions further.

BILLS PRESENTED
  CIVIL CONTINGENCIES
  Mr. Douglas Alexander, supported by Mr. Chancellor of the Exchequer, Mr. Secretary Blunkett, Mr. Secretary Murphy, Mr. Peter Hain, Mr. Adam Ingram and Mr. John Hutton, presented a Bill to make provision about civil contingencies: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed. [Bill 14].
  SUSTAINABLE AND SECURE BUILDINGS
  Mr. Andrew Stunell, supported by Sir Sydney Chapman, Sir Nicholas Winterton, Alan Simpson, Joan Walley, Brian White, Mr. Simon Thomas, Sue Doughty, Mrs. Patsy Calton, Mr. Peter Ainsworth, Paddy Tipping and Mr. David Amess, presented a Bill to make provision in relation to matters connected with buildings: And the same was read the First time; and ordered to be read a Second time on Friday 30 January, and to be printed. [Bill 15].
  CARERS (EQUAL OPPORTUNITIES)
  Dr. Hywel Francis, supported by Tony Baldry, Mr. Roy Beggs, Mr. Roger Berry, Mr. Paul Burstow, Mr. Tom Clarke, Mr. Haw Edwards, Mr. David Hinchliffe, Anne Picking, David Taylor, Mrs. Betty Williams and Hywel Williams, presented a Bill to make provision about life-long learning for, and the employment of, carers; to place duties on local authorities and health bodies in respect of carers; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 6 February, and to be printed. [Bill 16].
  GANGMASTERS (LICENSING)
  Jim Sheridan, supported by Mr. John Lyons, Anne Picking, Mr. Mark Simmonds, David Hamilton, Mr. Iain Luke and Mr. John MacDougall, presented a Bill to make provision for the licensing of gangmasters; to make further provision concerning the enforcement of legislation relating to gangmasters; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 27 February, and to be printed. [Bill 17].
  PROMOTION OF VOLUNTEERING
  Mr. Julian Brazier, supported by Mr. Iain Duncan Smith, Mr. Bruce George, Mr. Chris Smith, Mr. Tim Boswell, Mr. John Burnett, Mrs. Gwyneth Dunwoody, Mr. Nick Hawkins, Charles Hendry, Mr. Jimmy Hood, Mr. Lindsay Hoyle and Mr. Ian Taylor, presented a Bill to make provision for volunteering and voluntary organisations; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 5 March, and to be printed. [Bill 18].

  CARDIAC RISK IN THE YOUNG (SCREENING)
  Ms Dari Taylor, supported by Jim Dobbin, Mr. Kevan Jones, Shona McIsaac, Mr. David Drew, Ms Meg Munn, Andy Burnham, Jean Corston, Dr. Julian
  260
  Lewis, Mr. Eric Pickles, Dr. Vincent Cable and Mr. Nigel Jones, presented a Bill to make provision about screening for conditions leading to sudden cardiac death in the young; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 12 March, and to be printed. [Bill 19].

  CHRISTMAS DAY (TRADING)
  Mr. Kevan Jones, supported by Mr. A.J. Beith, Ann Coffey, Sir Patrick Cormack, Mr. David Crausby, Mrs. Gwyneth Dunwoody, Mr. Gerald Howarth, Helen Jones, Mr. Colin Pickthall, Mark Tami, Mr. Tom Watson and Sir Nicholas Winterton, presented a Bill to prohibit the opening of large shops on Christmas day: And the same was read the First time; and ordered to be read a Second time on Friday 26 March, and to be printed. [Bill 20].
  PROTECTIVE HEADGEAR FOR YOUNG CYCLISTS
  Mr. Eric Martlew, supported by Mr. Julian Brazier, Mr. David Rendel, Dr. Richard Taylor, Mr. Keith Bradley, Mr. Andrew Mitchell, Dr. Howard Stoate, Mr. Joe Benton, Mr. Hilton Dawson, Mr. Mike Hancock. Keith Vaz and Annabelle Ewing, presented a Bill to make provision for the wearing of protective headgear by children while riding cycles; to prescribe offences and penalties; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 23 April, and to be printed. [Bill 21].
  CONSTITUTION FOR THE EUROPEAN UNION(REFERENDUM)
  Mr. John Maples, supported by Mr. Frank Field, Mr. David Heathcoat-Amory, Kate Hoey, Mr. Peter Lilley, Mr. Archie Norman, Mr. George Osborne, Richard Ottaway, Sir George Young, Mr. Edward Garnier, Mr. Andrew Tyrie and Mrs. Gillian Shephard, presented a Bill to make provision for a referendum on any Treaty establishing a Constitution for the European Union; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 23 April, and to be printed. [Bill 22].
  RETIREMENT INCOME REFORM
  Mr. Adrian Flook, supported by Sir John Butterfill, Mr. David Curry, Mr. Frank Field, Mr. Edward Garnier, Steve Webb and Mr. Andrew Lansley, presented a Bill to amend the law relating to the provision of retirement income in respect of private and personal pensions, annuities and defined and additional voluntary contribution pension schemes: And the same was read the First time; and ordered to be read a Second time on Friday 26 March, and to be printed. [Bill 23].
  REFERENDUMS (THRESHOLDS)
  Mr. Gordon Prentice, supported by Mr. Graham Stringer, Geraldine Smith, Mr. Lindsay Hoyle, Mr. Ian Liddell-Grainger, Mr. Nigel Evans, Mr. George Howarth and Bob Russell, presented a Bill to amend the Political Parties. Elections and Referendums Act 2000 to make provision to set thresholds in respect of referendums; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 27 February, and to be printed. [Bill 24].
  TOWN AND COUNTRY PLANNING (ENFORCEMENT NOTICES AND STOP NOTICES)
  Mr. John Randall, on behalf of Mr. Eric Pickles, supported by Mr. Philip Hammond, Mr. Geoffrey Clifton-Brown, Mr. John Hayes, Mr. Robert Syms, Mr. John Randall and Mr. Mark Field, presented a Bill to amend the Town and Country Planning Act 1990 in respect of enforcement notices and stop notices; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 5 March, and to be printed. [Bill 25].
  WILD MAMMALS (PROTECTION) (AMENDMENT) (No. 2)
  Mr. Peter Luff, on behalf of Lembit Öpik, supported by Kate Hoey, Mrs. Gwyneth Dunwoody, Mr. Austin Mitchell. Mr. Barry Sheerman, Mr. Peter Luff, Richard Ottaway, Mr. James Gray, Mr. Andrew Mitchell, Mr. Roger Williams, Mr. Paul Tyler and Mr. Simon Thomas, presented a Bill to amend the Wild Mammals (Protection) Act 1996: And the same was read the First time; and ordered to be read a Second time on Friday 6 February, and to be printed. [Bill 26].
  PERFORMANCE OF COMPANIES AND GOVERNMENT DEPARTMENTS (REPORTING)
  Andy King, supported by Linda Perham, Mr. Michael Meacher, Mr. Martin O'Neill, Mr. John McFall, Mr. Barry Sheerman, Tony Baldry, Sue Doughty, Norman Baker, Mr. Simon Thomas, Mr. Andrew Dismore and Mr. John Horam, presented a Bill to make provision for the production and publication of annual reports on the social, environmental and economic impacts and performance of companies and Government departments; to specify certain duties of directors and Ministers; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 30 January, and to be printed. [Bill 27].
  PROPERTY REPAIRS (PROHIBITION OF COLD-CALLING)
  Mr. Andrew Robathan, supported by Mr. Paul Truswell, Dr. Julian Lewis, Ann Clywd, Sir Sydney Chapman, Ann Keen and Mr. James Paice, presented a Bill to make provision about cold-calling to solicit employment to undertake the laying of drives and other property repairs, maintenance and improvements: And the same was read the First time; and ordered to be read a Second time on Friday 12 March, and to be printed. [Bill 28].
  ILLEGAL HARE-COURSING (ENFORCEMENT OF PROHIBITION)
  Hugh Robertson presented a Bill to make provision for the enforcement of the prohibition on illegal hare-coursing: And the same was read the First time; and ordered to be read a Second time on Friday 12 March, and to be printed. [Bill 29].
  HIGHWAYS (OBSTRUCTION BY BODY CORPORATE)
  Mr. Michael Jabez Foster, supported by Dr. Desmond Turner, Norman Baker, Laura Moffatt and Mr. David Lepper, presented a Bill to apply section 314 of the Highways Act 1980 to offences under sections 137 and 137ZA of that Act: And the same was read the First time; and ordered to be read a Second time on Friday 6 February, and to be printed. [Bill 30].
  GENETICALLY MODIFIED ORGANISMS
  Gregory Barker, supported by Mr. William Hague, Mr. Peter Ainsworth, Mr. John Hayes, Mr. David Cameron, Tony Baldry, Mr. Jonathan Sayeed, Mr. Michael Meacher, Joan Ruddock, Alan Simpson, Sue Doughty and Mr. Simon Thomas, presented a Bill to establish a licensing regime in the event of the release of genetically modified organisms into the environment; to establish liability for the release of genetically modified organisms into the environment and for damage caused thereby; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 26 March, and to be printed. [Bill 31].
  TOWN AND COUNTRY PLANNING (TELECOMMUNICATIONS MASTS)
  Mr. Richard Spring, supported by Mr. Gary Streeter, Mr. Hugo Swire, Mrs. Marion Roe, Mr. Gerald Howarth and Mr. Keith Simpson, presented a Bill to amend the law relating to telecommunications masts: And the same was read the First time; and ordered to be read a Second time on Friday 5 March, and to be printed. [Bill 32].
  TRESPASSERS ON LAND (LIABILITY FOR DAMAGE AND EVICTION)
  Mr. Gerald Howarth, supported by Mr. Philip Hammond, Dr. Julian Lewis, Mr. Mark Todd, Mr. Crispin Blunt, Mr. Nick Hawkins, Mr. Graham Allen, Mr. Humfrey Malins, Mr. James Arbuthnot and Sir George Young, presented a Bill to make a person liable for any damage caused to land, or property on that land, on which he is trespassing for the purpose of residing there; to amend the law in respect of eviction from land; to make provision for compensation; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 5 March, and to be printed. [Bill 33].
  OLDER PEOPLE'S COMMISSIONERS
  Ian Lucas, supported by David Taylor, Mr. John Horam, Mr. Paul Tyler, Mr. Parmjit Dhanda, Mr. Roger Williams, Ms Joan Walley, Mr. Nigel Evans, Albert Owen and Gareth Thomas, presented a Bill to establish Older People's Commissioners for England and Wales; to make provision for the Commissioners' duties in respect of the protection of the rights and interests of older people; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 23 April, and to be printed. [Bill 34].
Opposition Day
[1ST ALLOTTED DAY]
Opposition Day

  NHS Performance Indicators
  Mr. Speaker:I inform the House that I have selected the amendment in the name of the Prime Minister.
  12.37 pm
  Mr. Tim Yeo(Con):I beg to move,
  That this House calls for an inquiry into the circumstances surrounding the decision in July 2002 to upgrade the star rating of the South Durham Health Care Trust from two stars to three following the involvement of the private office of the then Secretary of State for Health and with the knowledge of 10 Downing Street; further calls for greater transparency in the calculation and publication of performance indicators throughout the NHS; and is concerned that excessive reliance on such indicators inhibits the independence of professionals and managers and leads to distortions in the allocation of resources.
  I draw the attention of the House to my entry in the Register of Members' Interests.
  I am delighted that on its third day back at work the House has the chance to debate the circumstances surrounding the award in July 2002 of three stars to the South Durham Health Care NHS trust. We are indebted to the Health Service Journal for exposing those circumstances in a report published on 18 December, the day the House rose for the Christmas recess. The Health Service Journal revealed facts that raise serious questions about the integrity of the way in which the star rating system was operated in 2002, about the extent of ministerial interference in the award of stars to individual trusts and about the involvement of Downing street in that process.
  Let us examine the sequence of events. On 12 July 2002 the head of the performance development unit at the Department of Health, Mr. Giles Wilmore, sent a paper to the then Secretary of State, the right hon. Member for Darlington (Mr. Milburn), to whom I wrote last night to warn him that I would be mentioning him by name in today's debate. That paper explained that the methodology for calculating the 2002 star ratings had been agreed with the Commission for Health Improvement and that the inspectorate's assessment had been incorporated into the results, for which the Department was fully and solely responsible. The paper also explained that the results had been checked with the four directorates of health and social care.
  The list of star ratings was attached to the paper, showing an increase in the number of hospitals receiving three stars compared with the 2001 awards. Mr. Wilmore explained that despite the overall increase in performance
  "there are still a few high-profile trusts which we might have expected to be three stars which are not."
  His next comment, according to the report in the Health Service Journal, is significant and I shall quote it in full:
  "Unfortunately, even if time allowed it, further revisions to the
  methodology to promote these trusts would inevitably lead to other individual results we have not expected, as well as making the scoring system more complicated."
  In the view of Mr. Wilmore, tinkering with the basis for calculating star ratings at such a late stage would be undesirable.
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  The then Secretary of State disagreed. Three days later, on 15 July, his private office, in the shape of Sammy Sinclair, warned Mr. Wilmore in an e-mail that the Secretary of State wanted to reconsider the issue. The Secretary of State was apparently very unhappy about the rating given to the Northumbria health care trust and asked whether it could be
  "urgently revisited with the Commission for Health Improvement."
  The same e-mail from the Secretary of State's office went on:
  "The Secretary of State would also identify South Durham as a high-profile trust given that it serves the Prime Minister's constituency. Why has it fallen from three stars last year to two stars?"
  The e-mail no doubt anticipated the questions that the Prime Minister was likely to put and it had the desired effect. The very next day, on 16 July, a new paper arrived from Mr. Wilmore, confirming that the star ratings had been recalculated. That paper stated:
  "Alterations to the methodology have been made resulting in the changes to individual trusts that were requested."
  There can be no doubt about what was going on. That senior official received a request from the Secretary of State to make changes to the rating of the NHS trust that serves the Prime Minister's constituency. As it happened, it also served part of the Secretary of State's constituency. Imagine the relief in his office that day as his staff scanned the latest document to find that no fewer than seven more NHS trusts had now received the coveted three stars, and those seven included the all-important South Durham health care trust.
  The Secretary of State had prevailed. He had found a way—no matter at what cost in terms of lost integrity— to manipulate the ratings. There is no indication that the changes had the approval of the Commission for Health Improvement or even that it was consulted. Mr. Wilmore's latest note contained a warning, however. It said that changing the results in the way described
  "makes the scoring methodology more difficult to explain and less transparent."
  Mr. Adrian Bailey(Lab/Co-op):There is nothing new in the hon. Gentleman's allegation. It has been made a number of times and repudiated to the satisfaction of pretty much everyone except the Conservatives. As he is concerned about the integrity of the process and the abuse of ministerial position, I draw his attention to a real case of ministerial abuse, as outlined by his Front-Bench colleague, the hon. Member for West Chelmsford (Mr. Burns), in the Standing Committee on the Health and Social Care Bill on 18 January 2001—
  Mr. Speaker:Order. Interventions are usually short. The hon. Gentleman is making a speech.
  Mr. Yeo:That was a pretty disgraceful performance by the hon. Member for West Bromwich, West (Mr. Bailey). I hope that other interventions will address the subject matter of the debate.
  Given that the formula for calculating star ratings in 2002 had just five elements and that for one of those five—clinical focus—South Durham's performance for emergency readmissions for adults and children was

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  "significantly below average", Mr. Wilmore's warning about having to make the methodology less transparent looks like a euphemism. We are dealing with some very murky waters indeed.
  Mr. Ronnie Campbell(Lab):Will the hon. Gentleman give way?
  Mr. Yeo:No, given the last intervention I shall not give way; the hon. Gentleman will have to wait a little longer.
  No wonder there seems to be some reluctance on the part of the Government to open up the whole episode to the public scrutiny that it needs. Before considering the effects of that ratings recalculation on the South Durham and other NHS trusts and the patients whom they serve, we need to examine the role of No. 10 Downing street.
  The Health Service Journal broke its story on Thursday 18 December. Not surprisingly, given the reference in the Department of Health's e-mail to the Prime Minister, Downing street was immediately asked for comment. The next morning, on 19 December, the Prime Minister's spokesman was quoted in the Daily Mail, emphasising that, subsequent to the award of the 2002 ratings, responsibility for awarding stars had been removed from the Department of Health. The spokesman attempted to distance Downing street and the Prime Minister from the then Secretary of State's actions, saying:
  "As I understand it, Mr. Milburn queried the star ratings for a number of hospitals, not just this one. In some cases, ratings changed; in other cases, they didn't."
  What the Downing street spokesman did not say on 19 December and what emerged only a couple of days later was that No. 10 had indeed been consulted by the Department of Health at the very time when the then Secretary of State embarked on his manipulation of the ratings. The e-mail from the Secretary of State's office to Mr. Wilmore, which requested reconsideration of the decision to downgrade the rating of the Prime Minister's local NHS trust, was copied to the Prime Minister's health policy adviser at No. 10, Mr. Simon Stevens.
  The extent of the Prime Minister's direct personal involvement remains unclear at present; although I wrote to him about the whole matter before Christmas, I have still received no reply. I trust that when the Secretary of State speaks in the debate, he will explain whether the Prime Minister expressed a view about the matter at the time. I trust that the Secretary of State will also tell us whether Mr. Stevens sent any reply from Downing street to the Department of Health in response to the e-mail that Sammy Sinclair, in the Secretary of State's office, had so helpfully copied to No. 10.
  Let us turn to the consequences of the sudden re-rating of South Durham, because decisions about star ratings are not simply academic. The result of the last-minute upgrade following the then Secretary of State's intervention was to make South Durham eligible for a capital funding grant of £1 million. Very nice, too. But there is no such thing as a free lunch. That £1 million has to come from a finite pot of money—in this case, the £85 million available for three-star trusts. Less fortunate
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  than South Durham was, for example, the George Eliot hospital in the west midlands, one of the six hospitals that had been awarded three stars in the list originally sent to the then Secretary of State on 12 July, but which were mysteriously downgraded to only two stars by the time the ratings were published later that month. Other losers included the City hospital in Birmingham, the Royal Bournemouth and Christchurch hospitals, the Winchester and Eastleigh healthcare trust, and so on.
  Mr. Ronnie Campbell:I thank the hon. Gentleman for giving way. I am very interested in what he is saying, as it would surely be a good case to take to the parliamentary ombudsman so that she can investigate it.
  Mr. Yeo:I am grateful to the hon. Gentleman for that helpful suggestion. I had not previously thought of doing that but I shall give it consideration. I am sorry that I did not give way to the hon. Gentleman earlier on—[Interruption.] It was a good suggestion and he is being very helpful.
  The doctors and nurses who work in the hospitals that were downgraded from three to two stars and the patients whom those hospitals serve may conclude that if they had been lucky enough to have one of Tony's cronies as their Member of Parliament they, too, would have enjoyed in 2002 the benefits that three-star status bestows.
  Mrs. Gillian Shephard(Con):My hon. Friend is describing a series of rather murky events, as he puts it, but will he tell the House if the same star-rating system applies to hospitals in Scotland, and whether the current Secretary of State will be protected from the same problems as have apparently affected his colleagues?
  Mr. Yeo:My right hon. Friend raises a very intriguing issue. Of course we all know that the current Secretary of State will answer today for what went on in northern England, in this case, in a way that he cannot answer for what goes on in Scotland. From what we read in some of the public prints, the waters in Scotland are at least as murky as those in South Durham.
  One of the benefits of three-star status was described by the Health Service Journal in the same issue, which said that it bestowed
  "a place on the starting grid once the race to form the first wave of foundation trusts got under way. Anybody who remembers the formation of the first NHS trusts in the early 90s will understand how valuable being in the vanguard can be."
  We must remember that, back in July 2002, the then Secretary of State advocated a foundation trust model that was a great deal more robust, independent and exciting than the one that the Government, in the face of widespread rebellion from their own Back Benchers, introduced last November. The right hon. Member for Darlington would correctly have judged in July 2002 that the opportunity to be in the first wave of foundation trusts would be a great deal more valuable and advantageous than it eventually turned out to be.
  Mr. David Hinchliffe(Lab):I appreciate that the hon. Gentleman is developing his argument, and I am listening carefully to what he is saying. I have also studied in detail the Health Service Journal piece,

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  which deals with the previous Secretary of State's intervention in respect of a trust in Basildon. Does the hon. Gentleman intend to develop his argument and set out why the Secretary of State also intervened in respect of Basildon, which does not seem to have a connection with himself or the Prime Minister?
  Mr. Yeo:The answer is that the same article in the Health Service Journal did indeed raise the issue of Basildon, but because I am concerned about the role of Downing street, as well as that of the Secretary of State, I am concentrating on what seems to be the particularly scandalous example of South Durham.
  The Secretary of State for Health (Dr. John Reid):Can we take it that that is why the hon. Gentleman has not referred to the other seven trusts that have nothing to do with No. 10?
  Mr. Yeo:I am perfectly happy if, when the Secretary of State answers, he deals with the one trust with which I am particularly concerned, and we will take his answer as a proxy for how he might have answered on the other trusts that I could have mentioned. Indeed, if he is unable to answer in detail on South Durham, we have to assume that the waters are as murky in the case of all the others as well.
  The Secretary of State has a clear choice this afternoon. He can opt—as I fear he may, given the tone of his interventions—for the cover-up route. He can bluster about how the system has been changed since 2002, how the role of the new Commission for Healthcare Audit and Inspection has been strengthened and how the Department of Health's involvement in awarding star ratings has been reduced, but none of that will alter the facts of the episode that I have just described. The words of the note sent by Mr. Wilmore to the Secretary of State on 16 July 2002 are the smoking gun. Mr. Wilmore had clearly received a request from the Secretary of State—a request that, doubtless, the right hon. Gentleman assumed would never become known to the public, but a request made in an e-mail seen by the Prime Minister's own top health adviser in Downing street.
  Sir Nicholas Winterton(Con):Does my hon. Friend accept that what is not important is whether or not the Prime Minister or the Secretary of State made representations in connection with a particular trust? What is important is whether, if other hon. Members had made similar representations to the Secretary of State or the Department of Health, they would have received the same sympathetic acknowledgement of those representations and whether the decision made would be transparent in every way and be justifiable?
  Mr. Yeo:My hon. Friend is right. Of course any hon. Member on either side of the House is right to make representations about how their local NHS is treated. As my hon. Friend suggests, it is likely that representations from some hon. Members will receive more careful consideration than others. However, the circumstances in this case are indeed very much worse than in the situation that he implies. The Secretary of State and his senior officials were in possession of information about the conclusions arrived at by the
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  methodology already agreed with the commission, and it pointed out that a hospital in which the Prime Minister and the Secretary of State had a direct interest had been downgraded. They chose to use that information in a manner that is wholly lacking in transparency to have those ratings reconsidered—I would say manipulated—to secure advantages for that local NHS trust that are denied to the trusts operating in the constituencies of many other hon. Members.
  As I say, the Secretary of State has a choice today. He can become an accomplice of his predecessor. He can make himself complicit in this tale of ministerial interference, this case where the demands of low politics were put before the needs of patients and professionals. If he chooses that route, he will further undermine the integrity of the whole performance management process in the NHS because, if the people at the very top of the NHS, at the highest level in the Government, cannot be trusted to operate the system objectively, responsively and ethically, the public will have little confidence in the judgments that are reached.
  I urge the Secretary of State therefore to take the alternative route: to announce today that all the relevant documents, e-mails, correspondence and other material will be made public immediately and to welcome any further investigation—whether by the parliamentary ombudsman, as the hon. Member for Blyth Valley (Mr. Campbell) so helpfully suggested, by the Health Committee, which may like to consider the matter, by the Public Accounts Committee or by any other body that decides to inquire into the matter, perhaps including the Health Service Journal. If the publication of that material indicates any wrongdoing or improper interference—either by No. 10 Downing street or by anyone at the Department of Health, including the Secretary of State's predecessor—he should establish a proper, independent inquiry into the whole matter that can be conducted swiftly and report to the House on what actually happened in July 2002.
  Mr. Christopher Chope(Con):Will my hon. Friend go further and say that hospitals, such as the Royal Bournemouth and Christchurch hospitals, that suffered as a result of the arbitrary action by Ministers should be compensated for the loss that they suffered?
  Mr. Yeo:My hon. Friend raises a very important issue on behalf of his local hospitals and his constituents. It is perfectly true that, if it appears that that trust suffered as a result of the manipulation of the ratings for political purposes, there is indeed a powerful case for saying that it should be compensated for those losses.
  Mr. Henry Bellingham(Con):The local hospital in my constituency—the Queen Elizabeth hospital—has two stars. As my hon. Friend rightly points out, there are consequences for not getting

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  the third star, but surely, given all the obsession with targets, stars and ministerial control from the centre, what we need is more local autonomy.
  Mr. Yeo:My hon. Friend is absolutely right. Of course local autonomy is a key element in our policies to improve the NHS and the lot of patients throughout the country.
  Andy Burnham(Lab):Will the hon. Gentleman give way?
  Mr. Yeo:No, I must conclude, I am afraid.
  If the Secretary of State goes down the route that I propose, he will take the first step to redressing some of the damage that this rather shabby episode has inflicted. Opening up the circumstances that led to the re-rating of South Durham is necessary if public confidence is to be restored. I salute the work of Health Service Journal in bringing those facts into the public domain and the courage of those individuals who may have co-operated to help it do so.
  In conclusion, let me remind the House that it is not only the Conservative Opposition who regard the star-rating system as deeply flawed. Jim Johnson, the chairman of the British Medical Association commented last July:
  "Nobody should use star ratings to judge how well a hospital is doing. They measure little more than hospitals' ability to meet political targets and take inadequate account of clinical care or factors such as social deprivation. It is grossly unfair on staff working in low-rated trusts that public confidence in them is being undermined".
  Imagine how the staff felt in the trusts whose ratings went down from three to two stars as a result of the exercise.
  The Conservative party believes that the whole star-rating system should be scrapped. Its effect can be demoralising for staff and it does not provide valuable information for patients. It fails to acknowledge the complexity of the activities performed by the hospitals that it purports to judge. We shall return to the question of why the system is seriously flawed on another occasion. Today, however, we focus on one set of ratings that was unveiled 18 months ago and that has now been exposed as the victim of meddling by a Minister, which was perhaps carried out to curry favour with the Prime Minister—perhaps done even with the connivance or encouragement of No. 10 Downing street itself. I urge the Secretary of State to come clean on behalf of the Government, to publish all the documents that we need in full and to allow an inquiry to be conducted. I commend the motion to the House.
  1 pm
  The Secretary of State for Health (Dr. John Reid):I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
  "notes that record investment in the NHS has to be linked to reform, and that this investment and the devolution of power to the front line require greater accountability; congratulates the Government on its record of making the NHS more transparent through the development of performance indicators; welcomes the Government's development of such indicators in consultation
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  with patients and staff; congratulates the Government on giving responsibility for NHS performance monitoring to the independent Commission for Healthcare Audit and Inspection (CHAI), which reports direct to Parliament; and welcomes CHAI's commitment to developing new and more reflective indicators in partnership with representative bodies and the NHS itself."
  This is a good old week for conspiracies. I thought at one stage that the hon. Member for South Suffolk (Mr. Yeo) was going to demand an investigation by John Stevens into the murky deeds that he outlined. Let me make two things absolutely clear at the start. First, I—and all Labour Members—take allegations of this nature very seriously.
  Mr. Peter Lilley(Con):You do not.
  Dr. Reid:Yes, we do.
  Mr. Lilley:Then why are you laughing at it?
  Dr. Reid:Because we do not treat them naively—I thank the right hon. Gentleman for his useful intervention. We are not naive about why such allegations are sometimes made. Today's Opposition day debate is not really about the failings of any Minister, the NHS, the star rating system, or NHS staff. We are under no illusion about why the debate was hyped up, as it was before the holidays. Incidentally, no regard has been paid to the two replies that have been given to the previous demands for an investigation, which amazes me, but I shall come back to that. Today's debate is about the failure of the Tory party—
  Andrew Selous(Con):Will the Secretary of State give way?
  Dr. Reid:For goodness' sake, let me at least start. I know that Conservative Members want to pre-empt every investigation—their leader pre-empted the Hutton investigation today—but rational people without malicious intent allow the other side to have a say before intervening. [Interruption.] Conservative Members do not necessarily benefit from shouting down a speaker either.
  Today's debate is much more about the Tory party's failure to come to terms with one simple fact: the national health service has improved, is improving and will continue to improve. If I may use a metaphor, that is really what gets up its nose. [Interruption.] Opposition Members may say, "Rubbish", but we know that that is true, courtesy of the revelation of the former Opposition spokesman on health—now the half-chairman of the Conservative party—who was candid enough to tell us explicitly what his party's agenda was. He knows that if the improvements continue, and if people outside the House see them, Tory plans to undermine the national health service will themselves be undermined. His quaint words were:
  "If Labour fix the national health service we are"—
  I do not know what the final word beginning with "F" is—it is presumably "foxed". We know the Conservative party's agenda and why on every occasion it attempts to denigrate any achievements by people working in the health service, as it does with the case

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  that we are debating. Although we take the subject seriously, we do not do that naively. The debate is a politically motivated personal attack to harm the national health service as well as the Labour party.
  Mr. Kevan Jones(Lab):My right hon. Friend knows that I have been critical of the new health trust in Durham and the way in which it has been managed—I continue to have those reservations. However, three hospitals have been built in Durham since 1997, so does he agree that the situation is different from that under the Conservatives? A new hospital opened in my constituency last year, which replaced a hospital that was the old workhouse. There is a new £97 million hospital in the city of Durham and at Bishop Auckland. That represents a true record; the actual disgrace is the fact that the Conservatives never bothered about health care or investment in the county of Durham.
  Dr. Reid:I entirely agree with my hon. Friend. The reality of the record is there for all to see. However, the Conservatives minimise any achievement in the NHS, maximise and magnify any failure—failures do happen—and put every success down to fiddling managers, cheating staff or, now, corrupt Ministers because they cannot stand to see the improvements. Let me turn to some of the details.
  Andrew Selous Andrew Selous rose—
  Mr. Crispin Blunt(Con)Mr. Crispin Blunt (Reigate) (Con) rose—
  Dr. Reid:I shall give way if the hon. Gentlemen allow me to go through some of the narrative on this.
  The motion attacks not only my predecessor as Secretary of State—I wish that the hon. Member for South Suffolk had read the motion, which was presumably written for him and tabled in his name—but targets, performance indicators and the whole system of evaluation. The Opposition consistently attack performance targets and indicators, but the targets have been absolutely essential to the improvements in the NHS over recent years. They have resulted in our drive that has achieved 14,000 more doctors, 15,000 more nurses and almost 400,000 more operations. They have resulted in a 10 per cent. reduction in cancer mortality for under-75s and a 23 per cent. reduction in cardio-vascular related deaths among people aged under 75. Speedier operations are reducing waiting times. The Government stand by the achievements and the way in which we managed them, which was partly through the targets and performance indicators that are attacked by the Conservatives.
  Andrew Selous:Will the Secretary of State give way?
  Dr. Reid:I will give way after I have concluded my introductory comments. The motion for which the hon. Member for South Suffolk asks us to vote also attacks the transparency that we have introduced. That transparency is the basis for increased patient power. The wider availability of patient information, which for the first time since the formation of the NHS increases vastly the control exercised by ordinary members of the public over their health service, is dependent on that transparency.
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  The Conservatives also attack star ratings, which, for the first time, provide information about local health services and focus attention on what is important to patients and the public. None of their attacks arises by accident, and I shall continue to try to illustrate why they arise and go through the narrative of what happened during the events to which the hon. Member for South Suffolk referred partially, but not fully.
  Andrew Selous Andrew Selous rose—
  Mr. Blunt Mr. Blunt rose—
  Dr. Reid:In fairness, I shall give way to the hon. Member for South-West Bedfordshire (Andrew Selous) first.
  Andrew Selous:Will the Secretary of State assure the House that there will be no further use of terms such as "high-profile trusts" from anyone in his office merely according to the seniority or status of the relevant Member of Parliament? If our constituents think that health care is allocated according to the eminence or otherwise of their MP, it is an extremely serious matter.
  Dr. Reid:I do not know whether that is a major question, but I shall treat it seriously although I have misgivings about whether it is actually serious. I take it that the hon. Gentleman has looked at the e-mails. If he checks them, he will see that the phrases were introduced not by anyone in the private office of the previous Secretary of State or, indeed, the previous Secretary of State, but by another official. That official does not work in the office of the Secretary of State or, indeed, Richmond House, but in Leeds. The phrase "high-priority" was shorthand and a completely innocent way of referring to several trusts.
  Secondly, the phrase was not meant to define the trusts with major or high-priority politicians. If the hon. Gentleman reads the e-mails again, he will see that several other trusts are mentioned in that context—for example, from memory, the e-mail mentioned Great Ormond Street. When the former Secretary of State responded to it using the phrases and phraseology solicited from him, he referred to not one but nine trusts, one of which was subsequently moved up. That trust happens to be the local trust of a prominent Conservative Member, although she had nothing to do with the process. The interpretation of partial analysis of fragmentary so-called evidence by the hon. Member for South Suffolk is therefore utterly unjustified.
  Mr. Blunt:The issue is the political manipulation of the health service, and the right hon. Gentleman should be aware that his Department and his predecessor have a record in that regard, not least in my constituency and that of the hon. Member for Crawley (Laura Moffatt). Our hospitals were put together in a trust following an organisation programme agreed by the Department, which was unpopular in Crawley, as services were moved to my constituency. The right hon. Gentleman's predecessor ordered a moratorium two months before the general election in 2001 at a cost of £50,000 a month, as we established through parliamentary questions. The Department has refused to let me have the advice given

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  by the trust, which was against the moratorium, both in principle and because patient safety was involved. If the Secretary of State is going to address the need for greater transparency in the health service, will he give an undertaking that I will get a copy of the advice that the trust gave at the time of his predecessor's decision?
  Dr. Reid:There is a simple way, as the hon. Gentleman knows, to get information that is classified as confidential and privy to Ministers and their advisers. It is called an election, and such information is available to the elected Government, as the hon. Gentleman well knows because, as a former adviser to a Conservative Defence Secretary, he was privy for a number of years to information given in confidence to Ministers and on which assessments were based. Much of that information would have been of interest to hon. Members, but he was not expected to reveal it, and I am not prepared to reveal information that is confidential to Ministers and their advisers. That is how it will stay.
  Mrs. Angela Browning(Con)Mrs. Angela Browning (Tiverton and Honiton) (Con) rose—
  Dr. Reid:There will be plenty of opportunity for Members to intervene later.
  Mr. Blunt:On a point of order, Mr. Speaker. The Secretary of State does not appear to understand the consequences of the Freedom of Information Act 2000, which allow me—
  Mr. Speaker:Order. The hon. Gentleman is trying to draw me into the debate. This is not a matter for the Chair, but a matter for debate.
  Dr. Reid Dr. Reid rose—
  Mr. Yeo:Our debate is developing rather significantly. The Secretary of State accused me, I think, of relying on fragmentary evidence, but the solution to the problem is in his own hands if he publishes the documents. In relation to that request, he referred to parts of an e-mail, which did not appear in Health Service Journal, and mentioned Great Ormond Street hospital, which was not referred to anywhere in Health Service Journal. However, now that he has referred to that e-mail, is it not correct that he should place a copy of the full text in the Library?
  Dr. Reid:If we are talking about the fragmentary nature of evidence, there was a glaring omission in the hon. Gentleman's own speech. I find it astounding that he failed to refer to the reply that the Conservative party chairman received from no less a person than the Cabinet Secretary—[Interruption.] If I could deal with the matter in hand. The hon. Member for South Suffolk may not share my opinions, but it would be helpful if he showed courtesy to the House.
  The Cabinet Secretary, Sir Andrew Turnbull, sent a letter dated 23 December to the hon. Member for Woodspring (Dr. Fox), in response to a letter from the chairman of the Conservative party. Naturally, I shall place Sir Andrew's letter in the Library. It is astounding
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  that the letter, which was the first reply to the first demand for a Downing street investigation from the Conservative party chairman, has apparently not been shown to the hon. Member for South Suffolk, who spoke at considerable length about Downing street without revealing to the House the Cabinet Secretary's reply. I shall therefore remind him of what it says. He is looking puzzled—I do not know whether his party chairman has informed him of the letter. I know that there has been a holiday, but presumably they spoke on the phone to wish one another happy new year, and the matter might have been raised. In the letter, the Cabinet Secretary says:
  "I have looked into the involvement of No. 10. As they have already made clear, the adviser covering health matters, Simon Stevens,"—
  to whom the hon. Member for South Suffolk referred—
  "is routinely copied policy papers from the Department, and he was one of 65 people on the copy list for emails on the criteria for awarding star ratings. He did not intervene in this correspondence regarding South Durham nor any other NHS Trust. Nor did he raise the issue with the Prime Minister."
  It is astounding that the hon. Member for South Suffolk did not share that information with the House. To paraphrase the Leader of the Opposition, we will take no lectures about allegations of a cover-up when the Conservative health spokesman has not even revealed that the questions he asked have been answered by no less a person than the Cabinet Secretary.
  None of these attacks has happened by accident. The attacks are part of the Conservatives' unsuccessful attempts to undermine the efficacy and reputation of the national health service, and have nothing to do with discovering the truth.
  Mr. Yeo:On a point of order, Mr. Speaker. I asked the Secretary of State in my intervention a few minutes ago whether he would place in the Library a copy of the e-mail to which he referred and which is partially quoted in the Health Service Journal. Is it not a convention of the House, Mr. Speaker, that when a document is referred to and sections are quoted by a Minister that have not previously been quoted, it must be made available to hon. Members by it being placed in the Library?
  Mr. Speaker:There is a distinction, as an e-mail is not a document, so the matter is at the discretion of the Secretary of State. However, there is no requirement for e-mails to be placed in the Library. [HON. MEMBERS: "That is new."] Order. E-mails are relatively new, which is why I have to make a ruling that previous Speakers did not have to make.
  Dr. Reid:Thank you, Mr. Speaker. Having grabbed two jobs, I thought that the hon. Member for South Suffolk was beginning to encroach on yours.
  Let me make it clear that we are committed to providing patients, the public and, indeed, the House with credible, comprehensive and easily understandable information on how their local NHS organisations are performing. That is the primary purpose of star ratings. Our starting point—the premise that has been questioned in today's debate—is the Government's belief that the public need more information about how health services are working, both because their health is important to them and because public money pays for

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  those services. It is precisely because we have asked the public to increase the money that they pay for the health service that we have increased public accountability and transparency through mechanisms such as the performance ratings.
  That is why, in July 2000, for the first time ever, the Government introduced the concept of national health service performance ratings and the annual publication of information on all parts of the service. The rating awarded was to be based on an organisation's performance against a number of key targets such as waiting times and a wider set of "balanced scorecard" performance indicators. The hon. Member for South Suffolk said that he is troubled by three things. First, he is troubled that a Minister should respond, intervene or make queries about these issues. Secondly, he is troubled that a Minister should do so late in the process and shortly before publication. Thirdly, as I understand it, he is troubled that gradings were changed late in the ratings process. That is the essence of his concerns if we cleave away the conspiracy element.
  I shall try to address those issues, and take the House through the development of the ratings process, which was pioneering, complex and difficult. Hon. Members should remember that it was not just about grading hospitals or trusts but about establishing and developing a grading system for the first time, which was as difficult as it was important.
  The first set of ratings was published in September 2001, covering the performance of acute trusts in 2000–01. They were produced and published by my Department. We did not pretend then, nor do we yet claim, that those criteria were or are perfect in every way. Indeed, given the novelty of that pioneering approach to transparency, it could not be perfect at the first, second or even third attempt. We said so explicitly at the time.
  We made three things clear at the very beginning: first, that the assessments were not perfect, but were based on the best available data and that we would aim to improve those data sources; secondly, that the data criteria—not the data, but the criteria for assessing performance—would also be refined and improved over the years ahead; and thirdly, that we would be working not only with trusts and the independent Commission for Health Improvement, but most obviously towards this end, within the Department of Health itself in the initial stages. In short, this was the establishment, development and refinement of an iterative process—one that was changing by the day and by the month, and which is still changing by the year.
  That is the primary context that must be understood if we are to take a mature look at how things happened and what happened, rather than throwing it all aside and assuming that there is a great conspiracy behind everything that changes in Government and outside of Government.
  Mr. Stephen Dorrell(Con):The Secretary of State is placing great emphasis on the fact that the star ratings published in 2001 were the first time, in his view, that NHS trusts had been asked to account in public for their performance against pre-announced key performance indicators. Can he confirm that it was, in fact, my predecessor as Secretary of State for Health,
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  my right hon. Friend the Member for South-West Surrey (Virginia Bottomley) who introduced in the mid-1990s a system of publication of results by NHS trusts against key performance indicators, and that they were refined during my time as Secretary of State? It simply is not true to suggest that the star ratings published in 2001 were published out of the blue, with no previous experience in the health service or the Department of Health for the exercise on which they were embarking.
  Dr. Reid:With all due respect to the right hon. Gentleman, we do not have a difference of principle, but the level of sophistication, complexity and intricacy of what we are doing now is light years away from anything that was done previously. That is not to detract from the fact that he and his colleagues at the time pursued that route for a while. I am not suggesting that they did not, but as someone who has borne the responsibility in government, he would be the first to accept that when one implements such initiatives in education or health, there is an ongoing discussion and debate.
  Time after time, at Question Time and in debates, the Front-Bench spokesman prior to the hon. Member for South Suffolk got up and criticised me robustly and in some ways, perhaps, legitimately for some of the criteria that are used—non-clinical, non-medical criteria. I shall return to that point, because it is not only from one side of the House that we receive practical challenges to evaluate the criteria.
  Mr. Dorrell:I am grateful to the Secretary of State for giving way again, and for his recognition that some groundwork was done in the 1990s. Perhaps he will reflect on the gap between the work that we did and the work that he and his immediate predecessor are seeking to do to enhance accountability in the NHS. There was an interruption between 1997 and 2001, and the Secretary of State might care to reflect that we would have made further progress if the incremental approach, which he is rightly espousing, had been allowed to develop through that gap in the process.
  Dr. Reid:The right hon. Gentleman tempts me down a road down which I do not want to go. It is fair to say that as human beings in a complex world, the incumbent of my position during the relevant period would not agree with everything that I do, and I do not necessarily agree, on reflection, with everything that was done during that period. We will let the matter rest there.
  Dr. Howard Stoate(Lab)Dr. Howard Stoate (Dartford) (Lab) rose—
  Dr. Reid:I shall give way now, then I shall make a huge amount of progress before I give way again.
  Dr. Stoate:Can my right hon. Friend clarify a couple of points for me? First, the Opposition are presumably suggesting that the trust should not have had its third star and deserved only two, which is a kick in the teeth for the enormous amount of hard work and energy put in by many people who work for it. Secondly, those on the Opposition Front Bench seem to want to scrap the entire ratings system and performance indicators, yet the right hon. Member for Charnwood (Mr. Dorrell) claims credit for it. Perhaps my right hon. Friend could unravel the Tories' thinking on this important issue.
  Dr. Reid:Again, my hon. Friend tempts me to make invidious comparisons. I listen with great respect, not

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  because of personalities, but because some Opposition Members, such as the right hon. Member for Charnwood (Mr. Dorrell), have held high office in the Department of Health.
  Mr. Kevan Jones Mr. Kevan Jones rose—
  Dr. Reid:Will my hon. Friend allow me to make progress?
  I was saying that the process was an iterative one—a process of development and refinement, and discussions were going on inside the Department of Health and externally, with trusts, among others. The system was still under development when the next set of ratings, covering performance in 2001–02, were published in July 2002. If we want to define the changes that were taking place, we should note that a broader set of indicators was used, more account was taken of the CHI reviews of clinical governance arrangements, and the ratings were extended to cover specialist trusts and ambulance trusts for the first time, and to include indicative ratings for mental health trusts. A great deal of change was taking place.
  Again, put simply, the process of verifying data and refining the indicators to be used ran right up to the point of publication—the second element that worries the hon. Member for South Suffolk—precisely as it did the year before, which was the first year of star ratings. As anyone who has been involved in Government would know, when publishing large amounts of data it is quite normal for that to happen, particularly when the policy is in its early stages, when such large amounts of data are involved, and in this case, in 2002, when the release had been brought forward two months from September to July, putting greater pressure on the scrutiny and verification of the data and the final publication.
  We were sensitive to the need to be able to justify publicly and to the organisations concerned changes in the ratings, especially when they arose from additional indicators that we were using for the first time. I have nothing but praise, in retrospect, for the amount of work that was done by our officials and civil servants. I hope that it was not meant in that way, but there is an innuendo in the remarks of the hon. Member for South Suffolk. The officials in the Department, who are people of great integrity and commitment, would not involve themselves in something that they perceived to be a political stitch-up. That has been clear to me in the many Departments in which I have worked. Let us reject that implication out of hand.
  The Department was concerned to be able to justify publicly the nature of the criteria and the verifiable accuracy of the data. For that reason, and to ensure that the published information was as accurate as possible, NHS trusts were given the opportunity to comment on and to ratify the indicator constructions to confirm that they were correct prior to publication. In addition to the trusts, others were represented.
  A significant number of NHS organizations—estimated at the time to be close to half of those who made representations during the ratification process—expressed concern with data quality on two proposed indicators being used for the first time in 2002. Those
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  indicators were access to catering facilities, and information management and technology. If one were caricaturing the situation, as the Opposition sometimes do, one would define the criteria as 24-hour canteen facilities and 24-hour web-browsing facilities. During the consultation, a significant number of queries were raised about whether those were serious criteria.
  Mr. Andrew Lansley(Con)Mr. Andrew Lansley (South Cambridgeshire) (Con) rose—
  Dr. Reid:Will the hon. Gentleman allow me to finish this narrative? It is extremely important.
  It was clear that those indicators were not of a high enough quality and that the issue could not he resolved in time for publication of the ratings. I am advised by those who were involved as officials at the time that even if the timetable from the previous year had applied, there would not have been time to improve those particular indicators. They could not, therefore, be included in a refined and improved form in the final set of indicators. They could, of course, be removed.
  Mr. Lansley:I am grateful to the Secretary of State for giving way. He has described the discussions with trusts, and presumably the Commission for Health Improvement, that led to the submission to the then Secretary of State on 12 July. The point, however, is what happened that led to the change in the ratings between the 12 July submission and publication on 24 July.
  Dr. Reid:A little trust from the hon. Gentleman would be welcome. I am taking him through a narrative. I started in one year and I am moving chronologically. Consultations and discussions did not stop on 12 July, but continued. My point is that, even before the Secretary of State and Ministers were asked about the issue, a huge number of trusts that had been consulted—the estimate at the time was up to 50 per cent.—indicated dissatisfaction or problems with two particular criteria. As it happens, they were the criteria that were removed, which might be taken to show that they were not removed purely on the say so and diktat of the Secretary of State or purely in respect of one trust. Indeed, the Secretary of State mentioned nine trusts, and I shall go on to tell hon. Members where the movements occurred. All these suggestions take the conspiracy approach of the front page of the Daily Mirror to produce.
  Several hon. Members Several hon. Members rose—
  Dr. Reid:Let me make some headway; I shall come back to the issue.
  The change to which I have referred and which others made during the final weeks inevitably had an impact on the ratings. Some trusts benefited, while others lost out. Another part of the information that was not mentioned earlier is that, after 12 July and before publication on 24 July, not one trust, but 23 of them—[Interruption.] I urge the hon. Member for South Cambridgeshire (Mr. Lansley) to listen. After 12 July—
  Mr. Lansley:Will the Secretary of State give way?
  Dr. Reid:No; this is a crucial point, and I make it in response to a demand that was made constantly from

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  the Opposition Front Bench. After 12 July and before publication on 24 July, not one or two trusts, but 23 of them, received a higher rating—I might add that they included the trust serving the constituencies of Maidstone and The Weald and Tunbridge Wells—while 10 trusts received a lower rating, including those serving the constituencies of Dewsbury and South Shields. People who try to identify a political pattern in what happened and thereby attribute it to a conspiracy are doing a disservice to the hard work of the officials and the trusts themselves.
  The Opposition are today asking for another inquiry into the matter. As I pointed out, one of the two chairmen of the Conservative party requested an investigation from the Cabinet Secretary. The Cabinet Secretary also took it upon himself, I think legitimately and with due diligence, to ask the permanent secretary in my Department to conduct an investigation. He wrote this morning to the chairman of the Conservative party. I am surprised that the hon. Member for South Suffolk has not been informed by his party chairman. [Interruption.] Apparently, he has now received that information. To be helpful, I shall read out just two paragraphs of the letter, which I shall place in the Library. I quote the permanent secretary:
  "Ministers were, quite properly, involved in the process of developing the ratings system—which was one of the key commitments of the NHS Plan—and in preparing the announcement of the results for which they were Departmentally responsible. As part of ensuring that changes to the ratings of individual Trusts could be justified by reference to robust evidence, officials rightly highlighted individual cases to Ministers and they, legitimately, raised questions about other cases, including South Durham. One category of cases highlighted in this way—which included at one stage South Durham—were 3 Star Trusts at risk of losing a star. Naturally Ministers wanted to be reassured that any change in the ratings was a result of a genuine change in performance."
  He begins the next paragraph thus:
  "The ratings of some of the Trusts under discussion at this stage of the process did change as a result of the changes to the methodology which I have described. In other cases they did not."
  Here is the important point:
  "I am satisfied that no changes were made to the methodology in order to manipulate the rating of any individual Trust. I am also satisfied that political considerations played no part in any of these decisions."
  Let me repeat that sentence:
  "I am also satisfied that political considerations played no part in any of these decisions."
  I shall wait to see whether, having attacked trusts and managers and referred to cheats and fiddlers in the NHS, those on the Opposition Front Bench are now about to attack the permanent secretary at the Department of Health and Sir Andrew Turnbull at No. 10 Downing street. The fact is that the situation with regard to the crucial question could not be clearer: no political considerations were involved. In view of the relevance of Sir Nigel's letter to the motion, I have obviously asked for a copy to be placed in the Library.
  There is nothing unusual about changes to provisional star ratings status occurring prior to publication. We could look at many trusts and see changes in the weeks beforehand. Given the importance of the data, we recognise that we have to ensure that we continue to progress the independence of the system. I can tell the House that responsibility for continuing to
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  ensure a robust system of performance ratings for the third year of publication and for July 2003 was passed to the independent Commission for Health Improvement in 2002. The new Commission for Healthcare Audit and Inspection will take over responsibility for the ratings process from April 2004 and will publish the 2003–04 ratings as part of its annual report to Parliament this summer. It is independent of government and will continue to ensure the integrity of the ratings.
  In short, within three years, the Government have developed the data on which to base the performance and published them, and we have now made sure that responsibility for the publication of the data and criteria will be completely independent of government. In contrast, we know from the motion what the Opposition believe in. The motion calls for greater transparency in the calculation and publication of performance indicators throughout the NHS and goes on to express concern that these indicators might be used by people to indicate performance. If we check that position against the Opposition's actions, we see that it is difficult to find a bigger piece of hypocrisy, even in the Conservative party. Its actions in every conceivable area belie what it is demanding in parts of the motion.
  Mr. Kevan Jones:Will my right hon. Friend give way?
  Dr. Reid:I shall do so for the final time.
  Mr. Jones:I am grateful to my right hon. Friend for again giving way. The history of star rating that we have been given this afternoon has been interesting for the anoraks, but may I draw his attention to the fact that the abolition of the South Durham trust and the transfer of most of its management, including the chief executive, to the new County Durham trust raises issues that need to be addressed, including concerns among my constituents and others in Durham? For example, last week, the accident and emergency department of the new University hospital, Durham, was closed to new admissions because of lack of beds. Instead of talking about historic star ratings today, we would have been far better off discussing the investment that has gone into Durham and the management of the NHS trust there.
  Dr. Reid:I agree entirely with my hon. Friend. As he and other colleagues have pointed out, the Opposition are attacking trusts for the good work that they have done, and not only those in Labour areas are affected. Interestingly, one of the results queried by the previous Secretary of State was that of the West Suffolk hospital trust. I recommend that the hon. Member for South Suffolk listens, as the issue has some relevance to him. That trust serves the constituencies of three hon. Members, all of them from the Opposition Benches. Indeed, it includes South Suffolk, the constituency of the Opposition spokesman who opened the debate. Presumably, a sub-plot of the conspiracy is held to be that the previous Secretary of State was doing his damnedest to ensure that the hon. Gentleman's trust was moved up the ladder as well. That illustrates the ludicrous nature of the conspiracy that has been proposed today. It is the usual thing from the Conservatives. That is why they claim that nothing is

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  getting better in the health service, that the NHS cannot improve, and that if it does improve, it is all a fiddle or a conspiracy. That is why they denigrate and diminish everything that is done by the 1.3 million people who constitute the biggest army for good in western Europe—the staff of our national health service.
  The Conservatives know that slowly but surely NHS performance is improving. They know, equally surely, that the public and the electorate will reject their attacks on the NHS and, in doing so, will reject their failed, dogmatic policies—just as we should reject this cynical, opportunistic and politically-motivated motion and vote for the amendment that was tabled in my name and that of the Prime Minister.
  1.40 pm
  Mr. Paul Burstow(LD):This is proving an interesting and useful debate. In his response, the Secretary of State answered some of the questions, but gave rise to several others that I hope that the Minister will be able to address. Not long ago, on another Conservative Opposition day, we debated the target-setting culture in the national health service and the way in which it provokes changes in behaviour in the NHS that are not always those that are intended—indeed, poor target setting can be corrosive of NHS morale and lead to perverse outcomes.
  During that debate, we focused on the way in which targets and performance indicators can distort clinical priorities and lead to unintended consequences; today, we are focusing on the important exposé in the Health Service Journal and the information that it helpfully brought into the public domain. I hope that the Secretary of State will agree, even at this late stage, that that process should go further to ensure that we have all the information about the star ratings process and the build-up to its publication in 2002. A few bits have been teased out today, but there is still more to come.
  There is a fine line between what one might call the fine-tuning, data checking and reality checking of performance indicators and star ratings and the fiddling of figures. On the basis of the evidence that was published in the Health Service Journal before Christmas, one could conclude that that line has been crossed. I want to return to the letters that the Secretary of State mentioned, because they raise further questions.
  The basis on which the 2002 star ratings were calculated was changed—that is accepted. The Secretary of State tells us that that is part of an ongoing, iterative process. They were changed at the last minute, and the change had a real effect. Nine trusts went up from two to three stars and six went down from three to two stars. As a consequence, those six trusts were, in effect, robbed of up to £1 million each for service improvements that would have been available to them had they been three-star trusts. In addition, they were denied a range of modest, but nevertheless welcome, freedoms and flexibilities that are part of the star rating system.
  The Health Service Journal documents the e-mail exchanges between the office of the former Secretary of State and the head of the performance development unit in the Department, Mr. Wilmore, who warned on 12 July 2002—this has been quoted before, but it is important to my argument:
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  "Unfortunately even if time allowed it, further revisions to the methodology to promote these trusts would inevitably lead to other individual results we had not expected, as well as making the scoring system more complicated."
  The Secretary of State has laboured the point that so far the debate has focused on South Durham. That will not be the thrust of my argument, because the key question is not whether the methodology was changed to fix it for one trust, but whether it was changed inappropriately, at the last minute, with unforeseen consequences for a number of trusts that hitherto would have had three stars and all the benefits that flow from that. That is why Basildon and Thurrock general hospital was one of those mentioned in the official's report to the then Secretary of State. He said:
  "Adjustments to the methodology would have to be severe to move the trust to three stars and would inevitably demote other high profile trusts in the process."
  In his response to the hon. Member for South Suffolk (Mr. Yeo), the Secretary of State said, effectively, that the main changes to the methodology concerned catering services and information management. Yet the paper that was sent to the Secretary of State at the time, which was the basis of the article in the Health Service Journal, says that the reason why Basildon and Thurrock general hospital was not going to secure a three-star rating was because of the patient-focused element in the methodology, and specifically because of the results from the patient survey. I wonder, therefore, how that methodology was changed to reflect a high three-star rating for that trust in the final run of the star rating calculations for 2002. The Secretary of State has not yet dealt with that.
  Dr. John Reid:I hope that this will be helpful to the hon. Gentleman. As regards his suggestion that things were done late, they were done continually; some were done late. My hon. Friend the Minister will respond to that. The key word in his argument is "inappropriate", because we believed then, and believe now, that the changes were appropriate, and such changes continue. It is important to remember that changing one or two indicators will not affect the majority of trust results, but it will inevitably affect some—not only one—because the star rating system uses the relative position of trusts against a wide range of balanced scorecard indicators to help to distinguish between two-star and three-star trusts. That means that a trust's position can be improved or worsened by changes to the indicator scores of other trusts. That is the essence of the relativity effect whereby changing one indicator can affect a series of trusts, which, in turn, affects other trusts because of their relative performances.
  Mr. Burstow:I am grateful to the Secretary of State. That implies that the removal from the methodology of catering and information management did constitute a severe change in terms of that official's advice and warning to the then Secretary of State on 12 July 2002. I will look at what the Secretary of State says, because I accept that he is trying to be helpful.
  Mr. Wilmore asked the Secretary of State's office for comments by 15 July, and received an e-mail that stated that the
  "Secretary of State would also identify South Durham as a high profile Trust"—

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  we heard earlier that the Secretary of State's office had used the words "high-profile trust"—
  "given it serves the Prime Minister's constituency. Why has it fallen from three stars last year to two stars?"
  Mr. Paul Tyler(LD):That further suggests that there are some low-profile trusts. I hope that my hon. Friend agrees that there should be no such trusts. A quite different set of categories, which appears to be political rather than based on any clinical need, is being introduced into the discussion.
  Mr. Burstow:My hon. Friend makes an important point. I hope that the Minister will accept that "high-profile trusts" is an unfortunate use of terminology that should not have crept even into an e-mail that was not expected to become as widely disseminated as it has.
  In response to the e-mail, Mr. Wilmore stated:
  "Alterations to the methodology have been made, resulting in the changes to individual trusts that were requested. This makes the scoring methodology more difficult to explain and less transparent."
  He continued:
  "An explanation of the revised methodology has yet to be written up."
  Will the Secretary of State put into the public domain the detailed write-up of the methodology that followed the further recalculation that led to that exchange of e-mails? That would be a useful document in terms of understanding what the Secretary of State has said to me and to the hon. Member for South Suffolk.
  Mr. Wilmore then notes that Basildon and Thurrock and South Durham
  "now receive a three-star rating".
  His paper offers no further explanation of why South Durham was originally downgraded from three to two stars and does not attempt to answer the Secretary of State's perfectly legitimate question about why that change occurred. It will be interesting to have the answer so that we can be clear about the way in which the methodology and other processes that contribute to a star rating were affected to produce the outcome in 2002.
  We also know that the exchange of e-mails was copied to the Prime Minister's health adviser and we are told that the relevant e-mail was not acted upon. Does that mean that the e-mail was not read? Given that the Prime Minister's health adviser apparently routinely receives copies of e-mails between Health Ministers' private offices and the Department, what does he do with them? I am told that he is dynamic, proactive and hands on. The nature of e-mail drives people to respond and I am therefore puzzled that the health adviser did not respond and possibly chose to open it and do no more.
  A question, which I hope the Minister who responds to the debate can answer, about the Prime Minister's knowledge of events has not been asked. It is not whether his adviser, on the basis of the e-mail exchanges, notified him of the specific anxiety about the high-profile trust, but when he became aware of the South Durham star rating. It would be useful to have that specific piece of chronology.
  Since the publication of the e-mail trail, the official line has comprised two elements. First, what happened is part of the normal process of signing off the star
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  ratings, which would be subject to adjustments and corrections every year as part of the iterative process. Secondly, the responsibility for finalising and publishing star ratings is now that of the Commission for Healthcare Audit and Inspection—as if that makes okay anything that was inappropriate in the past.
  The unofficial line that the right hon. Member for Darlington (Mr. Milburn) has taken is that it is all a load of tosh. I hope that that is a parliamentary term and that I can therefore use it. How can it be tosh for a senior official to warn the Secretary of State that changes to the method of calculating the 2002 star ratings made them more difficult to explain and less transparent?
  I want to ask a few questions of the Minister who will reply to the debate. First, why were the changes made so late in the day, after they had been reality checked? That is especially relevant to the trusts that were part of the system in 2002. Secondly, why were the warnings of the head of the performance development unit about the difficulties of making the changes at such a late stage ignored? Thirdly, what changes to the methodology led to such a big shift in the star ratings but did not affect the trusts with zero star ratings? Again, that relates to the detailed write-up of the methodology that I requested earlier. I hope that the Secretary of State or the Minister who replies to the debate can provide that.
  The handling of the 2002 star ratings must give rise to questions about that of the 2003 ratings. In 2003, for the first time, the Commission for Health Improvement was responsible for publishing them, but it would be strange if the Department had not maintained a close interest in the way in which CHI was taking the work forward. As well as publishing all the Department's material that was relevant to the 2002 star ratings, will the Secretary of State undertake to publish all papers and e-mails about the methodology and weightings for each element of the 2003 star ratings, in the interest of restoring public confidence in the star ratings system, which he clearly wishes to achieve?
  The way in which the 2002 star ratings were handled raises wider questions about performance monitoring in the NHS and the way in which data are collected and published. In November last year, the Nuffield Trust published its mid-term review of the Government's progress in delivering improvement in the NHS. The report was positive—I am sure that that pleased Ministers. However, there was a sting in the tail. One of the report's authors, Professor Sheila Leatherman said:
  "There are significant data and analytic weaknesses in the NHS which mean carrying out a comprehensive, robust, definitive, transparent and defensible assessment is impossible.
  The unrelenting and distracting problem of inconsistent and highly contested data throws the whole of the quality agenda into a confusing fray."
  Until the data are collected, audited and published independently of the Government, how can the public have confidence that their money is being spent wisely?
  In its report, "Performance Indicators: Good, Bad and Ugly", the Royal Statistical Society calls for performance indicators to be accorded the same status as national statistics. In other words, the process should be clearly independent and at arm's length from the Government, to an even greater extent than the new Commission for Healthcare Audit and Inspection allows.

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  The report detailed several pitfalls that we discussed in the Chamber when we previously considered target setting, not least that performance measurement can create unintended consequences and lead to manipulation of data, gaming or fraud by service providers. Indeed, the Audit Commission and the National Audit Office found that in reports that they published last year.
  Performance measurement changes behaviour. The Royal Statistical Society stated:
  "Behaviour change is a factor because no performance measurement scheme can be viewed in isolation from the incentives—designed or accidental—that exist alongside it. Designed incentives often take the form of targets, and set of consequences associated with performance. If the assessment of management functions in the NHS depends centrally on whether explicit waiting time targets are secured, then this can affect such things as patient handling among health care professionals."
  In other words, what gets measured gets done.
  The Secretary of State recently told the Select Committee on Health that the Department was reviewing its data collection.
  Mr. Stephen McCabe(Lab):I am following the hon. Gentleman's argument with interest. What does he want to have done but not measured? Can he give some examples?
  Mr. Burstow:I am about to deal with the review of data collection, about which the Secretary of State told the Health Committee. [Interruption.] I shall answer the hon. Gentleman's point in my own way and in due course, if he does not mind.
  The Secretary of State told the Health Committee that the Department was reviewing its data collection with a view to rationalising what it collects. The NHS confederation has expressed concern for some time about the burden of reporting requirements on the NHS. In December, after a year of consultation and discussions, the Confederation published its report, "Smarter Reporting". The report found that more than half the information requests from the Department were perceived not to be useful for managing NHS trusts, either because it asked for duplicate information or because the data were of questionable value.
  The survey also found that a quarter of returns that the Department required were wholly or partly duplications. Much could therefore be stripped out of data collection without materially affecting the value of the data that the Department is currently gathering. Simply cutting back the duplication would make a difference. Rationalising data collection helps to improve the quality of the data that are being collected.
  In the conclusion to its report, the NHS Confederation warns that the exercise that the Department is currently undertaking entails a risk of losing the value of data collection in the existing system. I hope that the Secretary of State can assure us through the Minister who responds that an extensive dialogue is going on with the NHS Confederation and others to ensure that we get the best data collection and fill the gaps when that will add something to our understanding of service development, policy development and performance in the NHS.
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  Liberal Democrat Members will support the Opposition motion because we believe that there is a need to bring into the public domain information, which is not there, about what happened in 2002. We are critical of the way in which the star rating and performance management system has been rolled out in the past few years. It is clear from the events that surrounded the 2002 star rating that the process and reporting have damaged the credibility of the star ratings system. Indeed, they have dealt it a fatal blow. How can the public have confidence in the current star ratings system? What messages have been sent to NHS staff, especially those in trusts that lost their third star because of the recalculations? They were told one minute that they were an excellent trust, then suddenly that they were considered middle rating. What message does that convey?
  We will support the motion. The NHS is improving, but we need a reliable system that enables us to know that it is improving. That currently does not exist. Until it does, we cannot support the star ratings system.
  Mr. Deputy Speaker (Sir Michael Lord):Before I call the next speaker, I inform the House that Mr. Speaker has placed a 10-minute limit on Back Benchers' speeches. That will apply from now.
  1.59 pm
  Siobhain McDonagh(Lab):Whenever the star rating system is put under pressure or attacked, I feel the need to make a contribution in its defence on behalf of my constituents. It is the first system to allow people in my constituency to be heard on the subject of the performance of their local hospital. All my constituents, half of whom use St. Helier hospital, knew before 2000 that it was not up to scratch, that it was too dirty, and that the services provided were not good enough. Contributions from me, as the local Member of Parliament, and from the community health council, and missives presumably from the Department of Health all had no effect. The then chief executive carried on and refused to listen to the problems that existed. The only thing that broke that logjam was the star rating report that roundly, fairly and justly gave St. Helier hospital no stars.
  That marked the beginning of the improvements in my local hospital. It also meant that there was perhaps a distortion in the allocation of funds, because funds came to that hospital for the first time for the improvement of its Nightingale wards and its standards of cleanliness. For the first time, the hospital examined how elderly people in the geriatric wards were cared for, and whether they were being provided with food but not fed. Elderly people were actually starving in the wards. The fact that the star rating system can achieve those improvements, and that it allows the public to know that the Government know what they know, is essential.
  The system has led to enormous improvements in the services that people in my constituency receive today. I am not saying that St. Helier hospital is a perfect institution, but it is improving, and everyone there knows that it will be reviewed on an annual basis. That improvement must continue.
  Mr. Burstow:I entirely agree with the hon. Lady that there have been significant improvements at St. Helier

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  since the Commission for Healthcare Audit and Inspection report. The improvements followed that report, however, not the star ratings.
  Siobhain McDonagh:I disagree with the hon. Gentleman. People know that the hospital had a zero star rating. The rating was immediately understandable and one that people generally accepted. The then chief executive decided to resign and was replaced with another chief executive who achieved incredible improvements and has now been promoted. I wish every luck to the new chief executive in carrying on in the same way.
  St. Helier is far from perfect and it needs to continue to improve. I am glad that the star rating system is there to help it to continue that improvement. I should like to finish by quoting from a letter about St. Helier that I received today from a constituent:
  "I was admitted to the hospital two weeks ago as an emergency admission to A & E and then to both Ward C6 and then Beacon Ward. I was most impressed by the kindness of all members of staff during the day and nights, their attention to correct hygiene procedures at all times, and the doctors who with their regular visits make you feel special by keeping you informed in your progress. I would also like to thank the dinner and tea ladies and cleaning ladies and men, who were always cheerful and willing to help in any way they could. Words cannot express my gratitude to everyone involved in my recovery and their obvious pride in their work and their teamwork, which was second to none. Please pass on my thanks to everyone involved in my recovery."
  This is about people's health improvement, and the star ratings have led to Mrs. McNaughton having a much better experience at St. Helier than she would have done prior to 2000.
  2.3 pm
  Mrs. Angela Browning(Con):I should like to pick up on the theme pursued by the hon. Member for Mitcham and Morden (Siobhain McDonagh). My very recent experience of what star ratings have done, and of the state of our NHS hospitals, has been quite appalling. I believe that the focus on nationally set targets skews the way in which decisions are made about resource allocation in hospitals in order to meet targets and to get the extra finance so as to go up the star ratings system.
  I want to make it clear that I am speaking about a one-star hospital not in my constituency but in the home counties, to which an elderly lady relative of mine was recently admitted. She was very frail and had a fractured neck of femur—a common problem incurred when elderly people fall. She was admitted to casualty and I was anxious that she should not have to wait on a trolley for a long time. I was pleasantly surprised, therefore, when she was admitted to a ward within a few hours. I was told that she would be operated on the next day. Anyone with any medical knowledge will know that it is important to operate on a fractured neck of femur within a maximum of 48 hours, whatever the person's state of health or age. As is the normal custom, my relative was designated nil by mouth, but she went on being nil by mouth for five days, until eventually I threatened to go to the press unless she was operated on.
  I shall not go into any more detail about the individuals concerned in this case because I am pursuing a formal complaint with the hospital concerned. The
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  reason why I am raising it here is to point out that, in order to meet the elective surgery targets set by the Department of Health, that hospital has a long waiting list of former cases on an ongoing basis. That is where the skewing of targets and resources causes extreme detriment to patients. Hospital surgeons tell us that it is not uncommon for them to have 30 trauma cases waiting, but that their hospital management will not open up a second theatre over a weekend to deal not just with the existing backlog of trauma cases but with the increasing number of accident and emergency cases coming in. As someone who has worked in an operating theatre, I fully understand the dilemma of the doctors and nurses in our health service who, when faced with a road traffic accident admittance, for example, have to deal with some of those cases before they can deal with the fractured necks of femur or the trauma cases sitting on their wards.
  The one-star hospital in question here had met the Government's target of not having people sitting round in casualty for more than three hours. It had admitted the patient to a bed, but had not had the resources to deal with the number of trauma cases that such a catchment area naturally has. My investigations have shown that this is not a one-off. In fact, I intend to pursue the matter to find out just what the state of trauma surgery in our hospitals is, whether they have one star or three.
  Having been through that experience, when I hear Ministers talking about data, systems and civil servants, it all seems very remote from the day-to-day experiences of people up and down the country who are faced with a health service that, frankly, is not delivering. This is not just about what we used in the old days to call cold surgery—elective cases, as they are now called—painful though it is for people waiting to have a hip replaced. Of course we want those people to be treated as quickly as possible. When targets are introduced, they start to skew the service for others, for whom life and health are going to be critical. There is something seriously wrong with the target system that now exists, particularly in relation to surgical cases in hospitals.
  Dr. Stoate:I entirely share the hon. Lady's concern. It is completely unacceptable that an elderly lady with a fractured hip should wait five days for an operation, and I would welcome further information on how that was allowed to happen, and on what could be done to prevent it from happening again. This raises the important point, however, that unless we measure what is going on in our hospitals, we have no way of improving them. Does the hon. Lady not agree that the only way to ensure that the health service is as good for her constituents as I hope it is for mine is to ensure that the investment goes in to improve it year on year and that we introduce changes and improvements to ensure that the money is well spent and invested, and used directly to improve patient care. We must have information before we can measure those outcomes.
  Mrs. Browning:I am not saying that performance indicators and information are unnecessary. They are important management tools in any function, and particularly so in the NHS. I am not complaining about that. I am saying that, when targets are set by Ministers in Whitehall, it restricts the flexibility that hospital

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  clinicians and managers have at local level, in terms of what a hospital's priority should be on any given day or week. Therefore, in hospitals such as the one I have mentioned, which has a one-star rating—I hope that Members on both sides of the House, having heard my experience. will say, "No wonder it has a one-star rating"—where the real difficulty was that surgeons were asking to open up second theatres to deal with trauma and were being denied them by the management, the management clearly had to prioritise its resources and money to make sure that it met targets in elective surgery and other priorities that are not being decided at a local level. Meeting many of those targets is locked in to the star system, and we have heard arguments today about the funding that hospitals receive.
  Of course, nobody expects poor performance to be rewarded, but what choice is available to a patient who lives in one of those areas? It would be nice if all hospitals—in accordance with the experience of the hon. Member for Mitcham and Morden (Siobhain McDonagh)—were seeing an improvement. I have not seen an improvement, however, in a situation in which managers are told what their priorities should be by people who have no clinical responsibility. When we are dealing with real cases face to face rather than talking about statistics as we do in this place, and when real people whom we know and love are affected, that brings home much more clearly how wrong the current system is in terms of control from the centre that overrides what doctors believe should be the priority in a particular hospital. The hon. Member for Birmingham, Hall Green (Mr. McCabe) shakes his head, but when there are people who will die, and doctors know that they will die, doctors ask for second theatres to be opened. My experience when I worked in a theatre under the previous Labour Government was that such theatres were opened up. At weekends, there was always a standby team for a second theatre to be opened up. Things have not got better; they have got worse.
  Dr. Phyllis Starkey(Lab):Obviously, it is difficult for us to discuss the case that the hon. Lady raises, as we are not privy to all the details. Does she accept, however, that it is not self-evident that targets were the problem, but that the hospital concerned either did not have adequate resources or was not managing its resources properly? Had the hospital made available resources for the case she mentioned, I presume that it would have had to take them away from another one. Targets relate to real clinical need, so that would have meant other people waiting for operations. The case that she raises does not therefore attack targets but points to the need for additional resources.
  Mrs. Browning:In terms of prioritising resources for surgical cases in a general hospital, trauma cases would be high up, at the top of the list—they would have to come higher than elective surgery because they are life-and-death cases. In relation to the individual case that I described, it was not a one-off case: the hospital had a long trauma list that appeared to be ongoing, and apart from the case of which I have personal experience, 29 other people were in similar situations. In terms of resources and a surgical budget, priority must be given
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  to the trauma surgical budget over the elective budget. If one is subject to elective budget targets, and to achieving stars by meeting elective targets, or to having financial penalties in the next financial year, as some hospitals have experienced, that is wrong. It is wrong not from a management or systems point of view but from the point of view of the people who live in that area and who are dependent on that one hospital, to which they go if they have an accident.
  If people have elective surgery, even under this Government, certain flexibilities exist whereby they can try to choose which hospital they go to and who operates on them. If they have an accident and are taken to hospital in an ambulance, they do not have a choice. What I am saying is that if people are taken in an ambulance to an accident and emergency department and they need surgery following that admission so that they are stuck with that one hospital, that area of surgery should be given high priority and should not be subject to problems that relate either to how the budget is spent in other areas or to the need to meet elective surgical targets.
  I wanted to raise this issue because I am worried about the number of deaths in this country as a result of fractured neck of femur, particularly among the elderly. I am concerned that elderly people who are admitted on that basis are shunted down the list purely on grounds of age. That is an area of health care that needs investigation, not just because of my personal experience but because I am concerned that this is a widespread problem throughout the country and needs to be addressed as a matter of urgency.
  2.15 pm
  Mr. Stephen McCabe(Lab):The truth is that there are two parts to today's debate. The first part—the only one to which the hon. Member for South Suffolk (Mr. Yeo) referred—is the Tory agenda. It has none of the "I believe" and the "Be positive" in it. It says, "Get on the negative and hit it hard." The Tory party's strategy is to undermine the health service at every turn and at every opportunity, and it must persuade the public that the health service is failing. That is the only point at which any Tory policy begins to emerge.
  Coupled with that, we are starting to see a new trend in Tory performance. Yesterday, the shadow Secretary of State for Transport used the pilots' trade union as the bulwark for her argument. Today, the Tory health and education spokesman used the doctors' trade union spokesman—a gentleman whom I believe is a consultant at a one-star hospital, so, clearly, he has no vested interest—as the bulwark for his argument.
  The other part of the Tory agenda is clear. The Tory party is haunted by the sleaze that bedevilled the last Tory Government, so it has decided that the easiest way to defuse that is to apply to all politics and all politicians the taint that they cannot be trusted. Today, we heard a twin strategy to undermine and attack the health service at every opportunity, and to attack the people who work in it and who are doing their best to drive up standards and performance and to give the best care to those most in need—to attack, condemn and denigrate at every turn.

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  Simultaneously, the Tories are attempting to persuade the public that the way to deal with sleaze is not to make the Tories account for what they did and for why so many of them ended up in the courts and jails but to say that all politicians are liars, that all politicians try to distort, and that all politicians try to manipulate solely for personal gain.
  Mr. Lilley:In his contemptible remarks, is the hon. Gentleman trying to assert that only Conservatives and all Conservatives are dishonourable?
  Mr. McCabe:I am happy to give the right hon. Gentleman a list of former Conservative Cabinet Ministers and serious politicians who ended up in court and in jail. I am happy to assert that if that is what he wants. My point is that the Conservatives have a twin strategy: first, to undermine and denigrate the health service—
  Mr. Lilley:Will the hon. Gentleman answer my question? He has asserted by implication that all Conservatives, but only Conservatives, are dishonourable. Will he now withdraw that foul imputation?
  Mr. McCabe:I think that the right hon. Gentleman has a hearing problem. I did not assert that at all. I asserted that the Conservative party has a problem with sleaze dating back to the previous Conservative Government, and its political strategy to try to deal with that is to try to smear everyone else. I repeat that. I am not surprised that he does not like to hear it, but it is unfortunately the case, and he will hear a lot more of it if the Conservatives persist in their current performance.
  Mr. Mark Francois(Con):Does the hon. Gentleman accept that the basic text for much of today's debate has been the article that appeared in the Health Service Journal, and which was produced by its own, well-respected journalists? Is he trying to tell the House that that publication is an organ of the Conservative party, because I am not aware that it is?
  Mr. McCabe:I made no reference at all to the Health Service Journal, but I did refer to the motion before the House, and to the fact that the Opposition spokesman referred only to the first four lines of it.
  I want to turn to the second aspect of the debate, which is the effectiveness of indicators, the need for greater transparency and the question of whether the way in which trusts operate is distorted—a matter that the hon. Member for Tiverton and Honiton (Mrs. Browning) raised. I am not at all convinced that the indicators are ineffective. I would be the first to accept that they can always be improved, which probably explains why they have been revised at least three times already. As I understand it, acute trusts are currently using 44 indicators. Some 13 are the same as the originals, 23 are broadly similar and there are eight new ones. That has happened because in talking to the trusts and taking account of the other clinical governance exercises that have taken place, the Commission for Healthcare Audit and Inspection has been responding to demands for change. It has been told that some of the indicators are not particularly effective, are rather time-
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  consuming in terms of the way in which the data are processed, and do not deliver that much. As a result, it has been asked whether they can be got rid of or changed, and whether other factors that have not been taken into account could be included. That seems a sensible approach.
  I am constantly told that the indicators are useless, but it is important to bear in mind what young and adult in-patients say about the quality of care, the level of safety and the degree of co-ordination. Cancelled operations are a good indicator, and clinical negligence is another important factor that I would want to know about if I was going to a local hospital. The number of deaths following heart bypass operations might also offer a reasonably good clue as to how the hospital in question is performing. One might also want to take into account deaths following non-elective surgical procedures. Emergency readmissions following discharge are also worth knowing about, as are readmissions following discharge in respect of fractured hips.
  Dr. Stoate:My hon. Friend makes a very important point. Opposition Members say that it is their policy to scrap star ratings, thereby denying us, presumably, the information that he has so eloquently given on these extremely important indicators. Such knowledge would certainly influence my choice of hospital if I needed an elective operation.
  Mr. McCabe:My hon. Friend is absolutely right. I am not saying that the system is perfect. I have never heard a Minister say that it is perfect, and nor did the Secretary of State claim that today. What we are saying is that we have a method of measuring, and of giving trusts and the public an idea of what is happening. That is important.
  Mrs. Browning:It is not possible to make a choice in respect of non-elective surgery, so what does someone do if they are in an ambulance following an accident and the hospital to which they are being taken for treatment is terrible?
  Mr. McCabe:The hon. Lady knows as well as I do that, in that circumstance, the average individual would not be in much of a position to do anything. My point is that we have indicators that allow us to measure performance, and to try to drive it up.
  Mr. Lansley:Will the hon. Gentleman give way?
  Mr. McCabe:No, I have been very generous already.
  Mr. Lansley Mr. Lansley rose—
  Mr. McCabe:As it is the hon. Gentleman, I shall give way.
  Mr. Lansley:The hon. Gentleman has indeed been generous, and I am grateful to him for giving way again. I want to correct what might otherwise be a misapprehension on his and his colleagues' part. He asks us to look at the motion, but if he does so he will see that its purpose is to stop "excessive reliance" on indicators, not to remove the information that patients

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  need. But star ratings are an essential part of that excessive reliance, and as my hon. Friend the Member for Tiverton and Honiton (Mrs. Browning) pointed out, they are part of a system of targets that leads to distortions.
  Mr. McCabe:I am grateful for that intervention. If the Opposition spokesman had discussed the rest of the motion during his speech, rather than dwelling on the first four lines, perhaps we would not have needed that intervention.
  The indicators are owned by CHAI, which reports to Parliament, so they are hardly open to manipulation by Ministers. And what of the effect on trusts? We are told that the indicators distort the allocation of resources and inhibit the independence of professionals and managers. I asked my local acute trust how it makes use of them, and whether they in fact constitute an onerous chore. It gave a couple of examples that are worth pointing out. It examined the time involved in accident and emergency situations, and concluded that it had to change some of the doctors' practices. For example, more weekend work for consultants was mentioned. That may be a real drag in terms of time spent on the golf course, but sometimes such changes have to be made. It also examined some of the cancer indicators, and although it measured some progress, it discovered specific areas in which there were capacity problems. As a result, it knows that spending must be skewed to address that issue. Frankly, cancer sufferers will be delighted, rather than saddened, to hear that. Funnily enough, the trust also noticed that it has to do better in respect of people's complaints, an issue to which the hon. Member for Tiverton and Honiton referred earlier. It wants to deal with complaints openly and transparently.
  These indicators are not perfect, but they do give us and the public some indication of what is happening. In terms of their development, there is interaction between the trusts, the patients forums as they come on line, and CHAI. We also know that they are used in a practical way by good trusts that want to improve, in order to move matters forward. The choice is between sweeping that away or coming up with a credible alternative. When Opposition Members come up with a credible alternative, I shall listen to it seriously.
  2.27 pm
  Mr. Stephen Dorrell:I want to begin by making it clear that I am in favour of the principle that better management of the health service, better care for patients and better use of resources will be achieved if we require health service institutions to publish evidence of how they are performing against key performance indicators. I embrace that principle wholeheartedly, and for some fairly conventional reasons. I do not believe it right that this public service should be managed in secret, and that the people who pay for it and use it should be unaware of its performance. Nor do I believe that special rules in this respect apply to the clinical professions. In respect of NHS institutions, it is just as important that evidence of clinical performance be published, as well as non-clinical performance. It would be strange if I thought
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  any different, because as I said in an intervention on the Secretary of State, that was the route that we took when in government. It was my immediate predecessor as Secretary of State, my right hon. Friend for South-West Surrey (Virginia Bottomley), who introduced the principle. I developed it, and I share in the implied criticism offered by the current Secretary of State in respect of his predecessor, the right hon. Member for Holborn and St. Pancras (Mr. Dobson), in that the policy was not developed during the years immediately after our leaving office.
  It is not the principle of the Government's requirement that the NHS publish evidence of its performance that is wrong; what is wrong is the way in which the Government develop that principle in practice. I want to go through some of the reasons why the Secretary of State finds himself in such deep water as a result of the story published just before Christmas by the Health Service Journal. The story is powerful evidence that the Government are failing in practice to pursue the good principle that the NHS should be seen to be accountable. Why are they so failing? The first fact that anybody introducing performance indicators has to understand is that if they are going to influence performance in the hospital quoted by my hon. Friend the Member for Tiverton and Honiton (Mrs. Browning), for example, the indicators against which the institution is to be judged must have a broad measure of support within the institution itself, and within the wider health community. That does not mean that every single person working in the health service has to accept every single indicator, but it certainly means that we cannot be content with a position in which only 15 per cent. of primary care trusts believe that the star indicators published last year were fair. If only 15 per cent. of those people believe that the star system is fair, that is powerful evidence that the Government are failing to deliver their policies in practice.
  Why is that the case? There are several reasons, some of which have already been mentioned, some of which have not. One that has already been referred to—and it is hugely important—is the point made by my hon. Friend the Member for Tiverton and Honiton that indicators must reflect the local circumstances of the community that the NHS trust seeks to serve. We have an absurdly over-centralised management system in the health service, when there should be much greater flexibility to allow local PCTs and the local community to set indicators that reflect the particular circumstances of the community that the institution seeks to serve. That is preferable to setting single blanket indicators that apply across the board—the one-size-fits-all approach, which does not work.
  The second principle that the Government violate was made crystal clear in the Secretary of State's speech. His central defence to the charge that the South Durham NHS trust indicators had been fixed for political reasons was, "Oh no, they haven't." He reminded the House that the negotiation continued four months after the end of the period ostensibly being measured. He said that the negotiation in July determined the star ratings of NHS trusts during the period ending in the previous March.
  It is a pretty basic rule of influencing performance by setting targets or measuring performance through indicators that the targets should be set at the beginning

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  of the period in which one is seeking to influence performance, which allows people to respond to the incentives. If the hospital in the constituency of my hon. Friend the Member for Tiverton and Honiton sets, as it should, key performance indicators at the beginning of the period specifying that trauma patients should be treated within an acceptably short period of time—the maximum in that hospital was probably 48 or 24 hours—there is some chance that the hospital will manage its affairs to meet the target. However, if the key performance indicators are decided four months after the period has ended, it invites all the criticisms to which the Secretary of State has been subjected as a result of the Health Service Journal story about the South Durham trust.
  The first principle is that the indicators should be more local and the second is that they should be clear and set before the period that they are designed to influence starts. The third, of course, is that the detail of the targets themselves should be seen to be fair and reasonable, and to reflect a reasonable interpretation of both the efficient use of resources and clinical priorities.
  I cite one simple example from my own constituency in Leicestershire—the 12-hour trolley wait target for accident and emergency cases, which is wholly reasonable. I agree with the Government that people should not have to wait on trolleys for more than 12 hours in accident and emergency cases, but it is not surprising that Leicestershire acute hospitals trust finds it bizarre that a maximum of 10 patients in a year are being allowed to escape that target, because it applies as much to the neighbouring trust in Kettering, despite the fact that the Kettering trust treats only 20 per cent. of the the number of patients that are treated in the Leicestershire trust. One is therefore five times more likely to be caught in a 12-hour trolley wait in Kettering, which still achieves its target, than in the bigger trust in Leicestershire. That is an example of a target that is rightly viewed as bizarre in its effect. Targets must be local, clear and accepted as fair by those operating the system.
  The Secretary of State is operating a system that does not obey the simple rules of setting targets of accountability in order to affect NHS performance. It is not surprising that he has been subject to the criticism that he is fixing the system to accommodate the South Durham trust. That trust provides a good political anecdote, but it is also an important example because it attracts attention to inadequacies in the accountability mechanism for the health service.
  That example also illustrates a broader truth—this is my final point—that Whitehall hates accountability. When Ministers say to civil servants that it would be a good idea to set a series of indicators to judge the performance of a particular aspect of government in a clearly measurable way that is known in advance and makes the Government accountable to the public, the civil servant replies, in that hallowed phrase: "Minister, that is a brave policy, but it puts you at risk of an unhelpful statistic being published in the second week of an election campaign, and what would that do for your career?" What the civil servant really means in providing such paternal care for a Secretary of State's career is that it would not do much for his career as a civil servant if such a statistic were published in the second week of an election campaign.
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  The whole issue of targets needs to be addressed more seriously in order to ensure that we enforce proper accepted accountability in the health service and for public services more generally. Unless and until we do so, our taxpayers and service users will have to continue to accept second-rate service because none of us will be allowed to know any better.
  2.37 pm
  Dr. Phyllis Starkey(Lab):Before I begin, perhaps you, Mr. Deputy Speaker, could pass on to Mr. Speaker how helpful Back Benchers find the new arrangement with the digital countdown.
  Turning to the matter in hand, I was disappointed by the major part of the opening speech by the hon. Member for South Suffolk (Mr. Yeo), who indulged in—to inordinate length—a rather ludicrous conspiracy theory. I am pleased to say that it was effectively refuted by my right hon. Friend the Secretary of State and I do not intend to waste any more time on that matter.
  More interesting was the way in which the Opposition Front-Bench spokesman and the hon. Member for North-West Norfolk (Mr. Bellingham), who is no longer in his place, let the cat out of the bag regarding their attitude to performance indicators in general. I exempt from that criticism the right hon. Member for Charnwood (Mr. Dorrell), who made an extremely thoughtful contribution, though I take exception to his mathematical distortion in respect of the differences between the Kettering and Leicestershire trusts. However, I shall take that up with him outside the Chamber, as the matter is rather more complicated than warrants debate here.
  However, Conservative Front Bench Members and the hon. Member for North-West Norfolk demonstrated that the Conservatives are not just against, as it says in the Opposition motion, "excessive" reliance on performance indicators, but against all such indicators. That is an extraordinary line for the Conservative party to adopt. The NHS is a public service financed by public money. It is perfectly reasonable for it to be run in line with outcomes that the public require. That is what the performance indicators and, indeed, the NHS framework are designed to do. They are designed to set clear standards and outcomes. The frameworks are partly set by the various royal colleges, but also take into account the views of the public and of sufferers from diseases about how treatment should be shaped. The performance indicators are also clear and are designed to draw attention to the NHS services that the public feel are important. For example, people should not have to wait excessively for in-patient or out-patient services, accident and emergency services and others. It is perfectly reasonable that those performance indicators should be set by the Government, in consultation with the public. I cannot understand why the Conservatives object to that. Do they think that the Government should simply give the NHS and other public services money to spend as they wish, without interference? It is

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  extraordinary that the Conservatives appear to suggest that the public should pay their taxes and buy a pig in a poke when it comes to public services.
  Mr. Simon Burns(Con):Rubbish.
  Dr. Starkey:Of course it is true that doctors must exercise their clinical judgment about specific treatments for patients. However, when the Conservatives were in charge of the NHS and doctors were allowed to set NHS priorities, a very low priority was often given to operations such as hip replacements—exactly the sort of elective orthopaedic operations to which the hon. Member for Tiverton and Honiton (Mrs. Browning) objected. The suspicion was that those operations were given a low priority because they are not very interesting to do. They are dead straightforward; one needs to be reasonably competent, but for surgeons it is much more interesting to concentrate on the big, challenging operations.
  However, every hon. Member knows that hip replacements are incredibly important to constituents. The problems that such operations resolve are not life threatening, although old people who have to wait for treatment are much more prone to die from other conditions. Delays in hip replacement operations can have an extremely detrimental effect on people's quality of life. That is one reason why it is very important to have performance indicators that reduce the waiting time for such operations.
  I return now to the point made by the hon. Member for Tiverton and Honiton. Did she raise the matter with the Member of Parliament representing the constituency in which the hospital is sited? The issues that she raised have a much wider importance than their effect on her relative, and I repeat that the question is one of resources and their proper management. The hospital in my area faces similar problems, and it has brought in French surgeons to work in operating theatres at weekends to clear some of the backlog. Our own surgeons were working so many hours that they could not be asked to do any more. I do not understand why the hospital to which the hon. Lady referred did not do the same, instead of blaming performance indicators.
  Mrs. Browning:I want to clarify the record. I am more concerned about the waiting lists for trauma surgery than the waiting lists for elective hip surgery. My point was that if there are 30 people suffering from traumatic injuries, one of them might have a fractured neck of femur. That person might be required to wait five days for an operation, on a regimen of nil by mouth. It is wrong to put elective surgery ahead of that operation in order to meet a target. Finally, I assure the hon. Lady that I have raised the matter with the relevant Member of Parliament.
  Dr. Starkey:I think that the question is one of resources. The hospital concerned should have managed its resources better. It is not a matter of targets distorting provision, as it is also important to meet elective surgery targets.
  I find the general attack made on performance indicators by some Conservative Front-Bench Members extraordinary, especially given that they belong to the
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  Conservative party. They would not expect businesses to operate without performance indicators, so I do not understand why they think that public services should do so. Moreover, those indicators are set in ways that the public clearly support.
  Do the Opposition object to specific targets? My hon. Friend the Member for Birmingham, Hall Green (Mr. McCabe), who has just left the Chamber, talked about some of the specific targets. It would be helpful if Opposition Members would say which targets they object to. Do they object to targets on waiting times, or on cancer death rates? Which targets would they get rid of, or do they want to get rid of them all?
  I turn now to my constituency, which has had a rather interesting experience with the star rating system. This year, the hospital and the PCT that serve my constituency, and the constituency of my hon. Friend the Member for Milton Keynes, North-East (Brian White), were zero rated. That zero rating was quite properly applied, as the hospital and the PCT failed to meet their budgets and to meet their waiting times and accident and emergency targets.
  They failed to meet those targets because of under capacity in the Milton Keynes general hospital, which is a direct inheritance of the years when the previous Conservative Government were in charge of the NHS. Milton Keynes is a growth area: its population has grown by between 2 per cent. and 3 per cent. a year since goodness knows when. However, in the 10 years preceding the election of the present Government, not one extra bed was provided at Milton Keynes general hospital. Clearly, the hospital suffered from under capacity in that time, and it has not caught up yet. This Government have been very generous in the funding that they have made available and the problem is not as bad as it used to be, but the hospital still suffers from under capacity. That is why it and the PCT were zero rated.
  That zero rating highlighted even more clearly a problem that I and my hon. Friend the Member for Milton Keynes, North-East had highlighted already in our frequent representations to Ministers. The Modernisation Agency has studied the general hospital and the PCT and has crawled all over everything that is being done. It has come to the view that there is very little more that the management could do to improve matters. It has confirmed that the problem is the result of under capacity and not poor management. As a result, the case that I and my hon. Friend have been making has been strengthened. We have presented it again to my right hon. Friend the Secretary of State, who was kind enough to meet us just before Christmas. We are both confident that my right hon. Friend will devote even more resources to the problem.
  The experience in Milton Keynes is therefore that the star rating system helps to make clear where a hospital or PCT is encountering problems. It is then possible for the PCT and the Department of Health to look into why those problems have arisen, and to address them.
  Mr. Lansley:The hon. Lady says that the hospital in her constituency has a zero star rating. Does she accept that people consider that to be an expression by the Government of the quality of practice in the hospital? The hospital may have very good clinical practice, and

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  she has said that the zero star rating is the result of under capacity. However, the star rating does not indicate whether the hospital is meeting its targets in terms of capacity; it is interpreted by people as a much wider expression of patient satisfaction. Patient satisfaction may be high if there is good clinical practice.
  Dr. Starkey:In Milton Keynes, hospital managers and workers, and members of the public, are well aware of what the problem is. I and my hon. Friend the Member for Milton Keynes, North-East have been in dialogue with the hospital management. We have made it very clear that we understand that the problems that have been encountered are not the result of poor performance by anybody working in the health service in Milton Keynes, but that they are the result of under capacity. We have also made that clear to the Government.
  Although everybody was very disappointed that the rating slipped from one star back to a zero star rating, we all knew that the problem was one of under capacity—and that my right hon. Friend the Secretary of State was aware of that too. People were confident that the problem would be tackled, because it was evident that only by dealing with under capacity would the hospital's performance be improved.
  I should add that matters have already improved in Milton Keynes. Since the star ratings were handed out, our clinical precision unit has opened. It has greatly relieved pressure on the A and E unit, and a story in my local press this week suggests that performance is now worth something like two stars rather than zero.
  Finally, I believe that the Government's commitment to a properly funded NHS is self-evident. However, greater public funding must always be coupled with clear direction through the use of performance indicators and the national service framework. In that way, the money that comes from people's taxes can be spent on improving outputs. That must also be coupled with a continued drive to modernise the way in which health services are delivered across the piece.
  I am surprised that the Conservatives appear not to go along with the approach of increased funding, modernisation and a sensible system of performance indicators. I agree with my colleagues that the Conservative Front-Bench spokesmen seek simply to denigrate the NHS to soften people up in order to return to the two-tier system that the previous Government were trying to introduce.
  2.50 pm
  Mr. Archie Norman(Con):I want to build on the excellent speech made by my right hon. Friend the Member for Charnwood (Mr. Dorrell). Those of us who want the NHS to succeed know that that success depends not on the number of targets that we can generate, or even what they are, but on the management calibre that we bring to it, the teamwork and involvement of clinicians in a common vision of what they can achieve, and a framework of motivation and discretion within which they may operate. That of course is where the whole question of the target-based framework starts to apply.
  Like other hon. Members, I do not believe that it is at all surprising that we have seen a proliferation in the number of targets. In fact, given that the Government
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  have committed themselves to investing hugely greater resources in a substantially unreformed system with, in many cases, quite weak management, it is perfectly reasonable of them to say that they want to measure the outcomes. We must remember that in the early years, from 1999 to 2001, we had a 21 per cent. increase in expenditure for an increase in outputs of approximately 1.6 per cent. There are different ways of measuring output, but it is predictable that any Government faced with that sort of problem will want to establish greater clarity and measurement of performance.
  It is equally true, as Labour Members have said, that if we are ever to create any sort of internal market or sense of choice in the health service, the public need transparency of performance so that they may exercise whatever choices might be available in future. I am not, therefore, against the idea of targets or measures for their own sake. The issue is what part they should play in management and how they help build better-quality management with better clinical involvement as well as the right framework of motivation and commitment.
  The starting point is the sheer proliferation in the number of targets. It is quite unreasonable to generate so many targets that it is impossible for management to devote a reasonable amount of time to any single one of them. Chief executives of NHS trusts have 420 different targets to pursue. According to responses to my parliamentary questions, there are 151 performance indicators, up from 86 last year. That proliferation is a reflection of the preoccupation of Ministers and the Government with trying to impose control. Every time a new issue arises and every time something remotely threatening or critical of Government crosses their radar screen, it is extremely tempting to impose another target.
  The delusion is that a target will in any sense be a substitute for effective management. The target system is at risk of becoming a substitute for management. It is inevitable that it will be politicised; that is the nature of our system, and the episode with the South Durham Health Care NHS trust illustrates how a target-based system leaves Governments vulnerable to that. For management, that results in a vicious circle of demoralisation, a wedge between clinicians and management and a resulting decline in the calibre of people and resources available and rising costs in NHS administration.
  Mr. Michael Jabez Foster(Lab):The hon. Gentleman has made it clear that he is not against all targets, but against the extent of the targets. Will he make it clear which particular targets he is against? Which does he believe to be irrelevant, and which should be discounted?
  Mr. Norman:The hon. Gentleman asks a perfectly reasonable question. It is obvious that removing any of the existing targets would be a difficult and sensitive problem. I put it to him, however, that if targets are to achieve any reasonable purpose, there is no point in having more of them than the chief executives and management of trusts can sensibly devote their time to. All that does is invite them to fail. It is inevitable that

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  some trusts, even excellent ones, will underperform on some of the 420 different targets. As a result, the idea will be encouraged among the general public that the NHS is failing. I put it to Ministers that if they are sincere in their commitment to restoring public confidence in the NHS, and if they want to demonstrate that there is improvement, the first thing to address is the nature of the targets and whether they are giving the NHS a feasible or deliverable set of outcomes.
  No one should be deluded about the extent of the problem. By way of illustration, the British Medial Journal survey of clinical directors on 22 March last year found 60 per cent. responding that they do not have confidence in the management of their trusts. The reason is that we are increasingly driving a wedge between clinicians and management. Clinicians have very low regard for many administrators and feel that the targets, which put pressure on the administrators, are being imposed upon them.
  The evidence from all over the world of what succeeds in health management shows that it is top-calibre people and a common clinical vision. World-leading organisations, such as Kaiser Permanente in the United States, specialise in that. We need not more managers, but fewer. The Solucient study of the top 100 US hospitals found that they had 25 per cent. fewer managers and administrators than the average hospital.
  Yet the target-based culture will inevitably create more administration and management for no clinical purpose. The reality is that as long as we create huge numbers of targets, changing them every year, we will create a highly politicised system. While the Secretary of State acts, in effect, as the executive chairman of the NHS and is held accountable from day to day for the targets set, it is in the DNA of the system that we have that it is highly politicised, unless those targets are separated from the process of Government and there is a process of audit and verification that is seen to be independent.
  Dr. John Reid:The hon. Gentleman is making an extremely interesting and constructive speech. I do not recognise the 400-odd targets to which he has referred; I estimate that there are about 62. It is arguable whether there are too many; that is a moot point. Certainly, however, we will have that many in future precisely for the reasons that the hon. Gentleman has given about the need for strong leadership and so on in the first instance, which perhaps is not there. A radical transformation requires a degree of—I will not call it autocracy—central direction of targets, which will increasingly disperse downwards as we go through the transformation. I agree with a great deal of what the hon. Gentleman says, though I do not necessarily agree with his numbers.
  Mr. Norman:I thank the Secretary of State for that. I do not want to engage now in a debate about the numbers, but would say only that they are quoted from responses to parliamentary questions that I have asked of his ministerial colleagues. We can engage in discussion about the figures at a later date.
  What I do put to the Secretary of State, and what I think is undeniable, is that there is a question of morale among the management of NHS trusts. The evidence for
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  that is widespread, not least in the recent MORI survey showing that 62 per cent. of chief executives said, when asked about the target culture, that their role was becoming increasingly unattractive. Some 66 per cent. said that the NHS was losing its best leaders, and 69 per cent. said that negative perceptions now make it hard to attract clinicians into management, something which it is extremely important to achieve. The result is undoubtedly the loss of good managers and a failure to attract new management talent into the NHS, which is an increasingly difficult task when salaries are comparatively less competitive and perceptions are comparatively negative. Creating a management framework that is motivational for people, within which chief executives believe that they have the wherewithal to deliver their outcomes—a feasible set of outcomes—is absolutely crucial to the future stewardship of the health service and individual hospitals. Our system is simply not achieving that, and the target culture is one reason why.
  On top of that, I believe that the average life of a chief executive of an NHS trust is only 700 days in the job. One reason for that is that there have been substantial changes in management and mergers in the NHS, but it also results from the demoralisation and despair many managers feel about their ability to deliver in their role. At the same time, there has been a huge proliferation in the number of administrators. Ministers have failed to explain why the number of NHS administrators has increased. There may be many different reasons for that. One is that many of them are engaged in monitoring and responding to the scatter-gun approach to the proliferation of targets. I understand that the number of administrators may begin to reduce, but we have yet to see that. There was a huge increase—48 per cent.—between 1995 and 2001 compared with a 7.8 per cent. increase in the number of nursing and clinical staff.
  Faced with a crisis of management in the health service, according to my parliamentary questions—the Minister of State, the right hon. Member for Barrow and Furness (Mr. Hutton) and I have had a dialogue on this—the Department has no knowledge of the career background of 60 per cent. of NHS chief executives. He has told me that that is not right, but it is the response that I received to my parliamentary questions. Even if the responses are incorrect, which I am prepared to accept, they must reflect the management priorities and the attitudes of Ministers.
  Just in case anyone thinks that targets do not affect attitudes within the NHS and among managers, I refer hon. Members to the article in the British Medical Journal on 20 December last year entitled "Snakes, ladders and spin", which states:
  "How to make a silk purse from a sow's ear—a comprehensive review of strategies to optimise data for corrupt managers and incompetent clinicians".
  Some of it is gripping, some is tongue in cheek, but it does say:
  "Surgeons' and hospitals' positions in league tables can make or break their reputations. They therefore need to learn how to present data in the best possible light."
  It refers to different ways of distorting the data and how managers and clinicians can represent themselves in the best possible light. It concludes by saying:

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  "Performance managed healthcare settings encourage gaming and "creative accounting" of data. Creative accounting is driven by three dominant factor—attracting additional resources, meeting performance related targets, and improving positions in league tables".
  That is what administrators talk about. If Ministers can show that the target system is not distorting management priorities, they have to explain why everything in that article is wrong.
  Unless we get a different approach to management—one that concentrates more on developing quality leaders in the NHS; on getting better co-ordination between those leaders, managers and clinicians; on developing a common clinical vision of what is to be achieved; and on moving away from what is seen as a highly mechanical and one-size-fits-all approach to target setting—we will not get good value for money from the extra investment.
  3.3 pm
  Andy Burnham(Lab):Comment has been made on an ex-Secretary of State for Health. I begin by commenting on an ex-shadow Secretary of State for Health. The hon. Member for Woodspring (Dr. Fox) may be gone, but it will be some time before Labour Members forget his disarming honesty about Tory health tactics. Fox by name, but certainly not by nature. There was nothing cunning or shrewd about his crude campaign to disparage the efforts of NHS staff and undermine the principle of a publicly funded collective health system.
  As the Daily Mirror revealed, the hon. Gentleman's tenure was dedicated to creating a four-point plan with the clear aim of fuelling public cynicism about the NHS. He fed the belief that the NHS is a financial black hole and that the people who work in it are incapable of improving it and of spending the public's money properly. Accordingly, the architect of that nasty plan has been rewarded with the chairmanship of the nasty party. What is revealing about the debate is that we now know for sure that the so-called new team on the Conservative Front Bench is sticking with that unsavoury doctrine. Part of it means undermining confidence in any mechanism that shows whether the NHS is improving. That is the essential context for the debate on the star rating system.
  At other times, the attack takes a different tack, but the fundamental point is the same. Conservatives complain of the productivity gap—that double-figure percentage increases in funding lead to single-figure increases in productivity. It is an argument that shamelessly skates over the fact that the outgoing Conservative Administration left the NHS bereft of the human and physical capital it needed, something to which my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey) alluded. Given the time it takes to train clinical staff and build high-tech health facilities, there will inevitably be a lag before productivity levels rise again.
  What even the Conservatives cannot talk down are the black-and-white facts in the NHS chief executive's report published only in December. It shows solid progress and improvement that is a tribute to all concerned—Ministers, managers, nurses and doctors. It is hardly surprising if the public are unaware of the report's contents because it was largely dismissed by the
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  media, presumably because the message was not what they wanted to hear. It reported substantial and sustained reductions in waiting times and waiting lists, a major increase in productivity and, interestingly, that the public now rely heavily on services dismissed as a gimmick by both main Opposition parties. In 2002–03, NHS Direct handled 6,319,000 calls and there were 1,373,000 visits to NHS walk-in centres. Now the Conservatives criticise the NHS star rating system in the same way. That is part of the Fox plan and it should be dismissed.
  Patients in our borough are served by the Wrightington, Wigan and Leigh NHS trust. Initially, it was awarded a two-star rating, but after a couple of years of steady improvement and management focus on the weaknesses identified by the performance indicators, last year it received a three-star rating. The achievement of three stars has boosted morale and staff were rightly rewarded with an extra day off. Morale has clearly improved—[Interruption.] The right hon. Member for Charnwood (Mr. Dorrell) laughs. He was a Minister in that Conservative Government. What a difference it must be for members of staff to work in a health service that is on the up and receiving investment. They can feel improvements in the air, unlike when they worked in the health service in 1996, when it was under his stewardship and cuts and decline were the order of the day. It must be a very different place to work. My thanks go to the staff of the Wrightington, Wigan and Leigh NHS trust, and in particular to Sheena Cumiskey, the chief executive, and Brian Strett, the chair.
  The trust is moving forward, with an application for foundation status having achieved three stars. That application is supported by the staff at our trust. Perhaps some of my hon. Friends have not given enough thought to that. It gives Leigh, the other town in the borough, a chance to shape the future of our own hospital, Leigh infirmary. I will call on local people to seize that opportunity to give our hospital a new future, given the powers that foundation status will, I hope, give us.
  It is not just our trust that has had a positive experience of the star rating system. There is substantial evidence that it has lifted performance across the NHS. Let us consider the evidence given to the Health Committee's inquiry on foundation trusts—of which the hon. Member for West Chelmsford (Mr. Burns) is a member. Mr. David Jackson, chief executive of the Bradford Hospitals NHS trust, said:
  "I can tell you that when we became a three-star trust—and I was very cynical about the whole process—the atmosphere in the hospital changed and people felt they had been recognised for the hard work and motivation and commitment and it had a very tangible beneficial effect."
  Mr. Nik Patten, deputy chief executive of the South Tees Hospitals NHS trust told us:
  "We missed three stars very marginally last year; our inpatient data was very, very good but our forms in two areas were slightly off the leading pace … We were disappointed that we did not get three stars… Having failed last year marginally, we want to achieve that three-star status."
  He agreed that it had energised the trust rather than demoralised it.
  The improvement that the chief executive report catalogues is a huge tribute to the work of my right hon. Friend the Member for Darlington (Mr. Milburn). His

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  real achievement for patients and people in this country stands in stark contrast to the pettiness of the Opposition motion. That said, I want the Government to make more progress on one thing. Now that the NHS is back on its feet, I want our focus to switch to a sustained attack on entrenched ill health in some of our most deprived communities and to the health inequalities that still blight Britain. We have only scratched the surface. We need to tackle those huge structural and cultural problems. Ironically, that is a call for more political influence on the allocation of NHS resources.
  Last year Members, including me, lobbied hard for a change in the resource allocation formula that had previously been driven predominantly by factors such as old age. We succeeded. The Secretary of State listened and produced a formula that gives far more weight to deprivation and ill health as the guiding principles of resource allocation. However, in practice, we have yet to see the major shift in resources that the change in the formula accepts is necessary.
  Recently, I tabled a parliamentary question to the Department of Health to ask how far each primary care trust was from its target funding in the third year of the current spending review. The results are revealing. In some of the most affluent parts of the country, PCTs will be significantly over the target. Westminster will be £76 million over target. The figure will be £41 million in Wandsworth; £27 million in East Elmbridge and Mid Surrey; £18 million in Guildford and £19 million in Cambridge. However, in some of the most deprived parts of the country, with the most entrenched problems of ill health, the picture is reversed and PCTs are hugely under target. That is because although the formula now recognises the health needs of those communities, they do not yet have the resources. Central Liverpool is £26 million under target. The figure is £25 million for the Heart of Birmingham PCT; £24 million for Barking and Dagenham; £25 million for Easington; and in Ashton, Leigh and Wigan—my PCT—it is £12 million.
  I understand the rationale for the Department of Health's pace of change policy and the destabilising effects that could result from a rapid reallocation of NHS resources, but at a time of rising NHS funding the pace of change is far too slow. It is time to target new funding on the areas of the country where health is worst and that the Department itself accepts need significantly more resources.
  That focus should guide the Department's work in the medium term and it should be the bold agenda that guides a third-term Labour Government.
  3.11 pm
  Dr. Richard Taylor(Ind):I begin by agreeing with the right hon. Member for Charnwood (Mr. Dorrell) and other speakers: I do not want the abolition of star ratings because they have an important part to play. However, I want to discuss their accuracy and appropriateness and some of their unwanted effects, and especially to press for more notice to be taken of the views of patients when NHS ratings are being drawn up. I hope that the presence of the Commission for Patient and Public Involvement in Health will help to ensure
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  that the new Commission for Healthcare Audit and Inspection actually takes much more account of the views of patients.
  The assessment of quality in the NHS is a great interest of mine. Indeed, I held an extremely intimate Adjournment debate on the subject in Westminster Hall with a Health Minister on 10 June. I shall not go over the points that I made as they are recorded in Hansard, but I want to draw the House's attention to the balanced scorecard approach, to which the Secretary of State for Health has already referred, as that seems to be the most opaque method of assessing scores in a process that is supposed to be transparent and open to everybody.
  I argued that the people of whom it is most important to take account when establishing star ratings were being neglected. They are, of course, the recipients of health care—the patients—and its providers, the nurses and doctors. I shall not repeat what I said at that debate, but my views on the accuracy of the star ratings were borne out by the Audit Commission's report, "Achieving the NHS Plan", which concluded that the number of stars related only weakly to performance and management adequacy. The commission gave the stark illustration of a trust awarded two stars, yet from the detailed knowledge of the commission's local auditors it described that trust as "failing".
  I want to discuss the appropriateness of the current performance indicators and some of the possible unwanted effects of the system. As other hon. Members have pointed out, the indicators are incredibly important: the ratings carry rewards and foundation trust status. As an aside, it is no wonder that staff who are about to receive foundation status welcome it—it brings rewards. However, that high importance can bring risks. The Royal College of Nursing, in its submission to the Public Administration Committee's inquiry into targets, pointed out that there is a risk of influencing staff behaviour away from the best interests of patient care. A further risk is that to meet the target for seeing out-patients some trusts see more new patients at the cost of making essential follow-ups.
  Trusts may look for ways around the targets. Examples from accident and emergency departments have received much publicity: trolleys are converted to beds, waiting areas in other departments are used for patients, and there are queues of ambulances outside. Such cases have been well rehearsed in the past.
  The wait for out-patients begins only when the general practitioner's referral letter is logged in. That logging in may be delayed or, even worse, the letters may be lost. I have just received a letter from a constituent whose first delay occurred because the appointment letter was lost. A subsequent letter, in which he expected to be given a date for his appointment, stated:
  "Now you are on the outpatient waiting list to see Dr. X… the current waiting time is approximately 18 weeks… We will contact you about 4 weeks before the anticipated appointment time."
  It appears that there is a waiting list for the waiting list. Does the Minister admit that that is happening and is the practice widespread?
  Another risk is the cancellation of admissions for elective surgery for non-clinical reasons. What are the rules about that? Cancellation on the day of the operation is obviously counted, but can the trust avoid the stigma of cancellation by not recording it if it occurs earlier than that?

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  An example of the inappropriateness of one existing target was published last August in the Journal of the Royal Society of Medicine. Urologists at Medway Maritime hospital considered the effects of the two-week rule for seeing patients with suspected urological cancers. They found that although it achieved more rapid times for seeing patients it had no effect at all on the interval between referral and receiving definitive treatment. There were delays for scans, X-rays, and operating theatre time. I understand that the Government have spotted that problem and that by the end of 2005 the target for all cancer treatment will be two months from urgent referral to actual treatment. Sadly, that is a long way away for patients today and I wish it could be sooner, although obviously it is an improvement.
  My quandary today is which way to vote. There are valid points in the Opposition motion, but there are also valid points in the Government amendment. I shall almost certainly take the step that only I am allowed to take and vote for both the amendment and the motion. I cannot see that there is anything mutually exclusive in either. I hope that when the Minister responds to the debate he will not attack the Conservative Opposition politically, as has occurred so often in the past during questions and debates—even Mr. Speaker has referred to the matter—by hiding behind their refusal to vote for more money for the NHS, rather than actually answering the questions.
  As I have said, I am not arguing for the abandonment of star ratings—I am merely arguing for greater reliability, greater local relevance, a greater impact of staff and patients' views and, above all, a greater emphasis on outcomes.
  Professor Alan Maynard, director of the health policy group at York university, wrote recently in the British Journal of Health Care Management
  "Whether spending more or doing more improves population health is sometimes asserted, but never measured systematically and demonstrated. Ignorance is bliss, no doubt, for decision-makers in Whitehall."
  3.20 pm
  Dr. Howard Stoate:I shall be reasonably brief, as others wish to speak.
  I am very pleased that we are having this debate, because Members on both sides of the House are finding it useful. I am also pleased that the Secretary of State was able to explain how the star ratings are evolving, and how the indicators are changing year on year. It was reassuring to hear about the transparency of the system, and to learn that patients' involvement and experience were at the forefront, so that the patients could see that they were playing a part in the performance of hospitals.
  The facts are stark. The Government are putting record amounts of money into the health service: no one could deny that. It is important, however, to ensure that the investment is not wasted but is used to make genuine improvements in patient care. There is the rub: it is impossible to know how well investment is doing unless there is a coherent way of measuring outcomes.
  I do not want to dwell on this for too long, because many Members on both sides of the House have rehearsed the same arguments, but we obviously need a robust and coherent system of measurement to ensure
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  that we are using money wisely—that it is targeted where it is needed most, and that we see genuine improvements in outcomes.
  The hon. Member for Tiverton and Honiton (Mrs. Browning) told a harrowing story of a patient who had suffered trauma. That is clearly unacceptable. Anyone experiencing such trauma will have a significant chance of experiencing long-term ill health and possibly early death if it is not treated quickly. I would certainly consider it unacceptable if people waited for five days for a similar operation at my local hospital. Without transparency, though, we do not know what is going on in our hospitals.
  My local trust, the Dartford and Gravesham NHS trust, opened one of the first new hospitals under the private finance initiative following this Government's election. The fantastic new building won various design awards. Size was always going to be a problem—the hospital was never going to be large enough for an expanding population in a part of north-west Kent that is experiencing huge growth—and it soon became clear that the Government's expectations were not being met. I received complaint after complaint. Operations were being cancelled, and people were waiting on trolleys in accident and emergency for unacceptable periods.
  Many factors were blamed for the problems in the early days. Some people said that there was too much management; others claimed that it was the wrong sort of management, or that the number of beds was wrong. The hospital received a zero star rating. Then, however, there was a change of culture: we appointed a new manager, Sue Jennings, who brought in a new management team. Something very radical then happened. There were no additional beds, and there was no reduction in the number of managers, but within a year of Sue Jennings's arrival the hospital had one star and the following year it had three.
  The effect on morale has been dramatic. When I walk into the hospital I see that everyone is smiling. Patients are smiling, staff are smiling, and the porters welcome those who enter with a spring in their step. That change in the culture is itself driving improvements and innovations, and genuinely improving patients' experience. It is almost impossible to describe the enormous improvements that have been made. I am not saying that everything is perfect, but that change in the culture has taken place—not because of huge expansion or a radical change in the number of managers, but simply because beds are being managed more effectively by more efficient managers.
  The only way in which we can objectively tell that such things are happening is through performance indicators such as the star rating system. The proof of the pudding is in the eating. The number of complaints I receive has fallen to almost zero, and the number of letters I receive from constituents saying, "I had a really good experience in the hospital," has increased dramatically. That is not accidental; it is due to the enormous amount of work put in by all the trust's staff. The whole situation has been radically improved by the fact that performance indicators enable staff and others to see how much the trust has improved, and how the culture of the hospital has changed.
  I would counsel strongly against the assumption that a sudden increase in the number of beds, or a sudden change in the number of managers, can make a massive

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  difference. It cannot; we are talking about a change in culture, and the ability to demonstrate how much a hospital has improved.
  Let me give a classic example. When the hospital first opened and was clearly not doing particularly well, people would come to my surgery and say, "The Government are failing: the hospital is no good." I would say, "Look at the extra money that is going in." They would respond, "The extra money is making no difference. I am still having to wait for 12 hours on a trolley, or to wait for three months for an out-patient appointment. My operation has been cancelled. Your money is not doing any good." It was very difficult to persuade people that Government investment was making a difference. Now I can say, "Look at the performance indicators. Look at how the hospital has come on in the last couple of years"—and they now say, "Yes, I see that the money is beginning to make a difference. It is beginning to produce the improvements we have been demanding for the last few years."
  Debates like this are important because they give us an opportunity to air differences of opinion and to share our experiences. It is also important that our constituents can see what is going on in their hospitals, and ensure that what we hope to achieve is being achieved.
  The message is clear: the Government must go on investing in the health service as it is now. We shall not see an end to five-day waits for trauma surgery unless hospitals receive more investment, but it is clear that if hospitals do not use money effectively and have no effective measures to compare their performance with performances elsewhere in the region and the country as a whole, and with national standards, we shall not see the best results. There is no point in every hospital's reinventing the wheel. What is most important is for hospitals to take best practice from parts of the country where the system is clearly working, and use it to model their own performance. They will not necessarily perform in exactly the same way, because different local circumstances will require different approaches. But the only way in which to ensure that best practice is adopted throughout the country is to provide robust performance indicators that can be reproduced, so that we can genuinely compare like with like on a national basis.
  I am very pleased that my hospital has improved so much, and I am sure that other Members can recount similar stories. As long as the Government's money is invested and as long as it is spent wisely, everyone—particularly patients and NHS staff—will reap the rewards.
  3.27 pm
  Mr. Peter Lilley(Con): It is a great privilege to follow the very constructive contribution from the hon. Member for Dartford (Dr. Stoate), which had more in common with the contributions from my hon. Friends the Members for Tiverton and Honiton (Mrs. Browning) and for Tunbridge Wells (Mr. Norman) and my right hon. Friend the Member for Charnwood (Mr. Dorrell) than with that made from his own Front Bench.
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  The key question underlying the debate on the health service today is why, despite the superb dedication of NHS staff, the huge increase in taxpayers' money going into the health service has not resulted in a commensurate increase and improvement in clinical services. In a nutshell, the reason is that those resources are allocated by a system that is highly centralised and micro-managed from the centre and where the management is driven by the desire for media manipulation and good headlines in the press tomorrow. Perhaps I can give some concrete examples of how that obsession with media manipulation and micro-management at the centre results in, at best, waste and, at worst, the undermining of clinical standards and, invariably, staff morale.
  The Government announced a waiting list initiative. They got a good headline. They announced a waiting list budget for each hospital—another good headline. They announced that each hospital should have a waiting list manager—a third good headline. What does that mean in practice? Well, in hospital A—I am not at liberty to reveal which hospital that is, but it is not in my constituency—the waiting list manager used his waiting
  list budget to meet his waiting list target by employing locum surgeons on Sundays, at much extra expense, but from his extra budget, to operate on people on the waiting list. That seems a good idea—expensive, but on first sight, it would reduce the waiting lists. Unfortunately, sterilisation teams are not employed on those Sundays, so all the equipment needs sterilising by the end of Sunday. Come Monday, no operation can be performed until late in the day, when all the equipment has been sterilised, but that is part of a different budget, so it does not matter. So a huge amount of money has been wasted for no extra improvement or no reduction in the waiting list. That is waste, but the result can be much worse than waste.
  In the same hospital, one of the senior consultants had made major advances in reducing infection—I shall refer to that problem again in a minute—by having a dedicated ward where people went after open-wound surgery. No one with an infection was allowed on the ward. But the waiting list manager, up against his waiting list target, had some people on the list who would go over the target by just a few extra days, so the senior consultant found that they were plonked on his ward. Some of them had bowel infections—one even has MRSA—so he said that he was not prepared to operate with those infections in the feeder ward for his operating theatre. He was told that he had to, because he had to meet his targets. He said, "Well, I will if you insist." He told his patients that they could be operated on if they would first sign a disclaimer, which they would be wise to do only if they were feeling suicidal, so no operations were carried out that day. More waste, and possibly a risk to people's lives as a result of a target-driven culture in the health service. So that is what the Government's policies mean in concrete terms, and those are not isolated examples.
  Patients are not interested in targets; they want to know that, when they go for treatment in hospital, they will come out healthier than when they came in. Sadly, we have a system where nearly one in 10 patients who go into hospital acquire an infection that they did not have before they went in. According to the National Audit Office, between 5,000 and 20,000 people die of superbug

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  infections that they get in hospitals. The European Union says that the situation is worse in our hospitals than in any other country in Europe and getting worse faster in this country than elsewhere in Europe.
  When that first became a matter for public concern, the Government's response was to set up a system of traffic light indicators for hospital cleanliness: red for not so clean, amber for okay and green for fine. Unfortunately, they then discovered that, of the 20 hospitals with the highest level of MRSA superbug infection in the country, they had rated 15 green, five amber and none red. So they have naturally kept quiet about that expensive, time-consuming, costly and bureaucratic initiative for some while.
  I managed to raise the issue with the Prime Minister recently, asking him why we were fighting and losing that biological war in our hospitals. He said that I should not discuss negative aspects of NHS hospitals, but all hon. Members have to raise those matters and should continue to do so until our record is not the worst but the best in Europe. I will do so particularly because I had a hospital with one of the highest levels of MRSA infection serving my constituents. I am glad to say—I pay tribute to it—that it has halved that level during the past year, which shows that it can be done and that improvements can be made.
  A few days after I raised the issue with the Prime Minister, the Secretary of State—I regret that he is not here—announced with great fanfare a new initiative to deal with superbugs. There were headlines in all the newspapers. I asked whether he would make a statement about that new initiative and those new policies in Parliament. He wrote back to me, saying:
  "For the record, the press notice last Friday did not announce any new policy."
  The press statement actually says:
  "Mr. Reid gave his backing to wide-ranging proposals…which seek to revolutionise the way potential infections are handled in hospitals"
  involving,
  "new rules…a new system…a new drive…new plans".
  Apparently not new policies, however. It may well be that the Minister is happy to deceive the newspapers. I am certainly not accusing him of deceiving the House—I am accusing him of telling the truth to the House by saying that he does not have new policies to deal with an issue on which he should have new policies.
  In following this situation, I have done more than 20 radio and media interviews with consultants and people from the Academy for Infection Management. They have proposals to deal better with the problem, so why are the Government not giving them serious consideration? I have received many e-mails from consultants and doctors throughout the country pointing out what is happening and saying that solving the problem does not require large expenditure. The solution requires, above all, a transfer of responsibility back from management and bureaucracy to local clinical people. If that were successfully adhered to, it would save massive amounts, but it is not allowed because of the target-driven culture.
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  One e-mail I received said:
  "We have managed to keep MRSA out of our rehabilitation unit by a combination of pre-screening, rigorous hygiene and vigorous treatment…However, we have been put under pressure to relax our criteria because they delay transfers".
  It says that there is a target
  "to move people out of casualty departments within a set time",
  so targets are putting pressure on the person who wrote the e-mail to undermine the clinical standards that were saving lives. The issue is important and I am sorry that the Secretary of State is not in the Chamber to tell us why he has no policies to deal with something that is killing thousands of our constituents. I hope that the Minister of State, the right hon. Member for Barrow and Furness (Mr. Hutton), who will wind up the debate, will tackle the problem more seriously than his colleagues have so far.
  3.36 pm
  Mr. Adrian Bailey:In the few moments available to me I shall single out one or two of the points that I wish to make. I had a sense of déjà vu when I read the motion, because the substantive issues have been debated fairly comprehensively before. I took part in a debate on performance indicators and targets in October last year and, of course, the South Durham health care trust has been the subject of several questions in the Chamber, which have been adequately dealt with on each occasion. I can only deduce that the official Opposition's tactic is to reiterate a specific line of attack in the hope that constant denigration of, and carping about, performance indicators, targets and star ratings will somehow mask the huge improvements in the output of the NHS that are a result of Labour's investment in it.
  Conservative Members do not want to talk about the real issues that affect people's everyday lives, such as the length of time that they wait before they see their general practitioner or go into hospital for an operation, the number of people on waiting lists or the time that they have to spend in accident and emergency departments. Conservative Members do not want to discuss those points because they know that all the evidence from the indicators shows that the investment that Labour puts into the NHS is paying dividends and that the public appreciate that. They know that the NHS is the most popular service in the country—a service that not only improves the quality of life of millions of people but increases the length of their lives.
  A publicly funded service that is free at the point of delivery encapsulates Labour's values through and through. Conservative Members realise that if people appreciate that the principles that underpin the NHS pay dividends, they will support Labour at the next general election. They will therefore do everything in their political power to denigrate the service and hide the reality of the situation. In short, the motion is a politically motivated attack that is not rooted in the reality of people's everyday experience of the NHS, but designed to mask that reality in the interests of short-term political dividends for the Conservative party.
  3.39 pm
  Mr. Andrew Lansley:In some respects, this has been an enlightening debate, but not in others. Conservative Members have shed

  313
  considerable light on performance indicators, the way in which performance should be measured, the excessive nature of performance indicators and Government requirements for information, and the distortion of clinical priorities in the NHS and the severe consequences of the transfer of performance measurement to a system of centrally determined targets. My hon. Friends made excellent contributions, which reflected their experience in senior positions, both in government and in the private sector, and thus had a strong bearing on the way in which performance management should be conducted in large organisations. Their contributions also reflected their personal experience and the experience of real people.
  The hon. Member for Sutton and Cheam (Mr. Burstow) took up some of the forceful points made by my hon. Friend the Member for South Suffolk (Mr. Yeo) in his opening speech, but also raised the issue of Basildon and Thurrock. Can the Minister explain why, if the failure of the star ratings for Basildon and Thurrock was connected to patient surveys and patients' experience, the exclusion of catering, information technology and management criteria led to an increase in those ratings? The hon. Member for Sutton and Cheam referred to the excessive requests for information from the Government. The NHS Confederation produced a report just last month based on the experience of Manchester hospitals in which it said that there had been
  "a considerable increase in often unco-ordinated ad hoc requests…The quality of data provided at very short notice will be poor…Demands from the centre have often been poorly defined and do not always ask the right question…Information is requested without checking whether it already exists, leading to duplication."
  The confederation also says that
  "there is a lack of feedback on how information is used."
  As has been said, those hospitals concluded that more than half of the information requests that they received were not perceived to be useful for the management of the trust.
  That brings me to a point made by my right hon. Friend the Member for Charnwood (Mr. Dorrell). If a system of performance management, information gathering and data collection is to be devised within a large organisation, it should meet the trust's priorities. If we are serious about the devolution of management in the NHS—and Conservative Members are—priorities should be determined locally, so the system of performance of management should be devised locally and not centrally imposed. My hon. Friend the Member for Tiverton and Honiton (Mrs. Browning) spoke about the experience of real people in the NHS, which, as the hon. Member for Dartford (Dr. Stoate) rightly said, we should take to heart and acknowledge. I am sorry that my hon. Friend's speech was followed by that of the hon. Member for Birmingham, Hall Green (Mr. McCabe), which did not reflect the experience of real people in the NHS. I do not think that the hon. Member for Milton Keynes, South-West (Dr. Starkey) is aware of what is happening in the NHS. She said that everyone in her hospital in Milton Keynes agreed that there was a problem but she went on to say that they needed the star-rating system to tell what it was. There are two
  314
  three-star hospitals in my constituency—Addenbrooke's, which has been a three-star hospital from the outset, and Papworth, which has been one since 2002. We are a fast-growing area, and have experienced pressures on capacity, but those hospitals have retained their three-star rating. The reasons for that were touched on by the hon. Member for Dartford who, as my right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) said, made a speech in keeping with Conservative philosophy.
  It is a matter of culture. It is about delivering in the NHS, which is not happening. Star ratings are not needed in order to deliver. We in South Cambridgeshire knew that Addenbrooke's hospital and Papworth hospital were excellent hospitals before the star rating system. I trust that the Minister of State, the right hon. Member for Barrow and Furness (Mr. Hutton), visited those hospitals yesterday and discovered that for himself.
  If we are to have transparency and accountability in the NHS, as I hope we will, the priorities that are determined locally must be reflected in performance management and in indicators that are accessible to the public. As my hon. Friend the Member for Tunbridge Wells (Mr. Norman) rightly said at the outset of his speech, if we are to implement a system of choice for patients, that requires transparency in performance. Indeed, that is our philosophy. We have got used to Labour Back Benchers and the Government misrepresenting the policies of the Conservative party. Most of the speeches made from the Government Benches suggested that Conservative oppose performance indicators.
  We are not opposed to performance indicators. We are opposed to excessive requests for information and excessive reliance on performance indicators. We are opposed to the imposition of performance indicators from the centre, rather than indicators derived from local priorities. We are particularly opposed to a system of targets and star ratings leading to a system of rewards and penalties for those who work in the NHS, which is determined from the centre and which, in the case set out in the motion, could be open to manipulation, as my hon. Friend the Member for South Suffolk said, by those at the centre, particularly Ministers.
  That is not a criticism of civil servants; it never was. The Secretary of State rightly defended civil servants. We are defending civil servants by seeking to expose the ministerial interference in the system. Many in the NHS are sceptical of the credibility of the star rating system. That system will be further undermined by the fact that they can now see an instance where it appeared open to ministerial interference.
  That brings us back to the case at the heart of the debate. My hon. Friend the Member for South Suffolk asked some questions of the Secretary of State, but he did not get many answers. The Secretary of State did not explain why the Prime Minister has neglected to reply to my hon. Friend's letter. It is all very well replying to my hon. Friend the Member for Woodspring (Dr. Fox), but that and the letter from the permanent secretary have served only to raise more questions than they answer.
  The Secretary of State relied on a series of changes over the years, but that does not explain why, if the system is changing and has changed last year and this

  315
  year in the absence of ministerial involvement, ministerial involvement was so necessary in July 2002 to introduce the star rating system. The truth, I suspect, is that Ministers have been taken out of the star rating system in subsequent years, not least because of the interference in July 2002.
  Let me ask a question to which the Minister can reply in his winding-up speech. If it was necessary to drop two criteria—access to catering facilities and information management and technology—because the data were poor, were they dropped before 12 July 2002 or after? When the head of the performance development unit wrote to the Secretary of State, he made it clear that the process of consultation had already taken place. He stated:
  "Unfortunately, even if time allowed it, further revisions to the methodology to promote these trusts"—
  that is, the so-called high-profile trusts—
  "would inevitably lead to other individual results we had not expected, as well as making the scoring system more complicated."
  Responding to the request from the Secretary of State, the head of performance development wrote:
  "Alterations to the methodology have been made".
  The Minister of State said from a sedentary position that there had been no changes to the methodology, but the head of the performance development unit clearly said that there were. He went on to say that those resulted in
  "the changes to individual trusts that were requested."
  This was not some objective process derived from consultation with trusts and CHA1. It was in response to the Secretary of State's request. The head of the performance development unit went on to say:
  "This makes the scoring methodology more difficult to explain and less transparent."
  The Government's amendment refers to transparency. We all need transparency in the decision-making process, but it was perfectly clear that, as a result of the former Secretary of State's intervention, the system was made more difficult to explain and less transparent. Why did that happen? We need answers, and the Government have not given them to us.
  3.49 pm
  The Minister of State, Department of Health (Mr. John Hutton):This has turned out to be something of a surprising debate. It rapidly recovered from the low point that it reached after the contribution of the hon. Member for South Suffolk (Mr. Yeo) and turned into a high-powered, almost policy wonk-style seminar about the virtues and merits of performance assessment, performance indicators and the use of targets. I do not think that that was quite the intention behind the Opposition motion, but the debate was interesting none the less and I should like to return to some of the contributions that have been made.
  The other reason why the debate was surprising is that, when I was preparing for it, with some trepidation, I thought that the Opposition would set loose on the Government some of their Back-Bench parliamentary Rottweilers. Instead, to be fair to them, we heard some high-powered contributions from the Opposition Benches, as we did from the Labour Benches. We heard
  316
  from two former Secretaries of State, a former Minister and a leading member of the former Tory shadow Cabinet. The right hon. Member for Charnwood (Mr.Dorrell) usually speaks a great deal of sense about the national health service, and he did so again today. Many Labour Members would want to agree with much of what he said, but his problem is that no one on the Conservative Front Bench looked too chuffed with what he had to say.
  The Tory motion has two components. There is a sort of puerile bit of old crap at the beginning, if I can use that as a parliamentary expression, or a puerile reference to my right hon. Friend the Member for Darlington (Mr. Milburn). It also has a second section dealing with the use of performance indicators. Not a single Conservative Back Bencher referred to the first part of the motion. I know perfectly well why: they recognised that there was not a shred of substance in any of the allegations that the hon. Member for South Suffolk brought before the House today.
  I congratulate my hon. Friends the Members for Mitcham and Morden (Siobhain McDonagh) and for Birmingham, Hall Green (Mr. McCabe), who spoke well and certainly rattled Opposition Members, and my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey), who also spoke well. My hon. Friend the Member for Leigh (Andy Burnham) made some important points about the funding formula. He will know that my right hon. Friend the Secretary of State is aware of the issues and is considering them very seriously. My hon. Friends the Members for Dartford (Dr. Stoate) and for West Bromwich, West (Mr. Bailey) hit the nail entirely on the head in their analysis of what lay behind the motion.
  I want to congratulate the hon. Member for Tiverton and Honiton (Mrs. Browning) on her remarks as well. She was right to express her concern about the treatment of one of her relatives, and if she is prepared to write to me about the matter, I shall be very happy to look into it. I interpreted her remarks, perhaps wrongly, as largely an appeal for additional resources for the national health service. With the best will in the world, I do not think that she is in the best position to advance that sort of argument to the House.
  Mrs. Browning:Just for the record, I was not asking for more money. but talking about the way in which resources have to be allocated to meet targets instead of trauma cases.
  Mr. Hutton:The hon. Lady's comments certainly came across as an appeal for extra resources. I am grateful for her clarification.
  The hon. Member for Tunbridge Wells (Mr. Norman) spoke very well and made a number of very important points. He will know that I agree with much of what he has to say about management in the national health service. I look forward to further contributions from him.
  Perhaps I should not say this to the hon. Member for Wyre Forest (Dr. Taylor), who flummoxed us all by saying that he was going to vote both for and against the motion, but I do not think that he can do that. If he votes for the amendment, he will be seeking to delete the words of the motion and inserting words proposed by

  317
  my right hon. Friends. He is welcome to do that, but it will be rather difficult for him to vote against it 10 minutes later.
  The right hon. Member for Hitchin and Harpenden (Mr. Lilley) made a very important contribution about hospital-acquired infections. We certainly want to deal with that issue. Of course, it is the responsibility of the chief medical officer, and he is taking forward work in that regard.
  The hon. Member for Sutton and Cheam (Mr. Burstow) made several observations about the performance assessment framework, as did the hon. Member for South Cambridgeshire (Mr. Lansley), who said—this was a surprise to us, given everything that the hon. Member for Woodspring (Dr. Fox) has said in the past—that the Conservatives are not opposed to a national set of performance indicators. He provided the helpful clarification that although he was not against those indicators, he did not want anyone to rely on them too much. That is not a terribly sensible position for him and his party to adopt—perhaps we can look forward to further clarification of exactly what he means by it.
  The hon. Member for Sutton and Cheam raised several issues that I shall try to deal with. He expressed his concerns about the 2003 star ratings and whether there had been any inappropriate ministerial interference. I quote to him what Deirdre Hine, the chairman of the Commission for Health Improvement, said on 16 July:
  "The targets and many of the indicators were set by the Department of Health but we have compiled the ratings this year. I would reiterate that there has been no pressure from ministers and these have been produced absolutely independently."
  I hope that that deals with the hon. Gentleman's point.
  The hon. Gentleman asked whether the final methodology that underpinned the eventual selection of performance indicators in July 2002 would be published. It was published on the same day as the performance indicators themselves—that is, nearly 18 months ago.
  The debate has, predictably, generated a lot of heat, but very little light has emerged from any Conservative Front Benchers. I should therefore like to start by concentrating on the facts, not the hyperbole. Let us be clear about those facts. My right hon. Friend the Member for Darlington raised questions about the publications of the NHS performance ratings for 2002, and he was absolutely right to do so—any Secretary of State would have done precisely the same thing. At that time, the Department was responsible for the preparation and publications of those ratings, and my right hon. Friend was, rightly, accountable to this House for the work that was being done. Moreover, it was the first time that comparisons with a previous set of ratings were going to be possible, so it was entirely appropriate that he should be satisfied that the final assessments were fair and accurate, as some trusts stood to lose stars.
  Most importantly, my right hon. Friend, in raising the questions that he did, was voicing the very same concerns about the 2002 ratings that had been expressed by NHS trusts. A significant number of NHS organisations—estimated at the time to be close to be
  318
  half all those who had made representations during the ratification process—expressed concern about the inclusion of data from two performance indicators. The data on both were unreliable because there was confusion about what was being measured. That was the view of officials, who also advised that including the information from those two indicators in the final ratings could not be justified. The exclusion of the data from those two indicators was the sole reason why the South Durham NHS trust retained its three-star rating.
  The two performance indicators dealt with access by doctors to the internet and access by patients to 24-hour catering facilities. Neither of those indicators, on any reasonable measurement, can be said to be so important that it should have been included in the final ratings, as neither was central to shedding light on NHS trust performance. That is why they were not used in 2002 and why neither was used in subsequent performance assessment exercises.
  The hon. Member for Woodspring has repeatedly complained about the inclusion of such non-clinical data in NHS performance ratings. Far from criticising the actions of my right hon. Friend the Member for Darlington, as the hon. Member for South Suffolk chose to, he and his colleagues should welcome the fact that these two performance indicators were dropped from the 2002 ratings. Perhaps that welcome is being saved for another occasion, but I somehow doubt it.
  My right hon. Friend also raised questions about the rating of eight other NHS acute trusts. In half those cases, no change at all was made to their eventual rating. That demolishes the central thrust of the Opposition attack that officials were somehow under orders to improve the star ratings of those trusts about which my right hon. Friend had expressed concerns. That is patently not the case. Equally untrue is the allegation that changes to the star ratings of individual trusts were made for political reasons. That argument has been comprehensively rebutted by the permanent secretary to the Department of Health—Sir Nigel Crisp made it clear today that he is satisfied that no such improper influences were brought to bear. In not accepting those assurances—indeed, in not even referring to them—Conservative Members are not only impugning the integrity of Ministers, but calling into the question the integrity of civil servants. I find that utterly contemptible.
  The motion also calls for greater transparency in the use of performance indicators in the NHS. That is complete and utter hypocrisy. The Government have gone further than any previous Administration in providing the public with information about NHS performance. We want the public to know what is happening in the NHS and what use is being made of the initial investment. The policy that the Conservative party advocates would return us to the old days when there were no clear national targets for the NHS, and that would be unacceptable.
  It is clear from the way in which the Conservative party has raised the matter that it has only one motive: to deny that any progress is being made in the NHS. That is its sole purpose. In the process of constructing that argument, it wants to help pave the way for its plans to expand the use of private medical insurance. That

  319
  deeply reactionary and cynical policy would widen health inequalities, deprive the NHS of of £2 billion of vital investment and set back its long-term expansion.
  There is no substance to any of the allegations of wrongdoing that Opposition Members have made today. No evidence of impropriety has been disclosed; no misuse of power or authority has been established; no credible or convincing case has been made out that would lend any measure of support to any part of the interpretation of events that the Opposition presented. On that basis, I ask my hon. Friends to reject the puerile and fatuous motion.
  Question put, That the original words stand part of the Question:—
  The House divided: Ayes 204, Noes 338.

  Division No. 22]

  [4:01 pm

  AYES

  Ainsworth, Peter (E Surrey)

  Duncan, Alan (Rutland)

  Allan, Richard

  Evans, Nigel

  Amess, David

  Fabricant, Michael

  Ancram, rh Michael

  Fallon, Michael

  Arbuthnot, rh James

  Field, Mark (Cities of London &

  Bacon, Richard

  Westminster)

  Baker, Norman

  Flight, Howard

  Baldry, Tony

  Flook, Adrian

  Baron, John (Billericay)

  Forth, rh Eric

  Barrett, John

  Foster, Don (Bath)

  Beggs, Roy (E Antrim)

  Fox, Dr. Liam

  Beith, rh A. J.

  Francois, Mark

  Bellingham, Henry

  Garnier, Edward

  Bercow, John

  George, Andrew (St. Ives)

  Blunt, Crispin

  Gibb, Nick (Bognor Regis)

  Boswell, Tim

  Gidley, Sandra

  Brady, Graham

  Gillan, Mrs Cheryl

  Brake, Tom (Carshalton)

  Goodman, Paul

  Brazier, Julian

  Gray, James (N Wilts)

  Brooke, Mrs Annette L.

  Grayling, Chris

  Browning, Mrs Angela

  Green, Damian (Ashford)

  Bruce, Malcolm

  Green, Matthew (Ludlow)

  Burns, Simon

  Greenway, John

  Burnside, David

  Grieve, Dominic

  Burstow, Paul

  Gummer, rh John

  Burt, Alistair

  Hague, rh William

  Butterfill, John

  Hammond, Philip

  Cable, Dr. Vincent

  Hancock, Mike

  Calton, Mrs Patsy

  Harris, Dr. Evan (Oxford W &

  Cameron, David

  Abingdon)

  Campbell, Gregory (E Lond'y)

  Hawkins, Nick

  Campbell, rh Menzies (NE Fife)

  Hayes, John (S Holland)

  Carmichael, Alistair

  Heald, Oliver

  Cash, William

  Heath, David

  Chapman, Sir Sydney (Chipping

  Heathcoat-Amory, rh David

  Barnet)

  Hermon, Lady

  Chidgey, David

  Hoban, Mark (Fareham)

  Chope, Christopher

  Hogg, rh Douglas

  Clappison, James

  Holmes, Paul

  Clifton-Brown, Geoffrey

  Horam, John (Orpington)

  Conway, Derek

  Howard, rh Michael

  Cormack, Sir Patrick

  Howarth, Gerald (Aldershot)

  Cotter, Brian

  Hughes, Simon (Southwark N)

  Cran, James (Beverley)

  Jack, rh Michael

  Curry, rh David

  Jenkin, Bernard

  Davey, Edward (Kingston)

  Johnson, Boris (Henley)

  Davies, Quentin (Grantham &

  Kennedy, rh Charles (Ross Skye &

  Stamford)

  Inverness)

  Davis, rh David (Haltemprice &

  Key, Robert (Salisbury)

  Howden)

  Kirkbride, Miss Julie

  Djanogly, Jonathan

  Kirkwood, Sir Archy

  Donaldson, Jeffrey M.

  Knight, rh Greg (E Yorkshire)

  Dorrell, rh Stephen

  Laing, Mrs Eleanor

  Doughty, Sue

  Lait, Mrs Jacqui

  320

  Lamb, Norman

  Shepherd, Richard

  Lansley, Andrew

  Simmonds, Mark

  Laws, David (Yeovil)

  Simpson, Keith (M-Norfolk)

  Leigh, Edward

  Smith, Sir Robert (W Ab'd'ns &

  Letwin, rh Oliver

  Kincardine)

  Lewis, Dr. Julian (New Forest E)

  Smyth, Rev. Martin (Belfast S)

  Liddell-Grainger, Ian

  Soames, Nicholas

  Lidington, David

  Spelman, Mrs Caroline

  Lilley, rh Peter

  Spicer, Sir Michael

  Llwyd, Elfyn

  Spink, Bob (Castle Point)

  Loughton, Tim

  Spring, Richard

  Luff, Peter (M-Worcs)

  Stanley, rh Sir John

  McIntosh, Miss Anne

  Steen, Anthony

  Mackay, rh Andrew

  Streeter, Gary

  Maclean, rh David

  Stunell, Andrew

  McLoughlin, Patrick

  Swayne, Desmond

  Malins, Humfrey

  Swire, Hugo (E Devon)

  Maples, John

  Syms, Robert

  Mates, Michael

  Tapsell, Sir Peter

  Maude, rh Francis

  Taylor, Ian (Esher)

  May, Mrs Theresa

  Taylor, John (Solihull)

  Mitchell, Andrew (Sutton

  Taylor, Matthew (Truro)

  Coldfield)

  Taylor, Dr. Richard (Wyre F)

  Moore, Michael

  Taylor, Sir Teddy

  Moss, Malcolm

  Teather, Sarah

  Murrison, Dr. Andrew

  Thomas, Simon (Ceredigion)

  Norman, Archie

  Thurso, John

  O'Brien, Stephen (Eddisbury)

  Tredinnick, David

  Osborne, George (Tatton)

  Trend, Michael

  Ottaway, Richard

  Turner, Andrew (Isle of Wight)

  Page, Richard

  Tyler, Paul (N Cornwall)

  Paice, James

  Tyrie, Andrew

  Paterson, Owen

  Pickles, Eric

  Viggers, Peter

  Price, Adam (E Carmarthen &

  Walter, Robert

  Dinefwr)

  Waterson, Nigel

  Prisk, Mark (Hertford)

  Watkinson, Angela

  Pugh, Dr. John

  Webb, Steve (Northavon)

  Randall, John

  Whittingdale, John

  Redwood, rh John

  Widdecombe, rh Miss Ann

  Reid, Alan (Argyll & Bute)

  Wiggin, Bill

  Bendel, David

  Wilkinson, John

  Robathan, Andrew

  Willetts, David

  Robertson, Hugh (Faversham &

  Williams, Hywel (Caernarfon)

  M-Kent)

  Williams, Roger (Brecon)

  Robertson, Laurence (Tewk'b'ry)

  Willis, Phil

  Robinson, Mrs Iris (Strangford)

  Wilshire, David

  Robinson, Peter (Belfast E)

  Winterton, Ann (Congleton)

  Roe, Mrs Marion

  Winterton, Sir Nicholas

  Rosindell, Andrew

  (Macclesfield)

  Ruffley, David

  Yeo, Tim (S Suffolk)

  Russell, Bob (Colchester)

  Young, rh Sir George

  Younger-Ross, Richard

  Sanders, Adrian

  Tellers for the Ayes:

  Selous, Andrew

  Gregory Barker and

  Shephard, rh Mrs Gillian

  Mr. Peter Atkinson

  NOES

  Adams, Irene (Paisley N)

  Bell, Stuart

  Ainger, Nick

  Bennett, Andrew

  Ainsworth, Bob (Cov'try NE)

  Benton, Joe (Bootle)

  Alexander, Douglas

  Berry, Roger

  Allen, Graham

  Betts, Clive

  Anderson, rh Donald (Swansea E)

  Blackman, Liz

  Armstrong, rh Ms Hilary

  Blears, Ms Hazel

  Atkins, Charlotte

  Blizzard, Bob

  Austin, John

  Blunkett, rh David

  Bailey, Adrian

  Boateng, rh Paul

  Baird, Vera

  Borrow, David

  Barnes, Harry

  Bradley, rh Keith (Withington)

  Barron, rh Kevin

  Bradley, Peter (The Wrekin)

  Battle, John

  Bradshaw, Ben

  Bayley, Hugh

  Brennan, Kevin

  Beard, Nigel

  Brown, rh Nicholas (Newcastle E

  Beckett, rh Margaret

  Wallsend)

  Begg, Miss Anne

  Brown, Russell (Dumfries)

  321

  Browne, Desmond

  Foster, Michael Jabez (Hastings

  Bryant, Chris

  & Rye)

  Buck, Ms Karen

  Foulkes, rh George

  Burden, Richard

  Francis, Dr. Hywel

  Burgon, Colin

  Gapes, Mike (Ilford S)

  Burnham, Andy

  George, rh Bruce (Walsall S)

  Cairns, David

  Gerrard, Neil

  Campbell, Alan (Tynemouth)

  Gibson, Dr. Ian

  Campbell, Mrs Anne (C'bridge)

  Gilroy, Linda

  Campbell, Ronnie (Blyth V)

  Godsiff, Roger

  Caplin, Ivor

  Goggins, Paul

  Casale, Roger

  Griffiths, Jane (Reading E)

  Caton, Martin

  Griffiths, Nigel (Edinburgh S)

  Cawsey, Ian (Brigg)

  Grogan, John

  Challen, Colin

  Hain, rh Peter

  Chapman, Ben (Wirral S)

  Hall, Mike (Weaver Vale)

  Chaytor, David

  Hall, Patrick (Bedford)

  Clapham, Michael

  Hamilton, David (Midlothian)

  Clark. Mrs Helen (Peterborough)

  Hamilton, Fabian (Leeds NE)

  Clark, Dr. Lynda (Edinburgh

  Hanson, David

  Pentlands)

  Harman, rh Ms Harriet

  Clark, Paul (Gillingham)

  Harris, Tom (Glasgow Cathcart)

  Clarke, rh Tom (Coatbridge &

  Healey, John

  Chryston)

  Henderson, Doug (Newcastle N)

  Clarke, Tony (Northampton S)

  Hendrick, Mark

  Clelland, David

  Hepburn, Stephen

  Clwyd, Ann (Cynon V)

  Heppell, John

  Coaker, Vernon

  Heyes, David

  Coffey, Ms Ann

  Hinchliffe, David

  Cohen, Harry

  Hood, Jimmy (Clydesdale)

  Colman, Tony

  Hope, Phil (Corby)

  Connarty, Michael

  Hopkins, Kelvin

  Cook, Frank (Stockton N)

  Howarth, rh Alan (Newport E)

  Cook, rh Robin (Livingston)

  Howarth, George (Knowsley N &

  Cooper, Yvette

  Sefton E)

  Corbyn, Jeremy

  Howells, Dr. Kim

  Corston, Jean

  Hughes, Kevin (Doncaster N)

  Cousins, Jim

  Humble, Mrs Joan

  Cox, Tom (Tooting)

  Hurst, Alan (Braintree)

  Crausby, David

  Hutton, rh John

  Cruddas, Jon

  Iddon, Dr. Brian

  Cryer, John (Hornchurch)

  Illsley, Eric

  Cummings, John

  Ingram, rh Adam

  Cunningham, Jim (Coventry S)

  Irranca-Davies, Huw

  Cunningham, Tony (Workington)

  Jackson, Glenda (Hampstead &

  Curtis-Thomas, Mrs Claire

  Highgate)

  Dalyell, Tam

  Jackson, Helen (Hillsborough)

  Darling, rh Alistair

  Jamieson, David

  Davey, Valerie (Bristol W)

  Jenkins, Brian

  David, Wayne

  Johnson, Alan (Hull W)

  Davidson, Ian

  Jones, Helen (Warrington N)

  Davies, Geraint (Croydon C)

  Jones, Jon Owen (Cardiff C)

  Davis, rh Terry (B'ham Hodge H)

  Jones, Kevan (N Durham)

  Dean, Mrs Janet

  Jones, Lynne (Selly Oak)

  Denham, rh John

  Jones, Martyn (Clwyd S)

  Dhanda, Parmjit

  Jowell, rh Tessa

  Dismore, Andrew

  Joyce, Eric (Falkirk W)

  Dobbin, Jim (Heywood)

  Keeble, Ms Sally

  Dobson, rh Frank

  Keen, Alan (Feltham)

  Donohoe, Brian H.

  Keen, Ann (Brentford)

  Doran, Frank

  Kelly, Ruth (Bolton W)

  Dowd, Jim (Lewisham W)

  Khabra, Piara S.

  Drew, David (Stroud)

  Kidney, David

  Dunwoody, Mrs Gwyneth

  Kilfoyle, Peter

  Eagle, Angela (Wallasey)

  King, Andy (Rugby)

  Edwards. Huw

  King, Ms Oona (Bethnal Green &

  Efford, Clive

  Bow)

  Ellman, Mrs Louise

  Knight, Jim (S Dorset)

  Ennis, Jeff (Barnsley E)

  Kumar, Dr. Ashok

  Farrelly, Paul

  Ladyman, Dr Stephen

  Field, rh Frank (Birkenhead)

  Lammy, David

  Fisher, Mark

  Lawrence, Mrs Jackie

  Fitzpatrick, Jim

  Laxton. Bob (Derby N)

  Foster, rh Derek

  Lazarowicz, Mark

  Foster, Michael (Worcester)

  Lepper, David

  Leslie, Christopher

  322

  Levitt, Tom (High Peak)

  Purnell, James

  Lewis, Ivan (Bury S)

  Quin, rh Joyce

  Lewis, Terry (Worsley)

  Quinn, Lawrie

  Liddell, rh Mrs Helen

  Linton, Martin

  Rammell, Bill

  Lloyd, Tony (Manchester C)

  Rapson, Syd (Portsmouth N)

  Love, Andrew

  Raynsford, rh Nick

  Lucas, Ian (Wrexham)

  Reed, Andy (Loughborough)

  Lyons, John (Strathkelvin)

  Reid, rh Dr. John (Hamilton N &

  McAvoy, Thomas

  Bellshill)

  McCabe, Stephen

  Robertson, John (Glasgow

  McCartney, rh Ian

  Anniesland)

  McDonagh, Siobhain

  Robinson, Geoffrey (Coventry

  MacDonald, Calum

  NW)

  McDonnell, John

  Roche, Mrs Barbara

  MacDougall, John

  Rooney, Terry

  McFall, John

  Ross, Ernie (Dundee W)

  McGrady, Eddie

  Roy, Frank (Motherwell)

  McGuire, Mrs Anne

  Ruane, Chris

  McIsaac, Shona

  Ruddock, Joan

  McKechin, Ann

  Russell, Ms Christine (City of

  Mackinlay, Andrew

  Chester)

  McNamara, Kevin

  Ryan, Joan (Enfield N)

  Mactaggart, Fiona

  Salter, Martin

  McWalter, Tony

  Sarwar, Mohammad

  McWilliam, John

  Savidge, Malcolm

  Mahmood, Khalid

  Sawford, Phil

  Mallaber, Judy

  Sedgemore, Brian

  Mandelson, rh Peter

  Shaw, Jonathan

  Mann, John (Bassetlaw)

  Sheerman, Barry

  Marris, Rob (Wolverh'ton SW)

  Sheridan, Jim

  Marsden, Gordon (Blackpool S)

  Short, rh Clare

  Marshall, David (Glasgow

  Simon, Siôn (B'ham Erdington)

  Shettleston)

  Simpson, Alan (Nottingham S)

  Marshall, Jim (Leicester S)

  Skinner, Dennis

  Marshall-Andrews, Robert

  Smith, rh Andrew (Oxford E)

  Martlew, Eric

  Smith, rh Chris (Islington S &

  Michael, rh Alun

  Finsbury)

  Milburn, rh Alan

  Smith, Geraldine (Morecambe &

  Miliband, David

  Lunesdale)

  Miller, Andrew

  Smith, Jacqui (Redditch)

  Mitchell, Austin (Gt Grimsby)

  Smith, John (Glamorgan)

  Moffatt, Laura

  Smith, Llew (Blaenau Gwent)

  Mole, Chris

  Soley, Clive

  Moonie, Dr. Lewis

  Southworth, Helen

  Moran, Margaret

  Squire, Rachel

  Morgan, Julie

  Starkey, Dr. Phyllis

  Morley, Elliot

  Stevenson, George

  Mountford, Kali

  Stewart, David (Inverness E &

  Mudie, George

  Lochaber)

  Mullin, Chris

  Stewart, Ian(Eccles)

  Munn, Ms Meg

  Stinchcombe, Paul

  Murphy, Denis (Wansbeck)

  Stoate, Dr. Howard

  Murphy, Jim (Eastwood)

  Strang, rh Dr. Gavin

  Naysmith, Dr. Doug

  Stringer, Graham

  O'Brien, Bill (Normanton)

  Stuart, Ms Gisela

  O'Hara, Edward

  Tami, Mark (Alyn)

  Olner, Bill

  Taylor, rh Ann (Dewsbury)

  O'Neill, Martin

  Taylor, Dan (Stockton S)

  Organ, Diana

  Taylor, David (NW Leics)

  Palmer, Dr. Nick

  Thomas, Gareth (Clwyd W)

  Perham, Linda

  Timms, Stephen

  Picking, Anne

  Tipping, Paddy

  Pickthall, Colin

  Todd, Mark (S Derbyshire)

  Pike, Peter(Burnley)

  Touhig, Don (Islwyn)

  Plaskitt, James

  Trickett, Jon

  Pollard, Kerry

  Truswell, Paul

  Pond, Chris (Gravesham)

  Turner, Dennis (Wolverh'ton SE)

  Pope, Greg (Hyndburn)

  Turner, Dr. Desmond (Brighton

  Pound, Stephen

  Kemptown)

  Prentice, Ms Bridget (Lewisham

  Turner, Neil (Wigan)

  E)

  Twigg, Derek (Halton)

  Prescott, rh John

  Tynan, Bill (Hamilton S)

  Primarolo, rh Dawn

  Vaz, Keith (Leicester E)

  Prosser, Gwyn

  Vis, Dr. Rudi

  Purchase, Ken

  Walley, Ms Joan

  Ward, Claire

  323

  Wareing, Robert N.

  Winterton, Ms Rosie (Doncast

  Watson, Tom (W Bromwich E)

  C)

  Watts, David

  Woodward, Shaun

  White, Brian

  Whitehead Dr. Alan

  Worthington, Tony

  Wicks, Malcolm

  Wright, David (Telford)

  Williams, rh Alan (Swansea W)

  Wright, Tony (Cannock)

  Wyatt, Derek

  Williams, Betty (Conwy)

  Tellers for the Noes:

  Wills, Michael

  Mr. Fraser Kemp and

  Winnick, David

  Gillian Merron

  Question accordingly negatived.
  Question, That the proposed words be there added, put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to.
  MR. DEPUTY SPEAKER forthwith declared the main Question, as amended, to be agreed to.
  Resolved,
  That this House notes that record investment in the NHS has to be linked to reform, and that this investment and the devolution of power to the front line require greater accountability; congratulates the Government on its record of making the NHS more transparent through the development of performance indicators; welcomes the Government's development of such indicators in consultation with patients and staff; congratulates the Government on giving responsibility for NHS performance monitoring to the independent Commission for Healthcare Audit and Inspection (CHAI), which reports direct to Parliament; and welcomes CHAI's commitment to developing new and more reflective indicators in partnership with representative bodies and the NHS itself.

  Care Homes
  Mr. Deputy Speaker (Sir Alan Haselhurst):I must advise the House that Mr. Speaker has selected the amendment in the name of the Prime Minister. There will be a 10-minute limit on Back-Bench contributions to this debate.
  4.17 pm
  Mr. Simon Burns(Con): I beg to move,
  That this House expresses its profound concern at the continuing crisis in care for elderly people; deplores the Government's over-prescriptive, expensive and bureaucratic regulation of the care home sector, which has greatly exacerbated the crisis in care and has led to many care home closures: condemns the loss of over 70,000 long term care places since 1997 and is gravely concerned that the number of people receiving domiciliary care has fallen by 100,000 since 1997; is further concerned that the implementation of the Community Care (Delayed Discharges etc.) Act 2003 will merely place an unfair financial burden on Social Services departments, and could lead to patients being discharged prematurely from hospital into inappropriate care, resulting in an increase in emergency readmissions; and calls on the Government to recognise the crisis in the provision of long term care for elderly people, to take action to reduce the current rate of care home closures and to combat the decline in the availability of domiciliary care, rather than simply disregard the crisis.
  Despite the protestations of Ministers, there is clearly a crisis in long-term care for elderly people. That is not solely my view; it is also the view of many who work in, and provide care in, the long-term care sector. Only last month, the Independent Healthcare Association said the following:
  "As a nation we are facing a crisis".
  The Registered Nursing Homes Association has echoed that view, and the National Pensioners Association has declared that
  "there is clearly a crisis in care and older people are suffering".
  Ironically, the only person who seems oblivious to the crisis is the Minister with responsibility for long-term care, the hon. Member for South Thanet (Dr. Ladyman), who declared the following in an article in "This Caring Business" last November:
  "There is no national crisis in the sector".
  Frankly, the hon. Gentleman must be in denial if he is unaware of the crisis that is so apparent to everyone else. It is time that he began to listen to the concerns of those working tirelessly and selflessly to care for some of the most frail and vulnerable in our society, and to pay attention to those elderly people who are entrusted into such care.
  Mr. Andrew Mitchell:Far from the Minister being complacent, should he not be losing sleep and worrying greatly about the state of social services in Birmingham? Is my hon. Friend aware of the recent Audit Commission report, which singled out social services there as absolutely appalling and deeply letting down local people? What does he think that the Minister should be doing about that?
  Mr. Burns:I am extremely grateful to my hon. Friend for that intervention, and I shall indeed refer to Birmingham at a later stage. He will be as aware as I am

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  that in the year to the middle of 2003, 96 homes closed in Birmingham. Social services have been forcing down prices to a level at which it is not feasible to run homes. They are prepared to pay only £265 per client, whereas in respect of their own homes they are prepared to pay £525. I agree with my hon. Friend that it would be more reassuring for the elderly and their families in Birmingham if Ministers—including the Minister and his predecessor—were prepared to spend more time and be more concerned about examining what is causing so much distress in relation to care problems in the city of Birmingham.
  Mr. Patrick McLoughlin:My hon. Friend has just dealt with problems in Birmingham. Does he acknowledge that one problem that greatly annoys people who run private care homes is that the local authorities pay much more to their own care homes than they are prepared to pay to the private sector? That is one of the big problems often put to me by private care home owners.
  Mr. Burns:My hon. Friend raises an important and valid point. The fact that that is happening all over the country is not only unfair, but anti-competitive. If my hon. Friend will allow me, I shall deal with that point again later in my speech.
  I believe that the Government can pursue two options: either the dangerous one of remaining in denial and doing nothing, or the positive one of seizing the opportunity to end the current confusion and crisis surrounding the care of some of the most frail and dependent members of our society. Because the Under-Secretary seems so oblivious to them, it might help if I explain the problems facing the care of elderly people in this country.
  The first problem is the collapse in the provision of homes and beds throughout the country. The most recent data published by Laing and Buisson in July shows that long-term care capacity across all sectors is now some 74,000 places lower than its peak in 1996. Indeed, some 13,400 elderly care places were lost in the 15 months to April 2003 alone, yet demand for elderly care is growing. We estimate that between 2005 and 2020, 130,000 more people each year will require care than currently receive it—an increase of 25 per cent.
  Ms Meg Munn:What would the hon. Gentleman say to my constituent, Mr. Watson, who is currently waiting to be discharged from hospital? He wants to go home and be cared for by his family, not to go into a nursing care home. Is it not the case that most people want to stay at home and do not want to go into nursing care homes? Is that not the real issue?
  Mr. Burns:The hon. Lady makes a good point and is, in many ways, quite right. I would say to her constituent that he should not remain in hospital any longer than is
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  clinically necessary, and that he should receive the most appropriate care for his needs. If the hon. Lady will bear with me, I shall discuss the issue in greater detail in a few moments.
  Mr. David Hinchliffe:I am glad that the hon. Gentleman has clarified that point in response to my hon. Friend the Member for Sheffield, Heeley (Ms Munn). As a Minister responsible for community care in the previous Conservative Government, does he feel that his Government bear any responsibility for the current difficulties in the care sector? In particular, in the 10-year period before community care changed in 1993, there was a 4.7 per cent. increase in the number of elderly people, but the Conservative Government increased care and nursing home places by 500 per cent.? Is that not a factor in our current difficulties?
  Mr. Burns:No, it is not a factor. As the hon. Gentleman will recall, when community care was introduced with the support of his party in the early 90s, we had to deal with circumstances that needed to be controlled because of excessive—and I choose that word carefully—growth. The growth was due to demand and was not stimulated by Government. I shall return to that point later, as the portion of my speech that concerns domiciliary care was written with the hon. Gentleman in mind. I know his views, which he has made clear in the Health Committee.
  In the 15 months to April 2003, about 13,400 elderly care places were lost, yet demand for elderly care is growing. We estimate that, between 2005 and 2020, more than 130,000 more people each year will require care than currently receive it—an increase of over 25 per cent. New analysis shows that, as a result of that projected growth in demand, and of the rate of decline of availability of care, overall demand for care home places will outstrip supply by 2005—that is, in just 12 or 24 months.
  The human consequences are potentially dire. I know that the Government—and the Minister, who has done it often before—will claim that the problem is not as great as it seems, because there are about 10,000 spare beds in the country. However, what the Minister sadly fails to understand is that that spare capacity is not located where the demand is. Too often, areas where there is a shortage of beds are also those areas where demand for beds is greatest. The unfortunate result is that, too often, elderly people have to be placed further and further away from where they have lived all their lives, and from where their families and friends live. That is deeply distressing to elderly people, and to their families and friends. They feel that they are becoming increasingly isolated, in unfamiliar surroundings.
  However appalling the problem is, we must not forget that residential care is only one element of care for the elderly. It is important to remember that the guiding principle for the provision of long-term care must be that the elderly receive the most appropriate care suitable to their needs. That care may be provided in a residential home but, equally importantly, it could also be domiciliary care provided in the familiarity of an

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  elderly person's own home. Unfortunately, however, the number of people receiving domiciliary care has fallen by almost 100,000 since 1997.
  Ms Munn:Will the hon. Gentleman give way?
  Mr. Burns:No, I want to make some progress. That is a fall of more than 20 per cent., and it came about even though the 1997 royal commission on long-term care emphasised the need for increased levels of domiciliary care to allow people to retain their independence for as long as possible—something about which all hon. Members are, I am sure, united. It is all very well for Ministers to state that the provision of domiciliary care rose between 1997 and 2002, but that is disingenuous spin.
  The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)indicated dissent.
  Mr. Burns:The Minister may laugh, but Department of Health figures show clearly that, although the number of contact hours being provided has increased by 14 per cent.—as the Minister is very fond of saying—the number of households receiving services has fallen by 23 per cent.
  Mrs. Angela Browning:I am not surprised by the figures that my hon. Friend has quoted. I have done a lot of case work in this area and I know that the system involves people filling in endless tick boxes. The aim seems to be to stop people receiving anything, and not to make available the small amounts of care that would help them to maintain their independence. It is another example of bureaucracy gone mad.
  Mr. Burns:I fear that my hon. Friend's experience is replicated all too often around the country.
  Ms Munn:The hon. Gentleman may be aware that I have worked in this area for some considerable time. I was involved in the process of consolidating domiciliary care for those in need of intensive care. The aim was to give people like the constituent to whom I referred earlier the option to go home. That means that much greater care must be devoted to fewer people.
  Mr. Burns:I disagree with the last part of the hon. Lady's statement. I fully recognise, as will anyone familiar with domiciliary care, that many clients need highly intensive and time-consuming care. The fact is, however, that if, because it is considered more appropriate, we want more people to remain in their own homes rather than going into residential care, we need more domiciliary care. Ministers repeat the mantra, "We have increased domiciliary care". Yes, their figures show that the number of contact hours has increased, but not the number of people who need the care. That is the nub of the problem.
  Mrs. Joan Humble:Will the hon. Gentleman give way?
  Mr. Burns:No, I am going to make progress.
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  The question is why there has been such a contraction in care capacity. Part of the reason has been the policy of social services departments to use their bulk purchasing power to force down the price that they are prepared to pay for beds, as my hon. Friend the Member for Sutton Coldfield (Mr. Mitchell) said. Nowhere, as I told my hon. Friend, has that been more apparent than in Birmingham, where the price paid in the private sector has been forced down to £260 per resident while the price paid in the local authority homes is £525. That has resulted in 96 care homes closing down in the two years to 2002.
  In addition, the introduction of more and more bureaucratic regulations, many of which were minimal in raising care standards, has contributed to home closures. Before any Minister tries to misinterpret what I am saying, let me make it quite clear that no Conservative Member opposes in any way the raising of standards so that frail and elderly people can have the highest possible care. What we object to is unnecessary and over-prescriptive regulation. While the Secretary of State continues to mutter from his sedentary position, he should recognise what I am saying. His own Government, before he became Secretary of State, did a U-turn on regulations, recognising the problems that there were.
  Laura Moffatt:Will the hon. Gentleman give way?
  Mr. Burns:No, I will not.
  In addition, since 1997 we have experienced the Government's over-prescriptive, centrally driven approach, which I believe has contributed to the current crisis in care. In the last two years, we witnessed the Government's ridiculous and unnecessarily prescriptive implementation of some of the national minimum environmental standards. Then the Government had to do a U-turn. We saw the over-zealous and complicated implementation of Criminal Records Bureau checks for care home staff. Then the Government had to climb down. The Government vigorously imposed regulations but then said that they would use a lighter touch, because even they came to understand that their approach had been too officious.
  What we have not seen is consistency and a level of regulation that is reasonable to ensure that standards are raised to the levels that we all wish to see. Just last week, we saw the implementation of the Community Care (Delayed Discharges etc.) Act 2003, under which it is intended to fine local authority social services on a daily basis for delayed discharge payments. As I highlighted during the Bill's passage, we remain implacably opposed to what I consider to be a nasty and vindictive piece of legislation that will simply exacerbate a difficult situation and unfairly impose fines on local authorities that are unable, often through no fault of their own, to find places in homes or provide domiciliary care packages because of the crisis in long-term care brought about by the Government's indifference.
  Mr. David Heathcoat-Amory:My hon. Friend has not so far mentioned the cost of regulation. Care homes in Somerset are complaining about a 20 per cent. increase in the regulatory cost from the National Care Standards Commission on top of a similar increase

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  from the Criminal Records Bureau, which my hon. Friend mentioned. Will he comment on how the squeeze between low fees and rising regulatory costs simply means that fewer people can be cared for? Perhaps that is the root cause of the problem that he is addressing.
  Mr. Burns:My right hon. Friend is right. It is, of course, a double whammy in terms of costs. In addition to the significant increase in the costs that care homes have to pay to comply with many standards are the costs of the fees to ensure that they are complying. For example, registrations fees to use the Criminal Records Bureau have increased by 147 per cent. in 18 months, which has a significant impact not only on the larger homes that employ more people, but on small homes, for which it is a disproportionate amount of their costs. As he no doubt finds in Somerset, many of them-especially, although not exclusively, the smaller ones—have thrown in the towel because financially they cannot continue to provide care. They have either sold up or converted the homes into domestic dwellings and left the market. That has contributed to the problems we face.
  David Taylor: How does the hon. Gentleman justify the actions of his political colleagues in Leicestershire who took control of the authority for the first time for more than 20 years on general election day? They immediately decided to flog off the remaining 14 residential homes that were operated by the county, which had achieved the highest standards of physical and care provision. Is it not disgraceful that the residents of those homes were not even treated as sentient beings, but just as objects to be moved around?
  Mr. Burns:I do not share the hon. Gentleman's final analysis. I have no doubt that Leicestershire social services did not treat the clients in their homes as objects.
  On the general principle of whether it was wrong for the homes to be sold, it is up to any social service department and local authority to decide whether to continue to provide in-house care or to sell their homes. One reason why I have not opposed local authorities selling their care homes is that for many years those homes were not under the same inspection regime as the private sector. As they did not invest in their homes, for whatever reason, the quality and the fabric of the buildings—not the quality of care—deteriorated. The money was not available to invest in the homes to make them comply with the Government's minimum standards. It would have benefited the people living in those homes if the person who ran and owned them had the money to invest to improve and enhance the buildings and to maintain the highest standards of quality of care.
  Mrs. Humble:Will the hon. Gentleman give way?
  Mr. Burns:No.
  The Community Care (Delayed Discharges etc.) Act 2003, which came into force on 1 January and into effect this Monday, is illogical and unworkable. It will do nothing to combat the problem of delayed discharges in
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  our hospitals. Indeed, it has the potential to make the situation dramatically worse. Attempting to resolve the problem of delayed discharge in that manner is bizarre. Fining local authorities will place new burdens on them—
  Mr. Hilton Dawson: Will the hon. Gentleman give way?
  Mr. Burns:No, I will not.
  The fines will lead to an increase in red tape, damage relationships between local authorities and the NHS, and increase the likelihood of inappropriate discharge decisions. The 2003 Act is a knee-jerk reaction to the serious problem of delayed discharges and is incredibly short-sighted, endeavouring to reduce the levels of delayed discharges by imposing perverse incentives in the form of fines rather than positive long-term solutions.
  Mr. Dawson Mr. Dawson rose—
  Kali Mountford Kali Mountford (Colne Valley) (Lab)rose—
  Mr. Burns:I have been extremely generous in giving way and I want to make progress.
  The Government have missed a golden opportunity. If they were to legislate, they should have come up with a positive system of reducing the number of delayed discharges in our hospitals rather than the negative approach of introducing a fines system. These measures will also undo the excellent work that has been established over the last 15 years in fostering good working relationships and partnerships between the NHS and social services departments. That work was long overdue and it has led to a more seamless provision of service. It will— [Interruption.] The Secretary of State says that we were in power, but if he had been listening carefully he would know that I said "over the last 15 years". If he looks through his history books, he will notice that a Conservative Government as well as a Labour Government were involved in that work.
  The Secretary of State for Health (Dr. John Reid)That is precisely the point that I was making. The hon. Gentleman talks of the lack of money provided by Governments over the last decade—[Interruption.] He mentioned money about four minutes ago. Earlier, he also mentioned the lack of Government support during the past 15 years, so will he at least accept that a significant proportion of the alleged deficiencies must have come from the Government whom he supported? Indeed, as far as I can recall he was a member of that Government for a prolonged period.
  Mr. Burns:I do not think that the Secretary of State was listening carefully so I shall repeat what I said so that he can fully understand me—[Interruption.] The right hon. Gentleman obviously did not hear me because his intervention bore no relation to what I said. I said that the measures would undo the excellent work that has been established over the last 15 years in fostering good working relationships and partnerships between the NHS and social services departments. I still

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  believe that. Tremendous work was done in the 1990s and also, to be fair, under the Labour Government who have taken it to a logical conclusion, to ensure that the barriers—the them-and-us culture—between the NHS and social services were broken down and that the organisations worked seamlessly to provide a better service.
  I applaud the Government for doing that, just as I applaud the last Conservative Government for laying the foundations and starting the work. It is a good step forward and it must be continued. My concern, however, is that the Act that came into force last week will set back that good work, because it could reintroduce a blame culture when decisions are taken about when and how to discharge patients.
  Another consequence of the enforcement of the Act is that the number of emergency readmissions will rise further as patients are discharged prematurely from hospital so that local authorities can avoid hefty fines for delayed discharges. There will be a costly, time-consuming. bureaucratic shambles, which could result in the opposite of what the Government intended.
  Dr. Ladyman:How could that possibly be the case when the delayed discharge reimbursement system will not apply until a clinician has said that the patient is ready for discharge?
  Mr. Burns:The clinician may say that, but it may not be physically possible for the local authority to find a place for the patient in a home or to provide a domiciliary care package. We shall see arguments between the NHS and social services about whether a patient should be discharged, although I accept that the whip hand in the decision-making process rests with the NHS.
  Have Ministers considered how the burden of the fines could affect their constituencies? Of course, the Secretary of State must be delighted. This health policy, like all the Government's other health policies for England, will not impact on his constituency one iota. He is in a unique position in the ministerial team in that he is the only member of it whose local social services department will not face the possibility of paying out tens of thousands of pounds in delayed discharge fines every month, as his constituency is in Scotland and thus immune from this rather nasty measure.
  How will the measure affect other health Ministers? Let us consider the social services department in the county of the Under-Secretary of State for Health, the hon. Member for South Thanet. My hon. Friends may not remember that Kent is implacably opposed to the Minister's policy. Anyway, it originally estimated the cost of fines as potentially some £5.2 million a year.
  Mr. Julian Brazier:Will my hon. Friend give way?
  Mr. Burns:I would like to make a little progress.
  As the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton) will undoubtedly know, her local social services department will receive £315,000 for the remainder of the current financial year and £600,000 for next year. Although the department hopes that that will be enough
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  to cope with the fines, it is not yet sure how much it will have left to invest in mechanisms to reduce the number of delayed discharges in the future.
  In any event, this is a case of robbing Peter to pay Paul. Rather than being spent actively and positively in toto on mechanisms to reduce the number of delayed discharges, central Government money is being given to social services departments with one hand and taken away with the other, in fines. That is a cockeyed system. The net result is that the money, often a significant amount, is not being used constructively.
  The Under-Secretary of State for Health, the hon. Member for Welwyn Hatfield (Miss Johnson)—who, unfortunately, is not present—will find that her local social services department expects fines in the region of £25,000 a week. We have to ask whether that considerable sum could not be spent more positively and productively. As for the department in the constituency of the other Minister of State, the right hon. Member for Barrow and Furness (Mr. Hutton), it originally estimated that its fines would cost about £2.74 million in the first year of implementation. Again, exorbitant amounts are being used in fines rather than being spent positively and meaningfully to tackle a problem.
  I believe it is time the Government acknowledged the urgent need to give more security and confidence both to our vulnerable elderly people and to those who care for them. That is why I urge my right hon. and hon. Friends to support the motion.
  4.47 pm
  The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman):I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
  "welcomes the real terms increase in social services funding of 20 per cent. between 1997 and 2003, and the commitment to continue these increases by an annual 6 per cent. in real terms from this financial year to 2005–06; notes that councils are able to use these resources to increase fees they pay to care homes where they think necessary, with 2002–03 figures showing 56 per cent. of local councils in England and Wales increasing the fees they pay by at least 5 per cent; notes that the Laing & Buisson Care of Elderly People Market Survey published in July 2003 puts bed capacity in care homes from all sectors at 470,000 with demand estimated to be around 460,000; further notes that over 80 per cent. of older people say they want to live independently in their own homes for as long as possible; supports the Government's policy of improving choice by providing alternatives to residential care with 20,900 more households since 1998 receiving intensive home care packages, 143,200 additional people receiving intermediate care services since 1999, and a cash injection of £87 million to be spent on creating 1,500 new extra care housing places by 2006; and further supports the Government's policy of driving up care standards where the care is delivered and ensuring that older people are not held unnecessarily in acute hospital beds when their care needs can be better met elsewhere.'."
  Fond as I am becoming of these exchanges with the hon. Member for West Chelmsford (Mr. Burns) and the jousts in which we are increasingly engaging, on this occasion I can offer him no comfort—there seems to be no common ground between us. The voice of the care industry speaks loudly to him and his party, but the voice of older people speaks more loudly to the Government. The Conservatives seem determined to

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  champion the providers of care; my hon. Friends and I know of the importance of the people who provide care. but we put the needs of those who use it first.
  Chris Grayling: Will the Minister give way?
  Dr. Ladyman: I will establish my thesis first.
  The Conservatives seem wedded to a model of care for older people that could have been plucked from the 1980s. To them it seems that dependency and a care home place are the inevitable result of old age. We take a different approach. We want to put the individual at the centre of care. We want to offer a spectrum of care choices, and we will go the extra mile to help people maintain their independence and stay in their own homes for as long as possible.
  Our vision is a million miles from the service that we inherited in 1997. Although we are much closer to it today than we were then, we are not there yet. We inherited a low-quality, dependency-based care system that was imposed on people because it was all that was on offer to them. In its place, we are building a high-quality, well-regulated system that makes independence a real option and gives individuals control of their care.
  As we make that transition, however, the care industry and the market in which it operates will have to adapt. It will be a challenge for the industry and for care users, but it is not a challenge that we can duck. It saddens me, therefore, that rather than helping the industry to adapt the Conservatives have decided to set their face against change and to swallow every myth that the care home sector wants to throw out.
  Chris Grayling: Will the hon. Gentleman give way?
  Dr. Ladyman: No. Let me establish my thesis, and then I will certainly give way.
  Let us start with some of those myths: first, the notion that older people want to end up in care homes. They do not. More than 80 per cent. of them tell us that they want to remain independent and to live at home for as long as possible. The second myth is the so-called care home crisis. Yes, the number of care home places is falling year on year, but when will the Opposition understand that demand for those places is falling at an even faster rate?
  Mr. Burns: The Minister says that 80 per cent. of old people want to remain in their homes, so 20 per cent. presumably do not want to do so. Given that only 4.6 per cent. of people between the ages of 75 and 84 live in residential homes, what happens to the other 15.4 per cent.?
  Dr. Ladyman: If the hon. Gentleman is seriously telling me that he believes that older people want to end up in care homes and do not want to maintain their independence for as long as possible, he is, frankly, barking mad.
  Chris Grayling: Will the hon. Gentleman give way?
  Dr. Ladyman: I will give way to the hon. Gentleman in a moment.
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  I do not dispute that the number of care home places is falling, but by no stretch of the imagination is that a crisis; it is an inevitable contraction of market capacity, following a reduction in demand. People simply do not want to be in care homes any longer, and the Government are giving them a real opportunity to stay in their own homes instead.
  Chris Grayling Chris Grayling rose—
  Dr. Ladyman: As the hon. Gentleman is being persistent, I will let him make his point.
  Chris Grayling: I thank the Minister for giving way, but he is absolutely out of touch with the realities in care homes. Does he not recognise that there are very many people suffering from the chronic conditions of old age—Parkinson's and Alzheimer's—for whom a place in a care home is not just an option, but a necessity? Many of those people are stuck in hospital beds, unable to get the care that they need. What the Minister describes is absolute poppycock. Those people need places; they need help and support; and the Government are letting them down.
  Dr. Ladyman: The hon. Gentleman should not ask questions that he does not want to know the answer to. My mother has severe Parkinson's, and I can tell the House that she will do everything in her power to stay out of a care home. I believe that everyone else—the people that the Parkinson's Disease Society and the Alzheimer's Society represent—are all in the same position. Of course I accept that, eventually, some people will have to go into care homes, and the care home sector will remain an important part of the spectrum of choice that we want to offer.
  Several hon. Members rose—
  Dr. Ladyman: I will make a little progress before giving way to all those hon. Members who want to intervene.
  We want to offer real choice. The Government no longer collect care home figures, so the best figures that we currently have available are those collected by Laing and Buisson—a respected and independent health care consultancy. As the hon. Member for West Chelmsford said, it says that 470,000 places are available in the United Kingdom today and that there is demand for just 460,000 of them. Of course, I acknowledge that there are more difficulties in some parts of the country than in others. Those local problems need to be addressed locally, but even the Tories ought to accept that that is in no way a national crisis. In a minute, I shall describe some of the ways that we are giving resources to local people to deal with local issues.
  Several hon. Members rose—
  Dr. Ladyman: I shall give way to one hon. Member and then I will make some progress.
  Bob Spink: I thank the hon. Gentleman for giving way. Does he accept that the very

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  report that he has just cited states that demand for care home places is expected to expand again from 2005 because of population ageing?
  Dr. Ladyman: If the hon. Gentleman will bear with me, I will give some alternative views from other respected consultancies on that very figure, but I accept that Laing and Buisson believes that a further expansion in demand might take place. However, I remind the hon. Gentleman that the same report said that occupancy levels in care homes have only reached 91.3 per cent. and pointed out that that is still a relatively healthy proportion of capacity that is full.
  If there is a crisis in the sector, why did Richard Nunn, director of surveyors, valuers and agents at Christie and Co., write in Caring Times last November:
  "We have noted the activity of private equity companies keen to find rising markets in which to invest their capital. Their burgeoning confidence in the care home sector emphasises the opportunities available to the astute investor. We are also encouraged by the number of existing operators who are looking to extend their portfolios"?
  Mr. Nunn is not the only person to say that. Another article says:
  "The improvement in profits for the six months ended March 2003 reflects both better occupancy levels at the company's homes and improved margins".
  Its author describes the improved margins as being
  "in line with the rest of the industry".
  Later in the article the author says:
  "The financial position continues to strengthen and the company is well placed to take advantage of opportunities for expansion. These continue to be sought".
  Those are the words of the chairman of Univent plc, which is a nursing home and domiciliary care company. The chairman of the company is none other than the hon. Member for South Suffolk (Mr. Yeo), the shadow Secretary of State for Health.
  Several hon. Members rose—
  Dr. Ladyman: I shall give way to the hon. Member for Canterbury (Mr. Brazier), who is my neighbour.
  Mr. Brazier: The Minister told us that his main concern was with the elderly recipients of care rather than the industry. As a fellow Kentish Member, does he really think that it is fair that when bidding for places in Kent's overcrowded care homes sector, people from London receive funding rates that are more than twice the rates that Kent county council can afford for our elderly, especially given that he knows that our social services in Kent are overburdened in other ways, not least in the children's sector due to unaccompanied asylum seekers?
  Dr. Ladyman: The hon. Gentleman and I clearly have different conversations with officers from Kent county council. They tell me that there is huge capacity in the care home market in Kent. Yes, they constantly tell me that they think that it is unfair that London councils receive more funding and can therefore afford to pay better prices in the north of the county, but I do not believe that there is anyone from London with a care home place in the hon. Gentleman's constituency—
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  certainly very few people are placed in care homes in my constituency by London authorities. The situation about which he talks is simply not a factor.
  In this House, the hon. Member for South Suffolk is keen to promote the idea of a care home crisis, but when he writes for the stock market and his investors, he is keen to promote the idea of a booming sector in which money can be made. The truth is that the number of care home places reached a peak in 1995–96, as the hon. Member for West Chelmsford said, and began to contract as the National Health Service and Community Care Act 1990 started to bite. The number of places has been falling continuously since, but demand is falling faster still. Supply and demand are now starting to come into balance in many areas, which is why the hon. Member for South Suffolk and other industry spokesmen see a strong future for providers. Laing and Buisson, for example, believes that the rate of closures has slowed down significantly over the past two years, but I do not believe that we are at the end of the process yet.
  Mr. Tim Boswell Mr. Tim Boswell(Daventry) (Con) rose—
  Dr. Ladyman: Let me make this point because it relates to an earlier intervention.
  The personal social services research unit at London school of economics recently observed that if dependency rates fell by 1 per cent. per year, which is by no means unlikely, the number of older people cared for in care homes could remain roughly constant between 2000 and 2020 despite the rising numbers of older people. If that is combined with increasing choices and changing patterns of care, I believe that it is likely that the number of people requiring care home places could fall even further.
  Mr. Boswell: When I asked the Prime Minister whether he was the only person in the country who could see no connection between the 25 per cent. decline in care home places offered in the south of my county and the ratio of delayed discharges, which was reported at column 299 Hansard on 20 March 2002, he said that there was, of course, a connection and took some credit for the fact that the Government were providing additional resources to create or free up more beds. If even the Prime Minister could see that point, does the Minister accept it?
  Dr. Ladyman: That is why we have made a building capacity grant to local councils and have put substantial sums into the reimbursement scheme in the Community Care (Delayed Discharges Etc) Act 2003. We want to enable councils to make preparations for the requirements of that measure, and I shall deal with that in more detail later.
  Mr. Paul Burstow: The Minister has just cited research by the personal social services research unit, which found that a 1 per cent. reduction in dependency rates would stabilise the number of people going into care homes. Does he nevertheless accept that people receiving care at home are becoming increasingly dependent and are receiving more hours of care? Consequently, fewer people are receiving care at home, so the aim of reducing

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  dependency is hampered by the fact that the Government are not providing sufficient support for home care for people with lower-level needs.
  Dr. Ladyman: I thought that the hon. Gentleman was about to make a sensible intervention, but at the end of his question he lost the plot. We are increasing the number of hours available for home care and are targeting them on more intensive packages that enable people to remain at home. We are giving huge amounts of extra resources to local councils so that they can continue to build capacity for intensive home care. However, I agree with the hon. Gentleman's sensible suggestion that, as there is an increase in the elderly population and life expectancy, and as we want to keep people out of care homes—the LSE figures suggest that we might be able to do so—we must maintain many more people at home through intensive care packages. It is the Government's policy to provide resources to achieve that.
  Mr. Mark Todd: My hon. Friend is making a coherent case, but he has not touched on the fact that when we talk about market forces and the effect of home closures, we must recognise that the residents of those homes are clearly involved in the delivery of that market force effect. We should consider using a methodology to regulate that effect better. My hon. Friend commended research by Laing and Buisson, which has suggested a methodology for negotiating a proper rate for home care. Has he considered whether it is appropriate?
  Dr. Ladyman: I congratulate my hon. Friend on his constructive approach—I only wish that Opposition Members were equally constructive. I am considering the possibility of developing a model to allow the fair negotiation of price, and I shall discuss that later. The hon. Member for Isle of Wight (Mr. Turner) is not in the Chamber today, but there was recently a strike by care home operators on the Isle of Wight because they did not like the price that the local council was offering them. That price was calculated using the Laing and Buisson model, so it does not always meet people's needs. We must take that issue into account.
  Loss of care home capacity in areas where there is a significant over-supply is not a problem, provided that closures are managed sensitively. There is a greater problem when losses occur in an unplanned way in areas where there are few other alternatives or where supply and demand have not yet reached a balance. When that happens, it is important that action is taken by local authorities to rebalance provision. That might mean increasing fees, either to attract homes to expand or to encourage new homes to open. It might mean working with social landlords to create new care choices, or it might mean the local authority stepping into the market and providing council-owned homes. Those are all valid options for local decision, and cannot possibly be controlled successfully from the centre, which is why I
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  have resisted calls for a national review of care home fees or demands that I try to impose particular solutions from Whitehall.
  Mr. Chris Mole Mr. Chris Mole (Ipswich)(Lab) rose—
  Chris Grayling Chris Grayling rose—
  Dr. Ladyman: If my hon. Friend the Member for Ipswich (Mr. Mole) and the hon. Member for Epsom and Ewell (Chris Grayling) will forgive me, I want to make some progress, but I shall give way later.
  To tackle the problem, we have given local authorities substantial extra funding, together with the responsibility to manage care home capacity in their own areas. We have given resources dramatically above the level of inflation since 1997. We gave local authorities 20 per cent. more funding in real terms for personal social services between 1997 and 2003. We gave them a 6.3 per cent. real-terms increase on top of that this year, and we have promised them a 6 per cent. real-terms increase next year and the year after, as well. Compare that with a 0.1 per cent. annual increase between 1992 and 1997.
  This year councils have just over £13 billion to spend on personal social services; by 2005—06 they will have around £15 billion. That will be close to double the amount available when this Government came to power. Before anyone argues with these figures, the percentages I have used have been calculated on a like-for-like basis and adjusted to take account of additional responsibilities.
  Mr. Andrew Mitchell: I do not dispute what the Minister says about the additional resources that have been made available. Can he explain why the Birmingham social services department, of which I hope he is well aware, remains in such a shambles?
  Dr. Ladyman: Birmingham social services has serious challenges to meet; there is no question about that. One of the things that that department has decided to do, as the hon. Gentleman says, is to maintain its own care homes, because it believes that that is necessary to rebalance provision in its area. It has taken exactly the sort of decision that we are encouraging councils everywhere to take—to look at their local area and ask themselves, "What do we need to do locally to make sure we provide for our older people?" I realise that the hon. Gentleman has a problem because the social services department pays more to those homes than to the private sector. My advice to him—I think I have given him the advice before, but if not, I give it to him now—is that the department can do that only if it has carried out a best-value review and can justify the extra cost on the basis of increased services or quality. He and his constituents just need to get hold of that best-value review and they can find out why Birmingham chooses to pay a differential in rates between the two types of care home.
  The money that we have given to councils is money that they can use in any way they want. As I said, they can increase fees locally, if that is what they need to do; they can invest in new capacity locally, if that is what they want to do; they can make their eligibility criteria

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  for social care more generous, if that is what they want to do; and they can cut the charges that they seek to impose on people who have to contribute to the cost of care at home, if that is what they want to do.
  Some councils have reacted to local challenges with increased fees. Fees paid by councils to independent care operators have increased by an estimated 8 per cent. on 2002–03 figures, well ahead of wages. If anyone is in any remaining doubt of that, again I refer them to the annual reports of the chairman of Univent plc and his boast of increased margins. The key, of course, is to establish a fair market process. Falling demand has created a buyers market, and we expect care home owners to take on board what the market throws at them. But they are entitled to ask that councils also respect the market and do their share to create a level playing field on which businesses can compete to provide services. It is not acceptable for councils to decide how much they want to pay and to tell home owners to take it or leave it, knowing that most home owners will be unwilling to evict council-supported residents.
  Services must be commissioned fairly, using a process that allows the market to establish a fair price for the job and allows individual providers to bid the price they believe appropriate to their business. Once that is done, the council is entitled to take the best price on offer, but it must allow reasonable annual uplifts reflecting genuine annual cost increases. This type of best practice is fair to providers, fair to council tax payers and, most important, fair to service users, but too few councils follow such best practice.
  That is why I have announced a national series of conferences to disseminate best practice commissioning. They start this month, and there is no excuse for any council not to send a representative to those conferences. I will speak at the first one, and my speech will be recorded for the regional conferences to ensure that everyone understands that the Government expect councils to use fair commissioning practice. The Government have done their part by making resources available, and will continue to do so, but local democratic accountability is important too. While the Tories continue to believe in imposing solutions from the centre, and the Liberal Democrats pay lip service to localism, we believe in local solutions for local problems, and we have given councils the power and resources to address them.
  Mr. Mole: On local choice, does my hon. Friend agree that it is regrettable that the motion does not refer to the option of delivering in partnership with registered social landlords the sort of sheltered housing schemes that deliver extra care, offer people choice, meet modern standards and provide continuity of care as older people's needs change? Such schemes also give older people their own front door and the level of dignity in later years in which we, as a party of choice, believe. The only thing I ask him to do is continue his dialogue with the Office of the Deputy Prime Minister about the
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  availability of local authority social housing grant funds to local authorities to enable more such schemes to be brought on stream.
  Mr. Deputy Speaker: Order. Interventions are getting longer, which is taking away valuable time from Back Benchers who wish to contribute to the debate later.
  Dr. Ladyman: My hon. Friend is absolutely right—extra care is a model of older people's care for the future that we must promote. We must do so in all sectors, including the private and social sectors. We must do a lot more in that regard, and I shall say a few words about that later.
  The motion's reference to regulation is another example of the Opposition speaking for providers and not older people. When I speak to pensioner groups around the country, they tell me that they want more regulation, not less. They tell me that regulation and inspection should be thorough and rigorously enforced. Did any Member of this House not receive a letter from someone in his or her constituency following the recent "Panorama" programme on care workers, which made that very point? When the Tories were in power, regulation and inspection were at best inconsistent and were non-existent in many places. Every council carried out its own inspections and used its own criteria and decided how hard to push them. The results were poor standards in many areas, bad practice in many homes and abuse and misery for many older people. So we introduced national minimum standards and a consistent national inspection regime. That was the right decision, and it is driving up standards to the discomfort of those who cannot meet them.
  Mrs. Humble: I thank my hon. Friend for giving way. I congratulate him on highlighting the fact that the bulk of the care standards introduced in the Care Standards Act 2000 apply to good social care practice, which providers welcome. Is he aware that providers also welcome the additional investment that he and his colleagues have given through Topss England for training their staff? They want to deliver the best quality of care and they will do that by having well-trained staff. Government investment is helping them with that.
  Dr. Ladyman: My hon. Friend is absolutely right. We introduced the national minimum standards and have consulted about them continuously since. As the hon. Member for West Chelmsford acknowledged in an underhand way, we have shown that we are prepared to listen to what is said in those consultations and change the standards where necessary. My hon. Friend is right that we have put huge investment into training people involved in social care and into attracting people into the social care work force.
  Caring for older people is not only about long-term care, however, but about wider choices. That is why we have invested so much in intermediate care—a type of care provision that many developed nations do not even provide, but which we see as a valuable new tool to ensure that older people get the right care at the right time in the right environment and that there is a real alternative to an acute hospital bed. Compared with 1999–2000, by June last year there were approximately 3,600 additional intermediate care beds and about

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  12,800 additional non-residential intermediate care places. In 2002–03, that meant that 143,200 additional people received intermediate care services compared with 1999–2002. That is a fantastic achievement, which meant that a significant number of people avoided entering an acute hospital, that even more were able to get out of an acute hospital more quickly and that many avoided entering a care home unnecessarily. Would it not be nice if the Conservatives occasionally congratulated us on the success of that initiative?
  Over the past two years, we have made good progress in tackling the problem of delayed discharges. Older people do not want to be stuck in a hospital bed when they are ready to leave, becoming more dependent and less motivated. We have positively managed a reduction of almost 50 per cent. in the number of people over 75 experiencing a delay since 2001, and that progress is continuing as a result of people preparing for the Community Care (Delayed Discharges etc.) Act 2003. By September last year, there were only 2,988 people aged over 75 whose discharge was held up—a reduction of considerably more than half—and informal feedback from October to January suggests, contrary to the claims of the hon. Member for West Chelmsford, that delayed discharges are continuing to fall without any adverse impact on quality whatsoever.
  Councils have been given £50m for the period since last October, and £100m for the financial year to come, to pay reimbursement charges. I invite the hon. Member for West Chelmsford to do some simple arithmetic, although I know that he was not in school when the numeracy hour was introduced. If he multiplies the number of delayed discharges in September last year by the number of days in the year by £100 for each day, it is clear that even if councils did nothing to make the system better, they have been given a sufficiently large reimbursement to ensure that they are no worse off. In fact, if they put a bit of effort into helping with delayed discharges, they would make a profit under the 2003 Act—that is the positive incentive for which the hon. Member for West Chelmsford was calling. I was disappointed by the sloppy thinking in the article in the British Medical Journal that appeared over the new year. Its authors seemed not to realise that we have already consulted on changes to the direction of choice regulations or that we have put in place a single assessment process that means that prior to people's discharge we will have better information about them than ever before. I believe that the 2003 Act will prove to be one of the great successes of this Government, and I look forward to debating it with the hon. Member for West Chelmsford in a year's time when it has finally and incontrovertibly proved itself.
  Our vision is about meeting the genuine hopes and aspirations of older people—for most, that means care in their own homes. To deliver on our vision requires a range of high quality support services and good partnership between all partners. For example, a simple housing adaptation installed in good time can sometimes help someone to stay at home. That is why we have made housing adaptations that cost less than £1,000 free. Home care, especially intensive home care, has an increasingly central role in our plans. The hon. Member for Sutton and Cheam (Mr. Burstow)
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  mentioned that, but he did not say that 81,500 people now receive intensive home care as a result of what the Government have done. Since 1998, we have increased the proportion of people receiving intensive home care by almost 30 per cent. The total amount of hours of home care that we are delivering is 16 per cent. up on the amount that was delivered under the previous Government. We are targeting home care on where it can do most good in keeping people in their own homes, because that is what they want.
  We are targeting our resources at everyone, not at free personal care for the elderly—which the Liberal Democrats mention in their amendment, which was not selected. Those resources became available only because of the tough choice that the Government made in putting £1 billion towards making those choices available for everybody, not giving it to the better off. One of the things that we have been able to do with that money is to make £87 million available from the Department of Health to improve the amount of extra care facilities, which act as seed corn in starting people thinking about how they can increase extra care provision.
  It is a tragedy that too many Conservative and Liberal Democrat spokesmen do not appreciate the importance of the extra care model of housing. I wish that they would go around the country to see some of the people with severe conditions—dementia, Parkinson's or physical conditions—who will be able to stay in their own home because of the extra care model that we are going to roll out. Those are choices that we are making available. It is sad that the Conservatives do not understand that older people want to make those choices and do not see a care home as an inevitable consequence of old age. It is sad that the Liberal Democrats stick with the nonsense of free personal care for the better off when the resources that such a policy would consume would be better spent on making choices available to everybody. If older people cannot hope that the Conservatives and the Liberal Democrats will hear their voices, they can at least be confident that the Government are listening to them and know that they want independence. They want to be respected, given the choice of planning their care, and being at the centre of it. They want dignity in old age, and high quality and well-regulated services. The Government are proud to be delivering that to older people everywhere.
  5.20 pm
  Sandra Gidley: The debate is important and Liberal Democrat Members welcome it. Such is its importance that I was disappointed that the shadow Secretary of State for Health apparently did not feel able to put his name to the motion. However, the previous speech more than covered that issue. I wish to consider a more interesting subject: long-term care for the elderly. It is fair to say that neither of the two larger parties has much about which to be proud, but this is no time to comment on the Tory record, because the Government have also provided a lot of material.
  Mr. Nigel Jones: I believe that it is in fact time to comment on the Conservative party's record in power. I come from Gloucestershire, where the county council was capped year after year in the early 1990s so that it could not provide the sort of services that

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  we are considering for elderly people. Who was in charge of that damage and distress? The answer is the right hon. and learned Member for Folkestone and Hythe (Mr. Howard).
  Sandra Gidley: I dare say there are countless other examples, but today's debate is not about that. [Interruption.] The Tories say, "Let's not bother." That is because they know that the record does not stand up to scrutiny.
  Despite the words of the Government's amendment, they are in no position to rest on their laurels. Before the 1997 election, they promised to set up a royal commission to consider long-term care for the elderly. To give them their due, in December 1997, soon after the election, the then Secretary of State for Health, the right hon. Member for Holborn and St. Pancras (Mr. Dobson) said:
  "As people approach old age, many become anxious about how they will be looked after, how much it will cost and who will pay. At the general election, we promised that we would establish a royal commission to work out a fair system of funding long-term care for the elderly."
  He announced the commission and proudly trumpeted:
  "The new Government are keeping yet another of their election promises."
  He described the terms of reference and said that the commission had 12 months in which to report. He continued:
  "The task of this royal commission is neither simple nor easy, but it is important. The present situation cannot go on much longer. People are entitled to security and dignity in their old age"—
  I seem to have heard those words in the past few minutes—
  "so we must find a way in which to fund long-term care which is fair and affordable both for the individual and for the taxpayer. With the independent advice of the royal commission. I hope that we shall be able to establish a consensus from which we can fashion a sustainable system of long-term care that will meet the needs of elderly people well into the new century."—[Official Report, 4 December 1997; Vol. 302, c. 489–90.]
  At the time, the Conservative's big idea was to fund long-term care through an insurance scheme. The royal commission readily dismissed it. However, the Government, having established the royal commission with their usual fanfare, decided to ignore one of its key findings, which was:
  "Personal Care should be available after an assessment, according to need and paid for out of general taxation."
  The Government's response to that recommendation was to declare that they were making unprecedented new investment in older people's services, which would more than fund the cost of the royal commission's proposals. However, they subsequently stated:
  "The Government does not believe that making personal care universally free was the best use of these resources."
  In some ways, I can accept that, but I have heard some worrying rhetoric today. For example, it has been asked, "Shouldn't the rich pay?" The fact is that it is not the rich but people on modest savings who pay. They still have to sell their houses and break into their savings to provide funding in a way that they never expected to have to do. I believe that the Government would admit that that is unfair to many people.
  Dr. Ladyman: Seven out of 10 people already get some help with the cost of their personal care. Those who still
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  live in their home do not have to have the value of it taken into account when their contribution to personal care is being assessed. The hon. Lady is talking about making personal care free to the better-off. If we had another £1 billion or so, which would be necessary to do that, could she honestly say that it would be better to give the money to people who already have resources than to spend it on enabling more and more people to stay in their homes for longer?
  Sandra Gidley: The Minister is merely reinforcing the inverse snobbery that is so prevalent in the Government. Seven out of 10 people may receive some help, but the other three out of 10 are not necessarily wealthy. We shall shortly have the same debate on tuition fees.
  What is the point of setting up a royal commission if its advice is to be so roundly ignored? The Government will probably claim that they accepted the bulk of its recommendations, and that it would be wrong to place too much emphasis on this particular one. It might therefore be useful to turn to the statement made by the royal commission on long-term care, which was published in September 2003 and whose purpose was to review the extent to which the long-standing problems in long-term care and its funding had been resolved since the commission reported. The statement points out that the debate about long-term care and its funding is very much alive, that little has been resolved, that Governments in most of the UK still decline to act, and that there is widespread concern. That is the view of the commissioners. The statement also reminds us that this is an important issue not only for older people and their families but for the wider public.
  The statement was damning, and highlighted other areas in which the Government's response had been disappointing. The first related to the setting up of a national care commission. The Government will point out that they have set up the National Care Standards Commission, but the remit of that body is much narrower than that envisaged by the royal commission, as its role is merely regulatory and falls far short of the wide-ranging role proposed by the royal commission. The reality is that the establishment of the new Commission for Social Care Inspection will result in a further erosion of the principles originally envisaged by the royal commission.
  Ms Munn: My vision is that increasing numbers of elderly people will not need to go into long-term residential care and that they will be able to stay at home, sometimes at a greater cost than would be incurred by their going into a nursing home. How will anything that the hon. Lady is describing help to achieve that goal?
  Sandra Gidley: I cannot argue with the hon. Lady's long-term vision, but if she will wait for me to develop my argument, she will see that, while her vision is worthy, it is not being fulfilled by the Government or the party that she supports.
  Chris Grayling: The hon. Lady has talked extensively about the recommendations of the royal commission. Has she made an estimate of the proportion of a typical nursing home fee of £500 a week that is taken up by

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  personal care, and that she is arguing should be funded? What proportion of such a typical fee does she believe should be paid for?
  Sandra Gidley: I am sorry that I do not have detailed figures; I only have the overall costs. I do not know if the hon. Gentleman is referring to our manifesto pledge, but I can assure him that it is fully costed.
  The bulk of the report consisted of condemnation of the Government's refusal to adopt free personal care for the elderly. Tempting as it is to concentrate on that aspect of policy, however, it is not the only issue in this very crowded field, and I want to spend a little time examining the Government's record. It is difficult to argue with the assertion that people would prefer to stay at home. Many people would agree with that, but is it actually happening? Is that what the Government are achieving?
  It is difficult to get to the bottom of this issue. The latest figures show that, in 2001–02, some 1.4 million people were helped to live independently at home through the provision of a variety of community-based social services. This was an improvement on the 2000–01 figure. A response to a parliamentary question revealed that no figures were available for the years prior to 2000–01. Strangely, however, I came across some figures provided to the Health Committee in the public expenditure memorandum of 2001, which showed that an estimated 1.5 million service users were then receiving community-based care. The reality is, therefore, that 100,000 fewer people are now receiving such care. As the hon. Member for West Chelmsford (Mr. Burns) pointed out, that seems completely contrary to what the Government are trying to suggest.
  Although more money is being provided, it is reaching a smaller number of people. I have noted the carefully worded ministerial replies that refer to intensive home care packages. Those have increased, but a definition of "intensive" has been difficult to obtain. The reality is that the number of households generally receiving any sort of care has been reduced. I cannot square that with helping more people to stay at home. Many cases can be cited from around the country in which an older person who lives at home needs a small adaptation but cannot get it until they fall over, end up in hospital and social services come to the rescue. It seems that the system is skewed and is reactive rather than proactive.
  The Minister said earlier that people can have home improvements, but in many cases those will take six months to happen, and those six months can be six months of misery. A constituent of mine told me about her husband whose situation meant that they had to have a downstairs toilet. In the interim before it was built, the only way in which they could cope was to have a commode in the main downstairs room. This lady felt that she could not invite any friends home. Is the Minister happy to preside over a situation in which people must wait months to receive the help and care that can help them get on with their lives? I think not. He will surely admit, however, that his priorities are skewed.
  We should move on from the question mark over the figures, because that is a relatively small matter. What is of paramount importance is whether people who receive
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  domiciliary care packages are receiving the service that they require and that they deserve. A report called "Nothing Personal" by Help the Aged, highlighted certain worrying findings. It found that levels of care often fell short of the hopes and expectations of those interviewed, and staffing pressures meant that the number of care hours that could be provided often met only the bare minimum of needs and sometimes did not adequately cover that. There was a particular problem with low-level users, unreliability and poor time-keeping of care staff left users in substandard living conditions and sometimes even in danger, and a common complaint was that management allowed workers insufficient time to travel between appointments so that they often arrived 10 to 20 minutes later than expected. That problem was exacerbated when users did not receive a single carer regularly, especially if the user's residence was remote or difficult to find. The report also found that the quality of care varied significantly within authorities, some agency workers simply could not cope with the tasks that they were asked to perform, care was particularly unpredictable at bank holidays, and all too often users were let down, especially by agency staff. Some Members will have watched the chilling "Panorama" programme that covered the same subject area. Evidence from Age Concern seems to indicate that that programme did not have to try hard to obtain material and that, sadly, the situations portrayed are commonplace.
  I do not want a glib response from the Government saying that the matter is in hand and that all will be well because the National Care Standards Commission now has responsibility for this important area. In theory that is right, because the commission theoretically took over responsibility in April last year. All domiciliary care agencies operating before 1 April last year should have registered by 31 March, and any agencies wanting to set up after that date had to be legally registered before they could begin providing care—[Interruption.] I do not know what the hon. Member for South Dorset (Jim Knight) finds so amusing, but perhaps his constituents can enlighten him as to the reality of some of what I am talking about—[Interruption.] I apologise if he was actually coughing, but I am not sure about that.
  The Government made arrangements so that existing domiciliary care agencies can continue operating until their application is determined—granted or refused—and no inspections would take place in the first year. At first glance, that is all very sensible. I draw the House's attention, however, to the reply to a parliamentary question that was tabled on 1 December last year but only answered on 5 January. It asked how many domiciliary care providers have, first, applied for, and secondly, met, the registration standards. The answer was interesting, because although as of 30 November 4,322 domiciliary care providers had applied for registration, only 3,155 of those had been validated and were being processed—which sounds a little vague. Only 243 domiciliary care providers, however, had met the registration standard. That gives rise to the following questions. How many had not met the registration standard? An answer to that would be very useful, and if I do not get one I shall table a parliamentary question

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  immediately after this debate. How many had been approved, but have significant action plans in place? And why is it all taking so long?
  This morning, I rang the commission, but it could not tell me how many domiciliary care providers had failed the assessments. I hope that the Minister has that information at her fingertips when she sums up. I also searched the commission's website to try to establish the date by which all applications must be processed. The search proved fruitless, but when the question was put directly to commission staff, I was told, "There is no date." I am sure that the Government will admit that this endless procedure is completely unacceptable. Can the Minister explain why no date has been set, and what plans there are to rectify the situation?
  Dr. Ladyman: Perhaps I can help the hon. Lady with one or two of her questions. The phrase "validated and being processed" means that the forms have been filled in, all the documentation has been received and the matter can be properly investigated; that is different from such people's having been assessed and met the criteria, as she perhaps realises. Frankly, it is a serious problem and at the moment I doubt whether many, if any at all, will meet the standard and be capable of full registration. That is one reason why we introduced the standards and regulations—to drive up the quality of care that such people are providing, and the standards that they are working to—and why we are trying to push them through as rapidly as possible. The hon. Lady and I should be on the same side, fighting the Conservatives, who want to take away all that regulation and checking and return to the old, laissez-faire attitude.
  Sandra Gidley: The Minister's answer, although honest, is fairly chilling. He has set great store by this approach. He has admitted that the existing system is failing completely, yet he seems happy to move more and more people into it before the standards are in place. Basically, he has just admitted that an increasing number of old people are being allowed to be subjected to a substandard system. That is totally perverse.
  It would seem that the focus on bed blocking and care home places has taken the Government's eye off the ball. We often denigrate targets in this place, but the Government appear, as we heard in a previous debate, to be inordinately fond of them. Is the lack of domiciliary care targets evidence that the Government are paying only lip service to this aspect of care, or do they know the chosen solution has not been thought through and is ultimately bound to fail if nothing is done?
  People are staying at home longer, but in some cases an individual's care would continue for longer still were it not for the fact that the carer reaches the end of their tether. Written evidence to the Sutherland report highlighted the fact that respite care has emerged as a main priority, and the report itself also admitted that such care is expensive. The way forward would appear to be to extend respite care not necessarily as a right, but by making it available to those most in need. I concur with that, because I regularly come across constituents who are providing care services, but for whom respite is simply unavailable. Where it is available, it is the occasional hard-won week, with no prospect of anything else to come. One elderly carer told me that if
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  she could have a week off every six to eight weeks, she could cope indefinitely. It is the unremitting nature of such care that is affecting her physically and mentally, and in terms of her attitude to her husband.
  Hampshire county council pooh-poohed the idea because of a shortage of beds, but a similar scheme is operating on the Isle of Wight. There are regular respite beds, people are on a rota, the home in question gets to know the patients and the system seems to be working well. It is too early to say how cost-effective it is, but the Government should be looking creatively at such a solution. We need more of these places in order to establish a solution.
  All the evidence shows that these days when people do enter a nursing home—if they can find one locally—their general state of health is worse than it might have been some years ago. I am not saying that that is necessarily a problem if they have been allowed to stay at home, but it does mean that for many, a nursing care assessment is made and the individual is placed into one of three bands of care. That approach was the Government's alternative to that recommended by the royal commission, and it has been fraught with problems from start to finish. The first problem was the delay in getting through all the assessments. Okay, that is history, but it was a fiasco. The second problem was that this period seemed mysteriously to coincide with many nursing home owners putting up their prices. That may well also be history, but we are still stuck with a system that is bureaucratic, inconsistent and often downright unfair. It is not just me that thinks so, and I quote the royal commissioners again. In a recent statement they cited the general inadequacy of nursing care support levels in comparison to nursing home charges. They described the system as "arbitrary and inconsistent", when people with equal nursing needs receive different financial support rates.
  One study showed that in Shropshire 48 per cent. of residents were assessed in the top band whereas in neighbouring Worcestershire it was 12 per cent. That is bad enough, but the overall figures show that the vast majority of patients are placed in the middle band. If that is to continue, it would seem far more sensible to scrap the expense of the assessments—it lies in human resources and high administration costs—and redistribute the money on a flat-rate basis, as in Scotland and Wales. The lack of a proper appeals process is another problem.
  There are still further pitfalls. I make no apology for citing a recent constituency case. When a financial package is worked out, the assessment is usually that the patient will be in the middle band for nursing care. That is a fair assumption because, as we have already said, that is the reality for 90 per cent. of people. However, families often have to decide how much they can really afford to top up and then seek a nursing home that will fit those price criteria. In my neck of the woods, nearly everyone has to top up.
  In my constituent's case, the home did such a good job that her health improved, so by the time that she was assessed, she was in the lowest banding. That meant that her family had to find the difference of £35 a week in home fees, which was impossible because they had already worked out the maximum that they could afford. It also placed the home owner in a difficult position. No other home placement was available in the

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  area and the family was convinced that moving to another home would have made it difficult to visit the mother so often. The mother's health would decline, so she might then be eligible for the middle range of nursing care assistance again. The home owner wrote to me and described the system as providing a perverse disincentive to making sure that a patient's health improved. I am sure that other hon. Members will have similar stories to recount—
  Mr. Burns: Not if the hon. Lady keeps on talking!
  Sandra Gidley: I do not believe that the Government will take any notice.
  The hon. Member for West Chelmsford is being unfair. I have been speaking for a fraction of the time that he was on his feet.[Interruption.]
  I have alluded to the difficulty of finding care places and the motion before us today stresses that aspect of the long-term care system. That is why I have concentrated my efforts on other aspects.
  There are only so many times that the House can be expected to listen to the Laing and Buisson figures, so I shall spare the Minister a repetition of them. However, I query his selective take on those figures. I am pleased that, for once, he admitted that the number of hotspots was causing problems. As he knows, the report states that that is behind the drive to force local authorities to pay higher fees. The Minister may be complacent because he knows that hard-pressed social services departments throughout the land do not pay the going rate because they cannot pay the going rate. In many areas, top-up fees are the norm.
  Rukba, a charity championing independence for older people, highlighted that problem and spent £448,000 in making good the deficit in running its homes. Its assessment is that the funding gap is distorting the balance of supply and demand within the private care sector, and it predicts a major crisis in care provision. It also points out that when care packages are provided, they are retrospective and there is insufficient emphasis on preventing problems. That view is shared by the Association of Directors of Social Services in "All Our Tomorrows", which calls for a broadening approach to prevention and the development of universal services to support it. The Government's approach is far too top-down, and the most recent example is the introduction of a £100 bed-blocking fine, which will be levied—
  Mr. Burns: The hon. Lady is, I believe, the Liberal Democrat spokesman on long-term care for elderly people. Is she not aware that elderly people and those who live and work in the long-term care sector find the term "bed blocking" deeply offensive?
  Sandra Gidley: Yes, the term is deeply offensive—
  Mr. Burns: Then why use it?
  Sandra Gidley: The term is still used by many people to describe a particular situation.
  Kali Mountford: Before the hon. Lady moves away from the issue of delayed discharge, is she aware that the
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  Liberal Democrat local authority in my area has said that, to avoid fines, it is best to invest in rehabilitation? That is what that authority is doing, so should she not encourage other authorities to do the same?
  Sandra Gidley: I find that slightly confusing. I have said that I think that preventive care and rehabilitation are the goals towards which we should be moving. In some cases, I have no doubt that the money will be spent wisely, but a recent report by Allyson Pollock stated that, if elderly patients were not moved within two days, local authorities might decide to put them in any home rather than in the home of their choice. That would be at odds with the Government's supposed aim of providing choice in health care. It seems that old people will not be allowed to have that choice, and that is a clear case of discrimination.
  If that is the outcome, it would be very disappointing. We will have to wait and see, but there is a growing feeling of disappointment outside the House. A society can be judged by the way in which it treats its old and infirm. At the next election, the Government will be judged accordingly.
  5.46 pm
  Mr. David Hinchliffe: I have long been saddened by the cosy consensus between the three major parties in this House that the way forward for the care of the elderly is to shut up more and more people in care homes. Today, for the first time, I heard a Minister challenge that consensus and say that progress lies in another direction. I have been a Member of Parliament for nearly 17 years, and the speech by my hon. Friend the Under-Secretary of State for Health was the best that I have heard any Minister make in a debate on community care.
  I believe in being even-handed in these matters. I shall refer to the Tory motion in some detail, but there is one element with which I agree—its criticism of the Community Care (Delayed Discharges etc.) Act 2003. The Select Committee considered that legislation in some detail. I do not think that it is an appropriate measure, as it addresses the symptoms and not the cause of the problem. If I have time at the end of my contribution, I shall say more about that.
  I think that the Tories have displayed what we in the north of England call brass neck in tabling this motion. The previous Conservative Government created the supposed crisis in care. I want to look at that Government's record in this matter, as the problems that everyone accepts now exist are entirely the result of the policies that the Tories pursued when in office—and that includes the time when the hon. Member for West Chelmsford (Mr. Burns) was a Minister.
  The background to the current position must be examined so that we can understand where we need to go now. The Tories locked us into a hugely expensive, and outdated, institutional model of care, and they did so in a big way. The previous Conservative Government were right to move children out of children's homes and mentally ill people out of long-stay institutions. Why, then, did they do exactly the opposite in respect of elderly people?
  In an intervention earlier, I referred to figures from the House of Commons Library that I received in 1991. They showed that, in the 10 years between 1981 and

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  1991—when the Tories were in power—this country's elderly population increased by less than 5 per cent. and that the number of NHS elderly care beds fell by 17 per cent., but that the number of private care and nursing home beds rose by 500 per cent. There was a deliberate stimulation of the institutional care sector. Until the Treasury forced the Tory Government to address the Budget implications of that stimulation, the cost came to more than £10 billion. That money was spent on subsidising private care and nursing homes.
  What alternatives to the institutional care sector and to care homes could have been developed with that money? Vast numbers of people who did not need to be there were being sent to care homes without being assessed in any way. The Tories introduced the profit motive into the care of vulnerable and elderly people, and they did so big style. I find that offensive. I find offensive the wholesale privatisation and marketisation that took place under the Thatcher and Major Governments.
  The Tory motion deplores closures, but why do most care homes close? They close for the simple reason that owners know they can make more profit through selling them for something else. The property market has moved in a way that lets them make more money. The whole problem, which the Tories harp on about constantly, relates to their own policy of introducing a market into the care of elderly people.
  I am appalled that the Tory motion has the cheek to criticise regulation of the care home sector. The Tories' record was to draw into the care of elderly people some profoundly unsuitable people motivated solely by the opportunity to make big money. I was shadow Minister for community care between 1992 and 1995. I met people running care homes—a minority, I admit: I am not over-egging the pudding—whom I would not trust to care for a dog, never mind a vulnerable elderly person. Those were the kind of people attracted into the care home market under the Tory Government. I recall speaking at a care homes conference as shadow Minister, and my right hon. Friend the Minister without Portfolio was present. He applauded something that I said, and he was assaulted by one of the people attending the conference. Those are the kind of people whom the Tory Government attracted into the care home market.
  I recall raising in speeches here practices that were being undertaken in care homes. One example that I remember vividly was of 16-year-old youth training scheme students being used to catheterise elderly people in private care homes. That is on the record: it happened in Liverpool. That was the record of the Conservative Government when it came to care of the elderly. The hon. Member for South Suffolk (Mr. Yeo) talked about low politics earlier: low politics is the motion before us, which does not address the quite disgraceful record of the Tory Government on care of the elderly. They resisted—the hon. Member for South Suffolk was responsible for community care—my attempts on several occasions to introduce a Bill regulating domicilliary care to ensure that people who care for folks in their own homes were properly checked on for criminal records and so on. The Tory Government resisted pleas from the social work profession to
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  introduce regulation, but thanks to the present Government we now have the General Social Care Council to ensure that people working with the vulnerable and elderly are properly checked. That is right.
  The Select Committee on Health is currently looking into elder abuse, which is highly relevant to the debate. We were told a couple of weeks ago that 500,000 or more elderly people are being abused in this country at any one time. The question for the Tories on their proposed deregulation is whether it means the repeal of the Care Standards Act 2000, and the scrapping of the Commission for Social Care Inspection, the General Social Care Council and the national service framework for older people. If it does not mean that, what does it mean? Glib comments about deregulation and over-regulation are unacceptable against a background of serious problems with the care of elderly people.
  The Tory motion is clear evidence, as the Minister said, that the Tory party is entirely provider led. It has been hijacked, lock, stock and barrel, by the care home owners. Those owners are writing Tory policy, which is why Tory Back Benchers seem unable to see any possible alternative to care of old people other than sticking them in institutional care.
  I have one or two points on which I hope that the Government will reflect. I have made them before and will continue to make them. At some point, I hope, I will succeed in getting across their merits. First, I make a plea for a more radical longer-term agenda for care of the elderly. In both the Ministers present, particularly the Under-Secretary of State for Health, my hon. Friend the Member for South Thanet (Dr. Ladyman), we have people who are prepared to listen and who understand the need to move in a very different direction.
  I may be the only person in the House who is attracted to those countries that have got rid of care homes. My long-term objective, as someone who is 55, is that in 20 years, when I may need some form of care, it will not involve sitting wall to wall with and looking at other, similarly demented, gaga people. Frankly, we can do better than that. My mother ended up in that situation, and I swore that I would do all in my power in politics to ensure that we secure a very different future for elderly people. We are slowly but surely improving the quality of that care. We need to get away from the nonsensical outdated models of institutional care that, frankly, belong not in the 20th century, but with the workhouse in the 19th century.
  I want a planned policy of reducing dependence on institutional care with the development of positive alternatives. The Government are moving in the right direction on housing with care and on extra care. We need to follow the model established in other countries, such as Denmark, which have got rid of institutional care. The private, independent and voluntary sectors are gradually going in that direction. The obsession with old people's homes takes us away from the real agenda. Let us get into intensive home care packages and telecare, the type of facilities that we know we can provide to ensure that people remain in their homes.
  I end by making my usual plea that the way forward in the longer term is to merge health and social care within common budgets. If that were to happen, we would not need arrangements for fining social services when people are stuck in hospital beds.
  5.55 pm
  Mr. John Horam: I pay respect to the passion with which the hon. Member for Wakefield (Mr. Hinchliffe) stated his case. He is long experienced in the subject, which I have appreciated for many years, and he put his case well, although obviously I disagree about the history of the Conservative party.
  I also disagree with the Minister about the so-called myth that the Conservative party is in the hands of the providers and that it can talk only about nursing homes and residential homes. We all know that our elderly relatives wish to stay in their own homes as long as possible. I have an aunt who is 97. She gave up driving her car only recently, largely because she could not back it into her garage. She was insistent on staying in her home. Only very recently, in the past month or so, did she take the voluntary decision to go into a residential care home because she could not cope any longer. Most people wish to stay in their homes. If that is the Minister's vision, we share it. I have no doubt about that. Keeping people in their own homes is the vision of the hon. Member for Wakefield and my hon. Friend the Member for West Chelmsford (Mr. Burns). There is no disagreement on that.
  I agree with the hon. Member for Wakefield that there are problems across the board. We all accept that there are severe problems. I am privileged to be a parliamentary representative on the Greater London forum for the elderly. We recently held a seminar in the Jubilee Room of the House of Commons. It was attended by a large number of representatives—or at least as many as we could squeeze in—from all over London.
  The Minister may be interested to know that we did not simply discuss home care and care homes; a range of issues was raised. The representatives decided that the issue was the erosion of community care in the London area. We discussed chiropody services, the closure of local pharmacies, domiciliary care, NHS dentists and adaptations. I welcome what the Minister said about adaptations, and the representatives were concerned about how quickly they could be provided and whether people could get what they required. That range of issues forms part of the community care package as it is seen by the elderly. My hon. Friends were right to initiate the debate as an across-the-board issue, not just one that relates to care homes.
  On care homes—we must not be frightened of talking about them just because the Government say that we are in favour of care homes and nothing else—the Minister said there was a huge surplus of places in Kent. That is not the case in Bromley, which is not far from Kent, as he is well aware. The primary care trust recently had to convert beds in the local community hospital into 44 intermediate care beds. I know that intermediate care is only for six weeks, but it did that because of the great difficulty of finding suitable homes for people who were unable to leave hospital as a consequence of the homes and packages not being available to them. So there is a problem.
  The Minister also rightly said—I praise him for this—that he hoped to tour the country, pointing out best practice to local authorities and fixing fees for local care
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  home places. I welcome that, but he must be aware that exhortation from Ministers does not always produce results in the detailed way that he would want. The fact is that there is a marketplace, as he acknowledged, and market solutions are determined by local supply and demand. However much Ministers may wish it otherwise, fair and suitable conclusions are not always reached.
  Furthermore, local authorities use their muscle-power with adverse effects for local care homes. They drive down prices and, as a consequence, individuals who pay for themselves have to pay much more. There is often a difference of several hundred pounds between what a self-payer pays in a care home and the payment for a person whose local authority is funding their care. People who have provided for themselves for their whole life see that local authority support as highly unfair to them. That is one of the factors that has arisen due to the shortage of supply in places such as Bromley.
  Even with the private sector subsidising local authority clients, homes are still closing down, as the Minister acknowledged. They are closing down throughout England but especially in London where the costs and difficulties are greater and where the possibility for making a financial killing is much greater from property development than it is from running a care home. There is no doubt that that is a huge problem in the London area and the Minister must not ignore it. I hope that he will spend some time in London, as well as in the rest of the country, and point out that there are difficulties in the capital. too.
  I hope that we all agree about domiciliary care. However, there is a problem that seems to have escaped the Government's attention. I recently received a letter from a lady in my constituency, which states:
  "I started a small business 2 years ago, providing support services for the elderly, in order to keep them independent in their own homes. This involves shopping, meal preparation, prescription runs and domestic help etc. Quite often, we are the only people our clients see in any week and we become good friends. This year the Government introduced the National Care Standards Commission. Although I comply with all the standards as set, I am not in a position to pay the £2,500 registration fee, nor the £300 for registering each of my staff."
  That lady has a staff of 16.
  I had not realised that the fees for registration with the commission were so high. As the lady cannot afford to register her staff, she has to pay VAT. She serves some of the poorest people in our society, many of whom are on income support, and is competing with larger organisations that do not pay VAT and can make economies of scale. I raised the matter with Age Concern, which replied:
  "The issue of VAT on homecare is one that has been raised a number of times over the years and Age Concern has been very active in trying to ensure that older people who need care services because of their disability do not pay VAT.
  Your enquirer does raise an interesting point…We had hoped that the problem of VAT and home care had been resolved but your enquiry makes us realise that there are still some further outstanding issues."
  I have only just received that reply from Age Concern, and I shall write to the Minister about the matter as it affects people in our communities who are most in need and I should like him to address the problem. Although

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  those people receive domiciliary services, some providers have to compete against larger organisations that are VAT-exempt.
  We can all agree about the sort of vision that the Minister outlined, but it is not being delivered. There are many, many problems and the Minister and the Government have still to address them and acknowledge their importance.
  6.3 pm
  Laura Moffatt: It is a pleasure to follow the hon. Member for Orpington (Mr. Horam), who clearly has a great interest in care of the elderly—as I do. When I qualified as a nurse, I decided to concentrate on that specialism and I have always remained interested in the care and treatment of the elderly and in new innovations for older people in our community.
  The hon. Member for Romsey (Sandra Gidley) referred at length to the royal commission on long-term care for the elderly. In 2001, we held a fantastic conference on that issue in Crawley. Many people, especially the families and friends of people who had to remain in hospital, told us that they could not get access to residential care and that there seemed to be a huge problem. I thought that the best way to deal with the matter was to get everybody around a table at the House of Commons and to have a meeting of all the stakeholders, including the care home sector, so that we could discuss things at length and come to a conclusion about why we believed there was a problem.
  Since December 2001 there has been a huge improvement in Crawley, especially in terms of delayed discharges and lack of access to the care home sector. There are many reasons for that. The motion made me cross because it devalued and debased something important by making the spurious assumption that regulation is the main problem for long-term care of the elderly.
  I want to say a little about what is being done in my constituency to give older people the care that they deserve. Of course we cannot yet rest on our laurels, but enormous changes have been made. What struck me when I got everyone together—members of social services departments, GPs, people in the care home sector, housing representatives and many other stakeholders—was that few of those people had met before or had an opportunity to discuss how things could be improved. The crucial element that had galvanised them was Government regulation. It was no longer acceptable for 70 out of 400 beds to be inaccessible because of delayed discharges, for instance.
  We thought that there was a capacity problem in Crawley. We thought that there were difficulties related to funding, housing and a rapidly growing elderly population. When we began to discuss solutions, however, no one mentioned regulation; it was not an issue for all those who were trying to ensure that care of the elderly was the number one priority. What emerged were issues such as improved joint health and social services activity, and that is where improvement has been particularly evident.
  We managed to reduce the 70 delayed discharges to something in the teens, and the number has fallen even more since then. I know that my hon. Friend the
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  Member for Wakefield (Mr. Hinchliffe)—whose work on the Select Committee I respect enormously—is concerned about the Community Care (Delayed Discharges etc.) Act 2003, but I firmly believe that it has provided the extra lever that was necessary to get people round the table to stop the disgrace of patients being stuck in acute settings inappropriately.
  We found that when people met regularly to discuss individual cases, it was possible to get the figures down. What struck us most forcefully was that the capacity issue in the care home sector was, in fact, about inappropriate placement. Everyone seemed to think that because elderly people were not well supported at home—because they were having falls, taking drugs for a long time and not being checked often enough—they could not cope any more. Since then, however, there has been a massive intervention by Crawley primary care trust, which now watches older people much more closely. It ensures that they are checked properly to make sure that they are not being poisoned by the drugs they are taking, and are able to support themselves at home.
  We also found that it was a good idea to use care homes for intermediate and respite care rather than long-term care, and to set aside six beds to prevent older people from having to go into hospital in the first place. That has proved a tremendous success.
  Unlike my hon. Friend the Member for Wakefield, I see a future for the highest-quality residential care; but those who are not prepared to provide such care should not be in business. Therefore, the regulation issues are a complete red herring. If that is making people decide to leave the care home sector, so be it.
  We have an extra problem locally. As the hon. Member for Orpington suggested, land prices are incredibly high, particularly in the south-east, so it is very hard to persuade people, especially those who are getting older and have been in the business for a long time, to continue in the business if they are offered perhaps £1.5 million for a piece of land for redevelopment. So we have a difficulty delivering in that sector, especially in the south-east.
  None the less, with all the new proposals in place, we are making true headway on ensuring that people have proper choice. To walk into the extra care home in Crawley is an absolute delight for me. More than 90 per cent. of the people who went into that home five years ago are still there. That is a testament to having all sorts of care and not concentrating just on the care home sector, but providing real choice and making it available to all the people about whom we care.
  6.10 pm
  Mr. Tim Boswell: It is pleasure to follow the hon. Member for Crawley (Laura Moffatt), who sought to introduce an element of balance in the debate on what is an extremely important subject for almost all hon. Members.
  I begin by declaring my wife's interest as a non-remunerated trustee of Brackley cottage hospital, which is a charitable trust and was formerly in the NHS, but now provides services both as a registered home and as an agent for the NHS. Perhaps another debate would be

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  an appropriate occasion to piece together the history of that organisation's attempts to position itself in the right place to deliver intermediate care in the face of constant, serial reorganisation by the NHS. I am now personally involved in a stakeholder group convened by the local PCT to try to find a way forward. I have become very familiar with the situation that the hon. Lady has described in relation to step up, step down, intermediate, terminal and palliative care, as part of the range of provision that may operate and is certainly required.
  I have been most disappointed by the fact that the Minister tried to characterise the debate as one in which the Government say, "We are in favour of the widest possible range of care at home, and the Tories want to see only residential care." I can assure him that that is not our view. In any case, such care is not always appropriate at any given moment. I am thinking of my elderly mother, who died in July at the age of 93. She had to have spells in hospital and spells of respite care. In fact, she died at home, and we were pleased that she was able to be at home when she died.
  There is no simple solution to a complex problem, but I wish to draw on one statistic that came to me as part of the working studies for the local review. It relates to Oxfordshire because Brackley, although part of my constituency, is treated as part of the Oxfordshire health authority for this purpose, as my hon. Friend the Member for Banbury (Tony Baldry), whose constituency neighbours mine, will know. It was reported that 45 per cent. of beds in acute hospitals in the county of Oxfordshire on any one day were inappropriately occupied. I say to the Minister in all seriousness that that shows the extent of the current problem. His intentions to resolve it may be real, but he has not yet been able to discharge that problem.
  Mr. Mole: Does the hon. Gentleman accept that the number of people going into hospital inappropriately and interventions such as avoiding slips, trips and falls are needed to address delayed care transfers and that they must be considered as much as the output side of the equation?
  Mr. Boswell: I entirely agree—perhaps we are moving into a more constructive discussion. I tell the Minister that the Laing and Buisson study, the figures that have been cited and all my business experience suggests that if capacity is only 102 per cent. of demand, it is difficult to deliver a proper service. Long-term demographics suggest that the numbers will expand anyway. If we are in a situation, as the Minister conceded, in which some people will require residential care—albeit not for the whole time—or step-up, step-down or intermediate care, there will be a need for residential places, although they might evolve over time.
  However much the Minister tries to explain things away, there is still a strong element of complacency and wishful thinking in the Government's approach. I referred in an intervention to a study carried out by my local community health council—the situation therefore relates to Northamptonshire—that reported that there had been a 25 per cent. reduction in capacity over 30
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  months, which might reflect several of the pressures that exist. It is difficult to move to an ideal pattern of care if what is available is reduced at such a rate.
  Fining local authorities will do nothing to increase capacity. It was put to me recently that one of the interesting elements of the legislation that could apply is that the number of beds that are defined as finable because they are subject to the analysis for delayed discharge, might be refined down by agreement so that the real coverage of the total number of beds in Northampton general hospital, for example, would not come into the equation and thus there would be further massaging of NHS figures—we are perhaps not unfamiliar with that. The Minister might like to reflect or comment on that.
  The reality of our local situation is that our local authority's fee offer for the provision of care is unlikely to increase by more than 2 to 3 per cent. due to the state of its budget, yet costs in the sector are ratcheting up. It is inadequate for the Government to take no account of the pressures imposed by bureaucracy. One of my local medium-sized care homes that briefed me for the debate referred to the 20 per cent. increase in registration fees, which means that it is likely to pay some £3,000 in registration fees, let alone compliance requirements. Criminal Records Bureau checks will cost it an additional £1,000. It faces many other pressures because although it pays above the minimum wage, its wages will reflect changes to that rate. It also faces other general pressures from the economy.
  It is difficult to envisage even the best care homes keeping in step with the cost pressures that they face, and my experience suggests that it is equally difficult to find immediately available alternatives. I single out for the Minister another local case in which the local authority was unprepared to offer fees at the level that a care home required. The alternative provision suggested was in Wellingborough, but it would not have been fair to move an elderly person some 30 miles because of a row between two public authorities.
  The situation is worrying and it is insufficient for Ministers to say that it is not. It would be more sensible for them to say that they need a palette of different provisions, for things to evolve and to work in partnership with providers, but pretending that there is not a problem to start with will not help. Most of us know how the situation works for our constituents.
  It will be possible to solve the problem if sufficient resources are made available, but the solution is certainly not more bureaucracy. The danger is that the Government's present attitude might evolve in an unplanned way to address the problem. If what we do is insufficient and what is outlined in the press release on the new piece of eye-catching legislation with no substance is not delivered, there will be evolution—or regression—into a two-tier system. Those who can afford to pay the fees required in the market will continue to use the residential sector at high cost, although they will probably erode their capital or become unable to provide an inheritance for their descendents. People who cannot afford such care will simply fail to find a place, because their only recourse is to social services and it will be uneconomic to offer them one. They will end up bouncing back into hospital, at ruinous cost to us all, or into inadequately supported community care. That is light years away from a

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  rational and objective discussion of care requirements which, I hope, we all believe should be our starting point. It is sad that the Government have programmed themselves to fail. I do not believe that they can avoid that, but I would be delighted if they do. The burden is on Conservative Front Benchers to introduce the realistic proposals that we all want on the delivery of appropriate care for elderly people.
  6.20 pm
  Kali Mountford: It would not be right, as has been said many times in our debate, to assert that there are no problems in the system. However, to assert that there is a crisis is going much too far. It not only inflicts stress on people who are in the system, as well as their families and other people who are waiting for care, but skews the debate and stops us taking a sensible view of the situation. However, there have been signs of consensus among Members on both sides of the House, especially on domiciliary care. I was pleased to hear from the hon. Member for Orpington (Mr. Horam) that the Conservative party is not denouncing domiciliary care, as appeared to be the case at the beginning of our debate. I hope that I understood him correctly, because domiciliary care is a valuable part of the package that is required.
  Domiciliary care is one aspect of care where we certainly cannot say that one size fits all. We all know people in their 90s who are still digging their gardens, sweeping their paths and looking after themselves perfectly well. We also know people in their 60s who are in the early stages of Alzheimer's or dementia. The range of care must therefore fit people's circumstances and respond to their problems. We must consider how we got to where we are now, whether the arrangements work, what we learning and where we are going. I do not want to dwell too long on the Tory years, as they do not bear too much examination. However, I remind the House of Ray Griffiths' report on the care sector, which was commissioned by Lady Thatcher. The report appeared after the privatisation of care homes and examined care in the community. It said that the system was chaotic and more planning and investment were required for care in the community.
  The Government are dealing with those requirements. In my own area, people have told me that the measures that we are debating this afternoon were a stimulus for change. All the care in our area has been reviewed and the results have been encouraging, as people believe that the fines for delayed discharges will never apply to them because, in response to the Community Care (Delayed Discharges etc.) Act 2003, they have changed what they do. They invested quite a lot in rehabilitation so that elderly people did not have to go into hospital or, if they did, that there was appropriate care for them on discharge. However, they realised that much more needed to be done and there is now a huge amount of investment enabling that to happen.
  People in my constituency have looked at the range of care that needs to be provided. That is a distinctive feature of the mixed market of care homes, arid makes it different from other markets. We must plan that market. We cannot wait for market drift to determine how many
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  homes of a particular type are needed in any one area. We must look ahead and see how many types of provision are required for people with different needs. A pure market model clearly could not work in this sector. I am pleased to hear that that has not been suggested by anyone. Such a model would be mad.
  I would not be happy with any model that excluded any form of help that could be made available. To assume that any model could be taken out, on the assumption that we all want to be in our homes for ever and a day, would be wrong. It would say to people that even if their family felt that they could not support them properly in their own home with the package of care available, people could not make that choice. That would be wrong.
  If the package of care is to be available, it should be properly scrutinised. My own local authority is concerned about the level of scrutiny. It feels not that it is over-regulated, but that the inspections are stringent and sometimes difficult. I have thought carefully about what the local authority says, and I have also looked at the case histories of people who have been to see me. I want to see the evidence for the local authority's view that it is over-inspected. If it is over-inspected, why do I have cases in my surgery where people have had bedsores while they have been in care, where people have not had any stimulation during the day, where they have not received the proper food, or where the water in their water jug has not been changed properly?
  Such things, on a day-to-day basis, month in, month out, can change a person's life significantly. A jug of water may not seem much to us, but to an individual who does not have access to the proper drink during the day, it means an awful lot. It means a lot if someone is given milk when they have a milk allergy and the notes have not been checked. It means a lot if staff have not been trained in the proper use of hoists, when they can be used and when they should not be used, so that a person is left dangling uncomfortably, and in one case left dangling uncomfortably as a punishment, because she had been "a very naughty girl". A patient who is suffering from dementia is not a very naughty girl, but someone who needs the highest standard of care.
  When such cases are reported to me, that tells me that inspections are necessary and should take place ad hoc, without warning. I have heard from people working in homes that they sometimes have quite a lot of notice and they make sure that the place is spick and span. They make sure that all the proper cleaning equipment, which they often cannot be bothered to use, is used on that day. They make sure that the entrance to and egress from the building are clear, which they do not always bother to do as it is a lot of bother to move trolleys.
  I find such features of the system abhorrent. That is not historic information; it comes from people working in the system now. That tells me that we might not yet have the inspection system right, or such things would not happen. We should not loosen the inspection regime. We should work harder and make sure that the standards in our homes are the very best that we can provide.
  6.28 pm
  Tony Baldry: I shall be brief so that my hon. Friend the Member for Castle Point (Bob Spink) can get in.

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  Only time will tell whether Professor Pollock's concerns about the Community Care (Delayed Discharges etc.) Act 2003 leading to elderly people being put into inappropriate care come true. My concerns about the Act are different. It creates a blame culture and sets social services against health authorities, when they should be working collaboratively together.
  In Oxfordshire at present there are 55 people subject to delayed transfers. Only four of those come into the statutory category. The other 51 are waiting to be moved to other NHS facilities—by far the most common problem—or there are disputes with relatives about where they should best be placed. It seems daft to set social services against health providers. I agree with the Chairman of the Select Committee. I do not see why we have two separate budgets. We have five primary care trusts in Oxfordshire, a couple of acute NHS trusts and a huge social services department. I do not think that that involves anything about democratic accountability. To be honest, I do not think that any Members of Parliament or county councillors could say with their hands on their hearts that they knew where all the income streams were coming from and going to. If we are going to tackle delayed discharges and ensure that people get appropriate care, why on earth do we not have a simplified single budget and stop the blame culture in which health authorities and social services blame each other for what is happening?
  Sandra Gidley: Will the hon. Gentleman give way?
  Tony Baldry: No, as I have very little time.
  Next month, to try to get to grips with the problem, rather as Crawley had to do, we in Oxfordshire are having a conference including all the Members of Parliament in the area and county councillors and officials, simply because we need to have everyone in the same room at the same time to discover what on earth is happening. That should not be necessary, and we should have a collaborative approach.
  In addition to those who are delayed transfers in acute hospitals, I understand that there are about 46 delayed transfers in community hospitals. Of course we believe in domiciliary provision, but there is also a need for nursing home and residential care provision. Ministers must accept that that provision is not growing, but contracting. Whatever they say at the Dispatch Box, one of the reasons why it is contracting is over-regulation, and one cannot get away from that. In Oxfordshire, we are not seeing new provision coming forward from the private sector, and the public sector seemingly cannot afford to make it either.
  We have had a lot of Punch and Judy-style debate this afternoon, but I do not think that that helps anyone at all. Can we not try to ensure that more collaborative work is done? I do not think that the Community Care (Delayed Discharges etc.) Act 2003 will help to achieve that aim. I do not think that attacking nursing home proprietors as profiteers, as Labour Members have done, is helpful. Nursing home proprietors whom I have met in my patch are often concerned clinicians who have been doing a lot of detailed work over many years in dealing with patients with serious Alzheimer's and
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  dementia problems. They are not the sort of Dickensian rapacious profiteers that some people have suggested they are. That is a complete caricature.
  I ask the Minister to please see whether we can try to achieve a more collaborative approach. He talked about best practice conferences. I should like to give him an invitation. If he feels that the Oxfordshire health economy or social services are failing in any way, will he please let Oxfordshire Members of Parliament know? Otherwise, can we get away from blame and recognise that all of us have to work together to deal with what will become an increasing problem as we have a larger ageing population, as we will need better care and greater amounts of it? Simply fining or blaming authorities will not miraculously resolve the situation overnight, as the facts clearly demonstrate. We require a collaborative approach, not a confrontational one.
  6.33 pm
  Bob Spink: The long-term care of the elderly is clearly a complicated and very important issue for us all. Many excellent points have been made by colleagues, especially on the Opposition Benches, but also on the Labour Benches. I shall not repeat those points, as I wish to refer to a single example and a specific case study to show how wrong the Minister was to say in his opening remarks that residential care was somehow optional for some people. There is nothing party political in what I am going to say. I shall simply speak honestly for vulnerable people in society, as we must in this place.
  First, I should like to pay tribute to the many care home providers. I congratulate their staff at all levels, including the managers and owners, on their care and dedication in an often difficult area of work. Society is indebted to them and they generally do a most excellent caring job.
  I wish to raise a specific case in order to illustrate a major problem. Mr. Curran is a constituent of mine whom I have visited several times over the past year in Goldenley care home. It is a very well-run home with excellent, dedicated staff and management—a credit to its community. Mr. Curran is a delightful, dignified gentleman for whom I have the greatest respect, and he is singularly fortunate to have a wonderful, caring wife, Doreen, who has fought to ensure that he gets the very best possible care for his medical conditions.
  Sadly, Mr. Curran is very ill—indeed, I have seen him becoming increasingly so over the past six months. He has suffered a number of strokes and the ravages of neuro-degenerative disease. On 17 December 2003, Mrs. Curran wrote to me about her husband's
  "considerable health needs which are:
  Irreversible brain damage due to many strokes
  Epilepsy
  Parkinsonism
  and just recently arthritis has been diagnosed.
  My husband has deteriorated considerably within the last three months and is now mostly in a semi-vegetative state. There is very little response from him now. He cannot communicate; he is unable to move. He is bedridden most of the time. All food, including medication, is now liquid and there is difficulty in feeding as his mouth is rigid and he cannot open his mouth, necessitating the removal of dentures to access his mouth more

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  easily. His body is rigid and he cannot move or straighten his legs. His hands are very swollen and it is impossible for him to move them too."
  She continues:
  "From the outline of my husband's condition you will see that the care he receives is more than social."
  Mrs. Curran believes that her husband should qualify for health care funding for the care on which he so obviously depends for his life. I agree with her when she says, as she did in a further letter to me, also dated 17 December, that
  "it is grossly unfair for my husband to be forced to pay for care in view of the fact that he is such a very sick and disabled man."
  I am pleased to report some recent improvement in Mr. Curran's condition. He is now able to speak a few words—that took place over the Christmas period. I am sure that the whole House will send its very best wishes to Mr. and Mrs. Curran and to everyone at the Goldenley home.
  Having set out the background, let me read out the decision reached by the authorities on the funding of Mr. Curran's medical care. In a letter dated 5 December, the strategic health authority states:
  "As a result of the hearing the Panel reached the conclusion that the Castle Point and Rochford PCT had acted in accordance with the published eligibility criteria of the Strategic Health Authority in that Mr. Curran's needs for nursing and other clinical care are not more than incidental and ancillary to the accommodation provided."
  It seems that the published eligibility criteria of the SHA dictates that Mr. Curran's
  "needs for nursing and other clinical care"
  are "incidental and ancillary" to the accommodation provided. That is perverse and wrong. If the panel's decision was valid, I suggest that the criteria that it used are wrong. I therefore ask the Minister to look into those criteria and to make any changes that are necessary to reflect what should be a civilised society's response to providing medical care for the elderly.
  Home care is not an option for Mr. and Mrs. Curran. He could, of course, be transferred to hospital, where he would get his care completely free of charge, but that would be against his best interests and would reduce his personal quality of life at this time. That would not only be wrong, but against the public interest, because it would be more costly than his residential care home and would block a hospital bed, thereby denying care to other people. The Government clearly need to finesse their policy to prevent that kind of nonsense from taking place and to ensure that appropriate care, and the funding of that care, is provided for people like Mr. Curran, of whom there are many thousands at the moment and will be many more thousands in years to come. I see that the Minister is listening to me carefully, and I thank him for that.
  Will the Minister ensure that private residential care providers are encouraged by fair funding to supply what we expect to be an increasing demand on their services from 2005 onwards? Does the Minister also agree that we must break down the rigid barriers between health and social care and integrate funding streams for the NHS and social services? Above all, we must drop the political correctness in social care and become more person or patient committed.
  6.39 pm
  Tim Loughton: We have had a good debate—a bit of Punch and Judy as my hon. Friend the Member for Banbury (Tony Baldry) put it. I shall endeavour to be the peacekeeping policeman before I hand over to the crocodile of a Minister.
  There is a sense of déjà vu about this debate. Yet again, we are debating long-term care and the crisis in care for the elderly, whether at home or in residential care, about which we have held numerous debates. Each of those debates has been initiatied not by the Government in Government time, but by the Conservatives in Opposition time.
  There were some interesting contributions from Back-Bench Members. The hon. Member for Wakefield (Mr. Hinchliffe) congratulated the Minister excessively on the best speech he had heard in 17 years. It was not the best speech that I had heard from the hon. Gentleman. If anyone has brass neck, it is he, for laying all the blame for the current problems in care at the door of the previous Conservative Government. We were not criticising all regulation but excessive regulation. Frank Ursell, chairman of the Registered Nursing Home Association, said that the regulations make important what is measured, rather than measuring what is important. No one ever died from a small room, but elderly people have died from poor care standards. It does no one a service to rubbish the whole care home sector, as the hon. Gentleman did.
  Mr. Hinchliffe: Will the hon. Gentleman give way?
  Tim Loughton: No, I want to make progress. The hon. Gentleman suggested that the scandals and misdemeanours of a few in the past represented the whole sector. That is deeply offensive to many people who run good care homes, and to the people who pay good money to stay in them.
  Mr. Hinchliffe: On a point of order, Madam Deputy Speaker. I appreciate that the hon. Gentleman will not give way, but I should like to ask your advice about one point. According to the Order Paper, the debate is about the long-term care of elderly people, yet the monitors state that it is about care homes. That is an important point of procedure, and I would welcome your advice, Madam Deputy Speaker, on who is responsible for saying that the debate is about care homes. Perhaps the hon. Gentleman's comments will simply be about care homes, not long-term care for the elderly.
  Madam Deputy Speaker (Sylvia Heal): That is not a point of order, although I shall answer the hon. Member's question. The title on the monitor is simply a shorthand version for the terms of the debate.
  Tim Loughton: I am surprised that the hon. Gentleman did not blame us for the monitor problem. However, other hon. Members made more measured and positive contributions.
  My hon. Friend the Member for Orpington (Mr. Horam) said that homes were suitable for some people and care at home was suitable for others. The hon Member for Crawley (Laura Moffatt) made positive

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  comments. I am sure she would have paid tribute to West Sussex social services—an excellent authority—for many of the improvements that they have brought about in the north of the county that we represent. My hon. Friend the Member for Daventry (Mr. Boswell) referred to the use of step-up and step-down roles for care homes. The hon. Member for Colne Valley (Kali Mountford) emphasised that we favour domiciliary care. Of course, most people want to stay in their homes for as long as possible, but that is possible only if we provide the care to support them there. My hon. Friend the Member for Banbury made an important point about the blame culture in the Community Care (Delayed Discharges etc.) Act 2003, which causes so many problems. My hon. Friend the Member for Castle Point (Bob Spink) took up that point.
  There is a crisis, which is not improving. There was a crisis when we raised the loss of 40,000 care home beds; there was a crisis when we raised the loss of 61,000 beds, and there is a crisis now, when we have lost 74,000 care home beds since 1996. There is also the crisis caused by the decline in the number of care home packages for vulnerable elderly people, the increasingly high thresholds that have to be achieved to qualify for them and the potentially counter-productive implications of the newly up-and-running delayed discharges measure.
  My hon. Friend the Member for West Chelmsford (Mr. Burns) has presented all the stark figures concerning the number of lost beds, including the 13,400 lost beds that account for 745 independent homes that have gone out of business in the 15 months to April 2003. Decline continues in new registration for new homes, and hotspots with acute shortages of supply increase. That applies not only to the south-east and the south-west. The problems place greater strain on GPs and the army of 7 million carers who are increasingly exploited by the Government through stealth.
  The demographics over that time are also worsening. I know about demographics; I represent Worthing, where we have some of the oldest people in the country. For the first time, there are now more over-60-year-olds in the country than under-16-year-olds. It is predicted that, by 2015, nearly a quarter of the population will be over 60—anincrease of 9 per cent.—and that the number of over-85s, of whom we have the greatest number in Worthing, who need and deserve extra care, will increase from 1.1 million to 1.4 million over that time. Three times as many people over the age of 100 will be living by 2015.
  Throughout all this time, the Government's response has been one of denial, confusion, incompetence and caricature. There have been limited U-turns on the over-prescriptive implementation of care standards acts, climb-downs on Criminal Records Bureau checks, claims of using lighter-touch regulation, and a rubbishing of care homes across the board as "banging up" elderly people, as the former Secretary of State put it. Today we have again heard the Minister claim that there is no national crisis in the care sector. He is the "Crisis? What crisis?" Minister, and he spent 33 minutes today rubbishing the care home sector and accusing it of peddling myths, yet he was perfectly happy to quote a report from Christie's—of all people—about what was
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  going on in the care home sector. He also made a disgraceful criticism of the British Medical Journal for being sloppy in some of its reporting of this matter.
  We have heard some interesting innovations, including the claim that the Community Care (Delayed Discharges etc.) Act 2003 was actually a money-spinner for local authorities, and a profit-making exercise. Is this a new turn in Government policy? Are we now going to see an early discharge of pupils Bill to introduce truancy fines, so that education departments can benefit from truancy? Perhaps we could have a Bill to introduce fines on late-running buses to fund local authority transport. This is fantasy island in the extreme. Ministers may come and go, but this problem is set to stay and to get worse. It affects some of the most vulnerable people in our community, and they are being failed by the Government.
  The Minister complacently states that we must accept that the sector is contracting, and that that process will go on. He justifies that by saying that more people want to live in their own homes for longer. I am sure that that is right, but this is a matter of horses for courses, and what is needed is real choice: available, quality, serviceable choice. Of course staying at home is an ideal, but only if people are given the support to do so. We are increasingly seeing elderly people living at home, growing older and frailer, while the level of their care package diminishes or, in some cases, is withdrawn altogether. In some cases, there is no package available in the first place. Living at home is not a real choice if a person's quality of life diminishes unreasonably by doing so.
  There is an added problem of the shortage—particularly in the south-east of England—of skilled social workers, leading to the greater use of agency staff to service home care packages, often changing quickly and going in and out of homes quickly without building up a relationship with the clients they arc looking after. If the clients cannot cope, they then become emergency readmissions to hospital, of which we have seen an enormous increase in numbers. As the Royal United Kingdom Beneficent Association put it, people need independence without isolation in order to have a real choice about remaining at home. That is not happening, despite the best endeavours of social services departments, which are facing a crisis in funding.
  Despite all the Minister's bluster, the vast majority of increases to local authorities have been passported to education. West Sussex, my local authority, has left just £400,000 to service social services, transport, highways, the environment and all the other services. We also got another £6,000 recently thanks to the generosity of the Chancellor. This is in a county in which the formula grant per head gives £503 to my constituents, compared with £810 per head in an outer-London borough. It is also in a county in which social services budgets are being stretched between elderly care, child protection and the implications of the Laming report and the forthcoming Children's Bill; these all constitute demands on a dwindling budget.
  The pips have long since given up squeaking, and it is the elderly and vulnerable people who are being squeezed the most, whether in three-star, two-star or no-star authorities. This is a double whammy, because increasingly frustrated and abused care home managers

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  are being over-regulated, under-recompensed, generally put upon and abused constantly by the Minister and his colleagues. As one care home owner put it recently,
  "Everyone is running my business except me."
  There is little correlation between the quality of care in a home and the level of inspections and the hoops that it is put through. One doctor who was recently inspected by the National Care Standards Commission said,
  "I am perfectly happy to be assessed, provided that I feel we are working on the same side, trying to improve the care of patients."
  Far from pursuing a policy of being on the side of those looking after care of the elderly, however, the Government have set themselves on a course of confrontation and bullying with their response in the Community Care (Delayed Discharges Etc.) Act 2003. They are robbing Peter to pay Paul—the antithesis of partnership—undermining years of good work on bringing social services and health care closer together in the interests of patients. Because of the delayed discharges Act, if a patient's first choice of care home is not available, older patients will be offered an interim placement that may be far away from their families and not necessarily appropriate to their care needs. Allyson Pollock, who has been much quoted this evening, has said that that contradicts the Government's pledge to "give genuine individual choices" and that this legislation
  "is targeting really vulnerable people and placing them at greater risk."
  As with so much in new Labour's health service, far too many of the vulnerable among our communities' sick and elderly people are paying the price of a system dominated by bureaucrats not patients. We make no apology for raising this issue again. We do so not as a mouthpiece for care home owners but as a mouthpiece for many elderly constituents who are suffering from the Government's squeeze on social services departments and their obsession with constantly rubbishing care home owners and treating decent care homes on a par with the Lubyanka from whose clutches people must be saved at all costs. That is why we need this debate today. I urge all Members living in the real world, who recognise the problems that we have set out today, to support the motion in the interests of their elderly constituents before they join their ranks.
  6.51 pm
  The Minister of State, Department of Health (Ms Rosie Winterton): As the hon. Member for East Worthing and Shoreham (Tim Loughton) said, this has been a good debate. As the Under-Secretary of State for Health, my hon. Friend the Member for South Thanet (Dr. Ladyman) said in his opening remarks, however, the Opposition, in calling the debate, have started from completely the wrong assumption. As ever, they are living in the past. They assume that the way in which services to old people have been delivered previously is exactly the way in which they should be delivered in the future. That is not what older people want. What older people want and need is a Government who are committed to increasing standards in all sectors for older people, and who are committed to making independence and choice for older people a reality.
  That policy has not come out of thin air. This Government have consulted widely with older people and their representatives, and we know from our
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  consultation—from hard evidence—that as people get older they still have the same aspirations. The vast majority want to stay in their own homes and neighbourhoods as long as possible, and our policy delivers that.
  Let us be clear about the track record of the Conservative party. Under the previous Tory Government, funding to councils for social services rose by just 0.1 per cent. per year between 1992 and 1997. This Government have changed that. We have given councils a real terms increase of 20 per cent. over the last six years, and on average a further 6 per cent. real terms increase this year and until 2006. When the Conservative party left office in 1997, funding of social services was £7 billion. By 2006, that will have increased to £15 billion—a massive investment in services for older people.
  What Labour Members found most shocking, as my hon. Friend the Member for Wakefield (Mr. Hinchliffe) said, was the attitude taken by those on the Opposition Front Bench towards regulation. Thinking about it, however, perhaps we should not be surprised. They opposed the protection given by the national minimum wage, and they opposed the protection of people at work. Now they are opposing the protection of some of the most vulnerable people in our society. We completely reject their attitude towards regulation.
  The speeches from the Opposition Front Bench were in contrast to the rather more thoughtful speeches by the hon. Members for Orpington (Mr. Horam), for Daventry (Mr. Boswell) and for Castle Point (Bob Spink). The hon. Members for Castle Point and for Orpington both raised issues about which they intend to write to my hon. Friend the Under-Secretary, and he has undertaken to examine those issues. I can also assure the hon. Member for Daventry that we will not be massaging figures in the way that he described.
  The hon. Member for Romsey (Sandra Gidley) referred to the royal commission and to free personal care. I should point out that we accepted every single one of the commission's recommendations, but we stressed in our response that personal care for everyone would not in itself guarantee service improvements. We could spend on free personal care the additional £1 billion that we are making available annually for improvements in service delivery, but we do not believe that that is the best use of finite resources. As was pointed out, seven out of 10 older care home residents already have some or all of their personal care costs paid by their local council.
  My hon. Friend the Member for Wakefield made an excellent contribution; I say that not only because of his very perceptive comments about my hon. Friend the Member for South Thanet, but because of his devastating critique of the record of the previous Tory Government. I also congratulate my hon. Friends the Members for Crawley (Laura Moffatt) and for Colne Valley (Kali Mountford) on their contributions. They spoke very eloquently about the need for integration of health and social services, and about rehabilitation services. They showed that the fears that the hon. Member for Banbury (Tony Baldry) expressed about delayed discharges were misplaced.

  369
  The motion before the House is stuck in a view of the past that does not correspond one iota to what older people tell us they want, or, indeed, to what younger people want to look forward to in older age. It is true that each generation expresses higher expectations. We expect an improved standard of living, more choice and better services; that is as true whether one is 35, 55 or 75. That means that we as a Government have to change and to expand the models of care to meet those aspirations.
  This Government reject the concept of a model of care that creates dependency and is too often of low quality. We want high quality care that offers choice and independence. Meeting aspirations inevitably means changing services, and we fully recognise that change can be difficult. But what we have done is to set up a properly regulated system, so that councils and primary care trusts can work with providers to deliver high quality services to older people that meet local needs and reflect local circumstances. That is what local accountability and local democracy are all about.
  Let me remind the House of some of what we have done to make such choice a practical reality. We have set up an £87 million fund for extra care housing. We have made community equipment and intermediate care available free to the individual. We have provided £170 million to enable more people to live at home. And we have committed £70 million to support training for social care staff, many of whom work with older people.
  After years of stagnation and underinvestment under the previous Administration, change is challenging to those delivering services for older people. It is challenging to partnerships, and to those who want to keep on doing what they have always done, in the same way that they have always done it. It is challenging to poor standards of care and to limitations on choice. But the challenge is right and proper, and the Opposition motion does a disservice to older people by continuing to look backwards, rather than seeing the opportunities for the future. As ever, the Opposition have the wrong approach. They want to restrict choice to those who can pay, and to offer nothing to the majority. We believe in giving everyone choice.
  Question put, That the original words stand part of the Question:—
  The House divided: Ayes 200, Noes 334.

  Division No.23]

  [6.59pm

  AYES

  Ainsworth, Peter (E Surrey)

  Bercow, John

  Allan, Richard

  Blunt, Crispin

  Amess, David

  Boswell, Tim

  Ancram, rh Michael

  Brady, Graham

  Arbuthnot, rh James

  Brake, Tom (Carshalton)

  Atkinson, Peter (Hexham)

  Brazier, Julian

  Bacon, Richard

  Breed, Colin

  Baker, Norman

  Brooke, Mrs Annette L.

  Baldry, Tony

  Browning, Mrs Angela

  Barker, Gregory

  Bruce, Malcolm

  Baron, John (Billericay)

  Burns, Simon

  Barrett, John

  Burnside, David

  Beggs, Roy (E Antrim)

  Burstow, Paul

  Beith, rh A. J.

  Burt, Alistair

  Bellingham, Henry

  Butterfill, John

  370

  Cable, Dr. Vincent

  Lamb, Norman

  Calton, Mrs Patsy

  Lansley, Andrew

  Cameron, David

  Laws, David (Yeovil)

  Campbell, Gregory (E Lond'y)

  Leigh, Edward

  Campbell, rh Menzies (NE Fife)

  Letwin, rh Oliver

  Carmichael, Alistair

  Lewis, Dr. Julian (New Forest E)

  Cash, William

  Liddell-Grainger, Ian

  Chidgey, David

  Lidington, David

  Chope, Christopher

  Lilley, rh Peter

  Clappison, James

  LIwyd, Elfyn

  Clifton-Brown, Geoffrey

  Loughton, Tim

  Collins, Tim

  Luff, Peter (M-Worcs)

  Conway, Derek

  McIntosh, Miss Anne

  Cormack, Sir Patrick

  Mackay, rh Andrew

  Cotter, Brian

  Maclean, rh David

  Cran, James (Beverley)

  McLoughlin, Patrick

  Curry, rh David

  Malins, Humfrey

  Davey, Edward (Kingston)

  Maples, John

  Davies, Quentin (Grantham &

  Mates, Michael

  Stamford)

  Maude, rh Francis

  Davis, rh David (Haltemprice &

  May, Mrs Theresa

  Howden)

  Mitchell, Andrew (Sutton

  Djanogly, Jonathan

  Coldfield)

  Donaldson, Jeffrey M.

  Moore, Michael

  Dorrell, rh Stephen

  Moss, Malcolm

  Doughty, Sue

  Murrison, Dr. Andrew

  Duncan, Alan (Rutland)

  Norman, Archie

  Evans, Nigel

  O'Brien, Stephen (Eddisbury)

  Fabricant, Michael

  Osborne, George (Tatton)

  Fallon, Michael

  Ottaway, Richard

  Field, Mark (Cities of London&

  Page, Richard

  Westminster)

  Paice, James

  Flight, Howard

  Paterson, Owen

  Flook, Adrian

  Pickles, Eric

  Forth, rh Eric

  Price, Adam (E Carmarthen&

  Foster, Don (Bath)

  Dinefwr)

  Fox, Dr. Liam

  Prisk, Mark (Hertford)

  Francois, Mark

  Pugh, Dr. John

  Garnier, Edward

  Randall, John

  George, Andrew (St. Ives)

  Redwood, rh John

  Gibb, Nick (Bognor Regis)

  Reid, Alan (Argyll & Bute)

  Gidley, Sandra

  Bendel, David

  Gillan, Mrs Cheryl

  Robathan, Andrew

  Goodman, Paul

  Robertson, Hugh (Faversham &

  Gray, James (N Wilts)

  M-Kent)

  Grayling, Chris

  Robertson, Laurence (Tewk'b'ry)

  Green, Damian (Ashford)

  Robinson, Peter (Belfast E)

  Green, Matthew (Ludlow)

  Roe, Mrs Marion

  Greenway, John

  Rosindell, Andrew

  Grieve, Dominic

  Ruffley, David

  Gummer, rh John

  Russell, Bob (Colchester)

  Hague, rh William

  Sanders, Adrian

  Hammond, Philip

  Selous, Andrew

  Hancock, Mike

  Shephard, rh Mrs Gillian

  Hawkins, Nick

  Shepherd, Richard

  Hayes, John (S Holland)

  Simmonds, Mark

  Heald, Oliver

  Simpson, Keith (M-Norfolk)

  Heath, David

  Smith, Sir Robert (W Ab'd'ns &

  Heathcoat-Amory, rh David

  Kincardine)

  Hoban, Mark (Fareham)

  Smyth, Rev. Martin (Belfast S)

  Hogg, rh Douglas

  Soames, Nicholas

  Holmes, Paul

  Spelman, Mrs Caroline

  Horam, John (Orpington)

  Spicer, Sir Michael

  Hunter, Andrew

  Spink, Bob (Castle Point)

  Jack, rh Michael

  Spring, Richard

  Jenkin, Bernard

  Stanley, rh Sir John

  Jones, Nigel (Cheltenham)

  Steen, Anthony

  Keetch, Paul

  Streeter, Gary

  Kennedy, rh Charles (Ross Skye &

  Stunell, Andrew

  Inverness)

  Swayne, Desmond

  Key, Robert (Salisbury)

  Syms, Robert

  Kirkbride, Miss Julie

  Tapsell, Sir Peter

  Kirkwood, Sir Archy

  Taylor, Ian (Esher)

  Knight, rh Greg (E Yorkshire)

  Taylor, John (Solihull)

  Laing, Mrs Eleanor

  Taylor, Matthew (Truro)

  Lait, Mrs Jacqui

  Taylor, Sir Teddy

  371

  Teather, Sarah

  Widdecombe, rh Miss Ann

  Thomas, Simon (Ceredigion)

  Wiggin, Bill

  Thurso, John

  Wilkinson, John

  Tonge, Dr. Jenny

  Willetts, David

  Tredinnick, David

  Williams, Hywel (Caernarfon)

  Trend, Michael

  Williams, Roger (Brecon)

  Turner, Andrew (Isle of Wight)

  Winterton, Ann (Congleton)

  Tyler, Paul (N Cornwall)

  Winterton, Sir Nicholas

  Tyrie, Andrew

  (Macclesfield)

  Viggers, Peter

  Yeo, Tim (S Suffolk)

  Walter, Robert

  Young, rh Sir George

  Waterson, Nigel

  Younger-Ross, Richard

  Watkinson, Angela

  Tellers for the Ayes:

  Webb, Steve (Northavon)

  Mr. David Wilshire and

  Whittingdale, John

  Mr. Hugo Swire

  NOES

  Abbott, Ms Diane

  Clelland, David

  Adams, Irene (Paisley N)

  Clwyd, Ann (Cynon V)

  Ainger, Nick

  Coffey, Ms Ann

  Ainsworth, Bob (Cov'try NE)

  Cohen, Harry

  Allen, Graham

  Colman, Tony

  Anderson, rh Donald (Swansea E)

  Connarty, Michael

  Armstrong, rh Ms Hilary

  Cook, rh Robin (Livingston)

  Atkins, Charlotte

  Cooper, Yvette

  Austin, John

  Corbyn, Jeremy

  Bailey, Adrian

  Corston, Jean

  Baird, Vera

  Cousins, Jim

  Barnes, Harry

  Cox, Tom (Tooting)

  Barron, rh Kevin

  Cranston, Ross

  Battle, John

  Crausby, David

  Bayley, Hugh

  Cruddas, Jon

  Beard, Nigel

  Cryer, Ann (Keighley)

  Beckett, rh Margaret

  Cryer, John (Hornchurch)

  Begg, Miss Anne

  Cummings, John

  Bell, Stuart

  Cunningham, rh Dr. Jack

  Benn, rh Hilary

  (Copeland)

  Bennett, Andrew

  Cunningham, Jim (Coventry S)

  Benton, Joe (Bootle)

  Cunningham, Tony (Workington)

  Berry, Roger

  Curtis-Thomas, Mrs Claire

  Betts, Clive

  Darling, rh Alistair

  Blackman. Liz

  Davey, Valerie (Bristol W)

  Blears, Ms Hazel

  David, Wayne

  Blizzard, Bob

  Davidson, Ian

  Borrow, David

  Davies, Geraint (Croydon C)

  Bradley, rh Keith (Withington)

  Davis, rh Terry (B'ham Hodge H)

  Bradley, Peter (The Wrekin)

  Dean, Mrs Janet

  Bradshaw, Ben

  Denham, rh John

  Brennan, Kevin

  Dhanda, Parmjit

  Brown, Russell (Dumfries)

  Dismore, Andrew

  Browne, Desmond

  Dobbin, Jim (Heywood)

  Bryant, Chris

  Dobson, rh Frank

  Buck, Ms Karen

  Donohoe, Brian H.

  Burden, Richard

  Doran, Frank

  Burgon, Colin

  Dowd, Jim (Lewisham W)

  Burnham, Andy

  Drew, David (Stroud)

  Cairns, David

  Dunwoody, Mrs Gwyneth

  Campbell, Alan (Tynemouth)

  Eagle, Angela (Wallasey)

  Campbell, Mrs Anne (C'bridge)

  Edwards, Huw

  Campbell, Ronnie (Blyth V)

  Efford, Clive

  Caplin, Ivor

  Ellman, Mrs Louise

  Casale, Roger

  Ennis, Jeff (Barnsley E)

  Caton, Martin

  Farrelly, Paul

  Cawsey, Ian (Brigg)

  Field, rh Frank (Birkenhead)

  Challen, Colin

  Fisher, Mark

  Chapman, Ben (Wirral S)

  Fitzpatrick, Jim

  Chaytor, David

  Flint Caroline

  Clapham, Michael

  Foster, rh Derek

  Clark, Mrs Helen (Peterborough)

  Foster, Michael (Worcester)

  Clark, Dr. Lynda (Edinburgh

  Foster, Michael Jabez (Hastings

  Pentlands)

  & Rye)

  Clarke, rh Charles (Norwich S)

  Foulkes, rh George

  Clarke, rh Tom (Coatbridge &

  Francis, Dr. Hywel

  Chryston)

  Gapes, Mike (Ilford S)

  Clarke, Tony (Northampton S)

  George, rh Bruce (Walsall S)

  372

  Gerrard, Neil

  Lucas, Ian (Wrexham)

  Gibson, Dr. Ian

  Lyons, John (Strathkelvin)

  Gilroy, Linda

  McAvoy, Thomas

  Godsiff, Roger

  McCabe, Stephen

  Goggins, Paul

  McCartney, rh Ian

  Griffiths, Nigel (Edinburgh S)

  McDonagh, Siobhain

  Grogan, John

  MacDonald, Calum

  Hain, rh Peter

  McDonnell, John

  Hall, Mike (Weaver Vale)

  MacDougall, John

  Hall, Patrick (Bedford)

  McFall, John

  Hamilton, David (Midlothian)

  McGuire, Mrs Anne

  Hamilton, Fabian (Leeds NE)

  Mcisaac, Shona

  Hanson, David

  McKechin, Ann

  Harman, rh Ms Harriet

  Mackinlay, Andrew

  Harris, Tom (Glasgow Cathcart)

  McNamara, Kevin

  Healey, John

  McNulty, Tony

  Henderson, Doug (Newcastle N)

  Mactaggart, Fiona

  Hendrick, Mark

  McWalter, Tony

  Hepburn, Stephen

  McWilliam, John

  Heppell, John

  Mahmood, Khalid

  Hermon, Lady

  Mallaber, Judy

  Heyes, David

  Mandelson, rh Peter

  Hill, Keith (Streatham)

  Mann, John (Bassetlaw)

  Hinchliffe, David

  Marris, Rob (VVolverh'ton SW)

  Hood, Jimmy (Clydesdale)

  Marsden, Gordon (Blackpool S)

  Hope, Phil (Corby)

  Marshall, David (Glasgow

  Hopkins, Kelvin

  Shettleston)

  Howarth, rh Alan (Newport E)

  Marshall, Jim (Leicester S)

  Howarth, George (Knowsley N &

  Marshall-Andrews, Robert

  Sefton E)

  Martlew, Eric

  Howells, Dr. Kim

  Merron, Gillian

  Hughes, Beverley (Stretford &

  Michael, rh Alun

  Urmston

  Miliband, David

  Hughes, Kevin (Doncaster N)

  Miller, Andrew

  Humble, Mrs Joan

  Mitchell, Austin (Gt Grimsby)

  Hurst Alan (Braintree

  Moffatt, Laura

  Hutton, rh John

  Mole, Chris

  Iddon, Dr. Brian

  Moran, Margaret

  Illsley, Eric

  Morgan, Julie

  Irranca-Davies, Huw

  Morley, Elliot

  Jackson, Helen (Hillsborough)

  Morris, rh Estelle

  Jamieson, David

  Mountford, Kali

  Jenkins, Brian

  Mudie, George

  Johnson, Alan (Hull W)

  Mullin, Chris

  Jones, Helen (Warrington N)

  Munn, Ms Meg

  Jones, Jon Owen (Cardiff C)

  Murphy, Denis (Wansbeck)

  Jones, Kevan (N Durham)

  Murphy, Jim (Eastwood)

  Jones, Lynne (Selly Oak)

  Naysmith, Dr. Doug

  Jones, Martyn (Clwyd S)

  O'Brien, Bill (Normanton)

  Jowell, rh Tessa

  O'Hara, Edward

  Joyce, Eric (Falkirk W)

  Olner, Bill

  Keeble, Ms Sally

  O'Neill, Martin

  Keen, Alan (Feltham)

  Organ, Diana

  Keen, Ann (Brentford)

  Palmer, Dr. Nick

  Kemp, Fraser

  Perham, Linda

  Khabra, Piara S.

  Picking, Anne

  Kidney, David

  Pickthall, Colin

  Kilfoyle, Peter

  Pike, Peter (Burnley)

  King, Andy (Rugby)

  Plaskitt, James

  King, Ms Oona (Bethnal Green &

  Pollard, Kerry

  Bow)

  Pond, Chris (Gravesham)

  Knight, Jim (S Dorset)

  Pope, Greg (Hyndburn)

  Kumar, Dr. Ashok

  Pound, Stephen

  Ladyman, Dr. Stephen

  Prentice, Ms Bridget (Lewisham

  Lammy, David

  E)

  Lawrence, Mrs Jackie

  Prescott, rh John

  Laxton, Bob (Derby N)

  Primarolo, rh Dawn

  Lazarowicz, Mark

  Prosser, Gwyn

  Lepper, David

  Purchase, Ken

  Leslie, Christopher

  Purnell, James

  Levitt, Tom (High Peak)

  Quin, rh Joyce

  Lewis, Ivan (Bury S)

  Quinn, Lawrie

  Liddell, rh Mrs Helen

  Rapson, Syd (Portsmouth N)

  Linton, Martin

  Raynsford, rh Nick

  Lloyd, Tony (Manchester C)

  Reed, Andy (Loughborough)

  Love, Andrew

  Stringer, Graham

  373

  Reid, rh Dr. John (Hamilton N &

  Stuart, Ms Gisela

  Bellshill)

  Tami, Mark (Alyn)

  Robertson, John (Glasgow

  Taylor, rh Ann (Dewsbury)

  Anniesland)

  Taylor, Dan (Stockton S)

  Robinson, Geoffrey (Coventry

  Taylor, David (NW Leics)

  NW)

  Thomas, Gareth (Clwyd W)

  Roche, Mrs Barbara

  Thomas, Gareth (Harrow W)

  Rooney, Terry

  Timms, Stephen

  Ross, Ernie (Dundee W)

  Tipping, Paddy

  Roy, Frank (Motherwell)

  Todd, Mark (S Derbyshire)

  Ruane, Chris

  Touhig, Don (Islwyn)

  Ruddock, Joan

  Trickett, Jon

  Russell, Ms Christine (City of

  Truswell, Paul

  Chester)

  Turner, Dennis (Wolverh'ton SE)

  Ryan, Joan (Enfield N)

  Turner, Dr. Desmond (Brighton

  Salter, Martin

  Kemptown)

  Sarwar, Mohammad

  Turner, Neil (Wigan)

  Savidge, Malcolm

  Twigg, Derek (Halton)

  Sawford, Phil

  Tynan, Bill (Hamilton S)

  Sedgemore, Brian

  Vis, Dr. Rudi

  Shaw, Jonathan

  Walley, Ms Joan

  Sheerman, Barry

  Ward, Claire

  Sheridan, Jim

  Wareing, Robert N.

  Simon, Siôn (B'ham Erdington)

  Watson, Tom (W Bromwich E)

  Simpson, Alan (Nottingham S)

  Watts, David

  Skinner, Dennis

  White, Brian

  Smith, rh Andrew (Oxford E)

  Whitehead, Dr. Alan

  Smith, Geraldine (Morecambe &

  Wicks, Malcolm

  Lunesdale)

  Williams, rh Alan (Swansea W)

  Smith, Jacqui (Redditch)

  Williams, Betty (Conwy)

  Smith, John (Glamorgan)

  Wills, Michael

  Smith, Llew (Blaenau Gwent)

  Winnick, David

  Soley, Clive

  Winterton, Ms Rosie (Doncaster

  Southworth, Helen

  C)

  Squire, Rachel

  Woodward, Shaun

  Starkey, Dr. Phyllis

  Worthington, Tony

  Stevenson, George

  Wright, David (Telford)

  Stewart, David (Inverness E &

  Wright, Tony (Cannock)

  Lochaber)

  Wyatt, Derek

  Stewart, Ian (Eccles)

  Stinchcombe, Paul

  Tellers for the Noes:

  Stoate, Dr. Howard

  Paul Clark and

  Strang, rh Dr. Gavin

  Vernon Coaker

  Straw, rh Jack

  Question accordingly negatived.
  Question, That the proposed words be there added. put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to.
  MADAM DEPUTY SPEAKER forthwith declared the main Question, as amended, to be agreed to.
  Resolved,
  That this House welcomes the real terms increase in social services funding of 20 per cent. between 1997 and 2003, and the commitment to continue these increases by an annual 6 per cent. in real terms from this financial year to 2005–06; notes that councils are able to use these resources to increase fees they pay to care homes where they think necessary, with 2002–03 figures showing 56 per cent. of local councils in England and Wales increasing the fees they pay by at least 5 per cent; notes that the Laing & Buisson Care of Elderly People Market Survey published in July 2003 puts bed capacity in care homes from all sectors at 470,000 with demand estimated to be around 460,000; further notes that over 80 per cent. of older people say they want to live independently in their own homes for as long as possible; supports the Government's policy of improving choice by providing alternatives to residential care with 20,900 more households since 1998 receiving intensive home care packages, 143,200 additional people receiving intermediate care services since 1999, and a cash injection of £87 million to be spent on creating 1,500 new extra care housing places by 2006; and further supports the Government's policy of driving up care standards where the care is delivered and ensuring that older people are not held unnecessarily in acute hospital beds when their care needs can be better met elsewhere.

  Regional Broadcasting
  Motion made, and Question proposed, That this House do now adjourn.—[Jim Fitzpatrick.]
  7.15 pm
  Mr. John Denham: I am extremely grateful for the opportunity to raise concerns about the decision by Granada-Carlton, the new single ITV, to run down Meridian television, which is based in Northam in my constituency. With your permission, Madam Deputy Speaker, I shall try to allow other hon. Members to contribute to the debate.
  Before Christmas, Meridian announced 175 job losses. Its plans include the closure of the Northam studios and relocation to Fareham, the closure of the Maidstone studio, the winding up of the successful teams, which covered, for example, the recent rugby World cup and ocean racing, and a major restructuring of the most successful of the regional ITV news services.
  In part, I want to express local but important constituency concerns, but I also want to raise the implications of what Meridian is doing for the entire new ITV. The managing director of Meridian said that its plans are a blueprint for the rest of the new single ITV. If so, my right hon. Friend the Minister needs to recognise that there are major implications for regional independent television and serious challenges from the outset for Ofcom and the new regulatory regime.
  The contrast between the promises made to Meridian staff at the time of its take over by Granada and what is happening now should make everyone who is concerned about ITV cautious about relying on promises or assurances that its management might give. I hope that the Minister will note that, too. Of course some change is inevitable, especially in a highly technology-dependent and sensitive business. I understand that there is probably no real business case for large outdated studios of the sort at Northam in Southampton, but, although change is inevitable, that does not mean that we should not consider what is proposed carefully.
  I pay tribute to all the people who have worked at Northam over the years, not just under Meridian, but under TVS and Southern Television too, and who created programmes that will be familiar to hon. Members, such as "How?", "Worzel Gummidge", "Out of Town", the "Ruth Rendell Mysteries", "Village Voices", "Spotlight", "That's Life" and many other programmes, both regional and national, including sport, most recently the World cup.
  Southampton as a city has gained enormously in profile and prestige from being the main home for both BBC South and ITV for a long time. In the 1980s, the then Labour council fought a hard battle to keep BBC Television in Southampton, for which we have been well rewarded. It is a shame that the new Liberal Democrat council, despite its efforts, has not been more successful in keeping Meridian in the city.
  The south-east does not have a simple, clear regional identity, such as the south-west or the north-east, but neither are we a glorified suburb of London. The southeast has the most successful regional economy. We have distinct counties, sub-regions and communities. We

  375
  have our own sporting, cultural and artistic traditions. We have unique cities, towns, villages, countryside and coastal areas.
  The south-east should be reflected to its residents, to the country as a whole and to the wider world through good regional broadcasting.
  Bob Spink: Is the right hon. Gentleman aware that the region also includes people in my constituency in south Essex and in the constituency of the hon. Member for Thurrock (Andrew Mackinlay), who is in the Chamber nodding in agreement that our constituents would be impoverished by the proposals and that we should do everything we can to retain those facilities in Southampton?
  Mr. Denham: I am grateful to the hon. Gentleman for that intervention. People watching these proceedings on television may realise that there are far more hon. Members on both sides of the House than is normally the case for the end-of-sitting Adjournment debate. I hope that my right hon. Friend the Minister will recognise the concern that is being expressed in the Chamber.
  In the south-east, we also want our fair share—or, to be frank, a larger share if possible—of television production and its related creative industries in our region. The past two years and the current proposals suggest that responsibility for regional broadcasting is about to pass almost entirely to the BBC. First, there was the national deal with the Independent Television Commission, which cut regional programme slots from 15 to eight and a half hours a week—much of that can hardly be described as regional programming. Not long ago, budgets at Meridian were cut from between £20,000 and £25,000 for a half-hour slot to between £5,000 and £12,000 and I understand that the figure may fall further. Now, we learn that half the staff at Meridian are to go.
  What a contrast to the promises made by Charles Allen, then chairman of Granada, and Steve Morrison, its managing director, when they took over the company. I have been given what I believe are genuine and reliable transcripts of their presentation to staff. Mr. Allen, currently head of the new ITV, said:
  "The first thing is that we are absolutely passionate about regionalism. Regionalism is absolutely the heart of everything we do…we didn't spend £1.75 billion not to grow this business. You don't buy a company of this scale with this level of talent not to listen to them"—
  the staff—
  "you are now part of a much bigger operation…where particularly production plays a key part".
  Mr. Morrison told staff:
  "And to echo what Charles said, we are not in the business of contraction, we are in the business of expansion. What we want to see is more production more play coming from this studio site and indeed, you know, your other satellites than you already do… You've developed over the years a capability in certain types of programmes. And, you know, nationally important programmes, like your Dispatches are well recognised. And the issue for us is how do you build that up."
  "Absolutely passionate about regionalism", "the business of expansion", "more production coming from this and our other sites": what a contrast with the
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  closure and contraction currently facing Meridian. It is not surprising that many people working for Meridian feel badly let down.
  I know that Ministers cannot be responsible for what business executives tell their staff during company takeovers. However, the issue is not just the development of any old private business; it relates directly to the future of Channel 3, to the public service broadcasting obligations of ITV and to the development of one of the UK's major industries—television production. Those should be of concern to my right hon. Friend the Minister and I hope that she will take note that it would be dangerous to rely too much on the promises and assurances that might be given to her and others by the people now running ITV. Meridian staff did just that, and look what is happening to them.
  The truth is that the drive for a narrow interpretation of shareholder value in ITV is leading to the same short-term drive to maximise profit at the expense of the long-term investment in and development of the business as has been seen in other major companies in the US and the UK over the past few years. Even the much-vaunted new investment in the new studio looks likely to cost less than the money that will be made by selling the Northam site. I believe that one of the consequences will be a sharp decline in Meridian's ability to make regional programmes—whether we are talking about programmes about the region for the region, programmes about the region for the network, or the ability to make a wide range of programmes designed specifically for the network.
  Indeed, I fear that the impact may well be wider than Meridian itself. Of course, national or international sports coverage, a particular area of expertise in the Meridian company in Southampton, need not be based in Southampton or any other specific UK location; but the concentration of media skills in regional centres sustains the whole industry in that area. It is the pool of talent that supports independent programme-makers and the BBC, works with academic institutions and assists new local broadcasters.
  Let me say in fairness that I know Meridian does not intend—or says it does not intend—to turn its back on all those links, and wants to develop new links. Nevertheless, I believe that a sharp reduction in television employment such as the one that is proposed, and the loss of skills that that will involve, is bound to have a wider impact on the health of the television industry in the south. We have been told that Meridian is the model for the rest of the new ITV. If that is so, it means stripping out serious regional programme-making in ITV and also encouraging a decline in the strength of the regional television industry as a whole.
  I am also concerned about news coverage. It may well be possible, with new technology, to organise and deliver news coverage more efficiently and effectively than is the case at present, but it is pretty clear that the current proposals are driven primarily by a wish to cut costs rather than by an analysis of the best ways—including the most efficient ways—of delivering a news service in the future.
  Meridian is unusually successful as an independent television news service. Maidstone has regularly achieved ratings as high as 50 per cent., while Granada

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  usually achieves about 12 per cent. The outlets in Southampton and Newbury regularly secure about 30 per cent.—much more than many other ITV regional news programmes. I would say at the very least that altering the current arrangements, which are so successful, without really good justification based on an analysis of the best way of serving the public rather than an analysis of the best way of saving money, is a strange way of going about things.
  I have not been able to confirm this, but I have been told that the original announcement of job losses was not covered by Meridian's regional news. That is surely unusual; would it have happened if any other company was to lose 175 jobs?
  Moreover, is the regional political coverage that Members of Parliament enjoy safe? It is easy to understand that a single ITV company might want to save money on its political coverage, but I suggest that that would be at the expense of the local knowledge that makes regional news and regional political coverage worth having.
  These changes are happening just as the new regulator, Ofcom, comes into existence. I shall end by raising some issues that should be of direct concern to the Minister: that constitutes an invitation to Members who may wish to intervene. Let me say that, as the Government move towards statutory consultation rights for UK employees, I hope the Minister shares my distaste for the way in which Granada apparently went off to the ITC to secure support for its proposals before informing any of its staff.
  Mr. Mike Hancock: I agree that Ministers cannot be responsible for what Meridian told its staff, but surely they are responsible for what Meridian told its viewers about the retention and building up of a regional dimension in its programming. That is manifestly lacking in the proposals as we see them.
  Mr. Denham: The hon. Gentleman raises an important issue relating to, in particular, the new role of the new regulator. It brings me to my second point: the changes are taking place before Ofcom has decided how to interpret its requirements for regional production quotas and expenditure outside the M25. Ofcom recently wrote to me
  "We will be considering how this requirement will be interpreted and are establishing arrangements to gather the necessary data for ITV to demonstrate that there is a reasonable geographic spread in the sourcing of network programmes."
  That requirement was a key element of the Communications Act 2003. It seems that, by presenting a fait accompli at Meridian, the new ITV will effectively set its own baseline for Ofcom and reduce Ofcom's scope to set a challenging interpretation of those regulations.
  I should be grateful if my right hon. Friend the Minister would respond directly on whether the reduction in Meridian's programme-making capacity can be held back until Ofcom has decided how to approach the issue. If that can be done, will she use every power that she has, either legally or by persuasion, to
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  ask for that to be done? At the very least, it would be much better if the issue were looked at when those at Ofcom have got their feet under the table and have worked out how to approach the issue, which would ensure that it is considered properly.
  Norman Baker: The right hon. Gentleman is making a very good case. Does he agree that the transmission of local news for Sussex and Kent from a base in Hampshire, following the closure of any Maidstone outlet, will be detrimental to people in Sussex and Kent and that such news cannot possibly be of the same quality? More importantly, is this not the thin end of the wedge? If Granada gets away with that closure strategy without intervention from Ofcom or the Government, it will be repeated throughout the country.
  Mr. Denham: We have already been promised that what is being done in Meridian is the model for the whole of the rest of the ITV network. That is what we seem to have been told, and those are the risks. As I said earlier, I can accept that there may be different, better and less expensive ways to organise the way in which news is delivered, but I am pretty clear that these proposals have been driven by a desire not to improve, but to cut the cost of the news service, so my hon. Friend is right, as I hope that other hon. Members and I are, to express those concerns about the risks that are involved.
  A couple of colleagues wish to speak briefly in their own right, so I will conclude my remarks. I hope that everyone will recognise how many hon. Members have attended the debate. This is a matter of great concern. Unusually, while it is a big issue for my constituency, this Adjournment debate is of national significance. What happens in the south-east will have repercussions throughout the United Kingdom, and the fact that hon. Members from Northern Ireland and Scotland are present reflects that interest.
  7.32 pm
  Mr. Derek Wyatt: I congratulate my right hon. Friend the Member for Southampton, Itchen (Mr. Denham) on putting such a strong case, and I associate myself with all that he has said.
  I raised this issue first with the Select Committee on Culture, Media and Sport, and our report will be out shortly. Although I cannot say whether this will definitely be in the report, there is one thing that we will ask: will Ofcom please handle the issue in the open? In other words, when it takes evidence from Meridian, the National Union of Journalists chapels and other people, will it do so in the public domain, not behind closed doors? That is something about which the Minister might have a view.
  In the 1960s, a famous chairman of Anglia Television—once a very great company—said that ITV was a licence to print money, and it wants to get back to exactly that. The Carlton merger will benefit senior management, not the viewers. I am told that two things were on the agenda at a recent senior management away day—one was something about communicating the changes and the other was to ramp up the share price.
  Let me deal with the communications bit. The first thing is that there was a leak, which shows how good that management is. There was no communication with

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  the staff, the workers, the producers or anyone. The proposal came out of the blue, from left field. Those involved are running to catch up, which is what happens. Secondly, I ought to congratulate not just my constituents who raised the issue with me, but the NUJ chapel at Maidstone, which has been absolutely fantastic. I congratulate the chapel on its efforts.
  Why would anyone want to reduce the service to ramp up the share price? People would only want to do that for two reasons: first, to reward senior management and, secondly, to make the company attractive to a buyer. They are the only two reasons, and they do not serve the population and the viewers. I am a moderniser and I understand modernisation issues, but once Maidstone has been stripped out, the local journalists will be stripped out, even those with cars, laptops and digital cameras. Within three years, if the company has not been sold already, the political correspondents will be stripped out. Look at what has happened with the political correspondents in Parliament. In fact, there will be no local service, no local knowledge—no local anything—and certainly nothing regional. That is what the company wants to happen.
  ITV2 could have been the regional option for ITV, but it is not. ITV2 has a budget of just £1 million for original programming. The situation is crazy and a disaster because there was a chance to use the channel for regional programmes. I hope that the Minister will be persuaded that the BBC charter review could give a regional channel, as part of the public sector service review, to take the place of ITV. The situation is appalling, so I am grateful for the few minutes that I have had to make my case.
  7.34 pm
  Jonathan Shaw: I, too, congratulate my right hon. Friend the Member for Southampton, Itchen (Mr. Denham) on securing this important debate. The Meridian studios in Maidstone are located in my constituency and "Meridian Tonight", which covers both Kent and Sussex, has the highest ratings of any regional news programme in the country. My right hon. Friend cited a ratings figure of 50 per cent. Meridian has reached that figure and is talking about improving on that record, which I hope it does. However, for the reasons set out by my right hon. Friend, many of us have a jaundiced view about whether the figure will be breached. Many ITV companies throughout the country would look enviously on the successful regional news programme's record and we should not forget the advertising revenue that it brings to the company. The BBC recently moved its south-east operation from London to set up a dedicated news programme covering Kent and Sussex in response to Meridian's lion's share of the audience viewing figures.
  Although Meridian's studios are in my constituency, we are not wedded to buildings and there is not necessarily a question of whether the building will remain. However, the location and quality of the staff who produce such an excellent programme cannot be dismissed because that infrastructure has been built up over many years.
  We are greatly concerned about the mixed messages that have come from Meridian. Mr. Clive Jones, its managing director, recently told the Select Committee on Culture. Media and Sport:
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  "We are not proposing to diminish the number of journalists at all. All we are talking about is moving a presenter and maybe a technical director. The journalists will stay…the reporters will stay".
  Tim Suter of Ofcom said a similar thing in response to a representative of the National Union of Journalists. He said:
  "Colleagues here and in the south region have been given detailed information that the reporting staff in the South-East will remain at its present strength, as will the camera teams."
  In reality, however, both presenters will be based in Hampshire. The sports presenters will be based in Hampshire, so there will be no one in Kent or Sussex to cover sport, and the sports job in Maidstone is being axed. Only two out of seven production journalists will remain in Kent, the size of the news desk will be reduced from three people to one and one reporter's job will be lost. Perhaps it is not surprising that today's edition of The Guardian says that the head of ITV news is considering quitting. Ofcom must take a robust line, as the Prime Minister said to me a couple of months ago when the proposals came out. We want a robust response from the Minister.
  7.38 pm
  The Minister for the Arts (Estelle Morris): I apologise for the fact that I have only eight minutes in which to reply, but I wanted to give hon. Members as much time as possible to speak on what I know is an important regional issue. Every Member of Parliament understands the importance of regional media coverage. Indeed, I understood that importance better as an MP than as someone who was not especially actively involved in politics. I know that many issues that we raise on behalf of our constituents would never get back to them if it were not for regional broadcasting and journalism. Our constituents, as citizens, have the right to have their concerns raised here, so we need a channel of communication between this place and their homes to ensure that they know that we are acting on their behalf. I understand the anger that I sense and—without prejudging the issue—the feeling among hon. Members that they have been let down. It is for Meridian and hon. Members to talk about that, but I understand the strength of feeling and know what an important local issue we are debating. The irony, as my right hon. Friend the Member for Southampton, Itchen (Mr. Denham) said, is that, having set up a framework and given the regulators the power to act, there is very little that the Government can do at this time. I therefore want to make a robust response, as hon. Members asked me to do, and make a few observations.
  It does not matter whether it is Meridian or any other employer, it makes good sense and is good management to let people know that their jobs are at risk before telling the outside world. It is only humane to treat individuals in that way, and if that did not happen in this case, that is regrettable.
  Mr. John Redwood Mr. John Redwood (Wokingham)(Con)rose—
  Estelle Morris: I will give way on this occasion, but shall not do so again, as I have very little time.
  Mr. Redwood: I am grateful to the Minister, as I did not get the chance to make a speech. Is she happy with

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  the autopilot system set up by the Competition Commission and Ofcom, given the tragedy that is unfolding?
  Estelle Morris: Yes, I am. However, this may be a test case, and I expect Ofcom to act strongly, as I shall explain.
  The Communications Act 2003 has given extra protection to regional broadcasters. There is a framework of licences for regional programming and production, and the test will be whether Ofcom, the regulatory body, acts firmly if the terms of those licences are not adhered to. Having listened to right hon. and hon. Members, I believe that there are two particularly important issues. It is not appropriate for me to comment on one of them because the time to do so has passed. As my right hon. Friend the Member for Southampton, Itchen said, the target or quota for programming used to be higher. There is now a quota of eight and a half hours for regional programming, and there is also a quota for sub-regional news coverage. Ofcom must ensure that those targets are adhered to, but it cannot intervene in respect of a quota that has been changed by agreement with the Independent Television Commission from 15 hours to eight hours. We have set a lot of store by Ofcom's regulations, but the time to comment on them has passed. Whether they are right or wrong, good or bad, and whether the ITC could have come to a different agreement, the time for comment has passed. However, the licence clearly says that Meridian has undertaken to produce eight and half hours of regional programmes, five and a half hours of which must be sub-regional news and three hours non-news. Ninety per cent. of those programmes must be made in the region, because that is one of the quotas in the framework.
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  Ofcom is considering representations that it has received. If it is thought necessary, it could act to make sure that Meridian keeps to the terms of its licence. The bottom line is that those quotas or targets are in Meridian's licence, and I expect Ofcom to act to make sure that they are preserved. Members from all political parties must surely agree about that. The Government are trying to pull off the trick of giving companies flexibility and freedom to meet the competitive challenges that they face, to make changes to adapt to new technology and digital broadcasting, and to reorganise personnel as times change. Nobody wants things to stand still. My right hon. Friend generously said that Meridian, like any other company needs, from time to time, to make changes. As a media business, it needs to act quickly. No one wants to go back to the days when, to make change to, for example, patterns of employment, companies had to seek permission and jump a series of hurdles imposed by the ITC, Ofcom and the Government. Nobody wants to let that happen again.
  There is clearly a deal to be struck. If companies are to have the freedom that they need and want, we must make sure that Ofcom is empowered to act ferociously if they break the terms of their licence. This is a test case. The time to discuss whether the terms of the licence are sufficient to protect regional broadcasting has passed, but my robust message to the House is that I expect Ofcom to monitor the terms of licences and to take action if they are broken. I apologise for not answering all the questions asked by hon. Members, but I accept the importance of this debate. I can assure them that the Government will monitor what happens as far as possible. If things do not go as expected, we will have reason to comment in future.
  Question put and agreed to.
  Adjourned accordingly at fifteen minutes to Eight o'clock.

Preamble
[MR. FRANK COOK in the Chair]

Service Families (Schools)
Motion made, and Question proposed, That the sitting be now adjourned.—[Jim Fitzpatrick.]
9.30 am
Mr. David Cameron: I am delighted to have the opportunity to raise this subject and to introduce this short debate. I welcome the Minister as I am glad that a Minister of State will respond to the debate.
All hon. Members say how much we value our armed forces, and we all mean it. They do a magnificent job for our country and security, and we should be very proud of what they do. However, we also have a duty to turn those words into action. When we have an opportunity to ensure that our armed forces can lead happy and contented family lives, we should do something about it. The issue before us today provides one such opportunity.
The recent war in Iraq and the continued risks that our servicemen take on our behalf make the debate even more relevant. I am delighted to see my hon. Friend the Member for New Forest, West (Mr. Swayne) in his place, back from Iraq. We have all seen the television pictures of servicemen who died in combat being flown into RAF Brize Norton. Those pictures should reinforce the sense of debt that we owe.
I hope that the debate will range widely. The issue affects many parts of the country, and it is good to see so many hon. Members present. My focus will be relatively narrow. RAF Brize Norton, the country's most important air base, lies in my constituency.
Mr. James Gray: I think that my hon. Friend will acknowledge that RAF Lyneham, which is in my constituency, is the most important RAF base in the UK at the moment, unless the Government choose to move our Hercules planes to Brize Norton, in which case his local base may achieve slightly more importance than it has currently.
Mr. Cameron: In making that reference, I was just checking to see whether my hon. Friend was as alert and alive as I hoped he was. However, to many of us, RAF Brize Norton is the country's most important air base. It is already very big and, as he said, it may be about to get bigger. The possible closure of RAF Lyneham could see the relocation of many hundreds of servicemen and women and their families to Brize Norton by 2012.
The neighbouring town of Carterton, also in my constituency, is very much an RAF town. Its schools are closely linked to the RAF and educate many children from armed forces families. Those schools brought this issue to my attention, and I pay tribute to their work. My message is relatively simple: schools with a high proportion of children from forces families face particular issues and problems. The problems are chiefly
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associated with the high turnover of pupils and the costs that that entails—what I shall call "turbulence" and I believe the Minister will call "mobility". There are further pressures and costs when the parents of the children are sent overseas or into action.
The problems have, if anything, been getting more severe in recent years, not least because our armed forces have been involved in so many overseas actions. There is, as all hon. Members know, a high degree of overstretch in our armed forces. We are trying to do more with less in our armed forces, which has consequences for those left at home.
To put it simply, we need national recognition of the issues and problems and, more important, action to deal with them. Ensuring that the children of service personnel have a good education is in all our interests. It involves not only the Department for Education and Skills, but the Ministry of Defence. Problems with schools and family unhappiness can be a major cause of talented professionals leaving our armed services. We must ensure that that does not happen.
There are two types of service school. The first type is run by the agency, Service Children's Education—the SCE—in overseas countries specifically for the benefit of families stationed away from home. As I am sure the Minister will say and as hon. Members are aware, schools run by the SCE achieve extremely good results. Indeed, if it were an education authority, it would rank as one of the best in the country.
The second type is made up of the normal schools that are run by local education authorities in England for both service and non-service children. I shall focus today on that type. Before dealing with the position in my constituency, I want to make a point about statistics. The House of Commons Library tells me that there are 208,000 regular service personnel in the UK armed forces. However, it is much more difficult to find accurate statistics covering issues such as the number of forces schools in the UK and the proportion of forces children in those schools.
There even seems to be disagreement about the number of children of people serving in the armed forces. In his Adjournment debate in 1999, the hon. Member for Colchester (Bob Russell), who is present, said that there were 85,000, but the then Under-Secretary of State for Education and Employment, who is now the Minister for Industry and the Regions, said that there were 185,000. It would be useful if this Minister, perhaps not today but later, could give us clear statistics on that point. In addition, neither the SCE nor the Defence Analytical Services Agency was able to provide meaningful figures. I look forward to the Minister putting that right.
The situation at RAF Brize Norton and at Carterton is as follows: there are four well established primary schools with rolls ranging from 180 at St. Joseph's to 300 at the Carterton primary and the Edith Moorhouse primary school. The percentage of pupils from armed forces families ranges from 30 per cent. at St. Joseph's to more than 80 per cent. at the Gateway primary school. There is also a new primary school, St. John's, with just 100 pupils. The secondary school, Carterton community college, has more than 750 pupils with 20 per cent. of them from forces families. The numbers and percentages can vary widely, which is the nature of the problem.

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At the nub of the matter is the question of why a high proportion of children with a forces background leads to problems. The main reason is the high turnover of pupils, also referred to as turbulence, which owes something to the RAF connection, as I said earlier. The percentage of pupils arriving and leaving within an existing year ranges in the schools from 20 per cent. to 75 per cent. Last year, in the Gateway school, which I visited recently, there was a 45 per cent. turnover of pupils who had arrived after the school year had begun and left before the end of that year. That is far and away above anything experienced by a standard primary school in a town or village; it means that half the school arrive and leave each year within the year.
Such a vast turnover of nearly half the school makes it impossible to maintain continuity in any section of a school's life, and that makes teaching and planning a much harder prospect than would be the case in a standard primary school. There are different elements to that turbulence. First, the numbers arriving and leaving within a year are rarely the same, and different years and classes are affected. The numbers are unpredicted and wholly unpredictable. Secondly, turbulence can lead to large changes in overall pupil numbers; school rolls can rise and fall dramatically. For example, the Gateway school had an average roll for the years 1999 to 2002 of 312 pupils, then suddenly, in 2003, the roll fell by 50 pupils to 262. That was not because of poor results or parental choice, but because of movement of the armed forces, which is out of the control of the school.
The unpredictable nature of the turbulence can, with little warning, leave schools either over or understaffed, which has a great knock-on effect on budgets. Once an experienced professional has been laid off due to low school numbers, it is no simple task to replace them when the roll increases again. That is particularly true in the south of England where many head teachers tell me that they when they advertise for a new teacher, they get only two or three responses.
Thirdly, there may be a large number of what are called ghost pupils, who arrive and leave within the same year. If they arrive after the vital counting date, which in most cases is 16 January, and then leave before the end of the year, the school gets no additional funding for those pupils. I hope that the Minister will take note of that point.
Mr. Gray: Is my hon. Friend aware of a secondary problem? For security reasons, some parents are reluctant to allow their children to declare themselves at school to be from service families. For example, in Wiltshire, the reported number of children from service families is lower than the actual number.
Mr. Cameron: That is an extremely good point. It is one reason why the statistics are not as up to the mark as they should be. Perhaps the Minister will have something to say about that, too.
On the subject of ghost pupils, at the Gateway school last year, 10 pupils arrived after 16 January 2003 and left before 16 January 2004. As far as the funding is concerned, they never existed. That represented £15,000 of lost funding, yet all those children had to be
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integrated into the school, plans had to be written for them, reports compiled, and teaching and marking undertaken, to say nothing of everything else that a school does. Of course, other schools have to cope with ghost pupils, but not on that scale.
Fourthly, there is the issue of children coming from forces schools abroad. Many come from Germany, Cyprus or other bases. Some of them will not have been taught the national curriculum and those that have special needs may have had different provision in schools overseas. In some cases, there will have been much better provision for them; the head teacher at the Carterton primary school gave me an example of someone who had fantastic special needs attention through the SCE, but the school in Carterton did not have the necessary resources to provide it.
Mr. Desmond Swayne: Clearly the SCE schools will be subject to exactly the same pressures as my hon. Friend has described, but they seem to do well. Their results are higher than the national average. Does he think that that might have something to do with the funding? Some 13,000 pupils are being educated in SCE schools at a total operating cost last year of £75 million. That works out at slightly under £6,000 per pupil. That might partly explain why they are doing quite well.
Mr. Cameron: My hon. and gallant Friend makes a good point. There are clearly good results in the SCE. Funding probably has something to do with it, but there may be other reasons too. We give the extra funding to the SCE because we recognise the special role that the forces play and the difficulty of being posted overseas. My argument is more about the schools back at home. It is important that they are adequately funded so that we can give pupils the support that they clearly need.
The turbulence in pupil numbers can lead to a number of other problems. It becomes more difficult for teachers to set targets. If there is a high turnover of pupils, is target setting the right thing for teachers to do when they will have to work so hard to integrate the new pupils into each class? In addition to the work required to update targets, more time is needed for report writing. As children come and go, teachers will spend a lot of time showing parents and children around their schools. There is an increase in record keeping and in the myriad of documentation that now surrounds every school.
There is also an issue with benchmarking. That point was raised in a debate here in 1999 with particular reference to the work of Dr. Janet Dobson of University College London. She was quoted as saying:
"Schools with large numbers of children from forces' families expressed a particular concern about benchmarking as it currently operates. Not only did they have to cope with high levels of mobility and other aspects of family disruption associated with service life but their low level of free school meals meant that their performance was compared with schools that they perceived as being more stable and affluent than their own."—[Official Report, 25 October 1999; Vol. 336, c. 785.]
Does the Minister think that the situation has significantly improved since then? If so, perhaps he could update us on the Department's thinking since 1999.

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The fact that many parents of the children in these schools are posted abroad and sent into armed conflict creates another set of problems that needs to be addressed. As Mike Curtis, the head teacher of Carterton primary, puts it:
"Situations where the armed services are at war with another country or are involved in armed conflict have been continual since I was appointed as the head teacher five years ago. The support mechanisms that we have in place in our school to support parents and children during these difficult times are extensive. The present war and conflict in Iraq caused a great deal of anxiety amongst the parents left at home and with their children who were worried about their parents' involvement."
That can he a particular issue for state boarding schools. In Burford, we have an excellent example of such a school: 60 per cent. of its boarders are from forces families and many of them had parents involved in the recent conflict. Extra mechanisms need to be set up to support those pupils and those families. There is extra support for children through explaining, talking and listening, there is extra training for the teaching assistants so that they can manage these situations, and there is a parent support service in many of the schools. Sadly, of course, there is the need for bereavement counselling on occasions. All those extra initiatives and the extra work take time and cost money.
When men or women are posted abroad or into armed conflict, the number of single parent families in areas such as Carterton, Colchester, Aldershot or those represented by hon. Members here today effectively increases. Some of the postings can be for four months, nine months or even longer. Many of the families who move to Carterton or to other military establishments around the country have no extended family in the neighbourhood to help them. A single mother in another area might be able to ask her father, mother, an aunt or an uncle to help with picking up the children from school and so on.
Mr. Peter Viggers: Will my hon. Friend comment on a point that has long caused me concern? When a service family is posted to an area, they are sometimes told that all the schools of their choice are full. For example, if there are no vacancies in the four secondary schools on the Gosport peninsula, a service family is told that their child must be educated miles outside that area. Is that fair? Would it not be reasonable for Ministers to issue a directive to encourage local authorities to reserve spaces for service families that are posted to an area?
Mr. Cameron: My hon. Friend makes a good point. We are both in favour of giving parents a choice of schools, and that should apply equally to service families. He is saying that that choice is sometimes not available, and I hope that the Minister will address that point when he responds.
Mr. Gerald Howarth: May I assist my hon. Friend with his excellent presentation on behalf of all Members with military families in our constituencies? The problem of admissions is even worse. Talavera infant school in my constituency has been allowed to hold three places from the beginning of the year until August to accommodate children from service families. It has now been told from on high—not by Hampshire county council—that it is no longer
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allowed to hold those three reserved places. That is a Government action, and the Minister must explain that decision.
Mr. Cameron: My hon. Friend makes the extremely good point that schools are put in a difficult position. They either leave places open to provide choice at the risk of receiving no funding for those places if they are not taken, or they try to fill those places thereby denying service families a choice. The fact is that they are special schools that require special attention. That is the crux of the matter that we are discussing.
The Minister would expect me to mention the "F" word—funding—and I will not disappoint him. It is my understanding that there is no specific national funding stream for schools with a high proportion of children from armed forces families, but local education authorities can allow extra money for that purpose. Oxfordshire county council recognises the strength of that argument, but it has not yet been able to make extra money available. In a letter to my hon. Friend the Member for Henley (Mr. Johnson), Councillor Tony Crabbe, the executive member for schools, stated:
"We have recognised this problem in the Oxfordshire education department and hoped to include some additional financial support for these schools in this year's education budget. We consulted schools on the possibility of including a special factor in the schools delegation formula. The proposal received considerable support. In the event we were unable to include this factor because a no-growth education budget was the best we could achieve without an unacceptably high increase in council tax, and as a result of the poor education settlement."
We have debated that point many times in the House. I hope that the Minister will consider the issue on a national basis, because the forces are a national institution and it is a national problem.
Mr. Gray: Wiltshire contrasts with Oxfordshire, because £544,000 is allowed to go to schools heavily dominated by children from service families. That means that ordinary schools without a high percentage of children from service families are deprived of that money, which is equally unfair.
Mr. Cameron: There is the option of top-slicing the budget and giving it to forces schools, but that will always create tension with non-forces schools. As the forces are a national institution, we should consider the issue on a national basis. I hope that I am wrong, but there seems to be confusion among Ministers about whether the Government will consider the issue positively. I have found two written answers from the Minister for School Standards to the hon. Member for Colchester. In the first, the Minister said:
"The Department will be considering the overall needs of such schools through a working group being set up this autumn."—[Official Report, 20 October 2003; Vol. 411, c. 428W.]
That sounds positive and I look forward to hearing more about it. However, in an answer to a question about two particular schools, the same Minister said:
"There is no need for specific or additional funding from central Government"
for
"schools with a large proportion of pupils who are the children of Service personnel."—[Official Report, 23 June 2003; Vol. 407, c. 555W.]

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That does not sound as positive, and I hope that we can clarify the position this morning.
I have taken up too much time but will make three pleas to the Minister. First, there is a need for recognition of the problem at a national level. As I said at the outset, our armed forces do a great job for us, and we should do a good job for them in return. The head teacher, Mike Curtis, whom I quoted, suggested in the letter that he wrote to me and copied to the Department—all the schools in Carterton agreed with this suggestion—that those schools should be called
"forces schools in the UK."
Identification of those schools would be a function of the proportion of children coming from forces families. Recognition would not just be warm words. Ofsted inspectors, for example, when inspecting those schools, would immediately recognise their specific problems, some of which I have described, and others that have been raised with me by hon. Members in interventions.
Secondly, there is the need for funding, either as standards grant or directly to the schools. The case has been made about all the extra work that needs to be done and the pressure created by the turbulence or mobility. That matter needs to be addressed, and it is hard to see how it can be done without extra money. There seems to be a case for the Minister to address the issue on a national basis, as the services are a national institution.
Thirdly, the Carterton schools have suggested that a working party be set up, consisting of head teachers from a selection of relevant schools and the Minister. I know that there is an organisation called the National Association of State Schools for Service Children, and that the head teacher of Alderman Blaxill School in Colchester is its key contact. I should be grateful if the Minister could give us an update on that point, explain what work the association is currently involved in, and what such a working party would examine.
I look forward to hearing contributions from other hon. Members. The nub of the issue is simple. Forces schools in the UK face special pressures, and require special attention. Given the special job that the armed forces do for us, providing such special attention is the least that we can do for them in return.
9.51 am
Bob Russell: I congratulate the hon. Member for Witney (Mr. Cameron) not only on securing the debate, but on the excellent presentation that he made. I endorse every word that he said, and also support the spirit of the interventions.
The Secretary of State visited Colchester garrison schools on Monday 9 June, as reported in the headline in the Colchester Evening Gazette,
"Funding promise by Education Secretary during schools visit. You will get more money."
If that were the case, I suspect that today's debate would not be taking place. Four days later, the Colchester Evening Gazette carried a further, lengthy report on the visit, about which I knew nothing until it was in progress. It reported:
"Garrison schools have explained the cost of war to education minister Charles Clarke.
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The schools in Colchester, which have children from the garrison, are suffering budget shortages due to falling roll numbers, after the arrival of a new regiment in town was delayed due to the Iraq War.
And garrison schools took the opportunity to explain the problem to Education Secretary Charles Clarke, when he visited town this week."
The report then quotes Mr. Richard Bourne, the chairman of the governors of Kingsford junior school. Mr. Bourne is a Labour borough councillor and county councillor, who was fully aware of the visit. I suspect that what we witnessed was more a Labour publicity stunt than reality. The visit was reported at length, and that is why I have pursued the case through tabling parliamentary questions, why I am pursuing it again today, and will continue to do so until the Secretary of State's promise is delivered.
I should also point out that Councillor Bourne was so involved with the visit—a visit that the Member of Parliament knew nothing about—that he collected the Secretary of State from Colchester North station, drove him to the school and conducted the day's visit. The Evening Gazette reports that Councillor Bourne said that
"schools knew that they would be getting more pupils when the new regiment arrives but in the meantime had to cope with less money.
He said: 'Garrison schools have had a major problem. They have got a particular problem in funding.'
The chairman of the Colchester-based National Association for State Schools for Service Children, Ian Poulter, said Mr Clarke promised to get a report on the problem.
Mr Poulter, who is head of Alderman Blaxill school, said: 'We asked Mr Clarke to investigate the possibility of some cushion for service schools in times of this kind of matter.'
He said the impact on his school was about £65,000 to £70,000—or £2,000 per child who he would have expected in school with the arrival of the new regiment.
Teachers also discussed the emotional and educational impact the war has had on schoolchildren."
I have mentioned that schools in Colchester—and throughout the country—with a large number of children who have a parent serving in the Army are still waiting for the additional funding that they believe was promised by the Secretary of State when he met head teachers and governors during a visit to the town seven months ago. Hon. Members may wish to know that I raised that matter at last month's Defence questions, after an excellent question from the hon. Member for Witney. I said that the Secretary of State had
"promised the head teachers of schools with a large component of children from military families that more money would be forthcoming. When will that be delivered?"
The Defence Minister replying said that
"there have been more discussions about the matter in relation to the Colchester garrison",—[Official Report, 15 December 2003; Vol. 415, c. 1316.]
But seven months later there has been no progress.
The heads who met the Secretary of State were left with the distinct impression that not only did he accept the special situation faced by schools with a large number of children from military families, but that he had given a personal assurance that these issues would be addressed. However, seven months later nothing of any material substance has happened. I tabled several written questions pursuing the Secretary of State's

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promise—all to no avail. I have also raised the matter in the House of Commons, and I mention it again today. I hope that the Secretary of State will be embarrassed into keeping the promise that he gave to head teachers of Colchester schools all those months ago.
The importance of children as a factor in the retention of soldiers in the Army, Air Force and Navy cannot be underestimated. If a soldier feels that their children are getting a bad deal from the education system, he or she may take that into account in considering whether to leave the armed forces.
The schools that I have mentioned do not just have fluctuating numbers of children on which the funding is based. Other requirements that are caused by changing schools can affect education—the turbulence factor—and those provide reasons why there should be additional support funding for schools with a large component of children from a military background.
I secured an Adjournment debate on this subject on 25 October 1999—it can be found at column 782. No doubt the Department for Education and Skills, as it is now, has that on file. It would be nice if my contribution and the reply from the then Minister could be revisited. The National Association of State Schools for Service Children was formed in 1999. In the autumn of that year, there was a conference in London called "A Fairer Deal for Forces Families", which I believe the Department attended. Sadly, however, there was no ministerial presence.
In welcoming the formation of the NASSSC, I said:
"I wish to pay tribute to the pioneers—those schools in Colchester with a strong Army involvement who, in 1992, formed the Colchester Association of State Schools for Service Children. The schools involved are Kingsford infant and junior; St. Teresa's primary; St Michael's primary; Alderman Blaxill secondary; the splendidly named Montgomery infant and junior; and, from elsewhere in East Anglia, Wimbish and Debden primary schools.
The numbers of children from service families attending those schools range from almost one in five pupils at St. Teresa's Catholic school to 95 per cent. at St. Michael's."—[Official Report, 25 October 1999; Vol. 685, c. 783.]
I have referred to what I consider to be a high-profile publicity stunt visit by the Secretary of State. However, we must give credit where it is due, because my constant probing and prodding prompted Councillor Bourne to respond on two occasions to justify that visit. In a letter to the Colchester Evening Gazette of 9 July 2003, he said:
"The Garrison schools are still hoping for some form of additional help. and for acceptance of their particular problems."
That is good news. On 8 July, in a letter to the East Anglian Daily Times, he said that
"the heads asked if there was any other way central government could help with the particular problems this year. We await the answer and close examination of the actual parliamentary answers does not rule out such help. We wait in hope!"
He is still waiting; we are all still waiting.
I wonder whether the Minister for School Standards can recall the letter that he wrote to me on 1 August 2003 in response to a letter that I wrote to the Secretary of State. In the third paragraph, he told me:
"As a result of the problems high lighted by NASSSC, my officials are planning to convene a small working group with representatives of the Local Government Association, the Ministry of Defence and authorities with a high proportion of forces children to revisit the funding regulations and guidance to see how they could be adapted to take full account of the needs of
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schools suffering MoD related turbulence. In addition, my officials have already been in contact with Mr Poulter, the Chair of NASSSC, at Alderman Blaxhill School"—
Blaxill is spelled incorrectly—
"with a view to arranging a mutually convenient date to visit schools at the beginning of the new school term. I do feel this is the best way forward at this stage rather than a further meeting with the Secretary of State."
That letter was signed by the Minister for School Standards, although unfortunately the name typed underneath was spelled incorrectly.
Not hearing anything, and wondering what was going on, Mr. Poulter wrote to the Secretary of State on 5 November and said:
"You will doubtless remember your short visit to Colchester on 9 June this year when members of this organisation"—
that is, the National Association of State Schools for Service Children—
"met with you to discuss funding for service schools (particularly Army) and concerns we have following deployments to Iraq.
Early in September (8th) colleague Headteachers and I were pleased to meet representatives from DfES charged by your office to research the issues we had raised with yourself.
To date we await outcomes from the research within the context of exceptionally tight budgets this year anyway. We are finding that managing effective educational provision for our students with the added pressures we raised with yourself, now seven months into the financial year, of extreme concern to us.
I do hope you are able to respond with some encouraging news for ourselves and our governing bodies, for as you know, we do believe from your response to us in June that you do consider our schools to deserve special financial consideration both in the exceptional circumstances this year and via funding calculations for the future."
The Secretary of State replied on 28 November. He said that he certainly recalled his visit to Colchester, and went on to say:
"I asked my officials to investigate the concerns raised by yourself and your colleagues over the education of service children attending state maintained schools.
A small working group including representatives from my Department, the Service Children's Education Agency and the Ministry of Defence has been established to look into the issues raised by yourself an representatives of similar schools and is currently I understand considering a number of options. The group is scheduled to provide me with an update of progress including a proposed action plan by the end of November. I will of course ask my officials to contact you with a progress report."
I understand from Mr. Poulter that, as of a little more than 24 hours ago, the message has not yet arrived, so he is still awaiting the dispatches.
This is a sorry affair; the visit promised so much and has delivered nothing. Let me quote the parliamentary answer the Secretary of State gave me:
"The commitment that I gave to those head teachers…is that we are addressing the 250 schools altogether in the country that have that problem as garrisons move around, and we are discussing with the Ministry of Defence and others how we can give such schools the kind of stability that they seek."—[Official Report, 17 July 2003; Vol. 409, c. 465.]
The talking has been long; the German Government managed to demolish the Berlin wall in far less time.
Several hon. Members Several hon. Members rose—
Mr. Frank Cook: Order. Prior to this debate, no one contacted the Chair, although one

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Member approached me verbally before our debate commenced. For the benefit of the Chamber, therefore, I must remind hon. Members that it is the convention to commence the first of the three winding-up speeches at least 30 minutes before the debate's conclusion. I ask those who wish to catch my eye to bear that in mind when making contributions and interventions, and when responding to interventions.
10.5 am
Mr. James Gray: May I apologise for not having written to you, Mr. Cook, before the debate? I was not aware that we had to do so. I thought that the whole point of this Chamber was that we could just turn up and speak. However, I apologise, and shall ensure that I write in future.
I congratulate my hon. Friend the Member for Witney (Mr. Cameron) on a learned and clear exposition of the turbulence factor in funding for military schools. That applies just as much in my constituency and throughout the whole of Wiltshire as it does in his constituency. The fact that the hon. Member for Colchester (Bob Russell) took the opportunity of going through the complicated and internecine discussions that he has had with the Department for Education and Skills over many months and years shows how important the issue is in his constituency, too. I congratulate him on his contribution, and on achieving the headline in the Colchester Evening Gazette that referred to fact that the Secretary of State intends to put up extra money to take account of the turbulence factor that my hon. Friend the Member for Witney so clearly described. I very much hope that the Secretary of State is ready to live up to that headline.
I shall not repeat the complicated and interesting arguments that my hon. Friend made, which apply equally in Wiltshire, but I shall highlight a couple of facts about Wiltshire, which might set his arguments in context. We have 36,000 primary children, of which 9.6 per cent. are from military backgrounds. Some 5 per cent. of the secondary pupils are from similar backgrounds. Of our 260 schools, 24 are acknowledged as having a large military presence. To take account of the turbulence factor that my hon. Friend described so well, Wiltshire county council has done something rather different from Oxfordshire; namely, it has decided to give special funding to those schools that are badly affected by using a complicated formula, which I will not bore the Chamber with. Last year, a total of £544,037 was made available to those 24 schools.
That special funding is laudable, and I have no problem with it, although I know that some military schools argue that it is not enough. There is a downside to it, however. The other 236 schools that are not military are effectively sacrificing that £544,000 and are, in a way, cross-subsidising the military schools. That is a little unfair on the other schools in Wiltshire. There is no reason why they should be doing that. If the DFES acknowledges that extra costs are involved in having a large number of military children in schools, extra funding should be available to Wiltshire county council as a whole to take account of that. That is my first point,
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which relates to the turbulence factor and the extra administration costs that my hon. Friend described so well.
We should also take into account two other things that my hon. Friend did not mention. First, Wiltshire has identified a high percentage of children with special educational needs in military schools. Of the 3,862 service children in Wiltshire, 199 are either on a statement or a statement is expected for them shortly. In other words, 5.4 per cent. of military children are on statements. That compares with an average of 2 per cent. across England. That is a high percentage—[Interruption.] The Minister tells me from a sedentary position that the average is 3 per cent. The average is 2 per cent. in Wiltshire, but it might be 3 per cent. nationally. Certainly, 5.4 per cent. is a high number of SEN children. I shall not comment on why that is the case, but it nevertheless seems to be statistically accurate.
I pay tribute to the work of one school in my constituency that operates from the Services Cotswold Centre. It is a specialist centre set up for services families who might be split up or who are temporarily homeless. The services centre operates a school at the centre purely for services children so it is a 100 per cent. services school. The centre provides an outstanding service particularly to the Army, and to a lesser extent to the Navy and the Air Force. It is a wonderful school facility for children who are often disturbed or having difficult times in their family lives. I commend the school, and I hope that the Ministry of Defence and the Department for Education and Skills will continue to support it in the way that they currently do. It is an expensive school: there are a very small number of children and a very high turnover factor, but it makes an enormously useful contribution for our service families. The Minister might like to consider that point about SEN.
There is a third specialist point that applies particularly at present in Wiltshire, but which applies elsewhere. Because of the Gurkhas—and, to a lesser extent, other foreign servicemen—who are now making such a useful contribution to the defence of this nation, we have a particularly high and growing incidence of English as a second language in service schools in Wiltshire. In my constituency, we now have a company of Gurkhas in the Royal Logistic Corps at Lavington, and Stanton St. Quintin primary school has employed a teacher who speaks the Gurkhas' language to take account of that difficulty. That is another cost to add to those that have been mentioned.
Turbulence is an extremely important factor and I hope that the Government will consider providing extra funds to deal with it. It is an inherent problem when there is a high percentage of service families in an area. In addition, it would be useful if the DFES took account of the higher percentage of SEN children that might be in these schools and of the pupils with English as a second language, particularly with regard to the Gurkhas in areas such as mine.
I doubt that the Minister will say that he has listened carefully to the arguments and that he is prepared to chuck out extra money to address these difficulties.
Mr. Swayne: You never know.
Mr. Gray: As my hon. Friend says, "You never know", and we hope that the Minister will do that.

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I understand that a working party has been established to consider these matters. I value that; it is useful. Officers in Wiltshire county council would happily play a part in the discussions—and the Department might particularly like to consult Mr. Parker, who has been helpful to me in preparing for this debate.
The difficulties are great: we are the sixth worst-funded county in England. Education funding in Wiltshire has been under considerable pressure until this year. Before the Minister looks in his brief and quotes some statistic at me about how much extra money we got, I will say that he is right that education funding has picked up this year. Wiltshire has received extra money in this settlement, but it is still one of the worst-funded counties in England.
I hope that the working party will take account of my points about turbulence, SEN and English as a second language.
10.12 am
Mr. Desmond Swayne: In view of your remarks, Mr. Cook, I will be brief.
I begin by quoting from the quinquennial review of the SCE. It states:
"The children of people in the Armed Forces need to be educated and retention, recruitment and mobility will suffer if this important aspect of the military component is not given sufficient priority."
Given what we are now expecting of our armed forces, and the fact that they are significantly under-strength, we have to take serious account of that point. For the military population, this is an important issue. Housing, health and education are crucial ingredients in keeping servicemen and women in the services, and that is especially the case for those with young families.
The issue of providing the children of service men and women with a sound education is complicated by the increasingly frequent operational need to move their parents at regular intervals. That was ably described by my hon. Friend the Member for Witney (Mr. Cameron), whom I congratulate on securing the debate, and by the other hon. Members who have spoken. Those children have to change schools frequently within the United Kingdom, often transferring from English to Scottish curriculums. Many of them go abroad with their parents, and when they come to schools in the UK, they are often exposed to the English curriculum for the first time. There is therefore a need to compensate for the difficulties that services families inevitably face. Perhaps that turbulence should be countered by maintaining standards at a higher level than would ordinarily be the case for schools in England. Perhaps that would involve higher teacher-pupil ratios.
For those reasons, we have an agency charged specifically with the education of services families when they are overseas. In effect, it operates as a local education authority—admittedly, a rather small one—and accounts for 13,000 pupils educated overseas. As I said in an earlier intervention, its operational costs in 2002–03 were £75.5 million, which works out at about—by my back-of-a-fag-packet estimate—£5,800 per pupil. Those costs are not directly comparable, because there are additional costs such as overseas allowances for staff and so on. However, we have taken account of the
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special needs of services families in the creation of the agency, which acts, in effect, as a local education authority. That agency has set standards that are higher than those of English schools, and those standards, as the quinquennial review published in May last year shows, are being achieved. We are therefore making the effort to ensure that services families get the special treatment that they require to meet the special circumstances that have been so ably described by my hon. Friends.
The key question is whether we are meeting only part of the equation. The SCE accounts only for those 13,000 pupils who are educated overseas. For the rest of the equation, we rely on local education authorities funded by the Department. Is the Department living up to its part of the bargain? Is it doing what it is required to do? The story given so far in this debate is that it is not, and that there is something left to be desired. I draw the Minister's attention to recommendation 8.6 of the quinquennial review, under the heading "Financial Management". The recommendation is that a
"better formal mechanism for consultation and linkage between MOD, DfES and HM Treasury should be explored".
I hope that the Minister will say something about how that is being explored. Clearly, we cannot go on with a situation in which services families' needs are well addressed by the SCE when they are educated abroad, but not properly addressed, as has been described by hon. Members, when they are educated in this country.
10.18 am
Mr. Gerald Howarth: Like my hon. Friend the Member for North Wiltshire (Mr. Gray), I apologise for failing to notify you in advance of my intention to contribute to this debate, Mr. Cook. Like my hon. Friend, I was not aware that the convention is that one should notify the Chair in advance. I have now learned of that convention.
I join others in congratulating my hon. Friend the Member for Witney (Mr. Cameron) on securing the debate and on speaking for all of us in such a comprehensive and effective fashion. I am sure that the importance of the issue to the county of Hampshire has not been lost on those attending today, given that no fewer than four hon. Members from Hampshire are here or have taken part in the debate. They include my hon. Friends the Members for New Forest, West (Mr. Swayne), for Gosport (Mr. Viggers) and for Fareham (Mr. Hoban). I know that my hon. Friend the Member for Fareham will address the concerns of Hampshire county council so, to save time, I will not cover that issue.
I hope that the House will appreciate that my hon. Friend the Member for New Forest, West is so concerned about the issue that he has taken time out of his post-operational tour leave to attend and contribute to the debate. I am sure that we would wish to salute our hon. and gallant Friend for his assiduity in looking after the interests of service families.
First, it is obvious from this debate that all the schools about which we have spoken have a serious problem of forward planning that does not apply to other mainstream schools in this country. I will give the Minister just two examples. Marlborough infant school in Aldershot faces a clawback of £20,000 this autumn

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because the numbers that are likely to appear in the autumn were not provided for in the original estimate. As a result, it could lose its classroom assistant, or it might have to cut out specialist provision, such as music. The difficulties faced by such schools, which result from turbulence, have real consequences. Talavera infant school, which is also in Aldershot, faces a similar clawback. I have 4,500 to 5,000 troops in Aldershot, and I am sure that the Minister will recognise that turbulence is a big issue in garrison towns such as Aldershot and Colchester. Those are examples of two schools that will face difficulties.
The Minister will probably tell us that, in the good years, the schools will have had provision made for numbers that did not materialise, and therefore will have been overcompensated. It is true that, by deft management, the schools have managed to avoid getting themselves into too much difficulty. Nevertheless, my two examples illustrate the practical consequences of turbulence.
Secondly, I reinforce the intervention that I made on my hon. Friend the Member for Witney about admissions policies. Talavera has maintained three places to be filled later in the year, and it has been allowed to do so by Hampshire county council, which understands the difficulties of turbulence. However, the county council has now been told—I assume by the Minister's Department—that it will no longer be allowed to provide that dispensation. That will have an adverse effect on Talavera school. The school is popular in the constituency, and non-service families are attracted to it. The result is that the school fills up with non-service families. If the school is no longer allowed to hold those three spaces—a modest number out of the maximum 270 places—families returning from operations or posted from elsewhere will have to wait or to go elsewhere, because those places will have been taken by non-service families. Mothers arriving in the garrison find it difficult to exercise their choice when it comes to finding a school for their children, and that has a damaging effect.
As everyone will acknowledge, this year has been particularly difficult. The Iraq war has led to an enormous amount of churn in the military establishment. Units have been moving all round the country. They have been deployed to Iraq and then moved back. It has been a particularly fraught time. I hope that the Minister has taken into account what has been said across the Chamber today about the way in which teachers in such schools manage to cope with difficulties that other schools in the country do not face.
Such schools—particularly infant schools and junior schools—face the problem of dealing with children whose fathers, and in some cases mothers, are out on active service and who see evidence of that, in the case of the Iraq war, on television every day of the week. Talking to families during the conflict, I encountered two groups of wives. The first group was fixated by the television. Those wives turned the television on when they got up in the morning and were glued to it throughout the day. They were looking for their husbands. It is important that the nation understands the effect that the wall-to-wall coverage of war has on families.
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The other group of wives was completely different. They switched the television on in the morning, watched for half an hour to see what was happening and then switched it off until after the children had gone to bed, when they switched it on for another half an hour to get an update. It is important that the Minister and the Government recognise that the schools must deal with the difficulties and trauma of children whose fathers and mothers are out on operations and the effect that that has, as well as the unsettling nature of coming to a school from somewhere else.
My hon. Friend the Member for New Forest, West spoke about children coming from overseas and different curriculums. Teachers must accommodate such children. One headmistress told me yesterday that, just as children get settled, they are told that they will be moving and so no longer have an interest in the school. They just start to bond with other pupils when mum and dad say that they are on the move. The child is no longer interested in what is happening in their school, but is looking forward to the next stage at a new school. I pay tribute to the teachers in those schools who do an enormous amount to wrestle with those problems, which are not faced by other schools.
Finally, my hon. Friends said that educational provision is one consideration that people take into account when assessing the value of a job. My hon. Friend the Member for New Forest, West referred to a report on how military recruitment and retention were affected by factors such as mobility and education. I have been told that some mothers are getting exasperated, particularly when they are moved to Aldershot—this could equally apply to Colchester, Catterick, Lyneham, Brize Norton or anywhere else in the country—and find that they cannot get their child into the local school. What happens then? They go home and say to their husband, "What kind of life is this for us? You may be enjoying yourself doing the job you want, you may be enjoying this activity, but for the family it involves constant turbulence, turmoil and disruption. It is doing your children no good." I wonder how many MPs hear that line—no names. The difficulties that their children face at school place huge pressure on soldiers and service personnel.
I hope that the Minister will take that into account and also that he will get a move on with the consultative committee that he spoke about earlier. Perhaps he might involve some of us in that consultation.
10.28 am
Dr. John Pugh: I wish to thank the hon. Member for Witney (Mr. Cameron) for focusing on this forgotten area of education. It has certainly been an education for me to listen to hon. Members. I shall not in any way feign omniscience, but I can claim a certain amount of empathy. Like many service children, I changed school an inordinate number of times during my education, which took place centuries ago. I had been to five schools by the time I was 14—without, I rush to add, being expelled from any one of them.
I can testify to the fact that there is a learning curve every time one moves school. One must get used to different staff, different peer groups and, often, a different curriculum. What was bad for me is quite normal for at least 100,000 service children throughout

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this country. They have to put up not only with changing school but, in some cases, with changing country.
There is some recognition of that in the education system. For example, there is a list of approved maintained and independent hoarding schools for service families. The SCE is supposed to be consulted about local admission arrangements in areas where local authorities are particularly involved with service personnel, though some hon. Members have questioned how effective that consultation process has been and whether it has actually delivered what it is supposed to deliver.
In a previous debate, a Minister—I am not sure which Minister it was—said that some effort is made to try to synchronise movements of children with obvious turning points in the curriculum such as the end of term.
The SCE is a top-performing education authority. Research shows that local authority schools that are not in the SCE and that take a large number of the children of service personnel do commendably well despite the obstacles put in their way. The Dobson study said that such schools perform
"favourably in comparison with other schools where there is a similar high level of mobility".
I am not sure what that means because I am not sure what benchmark is being examined. I cannot think of other schools that have such a high level of mobility as the primary schools in Colchester, unless I include inner-city schools that experience sudden influxes of immigrants.
The schools' predicament is widely recognised as being special. That was acknowledged by the formation of the National Association for State Schools for Service Children. However, there is a general feeling in the Chamber that the special circumstances of such schools are not sufficiently recognised. There is no special grant to deal with their specific curricular and pastoral needs. The hon. Member for Aldershot (Mr. Howarth) dwelt eloquently on the pastoral needs of service children and their families.
Despite the enormous turbulence and dislocation, there is not much evidence that local authorities can capably adjust to sudden roll fluctuations and fund the schools appropriately. Two factors aggravate the general problems of service schools. First—this has not been mentioned hitherto—there is the relentless testing regime. Whenever children move schools, some tests are due. School transitions should be as seamless as possible to give children adequate time to find their feet. The Minister could legitimately argue that one new factor is that, wherever children go, the curriculum is the same, and adjustment is therefore made simpler. Nevertheless, children and their families are keen to do well, but moving to a new school means facing a set of tests, which is an added problem.
The second problem is the increase in Army movements. I recently visited my local regiment, the Queen's Lancashire, where I was alerted to a point that I had not thought about sufficiently. The activity level of the forces in the recent years has already taken its toll on family life and continues to take its toll. The father in service families is often absent for longer than had been expected, and such special circumstances matter.
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Everyone recognises that our soldiers have done their duty, and we are looking for the education system to do its duty by their children.
Two points must be considered. First, we must treat the matter as a funding issue. Special credence should be given in the standards fund for the individual schools that face the problems that Members have alerted us to. Secondly, the matter should also be treated as an organisational issue. The hon. Member for Witney talked about ghost pupils and other Members have discussed falling rolls. We know that local authorities are, by and large, funded by formulae, which need constant revision through consultation with Ministers. When there is a large number of service families in any one county or local authority, there is certainly a need for the Minister to be especially vigilant to ensure that schools are not disadvantaged by the formulae used by local authorities.
10.34 am
Mr. Mark Hoban: I congratulate my hon. Friend the Member for Witney (Mr. Cameron) on securing the debate and on the quality of his introduction. He set out the problems clearly, and his points have been echoed in the contributions of other hon. Members.
It is interesting that we do not understand the scale of the problem. The numbers given for the children involved vary between 85,000 and 185,000. It is important that the Government understand how many service children are educated in the state sector. Clearly, any issues concerning funding must be resolved with a thorough understanding of the numbers of children and of which counties are affected.
In his analysis of the problem, my hon. Friend touched on the topic to which the hon. Member for Southport (Dr. Pugh) referred: exams and target-setting. A head teacher of a school in my constituency told me that since she set the SATs targets for year 6, she has had 18 extra children in that class. She has a tight monitoring regime in place. and assesses children's needs closely, so I do not think that she will have a problem ensuring that children continue to make progress. However, within the context of setting targets and schools being measured against those targets, a clear issue arises when there is a great deal of turbulence and when the pupils whose targets are set at the start of the school year are not there at the end of the school year or when the SATs targets are set.
My hon. Friend also highlighted the recognition in many LEAs of the problem of mobility or turbulence that applies to the high proportion of service children in schools. In Oxfordshire, as he identified, the county council recognised the problem, but felt that there were no further resources available to tackle it. Each LEA should make its own decision about the allocation of resources to particular schools to tackle the problem. I shall return to that issue shortly.
The hon. Member for Colchester (Bob Russell) has talked about the issue before: I heard his question in Defence questions a couple of weeks ago. I feel that I know the Colchester Evening Gazette inside out, and almost as well as I know his correspondence with the Minister on this topic. It appears that we have had a list of, if not necessarily broken promises, certainly unfulfilled promises from the Government.

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My hon. Friend the Member for North Wiltshire (Mr. Gray) raised the important issue of children with special educational needs in Wiltshire schools. We know that such children need a great deal more support than others, and we should ensure that there are adequate resources to meet their needs.
My hon. Friend the Member for New Forest, West (Mr. Swayne) was right to pay tribute to the work of the SCE, which is important in educating service children who live abroad. I am sure that the Minister will tackle some of the issues arising from the quinquennial review.
My hon. Friend the Member for Aldershot (Mr. Howarth), who also represents a Hampshire constituency, tackled some of the problems affecting schools there. Hampshire has a high number of military bases and garrisons, such as those in Aldershot and Andover. There is a naval dockyard in Portsmouth, naval facilities in Gosport, and air bases in the north of the county, as well as the port of Marchwood, which serves the armed forces. Hampshire has particular exposure to these problems, and he was right to highlight the problems faced by schools in his constituency arising from the clawback of resources when pupil numbers change. Money is then taken away, often unpredictably, from those schools, and they cannot manage properly or effectively.
The converse is also true. As I have already said, a teacher from a school in my constituency commented that she has had an extra 18 pupils since September, and until the school's roll numbers are re-assessed, resources are not going to that school to educate those extra 18 pupils. There are two issues: the unexpected clawback of funds, and the increased burden on resources when there is an unpredicted influx of children into a service school.
My hon. Friend the Member for Aldershot raised the issue—as did my neighbour and hon. Friend the Member for Gosport (Mr. Viggers)—of admissions to local schools from service families and what provision can be made. The particular incident that I should like to highlight from the experience of schools in my constituency is the one in which primary schools have perhaps one or two classes that are full whereas in classes of other years there is incapacity. We have seen situations in which families—say, with three children—have been turned away or the families have chosen not to go to that school because the class for one of the children is full and cannot take that child, even though the mother wants, rightly, to send all her children to the same school.
There are many ways in which LEAs can look at the funding issues. I think that all LEAs with children from services families recognise that there are unresolved issues. In Hampshire they look at the number of children who leave or join the school—other than in July and September—as a means of assessing mobility, turbulence and determining how that should be recognised financially.
Other LEAs count the number of services children in their schools and allocate funding on that basis. However, through lack of resources, some LEAs, such as Oxfordshire, are not able to recognise that cost or have decided, as in one case I am aware of, that the problem is so pervasive across all its schools—
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Oxfordshire is a relatively small LEA—that no additional funding is needed because all schools are effected almost equally by the problem.
It is right, as hon. Members have indicated already, that there is no additional funding from the Government to cover this need. In one of the many answers that the hon. Member for Colchester received from the Government, the Minister referred to a review of mobility to be carried out in the context of the annual school census. I would be grateful if the Minister would take the opportunity today to explain how far that work has gone to and what is the timetable for completion. I understand from the answer to the hon. Member for Colchester that it is unlikely that any additional resources will be received before the end of the three-year formula freeze in 2006–07.
The Minister for School Standards (Mr. David Miliband): In 2005–06.
Mr. Hoban: The Minister corrects me, but his answer in July was 2006–07.
It will be some time before LEAs receive additional resources to tackle this problem. The variety of responses that LEAs have had in allocating money to represent mobility shows that there is no easy solution. Could the Minister tell us of the work that Professor Barber or Andrew Adonis have done in looking at the distribution of direct funding to schools from central Government and whether they have considered the issue of mobility of services children?
Education issues arise because services families move from school to school. That topic has been raised by several hon. Members in the debate. One of the big issues for any child moving between schools, particularly within the key stages, is the level of knowledge that they acquired by the time they move to a new school. Clearly a number of schools have developed their own resources and methods of gauging this, through rapid assessment when children arrive at the school, through close monitoring of progress and ensuring that children are not left behind. The national curriculum and the literacy and numeracy strategies enable schools to have a better idea of where children are in that process, perhaps tackling some of the issues that the hon. Member for Southport raised in his remarks.
Social issues also need to be resolved within schools. One of the biggest issues facing children when they arrive at a new school is to establish themselves in the school's social networks. In my constituency, Ranville's junior school identifies buddies to work with children who have just joined a school, so as to create friendship networks to enable them to become part of the school quite quickly. However, the strategies needed to tackle the social and educational issues divert resources from other people in the school. Teachers' and sports assistants' time is taken up, enabling children to become acclimatised and assimilated within the school to which they have moved. It is the view of several teachers to whom I have spoken that it takes about half a term before these children settle down in their new school. Clearly, if they are then told that for operational reasons their families will have to move to another part of the country, they will, as my hon. Friend the Member for Aldershot said, quickly start to lose interest in that school and look to move on.

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We talked earlier about the working party that the Department set up in conjunction with the Ministry of Defence and the SCE, which is looking at some of the issues involving the education of children from service families. To date, we have talked particularly about that in the context of funding. What work will that team do to look at strategies for easing the transition of pupils from school to school and for establishing best practice? It is important that best practice is shared when possible. I understand that some visits to schools have already taken place, but I am not yet clear about what the outputs of that working party will be, and when it will report.
It is easy to talk about the negative aspects of the issues that children from services families create for our schools and for school funding and, to an extent, all of us have done that today. However, there are some positive aspects to having service children in maintained schools. Children from service families tend to be more gregarious and outgoing. They have a more varied and wider range of experiences than many of the children in school, and the head teachers to whom I have spoken talked positively of the benefits that the children—and their families—can bring to the school in terms of their experiences and their support for the work of the school.
The Royal Navy in south-east Hampshire encourages its officers and men to become school governors and part of parent-teacher associations. Indeed, in Hampshire, a naval officer works with a group of local schools advising on security—an important issue for any school, but particularly for those in which there is a high proportion of children from service families.
There is a sense that some of the services, although willing to help, wait to be asked. If we are to tackle some of the recruitment and retention issues that we know affect all three services, the services should consider some of the ways in which private organisations tackle the relocation of their staff in order to ease the transition of children into new schools—my hon. Friend the Member for Aldershot raised that issue. When the National Air Traffic Services moved its operations to my constituency, parents already living there were asked to act as a reference point. They checked that there were places available in local schools. Those issues are important.
There is much more that we could say about the education of children from services families. It is an important issue across many parts of the country. I sense that people recognise the problems that exist. I hope that we will hear from the Minister about the Government's role in resolving some of those problems.
10.48 am
The Minister for School Standards (Mr. David Miliband): I am delighted to respond to this excellent debate. The strains and stresses on our armed forces are closer to the front of our minds in this and in recent years than they were 10, 15, or even five years ago. The hon. Member for Witney (Mr. Cameron) did an excellent job of outlining some of the issues. I congratulate him and all hon. Members on their contribution to the debate.
I single out two contributions: that of the hon. Member for New Forest, West (Mr. Swayne)—I am sure that we are all delighted that he is back safe and sound—and that of the hon. Member for Fareham (Mr.
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Hoban), who is making his debut on the Front Bench. His political career began in South Shields, as all great political careers do, as he tramped the streets of Ocean road. Although the electorate did not necessarily show their devotion to him when he stood there, I am sure that they are pleased that he has gone on to other things.
I first want to make some general remarks about the funding situation, and then I shall move on to the points raised in debate. Three points about schools funding are important in considering the issues facing armed forces families and their children. First, in our constitutional settlement, the funding of schools is a shared responsibility for central and local government—a shared responsibility for raising money for schools, and for distributing that money.
Some may believe that we should move to a national formula in which the Department for Education and Skills decides on the funding of every school in the country. That is not the Government's position. We believe that it is right that local government is in a position to make decisions about the distribution of funds locally. We believe that local government has an important role to play and that we need a strong partnership with local government in order to deliver for teachers and pupils. In that context, one needs to think about whether a national pot of money should be set aside, and how that might fit into a constitutional arrangement with an important role for local government.
Secondly, this has been a difficult year for school funding—there is no point in pretending otherwise. There has been a big increase in investment, but also a big increase in costs. Substantial extra funds have gone in, but particular strains exist in different parts of the country, and I do not want to hide that fact. Over the past three or four months, the Government have been able to show a clear determination to deliver predictability and stability for 2004–05 and 2005–06, along with significant extra funds.
My third general point relates to mobility, which has been mentioned in several contributions. There are 50,000 fewer primary school students in our primary schools this year than there were last year. There will be 55,000 fewer again next year, and 60,000 fewer again the year after. For the first time since the introduction of local management of schools in 1990, we are seeing significant reductions in pupil numbers, and that is contributing to turbulence.
There are also movements in and out of schools, and it is in that direction that much of the debate has flowed. I shall correct one misconception that has dominated the debate: the Department distributes money to LEAs on the basis of pupil numbers not for the current but for the previous academic year. For example, the LEA budgets for 2003–04 were set on the basis of primary school numbers in January 2002, and secondary school numbers in September 2002. That is a lagging indicator so that if a school loses some pupils in January, it does not lose the money in April. LEAs are free to take a similar approach to the distribution of funds to schools. It is important to realise that such lag and flexibility are built in.
I did not understand the reference to in-year clawback made by the hon. Member for Fareham. Perhaps he could drop me a line about it, and I shall respond.

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I want to move on to specific issues raised about the education of services children. Hon. Members are right that we do not have an exact number for how many children from services families attend state schools in this country; obviously, it fluctuates. The Ministry of Defence estimates that it is between 80,000 and 100,000, and I shall stick to that estimate. The largest proportion of moves is in connection with Army families. It is significant that we have talked in the debate as if all the armed forces are the same, but there are particular issues relating to Army personnel, who are the most numerous and mobile. They move either in entire units or as individuals. More than two thirds of moves of Army personnel consist of moves by individuals. Moves can take place at any time of the year and are subject to operational needs. However, I am pleased that, over recent years, the Army has made an effort to concentrate moves in the school holidays, and especially in summer holidays as that obviously makes transitions easier.
Services families want their children to complete whole years of schooling, and the Army is doing its best to meet that aspiration. The hon. Member for Aldershot (Mr. Howarth) spoke powerfully about the importance of ensuring that families of serving soldiers are secure and content with their provision—they must be if they are to perform to the highest standards, and if recruitment and retention are to be maintained. I certainly concur with that.
There were several references to the working group that the Secretary of State has set up. It includes departmental officials, and representatives from the agency, Service Children's Education, and the Ministry of Defence. The main function of the group is to listen to the concerns of schools and explore the most appropriate ways of addressing the issues that they raise. Members of the group have visited a wide range of schools, including Carterton primary school in the constituency of the hon. Member for Witney to try to gauge all the issues.
I shall offer some early reflections on the group's findings. First, schools with services children are affected in different ways, with some schools experiencing a constant trickle of pupils in and out of the school, and others being affected by unit movements in which large numbers of children move in and out of schools at a particular time. Secondly, schools with highly mobile populations have considerable demands placed on them, both in terms of administration and the induction of new pupils. Efficient communication of information and records between schools has been identified as an especially important aspect of the process. Third, pressures on schools also occur when children with special educational needs arrive. My briefing today did not include the suggestion that there is a higher proportion of children with special needs in services families, but we will contact Wiltshire county council about the figure of 5.4 per cent.
There can be delays in assessment, which cause difficulties, and problems in the retention of staff because of budget changes, and it has been brought to the group's attention that there are concerns about the supply of teachers of English as a second language. The subject of soldiers from Fiji was raised in respect of
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Wiltshire schools, and I am glad that boarding schools were mentioned, as I am speaking at the State Boarding Schools Association on 19 January.
In response to concerns that were raised, the SCE and the Department are working together to develop the National Association for State Schools for Service Children's Education into an organisation that operates more formally than at present. We hope that it will be an effective organisation representing schools with service children nationally and commenting on policy matters. The schools contacted so far have expressed support for the proposal. We have identified about 500 schools that need to be involved, and the SCE, with the Department's assistance, is in the process of writing to all the schools and arranging regional meetings to promote the development of regional organisations that will feed into the national organisation. A national conference is anticipated later this year.
We are working to see whether data from the SCE schools overseas can be involved in the pupil level annual schools census. Software is being exchanged and we hope that it will improve the flow of information and the sharing of data. It is significant that we are advising schools that the SCE and the Ministry of Defence are introducing a tri-service schools liaison policy to assist service families in meeting their aspirations.
Mobility is not a factor that affects only service personnel, but the Department has a duty to think about how it should be addressed. Recently, we supported a pupil mobility project in which 51 schools from 26 LEAs were involved in projects developing, trialling and evaluating strategies to narrow the achievement gap between mobile and static populations and Ofsted are reporting on it.
Hon. Members were concerned not just about the academic standards but about financial support. The issue of pupil mobility was examined in great depth by the education funding standards group, set up in preparation for the review of local government finance in 2003–04, including studies from Janet Dobson and others. I shall place the relevant papers in the Library. The group could not reach a consensus about the efficacy or need for a mobility factor in the funding formula for distribution to LEAs but it was clear that LEAs should have the power to introduce a mobility factor that reflects the needs of their area. We are considering whether it would be practicable to apply the mobility factor to LEA formula funding. However, we are clear that it could not interfere with the freeze on the formula that we have said should exist until 2005–06; 2006–07 would be the first year of any change.
Some school budgets have suffered as a result of troop movements to Iraq as pupils have left schools. However, LEAs can give additional funding to schools whose numbers have fallen by at least 20 per cent. because of armed forces movements. That is the case in Oxfordshire, but Essex has decided not to adopt that approach. LEAs can include factors that give extra funding for high turbulence levels or compensation for significant falls in numbers on the roll. If schools in other areas believe that insufficient account has been taken of those factors, they can seek changes through the schools forum.
The issue of admissions was raised by the hon. Member for Gosport (Mr. Viggers), who is no longer present, and by the hon. Member for Aldershot, and I

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will clarify the matter. Steps were taken to address the concerns of service children when the new admission framework in the Schools Standards and Framework Act 1998 was drawn up, including consultation on the draft code of practice. The code of practice gives specific advice—I underline the word "specific"—that admission authorities should ensure that the needs of the children of service families are taken into account. It states that although those authorities are not allowed to reserve places for blocks of children—that would not be sensible given the uncertainty of movement—they may accept applications from parents returning to the area some months in advance and may allocate a school place to them. That is how we have tried to give the flexibility that hon. Members seek. In recent years, we have also addressed the issue of access to higher education for students from service families who have spent time overseas. We hope to continue to support children from service families where appropriate.
We are considering the points raised by hon. Members with the seriousness that they deserve. There are no easy answers to the variety of issues raised, but I can assure hon. Members that we are committed to addressing these matters in a serious and sustained way.

Post Office Card Account
Mr. Frank Cook: In a 30-minute Adjournment debate, it is normal to allow roughly 15 minutes for the Member introducing the debate to speak and 15 minutes for the Minister to respond, but today has witnessed a healthy development, with five Back Benchers seeking to catch my eye. Therefore, I appeal for contributions to be brief and pertinent so that everyone who wants to can speak. I hope that we will not waste time with interventions that require a response.
11.1 am
Mr. Andrew Turner: I am grateful to you, Mr. Cook, for allowing other Members to contribute. I became aware of this issue when four sub-post offices on the Isle of Wight were threatened' with closure. One of the causes of that threat was the Government's policy of transferring payment from order books to a direct method. Closure of two of those sub-post offices has been confirmed, but Pan and Gurnard post offices are still open. Pan post office serves an estate containing many pensioners, young families and other benefit recipients. It is in the top 10 per cent. most deprived wards in the country, but the people there are likely to lose their post office and therefore any means of collecting their benefits locally.
The Post Office card account was introduced as a halfway house between the traditional order book and a bank account, following conclusion 15 of the performance and innovation unit's June 2000 report on modernising the post office network. The report described a post office-based solution as
"a cost-effective means of ensuring that benefit recipients can continue to access their entitlements in cash at post offices"—
in other words, a universal bank. However, far fewer people than expected are transferring to the POCA.
According to Postwatch—the voice of the post office user—in November 2003, about 1.6 million people had asked to open a POCA and 600,000 had received their account number, but only 200,000 had activated their account. Those who supported payment modernisation reckoned against the determination of the Minister's agencies to ensure that people transfer from order books to bank accounts rather than POCAs. We have the extraordinary phenomenon of a Labour Government— a Labour Government!—discriminating against a
product that enables people to draw benefits where they want, and in favour of big banks.
David Taylor: Does the hon. Gentleman acknowledge that, prior to direct payment, 15 million claimants used the post office, and current estimates suggest that as many as 5 million will use card accounts? That is a little out of kilter with the early figures that he quoted. Does he hope that the Minister will attempt to justify that figure?
Mr. Turner: I hope to explain why that is the case, and I will ask the Minister to put the situation right.
The discrimination arises in part from the fact that the POCA process is, according to Postwatch, "overlong and overly complex"; in part because many beneficiaries do not realise that they do not have to transfer from traditional order books at all, let alone to a bank

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account; and in part because agencies such as Jobcentre Plus are under such pressure to effect transfers that they are none too careful about misleading customers.
My purpose in calling this debate is threefold. First, will the Minister make it clear that every pensioner and benefit recipient is entitled either to continue to be paid by the traditional method, or to open a Post Office card account? Secondly, will he simplify the method of opening a POCA, which is currently an obstacle course? Thirdly, and vitally, will he withdraw Jobcentre Plus's advice that
"all benefits will be paid by direct payment in the future"?
That advice is factually wrong.
I hope that the Minister will also respond to Postwatch's concern that
"the payment modernisation process is continuing without any independent testing of the Government's processes".
The process to obtain a POCA is complex. We can argue about how many stages there are, but there are more than are involved in opening a bank account. In brief, the applicant receives a pack asking him to ring the Department for Work and Pensions, which takes his details and sends him a document to take to the post office, where he fills in an application form and sends it to Electronic Data Services, which sends him an account number, which he then puts on another form, which he sends to the Department for Work and Pensions. I hope that I have got that right. As Postwatch says:
"The…process requires customers to retain and assimilate documents that they have received at different stages in the process. The duration between receiving these different documents may sometimes be quite long…For applicants who have little or no experience of using bank accounts, this may be confusing and potentially off-putting."
What evidence do I have that the most vulnerable are having difficulty? Martin Lewis, the Brighstone sub-postmaster in my constituency, tells me of a pensioner whose name was misspelt at one of the many stages, but whose application was rejected because she had corrected it. Other applications were rejected because an applicant's signature went outside the box provided. The sub-postmistress at Wroxall, Rosemary Clayton, outlines the following cases:
"Mrs H has been granted Attendance Allowance—was bamboozled into giving her National Savings number by staff from DWP erroneously telling her money could be paid into it by them—it cannot. They paid £686 into somebody's account with the same number. After telephone calls from Mr & Mrs H money was sent to her by cheque and she got the benefit book she wanted all along.
Two separate cases of pensioner couples with elderly parents living with or near them. Mrs Pensioner has for some considerable time, collected her own money plus her husbands and parents both. Being told she cannot be an agent for both a husband and a parent, as nobody could be of pension age themselves and still have a living parent. Both had to be very firm before they were believed.
Lady who had three Christian names and uses them all, can only have one name and one initial on the card account. When she rang the helpline and said she could have as many names as she likes at a bank she was told to go to the bank.
War pensioner was told his money had to go into a bank or building society, which he agreed with. Only when he got his letter about his Old Age Pension was it clear a card account was an option. DWP appeared to have steamrollered war pensioner into the bank."
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Rosemary Clayton concludes:
"These are just a snapshot of the numerous problems our customers have had."
I should like the Minister to concentrate on the word "steamrollered". Sandown sub-postmaster Rodney Archer told me that in 2002
"the largest of the residential homes that uses this Post Office…has been visited and persuaded by representatives of DWP to arrange for ALL residents allowances to be paid through bank accounts and accessed via direct debits. The basis of the argument…was that collection of the allowances by an agent was no longer acceptable and if residents still wished to cash them they had to attend the Post Office in person."
Meanwhile child benefit recipients were told by Jim Harra, director of the Child Benefit Office, that
"Payment straight into an account at a bank, building society or the Post Office will replace order books and girocheques."
They were presented with a fait accompli. They were not told that if they did not provide an account number they would still be able to draw their benefit and that a new system was planned for those who could not use accounts.
A Jobcentre Plus document dated 7 October 2003 told field directors of their "payment modernization project" as follows:
"Previous material issued has contained many soft messages…We need to pay most of these customers into bank accounts which cost 1p rather than into POCAs which costs at least 30 times more".
That is an understandable objective, but look at how it is done: by emphasizing that POCA is probably not the best option for customers. The document goes on to say,
"You should be aiming to get 9 out of 10 new customers paid into bank accounts—
I think that means new customers' money—
"with a small proportion of these paid through POCAs…You must encourage customers to be paid by direct payment at every opportunity…You must not issue a PID"—
a personal invitation document, that is, to open a POCA—
"unless all the options have first been discussed."
In other words, they should not offer this supposedly universal service on which both sub-postmasters and benefit recipients are relying if they can possibly help it. To make things worse, if a customer refuses to open an account, the document suggests:
"advise them that the customer conversion centre will contact them at a later date as all benefits will be paid by direct payment in future."
Those last words are not true, and they run totally contrary to ministerial assurances. The Minister himself told the hon. Member for Gordon (Malcolm Bruce) that
"85 per cent of customers will have their benefits paid by direct payment"—[Official Report, 17 November 2003; Vol. 413, c. 486W.]
so presumably he accepts that not all benefits will be paid this way. When asked by the hon. Member for Portsmouth, South (Mr. Hancock) about
"the practice of his Department's managers and agencies seeking to dissuade claimants from using the Post Office to access their benefits in preference to banks and building societies",
he replied: "No such practice exists." —[Official Report, 8 December 2003; Vol. 415, c. 321W.]
David Taylor: Is the hon. Gentleman aware that the customer conversion centre goes through all the

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banking options when people who want to open a Post Office card account ring, but the reverse is not true? Applicants for other banking options are not made aware of the Post Office card option. Does he not think that that is a little unbalanced?
Mr. Turner: I think it is one-sided. What is worse, postmasters are not allowed to advertise the Post Office card account because the Post Office Ltd. says that it is a Department for Work and Pensions product, not a Post Office Ltd. product, and it is not allowed to advertise the product itself, but has to use words that have been agreed with the DWP.
On 8 December 2003, the Minister told me that there would be an "exceptions" service for those whose payments could not be paid "directly into an account."—[Official Report,8 December 2003; Vol. 415, c. 321W.] If the policies he outlined remain his policies, he must instruct Jobcentre Plus to withdraw the misleading document that it has issued. I urge him to simplify the system, to withdraw the misleading documentation and to make it clear that people do not have to transfer at the rate at which his Department would like them to.
The Prime Minister wrote in the foreword to the PIU report that the Government "fully accepts" its conclusions. One conclusion involved a universal bank. The Post Office card account, which is the Minister's product, could provide such a bank if he and his system allowed that. I urge him to do so.
11.11 am
Mr. Mark Hendrick: I congratulate the hon. Member for Isle of Wight (Mr. Turner) on securing this debate on a subject that is important to many of our constituents.
A number of my pensioner constituents have indicated to me that they do not want to change over to the new card account system. The new system provides a more efficient and secure service, but for disabled pensioners who are visually impaired or have another relevant disability, the requirement to key in a four-digit code may make the system difficult or impossible to use. Will the Minister consider retaining the paybook system for that group of pensioners? That would offer choice to a disadvantaged group.
11.12 am
Mr. Alan Reid: I, too, congratulate the hon. Member for Isle of Wight (Mr. Turner) on securing this important debate and on being generous with his time to other hon. Members. I have two points. First, according to DWP figures, millions of people have not responded to the invitation letters, yet the Minister says that order books will be phased out next year. Will he please tell us what will happen to those millions of pensioners next year? Will they be moved to the cheque-based exceptions system?
Secondly, if the current rate of movement to the banks is maintained, the Post Office will lose more than a quarter of its income over two years. No business can survive such a loss of income, so what will the Government do to ensure that small rural post offices survive?
11.13 am
Mr. Owen Paterson: I thank my hon. Friend the Member for Isle of Wight (Mr. Turner) for his great generosity in letting other hon. Members speak. I also congratulate him on landing the debate.
In August, I drove 150 miles around my constituency visiting all but four of the post offices there. The message I received was extraordinarily consistent. First, in an area such as mine, the post office is often directly linked to the village shop. One of the most effective postmasters, whom I brought down to meet the Minister for Energy, E-Commerce and Postal Services, said that if the post office goes, the shop goes, and if the shop goes, the village goes. The two are inextricably linked. The proportion of the turnover that comes from post office business is enormous. In some cases, it is as high as 70 per cent. and it is frequently more than 50 per cent.
Another message that emerged clearly is that, as my hon. Friend the Member for Isle of Wight said said, getting a card account is an extraordinarily complicated business. According to the National Federation of Sub-Postmasters, there are 22 steps—
The Parliamentary Under-Secretary of State for Work and Pensions (Mr. Chris Pond): It is not true.
Mr. Paterson: The Under-Secretary shakes his head and grins, but there are 22 steps. He can come to Knockin and meet Mr. Colin Doyle, who will tell him that those who have got past those obstacles have done so only thanks to his help. He helps local pensioners to struggle through the network. I explained this to the Minister of State and, like my hon. Friend the Member for Isle of Wight, asked that the system be made much simpler. If the Under-Secretary does not believe me, he should listen to some of the quotes from postmasters. One says:
"The Benefits Agency is bullying people to change. The Government has not been fair."
Another says:
"The Benefits Agency has been very difficult. The forms are designed not to help."
Another says:
"The initial letters give a clear idea that customers must go direct. They are misleading. The bank section is deliberately put before the card section."
The Under-Secretary will not like this one, which says:
"The Government have no idea of what they are doing. They are totally clueless. They are destroying the infrastructure of country life. The procedure for applying for cards is deliberately hugely complex."
They are really angry about the process. People are only getting cards with the direct help of postmasters. I echo my hon. Friend's request: will Ministers please consider redesigning the system?
The Minister of State told me when I visited him that a sum of money has been put aside for rural post offices —£450 million over the next three years. Will the Under-Secretary explain in detail how sub-postmasters can apply for that money during the transition phase?
11.15 am
The Parliamentary Under-Secretary of State for Work and Pensions (Mr. Chris Pond): I add my congratulations to the hon. Member for Isle of Wight (Mr. Turner) on securing the debate on direct payment and the future of the Post Office.
The move to direct payment and the introduction of universal banking services has resulted in a number of benefits, including an increase in customer choice, help in addressing financial exclusion and improvement in access to financial services. That last point is particularly important, and although it has not been mentioned by any of the hon. Members who have spoken during this short debate, it was certainly stressed to me when I spoke to a number of groups representing our customers—including Age Concern, Help the Aged, Mind and Citizens Advice—at a series of meetings before Christmas. All those organisations and others welcomed the process of moving more people into the financial mainstream.
Citizens Advice recently published a booklet on financial inclusion: "Beyond Bank Accounts: full financial inclusion", in which it said:
"The government, the banking industry and the Post Office should be commended for the progress they have made in establishing Universal Banking Services. The ambition to enable all people to own the most basic of financial services—a bank account—is one we share."
The booklet continues:
"Getting people onto the ladder of financial inclusion is vital and Universal Banking Services should be heralded in this regard."
David Taylor: The Minister says rightly that basic bank accounts have been designed to promote financial inclusion, but at least 80 per cent. of the basic bank accounts available from the various clearing banks are not operable at a post office. That does not promote inclusion, does it?
Mr. Pond: I shall come back to that point in a moment.
I came into politics to combat the poverty and social exclusion—of which financial exclusion is a most important part—that the Conservative party did so much to make worse when it was in government. I am frustrated and disappointed to hear so many hon. Members criticising the attempts to combat that financial exclusion that we are making in partnership with the Post Office, banks and voluntary organisations. The nostalgia for the days of order books and giros that we have heard during the debate is far removed from the drab reality that left 3.5 million of our citizens financially excluded.
Mr. Andrew Turner: Will the Minister give way?
Mr. Pond: If the hon. Gentleman will forgive me I shall make a little more progress first.
The new arrangements ensure a more modern, efficient and reliable service, which increases customer choice, provides better value for the taxpayer, cuts fraud, and boosts financial inclusion. Many hon. Members in this Chamber may not wish to accept the fact that more customers of the Department for Work
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and Pensions now have their benefits and pensions paid into an account than by order book or giro, but does anyone seriously suggest that we should take away the choice from those customers to have their payments into bank accounts, Post Office card accounts or other accounts, simply in order to shore up the Post Office? Even if they believe that that should happen, do they seriously believe that it would secure the future of the Post Office?
The Government believe in choice, and in giving our customers the dignity of the financial inclusion that the rest of us enjoy. I would be astonished if any hon. Member present does not enjoy the full range of financial services that some people wish to deny to the customers of the Department for Work and Pensions. The future of the Post Office does not depend on our continuing to deny people that choice. It depends on providing attractive services that people wish to use and a full range of banking and financial services through the Post Office. We share that vision with the Post Office and we are working with the Post Office to help to build it. I remind Opposition Members that 3,500 post offices were closed during the Conservatives' term of office without a single step being taken to deal with the financial exclusion that so many people faced at that time.
Mr. Turner: The Minister has taken five minutes to deal with this issue, but nobody is suggesting that people should have to go back to order books. We are concerned that people cannot open Post Office card accounts when they want to.
Mr. Pond: I shall address that point in a moment. However, it is important to remember that not only the Post Office card account, but many current and basic bank accounts can be used at post offices. Some 20 million people can access their current account electronically at post office branches. My hon. Friend the Member for North-West Leicestershire (David Taylor) makes the point that not all basic and current accounts are available at post offices—
David Taylor: Most are not.
Mr. Pond: A wide range is available for customers, and the Post Office is working hard with the banks to make more accounts accessible. There have been 13.5 million banking transactions at post offices since April.
Rachel Squire: In respect of partnership with banks to offer real choice, what action has the Minister taken on the three main Scottish banks' refusal to enter such a partnership with post offices?
Mr. Pond: My hon. Friend makes an important point. The Post Office is working hard to ensure that people in Scotland have the same access to banking services as people elsewhere. We are doing what we can to support that process in discussions with the banks and the Post Office, but my hon. Friend will recognise that that decision is for the financial institutions to take. We will do everything we can to support the process, but we cannot insist that the banks participate in the project.

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The hon. Member for Isle of Wight said that I had spent too much time talking about the wider issues and not enough time talking about the Post Office card account. Much of the wider debate so far—and much of this debate—has tended to give pensioners in particular the impression that they have to open a card account to access their pensions or benefits at a post office. That erroneous presentation of the actual situation will damage the future of the Post Office.
Why should we change the existing arrangements? The hon. Gentleman says that he is not defending order books, and I am pleased to hear that—order books came in with ration books, and I think we all agree that they have had their day. Certain Conservative Members are shaking their heads—they want to keep the order books. In April 2000, in this Chamber, a former Secretary of State for Trade and Industry said that
"the process of distributing benefits by order books was one of the most costly, inefficient and fraud-prone ways of delivering money."—[Official Report, Westminster Hall, 12 April 2000; Vol. 348, c. 62WH.]
Those were the words of the right hon. Member for Hitchin and Harpenden (Mr. Lilley).
Mr. Paterson: No Conservative Member mentioned order books. We hope that the Government's hopes for the banking system come off. Perhaps the Minister will address the main thrust of the debate, which is that an incredibly difficult system is geared to drive pensioners into not applying for card accounts. Will he answer the questions that we have asked? Will he come up with a simpler system, so that people can apply for card accounts?
Mr. Pond: Given an opportunity to do so, I shall deal with that point. I am pleased to see that the hon. Gentleman is also confirming that he is not in favour of order books. We know that order books would have disappeared long ago had the Conservative Government's plans been pursued.
Are we discouraging people from taking up a Post Office card account? If that were Government policy, we would be making a rather poor fist of it. Almost 2 million people have already said that they wish to open a Post Office card account. Eventually, the number of Post Office card accounts will exceed our operating assumption of 3 million. In the last month alone the number of pensioners requesting Post Office card accounts has increased by almost a third. Hon. Members have suggested that we are discouraging people from applying for Post Office card accounts by making the process very difficult, but if so, how have 2 million people managed to get through that very difficult maze to open a Post Office card account well in advance of the 2005 deadline? These figures disprove the suggestion that we are trying to discourage people.
However, the Post Office card account will not be the best option for some people. It will not accept direct payment of wages, so it will not make people ready to take on a job. The guidance given by Jobcentre Plus has been mentioned, but it is the responsibility of Jobcentre Plus to make it clear to people that if they have only a Post Office card account, they are not job-ready. The Post Office card account will also not allow people to access discounts on their fuel bills by paying by direct debit. It is an electronic order book. I suspect that every
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hon. Member present pays their fuel bills by direct debit in order to get a discount, yet they wish to deny that option to many of our customers.
We have emphasised all along that we want people to continue to collect their benefit or pension from the post office if they wish to do so. They will be able to do that by accessing their bank, building society or Post Office card account at the post office, rather than by using the order book, which is what they currently do. We have made it clear that although we have reprieved order books from the demise planned for them by the previous Government, they will be phased out in 2005. That is the fact of the matter. The hon. Member for Isle of Wight was upset that people had been told that.
Mr. Andrew Turner: Will the Minister give way?
Mr. Pond: In a moment. The hon. Gentleman suggested that sub-postmasters and mistresses could not advise people about the Post Office card account. I made it clear to him that the Post Office produces leaflets and posters that state:
"Collect benefits and state pensions in cash here."
We are doing everything we can to allow the Post Office to promote its position as a purveyor of financial services. That is where its future lies.
We are committed to the future of the post office network. As the hon. Member for North Shropshire (Mr. Paterson) suggested, the local post office—and, frequently, the shop that is linked to it—is often the heart of a community. I, like other constituency Members, have witnessed the heartache that can be caused by the suggestion that a local post office should close. We are committed to maintaining that network as far as we can: we have put in £2 billion over five years, there has been investment in post office technology and, as the hon. Gentleman mentioned, there has been £450 million for rural post offices. I will have to write to him to answer his specific question about how that might help his own post office. We are determined to support the post office network, but we do not believe that we can secure its future by continuing with order books and giros.
Mr. Hendrick: Will my hon. Friend address the point that I raised regarding the visually impaired and the disabled, who may not be able to use a complicated four-digit code?
Mr. Pond: I was about to address that point. My hon. Friend is a vigorous campaigner on behalf of such groups. I have been holding meetings with representatives of organisations such as the Royal National Institute of the Blind and other groups representing visually impaired people about both the process of direct payment, of which they are in favour, and how we can devise an exceptions service to make sure that those who are unable to access a bank account have the opportunity to receive their money through an alternative—probably cheque-based—method. We also discussed the changes that the Post Office is trying to make to ensure that people with those disabilities can access a Post Office card account through the post office through the improvements in the personal identification number pad.

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We have been trying to ensure that we can secure both the future of the post office network and financial inclusion for our customers, and I hope that the hon. Members who have contributed to this important debate will join us.
Sitting suspended until Two o'clock.

Progress2Work
2 pm
John Mann: It is a pleasure to instigate a full debate on progress2work, and I am delighted that there will be time for other colleagues to discuss their experience. I should like to begin by painting the backdrop, using my constituency as an illustration, because it demonstrates the current position possibly more vividly than any other part of the country.
Since I was elected, the constituency has had the largest fall in unemployment of any constituency in Britain. Indeed, month by month, over the past six months, it has consistently been in the top four in respect of rolled forward annual reductions in unemployment. To all intents and purposes, putting aside the small number of people always between jobs and those with a class A drug addiction, we have full employment. If one talks to employers in the area, there are skill shortages, some of which are long standing, some of which are newer and more unusual, such as the shortage of forklift truck drivers, and are being addressed. There is nothing unusual about an occasional skill shortage. There are no particular worries, other than in relation to traditional building skills, and that is true of the rest of the country.
There is, however, a general labour shortage. A number of major companies have problems finding employees able and willing to take the jobs on offer. Four weeks ago, one of my constituents challenged me—unwisely, if I may say so—about the availability of jobs. I kept a diary of all jobs advertised in all my local newspapers. He now has a permanent job. He did not have a drug addiction, but had some significant disability issues. He was very angry four weeks ago, but wished me a happy new year as I returned to Parliament.
The backdrop is important. We do not have mass unemployment—although we did when the pits closed. We do not have lots of unemployed people who cannot find work. We have a precise and specific problem. That problem will worsen due to further good news. B and Q has announced the creation of 1,200 new jobs. Other companies such as Terberg Matec and Hazelwood have recently announced permanent, full-time job increases owing to the success of the economy. That has not happened before. In the past, we had to shift people around the country, as the Nottinghamshire pits opened later than the rest. Even in those days, there was unemployment. The concept of full employment is new.
I campaigned for Finningley airport not only for the right to fly where we choose—we are not nimbys in my area—but for its job-creation possibilities. We shall struggle to find people to fill the jobs in, for example, the three new hotels being built, and in the construction and servicing of the new terminal. We shall continue to have general labour shortages. That is a good position to be in because wages will be pushed up. Standards of living are going up commensurately more than ever before. That is a very rosy picture.
The one problem is benefit recipients who could work: those people who have a class A drug addiction. In my area, virtually every one is a heroin addict. Most of them have not worked. They have a chequered history in terms of housing, the criminal justice system and employment.

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The general picture is that those people find work when they feel capable of working. I make no slight on their motivation, because most of them are keen to get hold of money for obvious reasons—to feed their addiction—and would prefer to earn money rather than steal. A minority are criminals who become drug addicts.
Progress2work was set up to deal with precisely that group of people. Indeed, it differentiates between them. It is set up to deal with the easy entrants, the non-chaotic drug users. The Government programmes in my area have been outstanding successes. Some of those currently dealing with drug addiction are outstanding successes. The action team for jobs and the custody to work initiative have been and are tremendous successes. However, one programme stands out as being only a partial success. I would not describe it as a failure, but it needs to be a full success, because we are talking about the key group—indeed, the only group—who are unemployed in my constituency, both now and for the foreseeable future.
Let us start with a definition of chaotic versus non-chaotic, because that is fundamental. I am not sure who is competent to differentiate between a chaotic and a non-chaotic drug user. Where a difference can be shown—with progress2work across the country, it has been—is between a drug user and a drug addict. Often, the drug of choice is part of the differentiation. Drug users may be in and out of the criminal justice system and in and out of work. They use drugs on occasion. They may use them regularly, but they are not addicted to them. They tend to be less chaotic and more available for work. In fact, they tend to work for periods.
Those people may take a cocktail of drugs at times. They tend to take cocaine. In my area, they occasionally take crack cocaine. They take cannabis. They take amphetamines. They take drugs on a non-injecting basis. They do not wake up on a morning requiring drugs to get through the day—they choose to take drugs. If they take stimulants such as amphetamines or crack cocaine and commit crimes, they may well end up, in a circuitous way, on progress2work, because they are quite happy to get back into work.
Of the addicts in my area who are injecting, about 30 inject amphetamines and the rest inject heroin. They wake up on a morning requiring drugs. In my analysis, the heroin addicts and the other drug addicts are not going through progress2work. Let me explain why and the fundamental weakness in progress2work.
I have the statistics for Bassetlaw. Over the existence of progress2work, 10 people have gone into jobs through that programme. The number is 25 according to my hon. Friend the Minister's figures, which I wholly accept, for north Nottinghamshire, which covers four constituencies, over the two years. Those are very small numbers when we consider that the number of known addicts, not users, in the catchment area is about 3,000. The numbers are tiny, but the definitions in respect of progress2work include users as well as addicts.
The Minister for Work (Mr. Desmond Browne): I follow the structure of my hon. Friend's argument. If I understand it properly, the challenge that he poses for progress2work is to do more with greater numbers in a comparatively short term. In north Nottinghamshire, of
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the 114 starts in progress2work in the comparatively short period since the programme has been running, 25 people have moved into work and seven have been sustained in work for more than 13 weeks. My hon. Friend knows the challenges that that customer group faces. Does he not think that, given the number of people involved in the programme, those measures of success are quite impressive?
John Mann: I thank the Minister for his intervention, but I draw the opposite conclusion. It is not my desire to diss progress2work, which was an appropriate Government expenditure. However, the results were very poor.
Mr. Desmond Browne: My hon. Friend is courteous in giving way in this important debate. My point is that, in terms of entries into work, the programme in his area enjoys a success rate of 22 per cent. As I hope to show later, that is among the best there is, even set against the best international comparisons for people who have taken on the challenge of that group of people in labour market programmes. Does he know of programmes that can produce better success rates in terms of job entries than 22 per cent?
John Mann: I will answer the Minister directly. I certainly do know of such programmes in Australia, New Zealand, Sweden and the Netherlands, which I have visited. I am visiting France to look at programmes in two weeks' time. I can give precise details of the systems in operation in those countries and show why they are more successful.
I do not want to enter into an argument about the figures, as it is the methodology that needs to be changed, but the figures for Bassetlaw show that only three people out of the 600 identifiable heroin addicts are in sustained work. That simply is not good enough. I know most of the addicts—more than 120 of them were at the public inquiry into heroin—and have assisted people to get back to work. My record is comparable with that of progress2work; indeed, in terms of sustainability, it is better.
Let me explain why there is a problem with progress2work. My view is shared, in confidence, by many of the agencies involved in the programme—I have spoken consistently to them in the past 18 months about what they are doing, why they are doing it and how they are doing it, to try to find out what does and does not work and to identify specific problems. There is one core theme. The progress2work system is straightforward. The order in which things are dealt with is, in essence, housing, employment, health and that is the fundamental weakness that causes the problems.
The logic is that people will not get work if they are not in proper housing—if, for example, they leave prison and cannot find housing they will not get a job. Therefore, sorting out housing becomes item number one. Some good progress2work agents have extremely good systems for sorting out housing. Some argue that that should not be their job, that housing should be sorted out first and that people should then go to the agencies. Finding employment is more difficult, but the health issues are not addressed.

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The order in which it should work—indeed, it is how it works in Sweden, the Netherlands, Australia and New Zealand—is health, housing, employment. The time difference between the three may be significant. The concept that someone who was a drug addict would go back into work and not have their health issues initially dealt with is not one that those countries would understand. In the Swedish example, which is the best model and is the best resourced, health comes first and foremost.
Over the past seven months, GPs' ongoing and successful treatment of heroin addicts has risen from none to approximately 100. That is just within my constituency. We have 100 people who are no longer using heroin and are in treatment via a GP. The system should work, so that the people who have received health treatment are moved to stable housing. From stable housing, they should then get into employment.
The second major structural problem with progress2work is that there is no employer involvement. In my area, no employer is directly involved. I used to be involved in this kind of thing with engineering workers; I dealt with job losses and retraining. It is easy to put on a skills course—I was employed through my union to put on courses—but to get people back into sustained work is a different ball game.
I shall talk about the employers in my area and explain why the scheme does not work, and why their engagement is fundamental. The biggest employer is Hazelwood. Why does not Hazelwood take on people who have or who have had a drug problem? It will not do so because it is a food company. It does not want the word to get out that a food company is employing druggies—it has been clear about that in private, although a bit more reticent publicly.
It is difficult to engage the company in the idea of employing drug users, although I know that it has had a number of class A drug users among its employees. It is fundamental that it accepts that it will need to take on such people because that is the pool of labour available.
Another major employer, Wilkinson, does not take on people who have a criminal record for theft. That excludes class A drug users with a heroin addiction, who will have a criminal record for theft. The third biggest employer is Rampton hospital, which again does not take on people who have a criminal record for theft. The fourth employer is Bassetlaw hospital, which, although it will not say so, has not yet managed to take on someone who has had a class A drug addiction because it is a health institution. There is no logic in that. The engagement of employers is fundamental.
I shall refer to other moneys that have been thrown at the issue. We have criminal justice intervention money for the whole of Nottinghamshire. We also have continuous treatment money from the Home Office. On 23 December, the drug alcohol action team allocated £540,000 to the re-employment of people.
That is a lot of money, but it is money well spent. That should be intertwined with progress2work. Through the DAAT, progress2work is setting up an employer advisory committee, engaging employers in precisely how to take people on and explaining that there will be
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support. The key support for the employer, above all else, is the GP. A person might be undergoing treatment from the GP. A heroin addict might receive either subutex or methadone as a substitute—in the Swedish, Australian, New Zealand and Dutch models, people use that for three, four, five or more years. The GP is the verifier for them to remain on treatment.
When I speak to employers, they say that they will be happy to consider changing their policy of not employing those people if the person who gives them validation for their success in being drugs-free is the GP. One of the structural problems with progress2work is that there is no such validation, just an assertion that the person is drugs-free.
DAATs were not even involved in the tendering process. We need a merging of what the DAATs and progress2work do if the latter is to succeed. There is variability across the country. It is a bit of a Cinderella operation. There is a range of voluntary groups, some of which are dabbling in every single aspect of drugs, whatever that means. Some dabble in residential rehabilitation.
Let me describe some of the problems with the statistics when it comes to residential rehabilitation and say what that means for progress2work, because in essence the same methodology is being used. What I say will not be of any comfort to the main Opposition party, because—unlike the Government, thankfully—their entire drugs policy is to have more residential rehabilitation. With residential rehabilitation, there is an immediate drop-off of about 40 per cent. Under progress2work, the drop-out rate on the 13 programmes is 37.5 per cent. Others have put the immediate drop-out rate at around 40 per cent.
With residential rehabilitation, people go through a programme and remain drug-free throughout it. When they leave—it is a bit like when they leave progress2work—they slip back into taking drugs. The success rate worldwide of residential rehabilitation programmes is 2 per cent. That is similar to the success rate for progress2work if it deals with class A drug users, unless there is an ongoing linkage with the health service, which in the community can only be made through the GP.
There is a problem that is not the responsibility or fault of the Department for Work and Pensions. It was inherited when the programme was set up. It is the reason why, uniquely among the DWP's successful programmes, this one has been far less successful, and that is the model for drugs treatment. That model has, until the last six months, been one of detox and sending people back into the community. The message is, "You're clean of drugs. Off you go, my friend. Go sort yourself out and, by the way, here are programmes to help you sort yourself out."
That is well meaning and, if taken in the right context, potentially very effective but all the evidence from across the world demonstrates that success with heroin addiction using a detox model is practically nil. No country has any evidence of the detox model working. The only two countries that have persevered with it have been the United States and the United Kingdom but, thankfully, there have been changes—I have been pressing for such changes since I came to the House—to the National Treatment Agency for Substance Misuse in the past six months.

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We are shifting away from that model, and Nottinghamshire is shifting away from it faster than anywhere else. That is why there are 100 people in drugs treatment who are no longer committing crime. They are the people who should be using progress2work, and there are questions to be asked about the linkages and why those people are not being fed in.
Mr. Desmond Browne: The heart of progress2work is the fact that it is a voluntary programme. People are not fed into the programme at all. The people from my hon. Friend's constituency and area who come into progress2work do so as volunteers. It is important that that issue is understood in relation to the size of the challenge that drug users present in his constituency and area. The programme is not intended to be the whole solution to the drugs problem of that area. It is part of a network of solutions.
John Mann: Again, the Minister, I fear, misses the point. With only three people in sustained employment, progress2work is only a very small part when there are 600 heroin addicts on the unemployment register in the constituency. Of the 89 referrals for progress2work, only 10 have been self-referrals. Of course, we cannot compel people—well, we can, but that is not the current approach. However, some of the health treatment has been voluntary. The 100 people with GPs volunteered to go for treatment. I would like the matter to become more straightforward. If a drug addict commits a crime, they should have treatment or go to prison. I would like to see more sanctions built in, and that is precisely the Government's approach with the criminal justice intervention programme—heavy sanctions are built in.
In Bassetlaw, there were no specific police officers allocated to arrest and referral duties, but an agreement has been reached with my local police force and we now have five such officers. There will now be a lot of arrest and referral there. As we have CJIP money across Nottinghamshire, there is compulsory drug testing in the custody suites of all police stations in the county. That offers progress2work a unique opportunity that is not available anywhere else in the country: to get people into treatment, knowing what drugs they have been on, and to get the system the right way round so that people are in treatment with their GP in the community, rather than with a drugs worker—a newly qualified psychology graduate, 20, 30 or 50 miles away. Thankfully, that system has been adopted in Britain at last, after 30 years.
The key issue for progress2work and the employment service is how to get the employers on board. The evidence from the Netherlands is not optimistic. It has been found that small employers there are significantly more likely to take on people who have had a drug addiction or who have ongoing drug problems than large employers. We do not have small employers in my area; in many coalfield areas, small employers are few in number. We have large employers. So we cannot simply rely on small employers. We need to track the large employer situation.
I have some suggestions. We need not to get rid of the progress2work programme but to make it permanent, despite its shortcomings and its weak levels of success. We need to tighten up the tendering process significantly. Not any Tom, Dick and Harry can claim to do voluntary drugs work, but in Britain that scenario
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has not been far off. Some people in the voluntary sector have a good track record. Some have a weak one. The progress2work programme is beginning to expose some of those with a weak track record. For some, such voluntary work can be like money for old rope if they are not held accountable, as the DAATs are.
I have just mentioned the £540,000 extra that has gone into the Nottinghamshire DAAT, which is held properly accountable with performance management indicators from Government and the National Treatment Agency for Substance Misuse. Sustained employment has to be a critical part of that accountability. The Minister will say that Jobcentre Plus is keen to have targets per worker, but that will not work until the progress2work initiative has caught up with the time changes by the Department of Health and the Home Office. That means that we should not deal with class A drug users as we have done.
A fundamental weakness has been to say housing, then employment, then health. Evidence from progress2work shows that that order of priorities has never succeeded other than for tiny numbers. We should do it the other way round, with health first. We should keep people in treatment, then ensure that their housing is sorted and then sort out their employment.
I suggest to the Minister that Nottinghamshire and and north Nottinghamshire would be ideal places to evaluate independently the different routes into work of those who have gone through progress2work and those who have gone into treatment through the primary care trust—through one of the GPs—so that we get the best from both models in terms of getting people into work.
Finally, employer involvement at local level is crucial. Employers must not only be engaged but challenged, and those who are not prepared to take on people must be exposed if that is necessary. If success is to be achieved, they will require a validation from the health service that people are no longer taking drugs, rather than simply an assertion from someone who is being paid to put those people into work that they are no longer doing so. That is a small alteration, but it will fundamentally change the results of progress2work.
I offer Nottinghamshire as the ideal place for the Minister to try some new methodology—to set up an employer forum and to throw progress2work and the DAAT initiatives on employment together, so that they work as one. If that is done, we will have the best of all worlds and this welcome initiative will have the same amazingly successful results as other Government initiatives on employment have had in my constituency over the past six years.
Several hon. Members rose—
Mr. Frank Cook: Order. To be helpful, I remind hon. Members that it is customary in a 90-minute Adjournment debate in this Chamber for the first of the three winding-up speakers to commence 30 minutes before the conclusion, which means that we have 29 minutes left. I ask the Members who are seeking to catch my eye to bear that in mind when they make their contributions, which should be pertinent and as brief as possible, and if they are tempted to take interventions and respond to them.
2.31 pm
Miss Anne Begg: I am delighted both that my hon. Friend the Member for Bassetlaw (John Mann) secured this debate and that I am present—as delighted as I was on Monday 24 November last year when I was asked to launch progress2work in Aberdeen. That is partly why I am present today.
What my hon. Friend has said is interesting. The criticisms that he makes of progress2work in his area are precisely the strengths of the one that is operating in Aberdeen, so perhaps his arguments have been listened to. I suggest that many of failings in the implementation of progress2work schemes that he has mentioned have been addressed, and I hope that what I have to say will show that that is the case.
It was Jobcentre Plus in Aberdeen that decided that it wanted to introduce progress2work. I must give it credit for realising that providing the specialist help that is needed to get drug addicts and recovering drug addicts into work was not its forte, and for turning therefore to an organisation called Aberdeen Foyer, which is experienced in dealing with getting into work not only hard-to-place young people but drug addicts.
Aberdeen Foyer started as a housing association. It provided housing for people—predominantly the young—who could not sustain tenancy in any other way. Part of its role is to move young people through the process of getting into permanent housing. It runs several housing projects. It is an innovative organisation. It has been quick to tap into various Government moneys and projects that have helped young people, particularly those with chaotic lifestyles such as drug addicts and those who have just come out of the criminal justice system, back into work and mainstream society. It has a proven track record. As a result, I am hopeful that progress2work in my area will be successful.
Despite the fact that progress2work was set up only a little more than a month ago, it already has 14 active cases and two people in full-time employment. It is far too early to tell whether these jobs will be sustained, because they have not been going for 13 weeks. Yesterday, however, when I spoke to the people involved in progress2work in Aberdeen, they were very positive, partly because they have involved employers, which answers one of the criticisms from my hon. Friend. In fact, much of the work has been done not only with drug addicts themselves, but with employers. Persuading employers to break down stigma against drug addicts has been a part of the work of the people involved in progress2work in Aberdeen, as well as persuading them that there will be ongoing support.
One of the big problems for any hard-to-place group is that, often, in most of the other new deals, help ends after the 13 weeks, if it lasts that long. Once someone has been in employment for 13 weeks, it is regarded as a success. For most long-term unemployed people, that is fine because the statistics suggest that, once a person has been in work for 13 weeks, they will probably continue working for six months or a year, and that if that person loses their job, they will get back to work relatively quickly because they have a track record of work.
The problem with drug addicts or recovering drug addicts is that that support needs to be much longer. That is what progress2work recognises. Help is targeted
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not just targeted at the person who needs it but at the employers. Ongoing support will be there. It will not disappear. In fact, help will be sustained beyond the 13 weeks, a recognition that 13 weeks is a relatively short time in which to get someone back into work from what was a chaotic lifestyle.
Aberdeen Foyer has been successful because it has been working with that client group for some time. It has had a number of them on the so-called life shaper programme. That has helped them to get ready to work. In answer to the point raised by my hon. Friend, we have an extensive methadone programme in the Grampian health region and the route from addiction to good health is through methadone. Large numbers of people are on methadone. Many young people, once they are established on the methadone programme, have come to Aberdeen Foyer, have been through the life shaper programme, which has not managed to get them into work. They have now graduated, if you like, to progress2work. It is progress2work that will finally identify suitable employment, get them into jobs and support them in doing so.
Aberdeen Foyer also works with the Prince's Trust. It is hopeful that, if it cannot find a job for a person at a particular time, it will be able to get them into one of the voluntary programmes run by the Prince's Trust. That would make them more likely to be able to get long-term employment, because they will have a track record of being in work and it will look much better on their CV if they have been involved in voluntary work.
It is worth pointing out that, until progress2work came along, there were no central Government-funded programmes specifically to help recovering and recovered drug addicts into work. There were local initiatives that were often starved of funds, that struggled against the prejudice that said "We might as well write these people off. There is no point in attempting to get them into work because who is going to employ them anyway?" I am very proud that this Government have changed that whole atmosphere, that we are not writing off anyone, whether they have a severe disability, are lone parents, have been out of work for years, or have been a drug addict or a criminal. As a Government, we now say that anyone, provided that they want to—that is crucial—should be given the support and help to get them into jobs.
That is a worth while and something that was brought home to me on 24 November, when I launched the progress2work in Aberdeen. I met the young people involved. One chap who had been in and out of prison most of his life, for the first time thought that he might be able to make a go of it. A young woman said that, 12 months before, she was in a black hole and that she could not see how she could ever get out of that black hole. The opportunity that she was given was the beginning of the rest of her life. Suddenly, there was a way out of the black hole. I became emotionally involved when I heard her stories. I felt uplifted that, for the first time, those young people had the prospect and hope that they would make a go of it, get a job, return to the life that the rest of us take for granted and be part of society.
I welcome the progress2work programme. It is still early days, but I hope that my hon. Friend will take it from me that lessons have been learned regarding many of the criticisms that he raised. I hope—I keep my fingers

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firmly crossed—that the Aberdeen progress2work programme will be successful, and that many more people than the 14 already involved will find work.
2.41 pm
Ms Meg Munn: I also congratulate my hon. Friend the Member for Bassetlaw (John Mann) on securing this debate. As he knows, I spent a period of my life working in Bassetlaw. It is a nice part of the world and I am pleased to hear about the general success in employment. Sheffield is not doing as well, although the situation has improved over the past several years. It still relies on objective 1 money from Europe because it is an area of deprivation. I am concerned about the range of people who have been unable to benefit from the new jobs in the area. Those people might not have had the necessary skills for the job, they might have been long-term unemployed, or they might have had problems such as substance misuse. Therefore, the programme is extremely welcome.
In Sheffield, the programme is jointly run by Sheffield Futures, which is a careers guidance service, and Phoenix House, which is a long-established organisation for helping people with substance misuse problems and drug addiction. There is a high level of expertise in the labour market and in supporting people who are struggling to give up drugs and live a drug-free life. Phoenix House employs people to work directly with former drug users to help them back into work.
The scheme in Sheffield has been running since April 2002. The co-ordinator, David Lythall, told me that there was a slow initial take-up of the programme, which is expected with such schemes. However, establishing the fundamental basis of the programme was important for making connections with the number of agencies involved, for example the criminal justice agencies and the treatment services. A good fundamental working network emerged between the programme and those groups already working in the area. I worked in the social care sector for many years and was concerned that people with problems would need to carry a filofax, or the electronic equivalent, to store the details of all the people and agencies with which they were in contact. Establishing co-ordination of support among those groups can be difficult. The progress2work organisation in Sheffield deals with and receives referrals from 22 agencies. The complexity of the sector is clear.
There has been a large drop-out rate in Sheffield. It is important to examine whether that is to be expected. Having decided to come off drugs and establish a life in the community, many drug users hope that something will happen quickly. However, the reality is that arranging everything that needs to be in place to enable them to get into work—not just any work but a job that meets their desires and needs and that they can sustain over a period—does not necessarily happen very quickly. As with many programmes for drug users to get over and work through drug addiction, there must be a recognition that people sometimes need to do it several times before they get to the stage where they can be reintegrated into society fully, go to work and maintain relationships in the same way as the rest of the population.
What works really well in the service in Sheffield is the one-to-one relationship with the workers, who provide support and who really are able to build up a rapport
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with individual users. It is a tremendous credit to the service, which has only two workers, that it has already had 150 starts this year, with another three months still to go of the programme. It continues to support 100 of the 150 people who started the programme.
The service's approach is to work through the barriers that stop people on the programme from getting into work. As my hon. Friend the Member for Aberdeen, South (Miss Begg) said, there are clear differences between programmes. My hon. Friend the Member for Bassetlaw said that it is necessary to deal with health first, then housing and then work. That is exactly the approach that is taken in Sheffield. The issues around health, stabilisation and treatment programmes are dealt with before accommodation and, finally, work, but at the same time consideration is given to whether people are getting the right benefits and support to enable them to live in the community.
There is a recognition that it may take as many as six months from the time a person first enters the programme until they get into work. Someone who comes out of prison and is drug free at that time may find that that can happen much more quickly, but there are success stories about those who have gone through a longer process. In addition to getting people into work, we must also take into account that some people need to build skills and that perhaps going into further education, whether part time or full time, and gaining skills and qualifications would be the right way.
Most people find that it takes some time to get through and that they might not make it the first time. Some people are much more motivated, but there are other barriers, which could be addressed in other ways. An issue that was raised by my project in Sheffield was the difficulty with some of the eligibility criteria for various programmes. For example, one can access the new deal only if one is on jobseeker's allowance. If one has been a drug user and has been on incapacity benefit, perhaps for a long time, the idea of losing that safety net to move to the jobseeker's allowance before going into a programme may be very scary and difficult. Therefore, I ask the Minister whether the Department could give consideration to these schemes and to whether there could be some flexibility on the eligibility for work programmes, rather than always having strict criteria that mean that one has to be on jobseeker's allowance to access them.
In terms of moving into employment, it has been interesting to hear my hon. Friends the Members for Bassetlaw and for Aberdeen, South discuss whether there has been access to employers. The view in Sheffield is that giving people a progress2work label might not be helpful because of what it means and because of fears about drug users and former drug users, as well as people with a criminal record. At the moment, nothing, has been done to build links with employers.
The other key lesson that I want pull out of both this debate and my discussions is that the different approaches across the country may cause some of the problems. Although there is always a benefit to allowing different schemes to develop in different areas in different ways, the important step is allowing people to learn from good practice in other areas. I understand that regional co-ordinators have meetings at the national level to share information, and that that must be done formally, so that issues can be picked up.

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I want to discuss the co-ordinator role, which is performed by a member of staff at Jobcentre Plus in Sheffield. It is important that it is within Jobcentre Plus and that someone on the drug alcohol action team performs it—my hon. Friend the Member for Bassetlaw raised that issue. That strong link means that all the work done within the area by the drug alcohol action team is linked to the progress2work scheme. I welcome the implementation of the programme, but lessons can be learned from across the country and there is scope to examine how it works and to improve it.
I should like to see schemes expanded to meet the full need in an area. In my area, it is clear that the scheme will overshoot expectations. Two workers deliver the programme at a cost of about £750 per service user, which is good. A lot of work has been done, and it could be built on further to improve the programme.
Mr. Frank Cook: Eight minutes remaining.
2.52 pm
Chris Bryant: Mr. Cook,
"But at my back I always hear
Time's winged chariot hurrying near".
I congratulate my hon. Friend the Member for Bassetlaw (John Mann) on securing the debate. This is about the sixth Adjournment debate that he has secured, and I have taken part in all of them. His constituency and mine face similar issues. As former mining constituencies they have many of the same socioeconomic and labour market problems. We are both engaged politically today and our constituencies face many of the same challenges.
My constituency currently has an unemployment claimant level of only 5.4 per cent.—most people would be shocked to hear that the unemployment level in the Rhondda is only 5.4 per cent. Unemployment in the Rhondda has halved since 1997. Only 1,103 people in the Rhondda are actively seeking work, which is a 44 per cent. fall since 1997. In case the hon. Member for Tatton (Mr. Osborne) is working out the mathematics—it does not sound as though the figures add up—many of us in the Rhondda are getting older, and fewer people are of working age.
We still have a dramatic problem with the number of people who live lives of benefit. The number of people claiming disability living allowance in my constituency has risen by 25 per cent. since 1997. The number of people on incapacity benefit has fallen by 25 per cent. The overall figure is coming down, but that still means that roughly 30 per cent. of working age people in my constituency are on incapacity benefit, which is a significant problem. If the first challenge for the socialist Labour Government was to tackle the scourge of unemployment, the second challenge must be to give people a better opportunity than a permanent life on benefit. That is why the issues that we are discussing today—the tough end of trying to enable people to get into work—are an essential part of a Labour Government's job.
Part of the problem in the Rhondda is new. In the past 10 years, we have seen a dramatic increase in the number of people with drug dependency problems and, in
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particular, heroin problems. So far, we have been lucky and crack cocaine has not made a significant inroad into the Rhondda, but heroin is a major and depressing part of life for many families across the Rhondda Fach and the Rhondda Fawr. For more than a century, alcohol has played a similarly destructive part in the lives of many families. I am glad that the Welsh Assembly and my local authority have been trying to work as closely together as possible to tackle the scourge of drug and alcohol dependency.
Employers' perceptions are also a problem. Those perceptions relate not just to those with drug and alcohol problems but to those who have been in prison. It may be that only 14 per cent. of employers in the UK say that, whatever the offence that somebody has committed, they would not employ that person, but the problem is worse locally, where many employers are nervous about employing people with a criminal record in a community that is tightly knit, where everybody knows everybody and where people cannot get away with pretending not to know someone's past.
The challenge is significant. First, we should help those who know that a life on benefits is not the fullest possible life, and, secondly, we should help the most difficult people to help—those are the people that progress2work is aimed at. I am talking about people with drug and alcohol problems, the homeless and those who have a criminal record. Helping those people involves joined-up thinking—I hate to use new Labour jargon. That is important if we are to achieve any outcome for any of the individuals or families that we are talking about.
Historically, it has been difficult to get the joined-up thinking that we need in Wales. Devolution has made it somewhat more difficult because we have to get the Welsh Assembly's health priorities to match the UK-wide health priorities, and the probation service to work with the local authority. Different cycles and sources of funding have made things significantly more difficult.
There is also the problem that 35 to 40 per cent. of GPs in the Rhondda are likely to retire in the next five to six years. That is a dramatic issue. Should we be training more GPs now to ensure that they have the skills to deal with drug and alcohol dependency, or should we be trying to ensure that we get new GPs coming to work in the valleys who already have the skills to deal with the challenges of the future?
Essential to any likely success in the programme—ours has been running for more than 18 months—is the idea of treating people as individuals rather than as numbers and statistics. I visited the Jobcentre Plus in Tonypandy—or Ikealand as it is known by many of my constituents—just before Christmas. Not only the change in lay-out of the building, but the change in mentality that has been brought about by taking down the screens and creating a secure environment in a different way has radically transformed people's experience of the service. It does not feel like going into a fortress anymore. When people go into the Jobcentre Plus, it feels like someone might be interested in them, their skills and abilities, and how to get them the opportunity of work. Binding together the Employment Service and the Benefits Agency has been an absolutely positive experience.

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In that context, the work of TEDS—TEDS has the local contract; it used to be known as Taff Ely drug services, but it cleverly changed its name to treatment and education drug services, so that it could cover more than Taff Ely, which is just part of the area—must fit integrally into the broader job of trying to give more people work opportunities. Contrary to the experience of my hon. Friend the Member for Bassetlaw, we have had 120 people use the service so far, and 76 of them have had positive outcomes of some kind.
John Mann John Mann indicated dissent.
Chris Bryant: I am sorry, but I am going from the statistics that I have. Some 76 people have had positive outcomes of some kind. My hon. Friend may think that the only kind of positive outcome is sustainable work. There are five people who have gone into sustainable work. However, as he said, we shall often be dealing with people who have very chaotic lifestyles who need to go in and out—[Interruption.] I note what you are signifying to me, Mr. Cook.
I make the simple point that one of the biggest difficulties we shall always face is not that of providing more drug treatment services but that of housing. Many of those with drug dependency problems are going into wholly inappropriate housing either because the local community is unable to cope with them or because the houses are uninhabitable due to the fact that an unscrupulous landlord has not made them habitable. Until we solve that problem, we will be unable to make the radical changes we still need to make in this area.
3 pm
Paul Holmes: I add my congratulations to the hon. Member for Bassetlaw (John Mann) on securing the debate. There are two general background issues that should be considered before we consider progress2work. One is how we perceive the drug problem as a whole. Unlike alcohol or nicotine, for a long time, drug addiction has been seen as a crime rather than an illness, especially from the 1970s onwards, when GPs were prevented from prescribing heroin to addicts. There has been some improvement in that attitude, and all credit to the current Government for taking some steps in that direction. I shall return to that point later.
There is also the question of the new deal framework, within which progress2work is one of many different schemes. One of the many criticisms of the new deal is that it has primarily dealt with the easy to place. Many reports—from the Public Accounts Committee, the National Audit Office and internal research at the Department for Work and Pensions have—indicated that many of those who have got jobs under the new deal would have got those jobs anyway during a 10-year period of constant economic growth. New deal resources have also been dissipated in the blanket interviews that were introduced for invalidity benefit claimants and single parents.
The new deal has been criticised for ignoring the hard to place, such as disabled people, although the Shaw Trust is doing work for the Department with difficultto-place disabled people. Now, we have progress2work, which is a step in the right direction—
Mr. Desmond Browne: I do not want to prevent the hon. Gentleman from rehearsing some of the reasons
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why his party does not support the new deal, despite its enormous success throughout the country, but progress2work is not a new deal programme.
Paul Holmes: I thank the Minister for the specific correction. Most people would see progress2work as working in the framework of the new deal. It is interlinked with Jobcentre Plus and the programmes it offers. If it is not a new deal programme, may I suggest that the Government make it a flagship of a new new deal, if they move on from the blanket new deal approach, which most reports indicate is of little practical use.
Progress2work is a step in the right direction. The hon. Member for Bassetlaw said that but, as he noted, it is a limited step in the right direction. It concentrates on those whose drug problem is, to a large extent, solved. The problems of people at the end of the cycle of drug addiction. offences, imprisonment, rehabilitation and detoxification are not so severe. The hon. Member for Bassetlaw described eloquently the difference between chaotic and non-chaotic lifestyles among former drug addicts.
My constituency of Chesterfield has a great deal in common with Bassetlaw. The town was largely built upon mining, associated engineering and a small amount of associated steel and chemical industry, almost all of which have been completely wiped out during the last two decades. As in Bassetlaw, unemployment is no longer the massive problem that it was in the early 1990s, when the pits were closed overnight, or during the 1980s, but it is still higher than the national average.
The problems of drug use in a community such as Chesterfield are found in every community in every part of the town. Similarly, they are found in public schools such as Eton, and in inner-city schools. Drug problems are not confined to one part of the community, but they are at their most intense in areas of traditional social and economic deprivation. During the 1980s and 1990s, those areas were devastated by mass unemployment. The medical focus on drug addiction emphasises the illness and the detox approach mentioned by the hon. Member for Bassetlaw, who referred favourably to the approach in other countries
A social model of drug addiction would consider matters rather differently. For example, a survey said that 70 per cent. of US servicemen took heroin while they were in Vietnam, but on returning to America and a more stable lifestyle, only 3 per cent. continued taking it. One social condition led to massive drug use in one set of circumstances. Under another social condition, there was almost no drug use later. Similarly, around 1979 to 1983, the number of known registered drug addicts in the UK trebled. That happened when unemployment doubled from 1.5 million to 3 million. The social model of drug addiction based on those statistics would regard the problem as much more than just a medical illness and addiction.
The hon. Member for Bassetlaw spent a lot of time talking about how a certain frame of mind and attitude among communities in Bassetlaw or parts of Chesterfield must be broken. Those communities may no longer have the mass unemployment that triggered the problem in the 1980s and 1990s, but there is still a frame of mind in which there is peer pressure on people, and a loop of drug addiction.

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Progress2work in Derbyshire is run by Phoenix Enterprises, which has a number of offices. I had the pleasure of opening its first Derbyshire office in Chesterfield before progress2work was introduced. At that time, Phoenix Enterprises told me that one of the problems of the new deal programmes it was administering was that it could not deal with the most difficult people, such as those with a drug problem. Phoenix argued that because it was a not-for-profit company, it had money of its own that it could recycle, which was not going into profit and, as far back as 2001, it was using its own funds to top up new deal money to send people to private drug rehabilitation programmes before even trying to get them into employment. Such people would normally not have been dealt with.
Andy Ellis is the operations manager for Phoenix Enterprises in Derbyshire. He is a great enthusiast for the progress2work scheme. He says that, from June 2003, when Phoenix Enterprises started in Derbyshire, to December, 116 people started the programme. The success rates have been high compared with some of the examples we have heard from other hon. Members. For example, there is a success rate of about 89 per cent. Some 42 of those 116 people have gone into permanent full-time employment, 32 have gone into full-time further or higher education courses, and 22 are on mainstream Jobcentre Plus training programmes.
Andy Ellis's Derbyshire scheme is the fourth most successful of the 44 second phase progress2work schemes, and the 11th most successful of the 75 first and second phase schemes. That is a good example for the Minister to consider. He visited the Phoenix offices in Derby at the start of the scheme. I invite him to visit the Chesterfield offices now that the scheme is under way and well proven after six or seven months.
Another success story that Andy quotes is an anonymous one from Derby. An ex-offender who had been in jail due to his drug use and associated crimes went on to do a NVQ level 3 in cookery. The course ran in the evening and he still had an electronic tag, so he could not attend. At that point, he would normally have gone back into the community and ended up reoffending. However, the progress2work scheme found him a placement in a restaurant, which turned into a full-time job, and got him a day off for college in the daytime. The scheme was able to tap into the discretionary fund and bought him a chef's uniform and a set of knives to enable him to start his full-time job.
There are other success stories. For example, the scheme has provided people with deposits for a flat, so that they can move away from the peer group pressure of their former friends and neighbours the people they grew up with who are trying to get them back into drugs after they have come off them. Then those people can start a new lifestyle and move back into work.
Andy Ellis is a great advocate of progress2work. He has, however, pointed out some problems. Many people have multiple issues, including debt, homelessness, health and all sorts of problems, about which we have heard from hon. Members. Andy believes that those problems should be dealt with in a one-stop programme, rather than having to refer people to other programmes
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for certain difficulties that they face. It would be cheaper; it would be less bureaucratic and it would be less of an obstacle for the individual client.
Some drug agencies in Derbyshire will categorically not refer people to the progress2work scheme. Primarily, that is due to funding. If the targets are funding led and a successful outcome means that the funding goes to, say, progress2work Phoenix Enterprises, the drug agency that had the initial referral will lose the funding. Andy Ellis suggests that drug advisory teams, for example, need to introduce referral targets and instructions to work in partnership as part of the allocation of money and contracts.
I come now to funding. Andy Ellis has five outreach workers in Derbyshire and says that, at present, he could easily use 10 outreach workers to their full capacity. Again, that may be a step in the right direction. However, as the Minister said earlier, perhaps the argument is that we do not need more of the same. The praise for, and the problems of, the schemes were reflected throughout the country by those who run them. For example, Working Links, which operates several schemes in the south of England, echoed in particular the first point made by Andy Ellis about the multiple issues faced by clients and the problems of having to refer people to different agencies and groups. He said that a one-stop shop approach, such as that in employment zones, would be a much better way in which to deal with such issues.
Another difficulty is that Jobcentre Plus managers in different parts of the country interpret the rules or flexibility of the schemes differently. In Derbyshire, the managers work extremely well with progress2work. For example, when someone with a drug problem and a chaotic lifestyle has had to drop out of a training course for a while, Jobcentre Plus in Derbyshire has waived the imposition of sanctions. I have been told that Jobcentre Plus managers in other parts of the country are not always so liberal in their interpretation of the rules concerning the imposition of sanctions.
My conclusions are that progress2work is a welcome initiative. As the Minister said, perhaps the call is for more, but not more of the same. When interpreting the way in which regulations are applied, more flexibility is needed from Jobcentre Plus managers throughout the country. A one-stop advisory approach needs to be introduced as opposed to multiple advisors or agencies. To return to the case put by the hon. Member for Bassetlaw, more intervention is needed with chronic cases, not just the cases of those who have already reached the end of the process and are mainly rehabilitated already.
Ultimately, the scheme needs more money. Where would that come from? The Treasury has a case to look at. For example, to keep the 25,000 extra people in our overcrowded prisons costs £3.5 million a year, which is £3.5,000 per inmate. Many inmates have been sent to prison for burglary, petty theft and car crime associated with obtaining the money to feed their drug habit. If they do not have work and a settled lifestyle, they will reoffend and be sent back to prison. Andy Ellis receives only £375 per client compared with the £35,000 that it costs to lock up a person. The redistribution of that money would be an obvious way in which to tackle such a major social problem.
3.12 pm
Mr. George Osborne: This has been an interesting debate. I know that we are always supposed to say that. In fact, since I became a Member of the House, every hon. Member who I have heard wind up a discussion has begun by saying the debate has been interesting. However, I mean that particularly in respect of the hon. Member for Bassetlaw (John Mann). When I have heard him speak in the main Chamber, he has spoken with extraordinary passion and knowledge about the problems of drug addiction in his constituency. He has done so again today. In many ways, he is a model of how, if a person has enormous knowledge about a specific subject, that person can speak with great authority in Parliament. Having heard him speak before, I have certainly taken such a lesson from him and, having listened to him today, I have taken it again. I cannot add to his criticisms of the progress2work scheme and suggestions for its improvement because I do not have the same in-depth knowledge.
On behalf of the Conservative party, the official Opposition, I say that, despite the occasional sniping from some who have spoken today, we genuinely want the progress2work scheme to work. Naturally, we believe that there is great purpose in trying to put people with a history of drug addiction back into employment. Not only is that good for the country, because we all know the horrendous cost of drug addition to our society, but it is good for the individuals concerned. Every available piece of evidence—the statistical and personal evidence that we have from our constituencies and personal lives—is that the best way to help drug addicts out of addiction after they have received rehabilitation treatment is to try to get them into permanent housing and employment, and bring them back to the mainstream of society. We all want to achieve that.
As Members of Parliament who are here to hold the Executive to account, we should question whether the money being spent on progress2work is money well spent. Could it be better spent on different kinds of schemes and could the scheme be improved? We are talking about considerable sums of money. The Government invested £40 million in the first three years of progress2work and have committed themselves to an annual ongoing cost of around £20 million for the scheme. We are talking about large sums of money that have the capacity to do real good.
In my remaining five minutes, I should like to ask the Minister some specific questions and to pick up on some of the points made by hon. Members. First, what record does progress2work have in placing people into sustained employment? The hon. Member for Bassetlaw called it a poor record. The hon. Member for Aberdeen, South (Miss Begg) conceded that the scheme had been up and running for only a month in her constituency. The hon. Member for Sheffield, Heeley (Ms Munn) conceded that there was a slow take-up and the hon. Member for Rhondda (Chris Bryant) said that only five of his constituents had found sustained employment. What is the national record? The written answer that the Minister gave to the hon. Member for Bassetlaw in
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November 2003 said that, up to the end of 2002, only 31 people had been placed in sustained jobs. What are the latest figures?
Chris Bryant: Will the hon. Gentleman give way?
Mr. Osborne: As the hon. Gentleman used the word "socialism" in his speech I must give way to him. It was such a first that I want to hear what he has to say now.
Chris Bryant: It was not a first and will not be a last. Although only five people went into sustained employment, 21 have gone into other jobs. Moreover, 23 people in the Rhondda have gone into other training and educational opportunities.
Mr. Osborne: I accept that there may be other outcomes from the progress2work scheme, but its principal purpose is to put people into sustained employment. I merely ask the Minister to tell us the current record of progress2work.
My second question is: what is that as a proportion of the total number of people who have been in a progress2work scheme? Can the Minister confirm that there are targets? Mike Stuart of the Centre for Economic and Social Inclusion, which was involved in setting up progress2work and monitoring it, said that there was an initial target of 33 per cent. of people progressing into these jobs. That is not being achieved at the moment. I should be interested to know whether there are targets, even if they are not being achieved.
Thirdly, why does the Minister think that there is such a variation between the different districts? Hon. Members talked about the areas that they represent but it is striking that, in Plymouth, the scheme managed to get 70 people into jobs, in Glasgow, north, it managed to get 55 people into jobs and in other areas such as north Birmingham, Newcastle and Tayside, the numbers are five or fewer. Nothing is obviously different about those places, so why is there a variation? What is the Minister doing to monitor the difference in success rate, so that he can identify what works and what does not?
Fourthly, does the Minister think that there needs to be earlier involvement in the rehabilitation process by progress2work? John Hollis-Davis, chief executive of the Social Partnership in Liverpool, clearly believes that progress2work did not get involved early enough. He calls it an
"Elastoplast to cover an enormous sore".
He argues that it is simply an add-on at the end rather than being fully embedded in the system. What is the Minister doing to tackle a problem that all hon. Members have raised: the involvement of employers and persuading larger employers to engage with the scheme?
My fifth question concerns "joined-upness"—that is probably not a word. How is progress2work working with other schemes? The hon. Member for Bassetlaw gave the example of the DAAT in his having £540,000 to put people into jobs. How is that working with progress2work? There seems to be no joined-up thinking.
My final question concerns prisons, in which I have a personal interest. In my constituency, I have what is about to be the biggest women's prison in the country.

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At least 80 per cent. of the women are heroin addicts. The prison is about to be substantially enlarged. What is being done to help them when they come out of prison? I know that there is the fresh start initiative, but how does that interact with progress2work and what is being done with prisoners?
I find it difficult to add to the very powerful speech made by the hon. Member for Bassetlaw. We all want recovering drug addicts to be helped into full-time employment, but is progress2work working as well as the Minister hopes, and what can be done to improve it?
3.20 pm
The Minister for Work (Mr. Desmond Browne): I add my congratulations to those of other hon. Members to my hon. Friend the Member for Bassetlaw (John Mann) on securing a debate on this important subject. I have listened carefully to the points made by him and other hon. Members. I shall try to come to them individually, and in the inadequate time left to address them as best I can. A frustration of this welcome additional debating Chamber is that issues often generate questions that the Minister is left with insufficient time to answer. I shall, however, do my best.
My hon. Friend the Member for Bassetlaw is to be congratulated not only on securing the debate but on his commitment to the issue of drug abuse in his constituency and on the work that he has done consistently since he has been a Member of this House. He may have been involved in such work before he was elected. That includes the helpful work that resulted in the Bassetlaw heroin inquiry report. One of the recommendations of that report to my Department was to roll out progress2work in other parts of his constituency. He says that his experience is relevant to his constituency but, as my hon. Friend the Member for Rhondda (Chris Bryant) said, it is reflected in constituencies across the country where there are, unfortunately, significant numbers of people suffering from class A addiction problems. That is why my Department has developed a special programme for former class A drug abusers. In my Department, we refer to those facing the greatest barriers to work as the hardest to help.
It is undoubtedly true that those who are addicted to class A drugs are among the hardest of the hardest to help. I make that point because, when Parliament makes not only the Government but those whom we charge with the responsibility of delivering programmes accountable for expenditure of public money, and when we assess whether their programmes are a success, we must realise what challenges the customers—drug abusers—present. I welcome the fact that the programmes appear to be welcomed across the House. Those customers have to overcome multi-faceted barriers because, quite often, drug addiction is only one part of a very chaotic and difficult lifestyle. It must be dealt with in many different ways.
I accept that the Government must become better at joining up those resources and the programmes for class A drug abusers, so that they work together to best effect. I cannot always promise that Department for Work and Pensions programmes can provide, for people who want
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to address their drug addiction problems or their longterm ambitions, a one-stop opportunity in every part of the United Kingdom, such as a work-focused one-stop centre bringing together all the support that they need. However, as the progress2work programme develops—it is in its earliest days as the first areas went live in October 2002—it will do so through the co-ordinators that we have put in place in Jobcentre Plus offices. It will also develops— through growing and building relationships with organisations such as DAATs and other organisations in the private and public sectors that work with this client group. That will increase cohesion. enable the programme to become better known and provide such opportunities to people in a better and more focused way.
Underlying some of the constructive criticism from my hon. Friend the Member for Bassetlaw and from the hon. Members for Tatton (Mr. Osborne) and for Chesterfield (Paul Holmes) was a sense that this labour market programme was under-performing. As the Minister with responsibility for the programme, I say to them that that is far from the conclusion that I have drawn. I shall seek to address the performance issues in the way in which the hon. Member for Tatton asked me to do, by giving the House the figures that he asked for. I believe those figures to be impressive, and I shall explain why.
I believe that I shared the figures with my hon. Friend the Member for Bassetlaw in a letter that I sent to him, following a recent conversation that we had. The national figures for progress2work show that, to date, 6,736 people have started the programme. Of those. 1,215 people have moved into jobs, 333 of which are described as sustained jobs. The Department defines a "sustained" job as one that a person has sustained for 13 weeks or more.
Those figures must be considered against the background that progress2work is being phased in. At present, we are in the third stage of progress2work, the first stage having gone live in October 2002, the second in July 2003 and the third in October 2003. I shall not do the mathematics for the hon. Member for Tatton by telling him what percentage 1,215 is of 6,736 he can do that for himself. Equally, I do not have to do the arithmetic for him on how long someone needs to have been in work from October 2003 for them to be considered as having a sustained job.
We need to apply a degree of common sense to the matter. We are dealing with people who are among the hardest to help, and so getting them into a programme and maintaining them in that programme is an achievement. That is why the programme is called progress2work. Although the focus in our Department is consistently on the outcomes of jobs—rightly so, because that is our business—we recognise that, with that particular client group, progress to work, as well as the outcome of jobs, is a measure of success.
It is for Parliament to decide whether that level of progress to work is consistent with the expectations of the programme when it was designed. However, the progress achieved to date is still among the best of the international comparators. My hon. Friend the Member for Bassetlaw undertook to write to me about where there were programmes that were giving better

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results than this one, and I am grateful for that. I will look specifically at the countries to which he referred in his speech.
Before coming to the House today, I commissioned some research on other countries that have attempted to deal with that particular client group. I discovered that, around the world, most programmes are small and some are time limited, unlike progress2work. Very few of the programmes have good quality follow-ups and the client groups' problems are of varying severity. However, I shall share with hon. Members some of the measures of success. For example, in Bielefeld, Germany, five out of 74 people obtained paid work through a programme that was specifically designed for class A drug users. In the Integra scheme in Ireland, the figure was 20 out of 71. In New Zealand, in a programme working with Maori youth, who were much harder to help than those just facing class A drug addiction problems because of additional problems related to ethnic issues, one person out of the 235 referred to the programme obtained work after three months. On a programme in the USA that worked with women, 41 per cent. of the 366 who enrolled obtained at least part-time work.
I am running out of time, but I undertake to review the debate—
Mr. Frank Cook: Order. We must move on to the next debate.

Post-war Iraq
3.30 pm
Adam Price: At the outset of my remarks, I would like to place on the record, somewhat breathlessly, that I have the utmost admiration for our servicemen and women, who have shown great fortitude in difficult circumstances in pursuance of their duties in Iraq.
The occupation of another country is always difficult and dangerous, but it is also dangerous to be occupied. I wish to focus this afternoon on the civilian casualties since the end of the war. The sad fact is that Iraqi civilians—non-combatants—more than any other group have died in the battle between insurgents and coalition forces in the past seven or eight months. According to the Washington-based Project on Defence Alternatives, in the first six months of the occupation 200 civilians have been killed by insurgents and 200 have been killed by coalition forces. Let us remember that these unarmed civilians have been not simply caught in the crossfire, but killed by coalition forces in the street, in demonstrations, in their own homes and in custody.
Following the killings early on in Fallujah, we have, rightly or wrongly, come to expect such incidents from nervous and inexperienced American troops. However, it has only recently begun to emerge in press reports and through some carefully crafted parliamentary questions that the problem of civilian casualties caused by coalition forces is as much an issue in the British zone as in the rest of Iraq. That calls into question the perception that human rights violations by the coalition forces are the preserve of the Americans.
It is certainly true that the Ministry of Defence has had plenty of recent relevant experience in peacekeeping, facing similar problems in Bosnia, Kosovo and East Timor. However, the key lesson of those conflicts—s namely, the need to deploy international law enforcement and judicial personnel as quickly as possible after the end of hostilities—appears to have been forgotten in the case of southern Iraq. In May, the Government promised 1,500 international civilian police officers to protect the city and train local police. Yet Stephen White, our appointed Director of Law and Order in Iraq, complained that by October there were only 15.
Whatever responsibility individuals may have for any of the alleged deaths, I contend that the deaths are also a direct result of the Government's failure to localise and internationalise law enforcement sufficiently quickly. In that vacuum, soldiers and civilians have lost their lives unnecessarily, and lives will continue to be lost unless we show a greater sensitivity to civilian deaths allegedly caused by coalition forces. To date there has been little evidence of that sensitivity from the MOD. No soldier has been charged, either by the Americans or by us. We refuse even to keep a count of the civilians our forces have allegedly killed.
Apart from the morality of the situation, we are making a huge strategic error. Nothing is more certain to antagonise an indigenous population now and for generations to come than killing innocent civilians with impunity. Think of Bloody Sunday and the disastrous effect that it and the subsequent cover-up had in intensifying and prolonging the troubles over a quarter

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of a century. Think, ironically, of the composition of the coalition involved in the Boston massacre in 1770, when five civilians were killed by British forces in an incident that became the starting point of the American war of independence. A conflict is only intensified when soldiers kill unarmed civilians and their actions are excused.
It is in everybody's interest, from every perspective—pragmatic and principled—to minimise civilian casualties and, when they happen, to treat them with the gravity and the sensitivity they deserve. That does not seem to be happening at the moment. I shall concentrate on three areas: the refusal to publish the number of civilian casualties; the lack of transparency in the process of investigating those deaths; and our failure to fulfil our obligations under international humanitarian law.
First, on the number of civilian deaths, although the coalition, rightly, keeps meticulous records of coalition deaths, it has consistently refused to give statistics on the number of civilian casualties, either during the war or in the period since 1 May. Every civilian death is a tragedy, but the failure even to count them is a travesty of justice. Trying to get accurate information from the Ministry of Defence has been like getting spilt blood out of a stone. The Secretary of State for Defence said in a written answer:
"We have no reliable means of ascertaining the numbers of civilians killed by United Kingdom forces since the conflict ended."—[Official Report, 14 October 2003; Vol. 411, c. 8W.]
The Minister of State explained that that was because in some incidents Iraqis, injured or dead, may be buried or hospitalised by the time British forces return. With due respect, the fact that a body has been removed does not prevent its exhumation for the purposes of post-mortem examination, the taking of witness statements, or the examination of the report detailing the number of rounds fired and the casualties inflicted, which has to be filed by the commanding officer.
In a reply yesterday, the Minister of State said that all casualties witnessed by UK forces are reported, so I ask him today how many civilian casualties have been reported by British forces in southern Iraq. I also ask him to comment on the report in the Sunday Mirror on 7 December that the Secretary of State has ordered an inquiry into the number of civilians killed and told field commanders to submit more precise and detailed reports, including the numbers of civilian casualties, in any future incidents.
On the issue of accountability, coalition provision authority regulation No. 17 states that coalition personnel are
"immune from local criminal, civil and administrative jurisdiction and from any form of arrest or detention other than by persons acting on behalf of their parent states".
What is interesting about that is that it contravenes the sixth amendment of the American constitution, which was one of the key issues in the complaints against George III in the declaration of independence. Following the Boston massacre, British soldiers were given legal immunity from prosecution in the United States for the deaths they caused in the local population. That created the impression that the military were, in
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effect, above the law. That is surely the perception that people in Iraq have of "George II" and the forces in Iraq. No member of the coalition forces has been charged in relation to any of the 200 alleged deaths caused by coalition forces since the end of the war.
Many people will have read with horror and disgust Robert Fisk's account in The Independent on Sunday at the weekend of the death in September in British custody of Baha Musa, who was hooded and tied with a rope around his neck—a pretty horrible way to die. Can the Minister confirm that there have been five other deaths in British custody in Iraq? Can he give us the names of the deceased and tell us whether anyone has been charged in relation to those deaths?
The British Government have apparently offered £4,500 to the Musa family. Can the Minister tell us how that figure was arrived at, especially considering the excruciating nature of Baha Musa's injuries, and the fact that he was such a young man, whose death left two children orphaned. Does the Minister agree with the statement made by a senior coalition official that the value of a life in Iraq is probably a lot less than it would be in the United States or the United Kingdom? Compensation arrangements are governed by section 6 of coalition provisional authority regulation No. 17, which provides that any claim shall be submitted to and dealt with by the parent state of the person whose activity is alleged to have caused the loss; and the claims will be dealt with in a manner consistent with the national laws of the parent state. The principal law in England and Wales that relates to claims for compensation for a fatal accident caused by another person's negligence is the Fatal Accidents Act 1976. Will the Minister confirm whether Iraqi families have been informed of their right, under the CPA order notice, to bring a civil action in this country under the terms of that Act?
The MOD has rejected seven claims for compensation for fatalities. Possibly, though by no means certainly, those relate to a large number of alleged civilian deaths in Majar al-Kabir, which were attested to by the assistant director of the local hospital, the local Iraqi police and several news agencies, but denied by the MOD. Will the Minister give us the details of the claims that were rejected and the reasons for their rejection? In this context, it is particularly relevant to note that the MOD denied reports of beatings of 11 innocent Iraqis in Majar al-Kabir, including a woman who, according to reports, begged the soldiers not to hurt her children and was struck over the head with a rifle butt. However, the MOD was forced to apologise following press reports in this country. There is a question mark as to whether it is right for the military to be judge, jury and investigating officer in these cases.
That brings us to the legal framework. Under articles 65 to 77 of the fourth Geneva convention, occupying powers are obliged to observe international standards of due process. However, the MOD has failed to comply with those on a number of occasions. In May 2002, the European Court of Human Rights ruled that the UK had violated the right to life of Dermot McShane—who was crushed by an Army vehicle in Northern Ireland in 1996—by failing to ensure an effective, independent investigation into his death. That was confirmed in the recent High Court decision in the case of Kathleen Thompson.

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The case law in respect of the European convention is clear that there must be an effective investigation, and the criteria for such an investigation are laid down. The persons responsible for the investigation must be independent of those implicated in the events. The investigation must be effective in the sense that it is capable of leading to a determination as to whether the force was justified. There is a requirement for promptness and reasonable expedition, and there must be a sufficient element of public scrutiny of the investigation. In particular, the victim's next of kin must be involved to the extent necessary to safeguard their legitimate interests. None of those criteria has been met by the investigations conducted by the special investigation branch so far in Iraq.
In the case of Manning, the courts in this country held that, given the importance of article 2—the right to life—of the European convention, there had to be compelling grounds for not giving reasons as to why a prosecution would not follow a death in custody. What are the compelling reasons why no one has so far been charged in connection with the six deaths in custody, some of which date back as far as May last year? I should confirm in passing that the European convention applies in Iraq. A case has already been admitted against Turkey for operations in northern Iraq. Was the Minister aware of the applicability of the European convention and, again, have we advised the families of the deceased that the option of bringing a case against British forces under the European convention is available to them?
I put three principal recommendations to the Minister in the light of the above. We should begin to keep accurate records of civilian casualties in the areas under our control. We should facilitate a complaints procedure through adequate legal representation for the Iraqi population, and agree to pay compensation to victims of unlawful use of force. We should ensure that proper mechanisms are in place to ensure prompt, impartial and independent investigations into all noncombatant deaths. The last point necessitates a civilian, rather than a military, internal investigation system, possibly through the appointment of an independent ombudsman in the coalition authority, who could oversee all complaints.
I ask the Minister to cast his mind back to his time in Northern Ireland and his dual role as the Minister with responsibility for both security and victims. We were told that he was to be the listening ear to thousands of people who had suffered. I ask him sincerely to take up that dual role now in Iraq, and to be the Minister for both the armed forces and the innocent victims of the occupation—not just the victims of the Ba'athist rump, but our victims: the victims of our mistakes and misdeeds. That is what real accountability means in a mature democracy. It means taking responsibility for one's actions.
By inspiring the confidence of the victims of abuse, we will inspire confidence in a future based on the respect for human rights, the rule of law and a democratic culture. Justice must be done, and must be seen to be done, for the long-suffering people of Iraq. That is the grave responsibility of the Minister.
3.46 pm
The Minister of State, Ministry of Defence (Mr. Adam Ingram): I congratulate the hon. Member for East Carmarthen and Dinefwr (Adam Price) on securing this Adjournment debate. He has touched on a number of important issues, and I welcome the opportunity to set the record straight. The hon. Gentleman has been a consistent critic of our policy in Iraq, and his contribution today should be considered against that background. I would argue that it is neither objective nor accurate in many of its salient points. I shall deal with those points, but first I shall set his criticisms in the context of what the coalition of some 30 nations has achieved to date against the barbarism and brutality of Saddam Hussein's regime.
For 12 years that regime flouted the will of the international community and United Nations Security Council resolutions. It launched unprovoked and senseless wars on its neighbours and tortured, terrorised and destroyed the lives of Saddam Hussein's citizens, including through the use of chemical weapons. The hon. Gentleman did not mention any of those matters.
I now come to the charges made by the hon. Gentleman. He called for the establishment of an ombudsman and some independence in the process in Iraq. In essence, he was saying that our troops have acted indiscriminately, without due regard for the rule and import of international law; and that their investigations are not independent, and because of that we do not know the circumstances of incidents, or even the names of the victims. Nothing could be further from the truth.
Our forces are working in partnership with the Iraqi people to establish a safe and secure environment. and are doing so under the rule of law. That principle governs the training that our forces receive and all that they are doing in Iraq under the most difficult conditions, at times under fire, and often showing remarkable restraint. None the less, as the hon. Gentleman said, there have been some civilian deaths.
Without prejudging those cases, it might be helpful to clarify what we mean by "civilian death". For our purposes, the term "civilian" applies to all Iraqis. Besides peaceful law-abiding men, women and children, it includes those former regime loyalists who have since April continued to bomb, kill and maim their fellow Iraqi countrymen and women and coalition troops. It also includes those who are frustrating the work of the vast majority of the Iraqi people to build a safe, secure and prosperous Iraq.
It has been suggested that we are refusing to keep records of such casualties. That is not true. All incidents of alleged or possible fatalities of which our people are aware are recorded by the unit involved. Although we record all such incidents, it would be wrong to claim that we have an exhaustive record, because we cannot always be certain of the number of fatalities that result. In some incidents, such as ambushes on our forces and firefights, those who have been attacking UK forces and who have been injured or killed are removed from the scene.
I was interested in what the hon. Gentleman said about exhuming bodies. I wonder what impact it would have on the local communities if coalition forces dug up graves because we thought that someone who had been killed by a member of the coalition forces had been buried there. He Should reflect on his suggestion.

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There have also been incidents in which UK forces have been forced to withdraw from an engagement with no reliable means of ascertaining the number of fatalities. Given the criminal nature of some attacks, it is unsurprising that the former collaborators of the dead are reluctant to report fatalities. Finally, gun battles have taken place in which our forces were not involved, but there have been claims that they were responsible for casualties none the less.
Against that background, I hope that the hon. Gentleman understands why it is impossible to claim to have complete and accurate records. Any organisation that claims so is doing a disservice to the truth. However, let me make it clear that we take our obligations and responsibilities seriously. If a confirmed civilian fatality was allegedly caused by UK forces, and we are aware of that, we endeavour to inform relatives through the International Committee of the Red Cross. The local commander reviews the circumstances to determine whether the UK forces involved acted within their rules of engagement. If he judges that they did—for example, they were returning fire against the deceased, having first been fired at themselves—no further action is taken other than a report of the incident being prepared and retained.
If there is any doubt for whatever reason about the circumstances, the commanding officer must initiate an investigation by the Royal Military Police. Seventeen cases have been referred to the RMP in that way. It was found in three cases that forces acted within their rules of engagement; four were traffic accident cases, and the deaths were the result of tragic accidents. In the case of Radi Nu'ma, it was found that he had died of natural causes in our custody and there was no case to answer. Investigations into the remaining cases continue.
I am also aware of the case of Baha Musa, about which there has been much public comment. A complex and thorough investigation involving interviews in Britain and Iraq is now at an advanced stage. Given that, it would be inappropriate to comment further at this time. Unlike the hon. Gentleman, I do not have it in my gift to set myself up as judge and jury in the way that he has done in predetermining where guilt should lie.
It has been suggested that the RMP cannot conduct impartial or independent investigations. That is not the case, and is a calumny on the integrity of those who carry out that function on our behalf, often in dangerous circumstances. In exercising its constabulary powers, the RMP is independent of the Army's chain of command.
The Army Prosecuting Authority is statutorily independent of the chain of command. The chain of command is not allowed to seek to influence it. That independence was confirmed only last December by the European Court of Human Rights in the Cooper case. As members of professional bodies—the Bar Council or the Law Society—Army prosecutors have an overriding duty to the court to act with independence in the interests of justice. As an additional protection from interference, the APA is answerable to the Attorney-General.
In addition to possible disciplinary action and in accordance with the coalition provisional authority order, British Forces deal with third-party claims for
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personal injury or death allegedly caused by British troops that have not arisen through military combat operations in a manner consistent with English domestic law. Such settlements are made without prejudice to other claims. Where a claim made against British forces arises from an activity that would not normally give rise to a liability under English Law, we may nevertheless make a small ex gratia payment, in accordance with local custom or to meet an urgent humanitarian need.
It has also been claimed that UK forces are not given adequate guidance on the use of force. In fact, they receive training on the use of force both prior to and during their deployment. That includes a lecture on the legal issues relating to the use of force and the rules of engagement, an operational brief to put the rules of engagement into context, and scenario-based training under RMP instruction on the use of force. Once in theatre, they are given a lecture on the rules of engagement by the legal advisor. Further training is available if required.
Mr. Tam Dalyell: Will my right hon. Friend give way?
Mr. Ingram: I am trying to deal with specific issues. I understand my hon. Friend's views and his desire to enter the debate, and if I can give him time later, I will.
Individual service personnel are aware that in all situations they may use no more force than is absolutely necessary. The principles for the use of lethal force in non-combat situations are based on UK domestic law. As well as receiving training on the relevant principles, UK forces are issued a summary in the form of what is known as a "soldier's card", which they carry with them. Those principles are no different from those in force in other theatres of operations, such as Afghanistan and the Balkans. In Iraq, where British Forces have faced a higher and more sustained threat, the same principles apply.
In November and December, British forces were subject to two dozen attacks per month involving mortars, rocket-propelled grenades, small arms and improvised explosives. I commend the restraint of our people in dealing with those situations: the hon. Member for East Carmarthen and Dinefwr did not even mention that. The measured response of soldiers from the Royal Regiment of Wales—constituents of the hon. Gentleman might be serving in Iraq—in diffusing a riot in Basra, which was widely reported in today's press, is further testament to the quality of our people and their training, and it highlights the benefits of the plastic baton round in dealing with such incidents.
The hon. Gentleman listed many extracts of law, and referred to the corpus of law in some areas. As I have said, we seek to build the rule of law in Iraq, in partnership with the Iraqi people. The practices that we adopt, and which I have set out, are in accordance with two key United Nations documents—the code of conduct for law enforcement officials, and the basic principles on the use of force and firearms by law enforcement officials. The code of conduct sets out the basic minimum standards for all civilian and military law enforcement officials. It covers matters such as upholding human rights and the use of force only when strictly necessary and to the minimum extent. The basic

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principles document covers both officials and the Governments that employ them. The document is aimed at ordinary policing duties rather than occupying forces policing a recent war zone, but our rules, practices and procedures comply with it.
The hon. Gentleman mentioned Assistant Chief Constable Stephen White and his comments of last year about the level of UK civilian police support in Iraq. I visited Iraq shortly before Christmas. I know ACC Stephen White well: the hon. Gentleman referred to my time in Northern Ireland, and I knew Stephen White then when he was a officer in the then Royal Ulster Constabulary. I had a high regard for all that he did there, and I was pleased when he took on his current appointment in our area of involvement in Iraq. I sought him out to find out about his comments, and I was glad to hear him say that he is pleased with the level of support that he is now getting. While his comments might have had some relevance at an earlier time, that is not the case any more. We should deal no longer with history, but with current facts.
Adam Price: Can the Minister say how close we are to the target figure set in May of 1,500 international civilian police officers in southern Iraq?
Mr. Ingram: ACC White is the best person to judge that. He is the person who made the comments. When I asked him about them, I said that if he had expressed a similar type of concern to me, I would have pursued that appropriately. I am less concerned now than I was then.
We regard any loss of life as deeply regrettable and we take our obligations to avoid or minimise casualties extremely seriously. Steps to avoid such casualties are integrated into every aspect of military operations. When there is any indication that those measures may have failed, we investigate fully in order to learn the lessons that will make incidents of civilian death and injury fewer still. I believe that, thanks to the courage and professionalism with which the armed forces have conducted themselves in Iraq over the past 10 months, the need for such investigations has been limited.
The hon. Gentleman referred to my time in Northern Ireland. During some of that period, I held a dual ministerial role: I had responsibility for both victims and security personnel. I therefore take the issues under discussion very seriously. The moral high ground does not rest solely with critics in respect of Iraq. This matter goes right to the heart of Government, and all Government Ministers who have a responsibility take these issues very seriously.
Mr. Frank Cook: I suspect that there is about to be a Division in the House so, with the consent of hon. Members, I propose to suspend the Sitting for 15 minutes.
4 pm
Sitting suspended for a Division in the House.

Tuition Fees (Cornwall)
4.15 pm
Matthew Taylor: I welcome the opportunity to have this debate, as we await the publication of the final details of the Government's proposals, and I welcome the Minister.
It may be worth touching on the background to the Government's position. On 23 July 1997, announcing the introduction of university tuition fees, the then Secretary of State for Education and Employment, the right hon. Member for Sheffield, Brightside (Mr. Blunkett), said that
"the entire objective in taking our difficult decisions has been to put higher education on a firm footing for the next two decades."—[Official Report, 23 July 1997; Vol. 298, c. 958.]
What happened? Asked that question by the Public Accounts Committee on 28 January 2002, the chief executive of the Higher Education Funding Council for England replied:
"The grant to institutions was reduced by exactly the amount that was coming through in tuition fees".
So the level of public funding per student in Labour's first term was cut by 7 per cent., and the gap in funding was plugged by the introduction of tuition fees. That did not mean more money for universities, just a different form of funding, which has resulted not in the financing of higher education being on a firm footing for two decades, but, after five years, in the universities being in an even worse position. Tuition fees have not put a single penny of extra money into higher education, despite that being their original justification. They are used simply to cut the Department for Education and Skills' annual spend, yet we are presented with the same arguments for top-up fees.
On 8 February 2001, the same Secretary of State said:
"We introduced the new funding arrangements for students … precisely to avoid the universities levying additional charges … I have made my position clear during the past two years: I am against the levying of top-up fees."—[Official Report, 8 February 2001; Vol. 362, c. 1061.]
That is a position that has changed just a couple of years or so later. It is not surprising that the right hon. Gentleman made that error, because the Labour manifesto that was published only a little later that year—the manifesto on which current Labour Members, including the Minister, were elected—stated clearly that
"we will not introduce top-up fees and have legislated to prevent them."
I might be under some misapprehension—if I am, the Minister can correct me and we can draw the debate to an early finish, as I am sure you would like, Mr. Cook—but it seems that the Government are now proposing to introduce top-up fees and have presumably not legislated to prevent them. Both promises were broken.
If we fast-forward to the White Paper on higher education in January 2003, we again find the Government talking of a need to ensure stable and sustainable funding in the long term—a case of déjà vu. To achieve that aim the Government are proposing variable top-up fees levied on students of up to £3,000 from September 2006. Is not putting in place stable and sustainable funding for the long term exactly what the

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Government said that they were doing in 1997? Why on earth should we believe the Government when they say it now, when they so clearly did not mean it then?
I have raised the debate to focus on the impact on Cornish students, particularly in relation to debts and disincentives. The Government set the goal of widening participation in higher education. As a Liberal Democrat, and unlike the Conservatives, I welcome that commitment, even though I am not sure that an arbitrary 50 per cent. target meets the point. All students who are able and keen to benefit from the opportunities of higher education should have the chance to do so.
How do the Government reconcile that goal with a top-up fees policy that will increase student debt and deter school leavers from university? The figures are plain: independent studies estimate that average student debt is about £12,000, although the Government acknowledge only a figure of about £8,600—either way, it is a substantial sum. The Government acknowledge that debt will almost double to—on their figures—about £15,000 if top-up fees are introduced. By my calculation, over three years a student pays three times £3,000 in top-up fees—setting aside any issues of inflation. Assuming three full student loans of £4,000 each, which is not unlikely except for those in the tiny minority from such wealthy backgrounds that their parents can cover the full costs, a student will be left with a debt of at least £21,000. That does not even take into account those who must borrow more to meet their living costs, which is a typical student experience.
A more independent study, by Barclays bank, concluded that by 2010, the year in which the first full cohort of top-up fees students will graduate, average student debt could top £30,000. Those figures are important because top-up fees make the problem of student debt even worse, debt deters children from going to university, and young people from low-income families are deterred most of all. In other words, top-up fees will deter the very people whom we are trying to encourage into higher education. For example, according to research commissioned by Universities UK and the HEFCE:
"one of the most significant findings … is that debt aversion deters entry into higher education … Debt aversion had the greatest impact on the participation of the very groups the government most wants to attract into higher education."
However, the Department for Education and Skills student income and expenditure survey 2002—03 states:
"Top-up fees of £3,000 will put even more poor students off university".
Other research on the DFES website demonstrates that the students most dependent on paid work while at university are those from the poorest families. We can see the impact of student tuition fees: in 1998–99, 47 per cent. of students took paid work in term time, at a cost to their studies; by 2002–03, that figure had increased to 58 per cent. Therefore, a disadvantage is built into the system for the very families about whom the Government care. Such students are not only from a poorer background and building up debt, but have to work and take time away from their studies, which students from wealthier backgrounds do not need to do.
The Government argue that, on their current plans, 30 to 35 per cent. of the poorest students will be exempt from fees. That assumes that such students will use their
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grants to pay off fees, but they will still have to cover their maintenance costs, and so on. They will be robbing Peter to pay Paul; they will still have to empty the piggy bank and build up debt. Under Liberal Democrat plans, however. there would be no top-up or tuition fees and an introduction of grants for poorer students to meet their living and study costs.
If we put that in the context of Cornwall and remember the three basic principles, we realise the problem. First, as the Department's research shows, the prospect of debt deters students from going to university; secondly, the prospect of debt acts as the strongest deterrent for children from low-income families, as the Department's research also shows; and, thirdly, as even the Government acknowledge, debt will increase significantly to an average of at least £15,000 once top-up fees are introduced. That raises very serious concerns for students in Cornwall, which is a relatively low-income county that, as a result of tuition fees, has not shared in the national expansion of student participation rates in higher education experienced in other parts of the country. Tuition fees have already had a relative detrimental effect, and top-up fees will make that even worse.
For the Minister's information, in 1997, 21.79 per cent. of school leavers in Cornwall entered higher education; in 2001, the figure was lower, at 21.77 per cent. That follows from the basic principle that debt deters children from relatively low-income families from going to university, and the fact that Cornwall is a county with below-average income levels. By contrast, in higher-income earning areas, there has been a consistent expansion in HE participation, especially in the wealthiest area, London and the south-east.
Relatively low wages in Cornwall mean that the impact of those increased debts that the Government are introducing on those looking to work in Cornwall will on average be three years more hard labour. There is evidence that graduates in Cornwall are hit harder by lower wages than comparable individuals entering work in other parts of the country. If we assume that lower income in Cornwall spreads across the spectrum fairly equally, we can conclude that it will take graduates returning to work in the county approximately three more years to pay off their student debt. It will take a female Cornish graduate returning to work in the county approximately 20 years on average Cornish wages to pay off the debts incurred as a student, and 17 years for a male graduate to do so. The Government entirely ignore that in their figures on the so-called graduate premium—the extra money a graduate is expected to earn. Women do not get that premium as men do.
Although we have low wages, our county has among the highest property prices in the country because of people moving to the county later in life or for retirement. A graduate couple starting their life together in the county and looking to buy a first home will, already be saddled with £30,000 of debt, according to the Government's figures, and with debt of £60,000 or more according to the Barclays bank figures. We might

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rationally assume a figure in between, but either way, that is the size of a small mortgage—indeed, quite a large mortgage for most adults—and that is before the couple have even started their first job, let alone bought their first home or had their first child.
The latest speculation is that former students will not have to repay until they are earning more than £15,000, but that is still lower than the average wage in Cornwall, let alone the average graduate wage. On the Government's figures, top-up fees of £3,000 will increase student debts on graduation from an average of £8,600 to at least £15,000—and more likely from £12,000 to in excess of £20,000. We already know that a smaller proportion of Cornish 18-year-olds are enrolling in higher education now than in 1997, when tuition fees were introduced. Before then, numbers had been rising, as they had in other parts of the country.
Almost half—46 per cent.—of the 18-year-olds whom I surveyed in the county and who responded said that tuition fees, let alone top-up fees, made them less likely to go to university. That finding has been consistent in all surveys of 18-year-olds in my constituency over the past seven or eight years. Of the 18-year-olds surveyed, 58 per cent. believed that because of low wages and poor job prospects—and even without the threat of top-up fees—they would have to leave Cornwall within five years to seek better employment. Not only is there a disincentive for Cornish students to go to university in the first place, there is a built-in disincentive for them to return to the county. That is made worse by large debts. We already know that when people have a large debt it is difficult for them to take on the prospect of lower wages than they might get elsewhere. The draw of London and the south-east for graduates will therefore increase, while the disincentive to go to parts of the country that need skills most, such as Cornwall, will increase.
The so-called premium of £400,000 that the Government claim a graduate can expect to earn over a lifetime is nonsense. I do not believe that the Minister can defend that claim in any way today. It is based on an unweighted 2001 sample—it is not statistically accurate—and most of those in it graduated when only 15 per cent. of the population went to university. At that time, a substantial earnings premium was expected over a lifetime, but given that the Government now want half the population to go to university, it cannot by definition be true that the same premium will apply. In any case, as I said, the premium does not apply to women, and it certainly does not apply to people in Cornwall.
One hundred and fifty-nine Labour MPs share the Liberal Democrats' concern and have signed an early-day motion opposing variable top-up fees, although, regrettably, none of the Labour MPs representing Cornwall or Devon has had the courage to do so. Only Liberal Democrats have proposals to abolish all student top-up and tuition fees without cutting higher education. Recent Conservative proposals to abolish tuition fees would cost more than 200,000 university places, let alone any planned expansion. So, the Conservative option is that there will be no fees for those lucky enough to go to university, but that many, many more students will not have the chance to go in the first place. Those students from Cornwall who find it difficult
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to get a place at the moment will find it even more difficult in future.
Indeed, the implication is no combined universities in Cornwall. The university education project that the Labour Government have implemented, which we welcome and for which I have campaigned from the day that I was elected—as have many others across the parties—is ruled out by Conservative plans. Inevitably, places such as Exeter and Plymouth, where student numbers are contracting, will not be willing to provide the extra investment or the extra places that are needed for the combined universities in Cornwall project.
While the Conservatives might be voting in the same way as many Labour Back Benchers, they are doing so on a different, narrow-minded and restrictive basis. By contrast, Liberal Democrats have consistently opposed all tuition and top-up fees since 1997, which the Conservatives have not, and are calling on the combined universities in Cornwall to rule out any use of top-up fees if Labour introduces them, in order to guarantee an affordable higher education opportunity for Cornish students. Of course, the combined universities say that they cannot afford to do that because the per-student funding that the Government say is necessary to see students through is based on the assumption that the charges will be levied. Were they to do so, the combined universities in Cornwall would have to offer a second-class education because they would not be able to afford to do things properly. Understandably, and regrettably, they are not able to rule out the levying of fees in the county.
Unlike that of the Government, our policy is crystal clear. Unlike that of the Conservatives, it is based on principle—the principle that all who can benefit from higher education should have the opportunity to do so without saddling themselves with unsustainable debt. As the Prime Minister keeps quoting entirely inaccurate evidence, I shall finish by explaining our point. The richest 1 per cent. of the population—those earning over £100,000—would pay 50 per cent. tax on their earnings above £100,000, compared with the normal higher rate of 40 per cent. is comparable with top rates across Europe and in parts of America, such as New York. That would raise £4.5 billion, according to the Government's figures. Of that, £2 billion would be used to abolish all university fees, including tuition fees, as well as top-up fees. We would also free up £350 million to cover the reintroduction of student grants—not to pay the top-up fees, which the Government plan, but to help students with the basic costs of getting to university and studying, so that the poorest students could, once again, afford to do so. Would we expect students to make any contribution to their higher education? Of course. They would—except for those very poor students who could not afford it—be responsible for maintaining themselves, funded by student loans. However, they would not have to pay for the basic costs of the education itself.
The Government have already stepped the wrong side of that principle with the introduction of tuition fees, but with top-up fees they are going many thousands of pounds further in the wrong direction. It is clear that, although under the Government's plans some Cornish students would not have to pay the top-up fees because their families had such low incomes that they did not need to, many—including those on relatively low

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incomes—would have to pay. We know the impact that tuition fees have had, and the impact of top-up fees is staring us in the face. The principle is wrong. Students' only chance of getting out of them will be if some universities—and it does not look as though that will include the combined universities in Cornwall—offer not to charge them, but those universities will then provide a second-class education.
I welcome the fact that so many Labour Back Benchers have decided to stand by their manifesto pledges of 2001 and the promises made during the 1997 to 2001 Parliament, and I regret that the Government seem determined to press ahead. We shall see what they say when the Bill is finally published, but I hope that enough Labour MPs will stand together to defeat the measure and that, at long last, that might include some from my part of the world.
4.34 pm
The Minister for Lifelong Learning, Further and Higher Education (Alan Johnson): I congratulate the hon. Member for Truro and St. Austell (Matthew Taylor) on having initiated this debate at a time when the subject is topical. I was hoping that we would avoid the party political Punch and Judy show in which we shall, I am sure, have plenty of opportunities to engage in the coming weeks, and that the debate would provide me with a further opportunity to set out the Government's thinking.
However, I should start on a point of agreement—probably the only one that we have—which is that the policy of Her Majesty's official Opposition would have a detrimental effect on university education and, in particular, on the combined universities in Cornwall. I know about that issue because I was dealing with it as the Minister responsible for regional development agencies when the proposal was first mooted, and consider it vital to the future of Cornwall and the south-west.
Having outlined that point of agreement, I will calmly set out the rationale behind the Government's proposals. The need for reform, investment and expansion is compelling. The hon. Gentleman mentioned the figure of 50 per cent. If a target of 50 per cent. causes a hang up, forget it. We need expansion and we think that setting a 50 per cent. target is the way to move towards that expansion. However—this is a point for Her Majesty's official Opposition, who are not present—even people who disagree with all the arguments for expansion must still agree with the need for increased investment, not least because if we want to keep the participation rate at the current level of 43.5 per cent., we will need to provide places for about another 124,000 students, because of the demographic blip that will affect the system. So, even to maintain the current figure, more university places are needed.
The need for reform is compelling and we have an opportunity to create a well-funded university sector that is able to maintain its position in the world. In the short time available, I will not go into the points made about 1997, 2001 and now. The only point I will make is that, in the countries responsible for 40 per cent. of the world's population, there has been a dramatic change
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even since June 2001. When we were all marching around the doorsteps during the election campaign, there were 5 million higher education students in China. Two years later, there were 15 million, which is an incredible expansion. That is mirrored—although not to the same degree—by a huge expansion in India. In Canada, Australia and America, the whole thrust is towards increasing the number of graduates so that they can take advantage of opportunities that are available in the knowledge-driven economy. That is why the position of Her Majesty's official Opposition is so questionable. Even in 2001, that momentum and competition were not around.
The number of people in higher education is continuing to rise year by year, and, according to my statistics, it is continuing to rise in Cornwall. The hon. Gentleman mentioned 18-year-olds. I have figures for 18 to 20-year-olds entering higher education, which is fair because that takes into account gap years and other things. They are the figures that are generally used and they show that in 1997, 33.7 per cent. of 18 to 20-year-olds in Cornwall went into higher education, as opposed to 32.4 per cent. in England as a whole. So, the numbers in Cornwall were higher than the English average. In 2001, the figure for Cornwall had risen to 35.4 per cent. and was still above the English national average of 35.2 per cent.—we are talking only about England, and Cornwall, in this debate. [Interruption.] I realise that there are those who argue that Cornwall is not part of England. There are those who argue that Hull is not part of England. My figures suggest that numbers are expanding in Cornwall, and in England, and it is important that they continue to do so for reasons that we agree on and that relate to the number of jobs there will be by the end of the decade that will require graduate qualifications.
Our White Paper makes it clear that institutions need greater levels of funding to be able to compete. There is a big area of difference—an area about which Liberal Democrat Members would disagree even with the 159 signatories to the early-day motion. The real difference is that for Labour Members the debate is not about whether graduates should make a contribution, but about how that contribution should be made. That is where the Liberal Democrat policy is wrong. I agree with them completely on the need for expansion and investment, and on many of the other issues of widening participation, but I disagree fundamentally with their opposition in principle to graduates making a contribution.
That has to be the nub of the debate because until we cross that rubicon we cannot have a genuine debate about where we go. I say that not in a party political sense but because every proper analysis of the problem, from the Dearing national committee of inquiry to the Cubie commission and the Rees commission post-devolution—all set up to consider the question of student funding—rejected the argument that graduates should not make any contribution whatever. Cubie rejected it in far starker and sterner terms than Dearing. All those commissions argued that graduates should make a contribution, as has the Select Committee on Education and Skills in four reports—although I know

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that that Committee has the famous "Lib-Dem one" who stands against it.
The Conservatives on that Select Committee should be applauded because going against party policy, and having considered all the evidence, they have decided that graduates should make a contribution. I will say one thing for the Liberal Democrats: their policy has been consistent since 1997, whereas Her Majesty's official Opposition, having set up the Dearing commission and walked through the Lobby to support it, now claim that they oppose the whole principle of graduate contribution.
The important point for students in Cornwall, East Yorkshire, Worcester, the north-west and throughout the country is how they should make that contribution. Our proposals are to abandon the up-front fee, which may well have an effect on poorer students in Cornwall. However, there were those who said that introducing a fee would put students off higher education, but the figures show no evidence of that. There were those who said that moving from grants to loans would put students off higher education. It has not; student numbers have expanded. It is fair to say that even among students from poor backgrounds who would not have to pay a penny of that up-front fee, something in their minds suggested that they would have to ask their parents to pay for it; it was an entry fee to higher education.
We shall abolish the up-front fee, and introduce the ability for universities to set a fee between zero and £3,000. I could argue that that is not a top-up fee as we understand it. I will not, but I am tempted to because there is a Scottish graduate endowment scheme that leads many people to think that students in Scotland do
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not pay a penny towards their university education. Of course they do, but I will not engage in any sophistry on the matter.
On the level of fees, at the moment no university can charge more, or less, than £1,125. We are saying that it is for the universities to decide where to set that fee, between zero and £3,000. The graduates make their contribution rolled up with their loan repayments after they have graduated. We have increased the earnings threshold for when they commence their contribution from £10,000 to £15,000 a year, and graduates will pay their contribution on an income-contingent basis when they are earning more than £15,000 a year. That is very important because it means graduates will make a lower contribution than they are at the moment. A total of 83 per cent. of students take out loans. As far as I am aware, Liberal Democrat policy is not to return to grants instead of loans—I might be wrong about that. [Interruption.] That is their policy. At the moment, the contribution for someone earning £18,000 a year—the average starting pay of a graduate—is £13.85 a week. That would drop to £5.19 under our proposals.
For those and many other reasons—the reintroduction of the maintenance grant, the introduction of the regulator and the other facilities that we have put in place—we sincerely believe that the policy is not good just for widening participation in higher education, but for our economy and for the whole of the HE sector, which is why Universities UK agrees with our policy.
Question put and agreed to.
Adjourned accordingly at sixteen minutes to Five o'clock.

TREASURY

  Annuities
  Kevin Brennan
  To ask the Chancellor of the Exchequer what steps he will take to improve competition in the market for bulk-buying of index linked annuities; and if he will make a statement. [145727]

  Ruth Kelly
  The operation of the market in bulk annuities is a commercial matter for the companies and pension schemes concerned.

  BCCI
  Harry Cohen
  To ask the Chancellor of the Exchequer what matters relating to BCCI and(a) the Bank of England and (b) his Department are outstanding; whether any of these matters could carry a liability to the public purse; and if he will make a statement. [146359]

  Ruth Kelly
  The Bank of England's position on the impending legal proceedings relating to BCCI, including an indication of costs already incurred, is set out on pages 35–37 and 91 of its 2003 annual report. A further update will be given in this year's annual report.

  The Treasury are not a party to these proceedings.

  The Treasury are considering a request unrelated to the legal proceedings against the Bank of England for the release of a BCCI-related document. This has no implications for the public purse.

  Child Trust Funds
  Mr. Gardiner
  To ask the Chancellor of the Exchequer what information will be provided to(a) children and (b) parents to show them how different investment scenarios will affect the return on their child trust funds, with particular regard to how (i) equities, (ii) cash and (iii) bonds are likely to perform. [145697]

  Ruth Kelly
  The Government want parents to engage actively with the child trust fund (CTF) and recognise that, for many parents, this may be their first investment product. We will provide resources to ensure parents are helped to make choices about their child's CTF, including an information pack, which will be issued alongside the CTF voucher and a dedicated CTF website.

  Information will include illustrations of investment returns, which will also be of interest to children as they grow older. Annual statements issued by providers to all children, and teaching and learning resources for use in the classroom, will also help children engage with their accounts and develop an understanding of how different investments could affect returns.
  348W
  Mr. Gardiner
  To ask the Chancellor of the Exchequer what assessment he has made of the implications for those on non-family benefits should they wish to make contributions to child trust funds. [145700]

  Ruth Kelly
  Money held in children's child trust fund (CTF) accounts will not affect family benefits claimed by a child's household.

  The Government will keep under review the treatment of capital in income-related benefits so that a sensible balance is struck between providing state support and not unfairly penalising those who have acted responsibly by saving. As a first step, the Government announced on 15 December 2003, Official Report, column 1344 that, from April 2006, the £3,000 threshold above which savings reduce eligibility to income support, jobseeker's allowance, housing benefit and council tax benefit will be increased to £6,000 in line with pension credit.

  The pension credit rules include protection against capital deprivation to deal with cases where the real reason behind disposing of savings is to access pension credit or increase the amount of pension credit payable.

  Whether payment into a CTF is treated as a deprivation of capital will depend on all the circumstances of the case. However, in most cases it is unlikely that modest contributions to a CTF would be treated as deprivation of capital.

  Civil Servants (Disabilities)
  Mr. Goodman
  To ask the Chancellor of the Exchequer what progress has been made in meeting targets for the proportion of people with disabilities in senior posts in his Department. [146002]

  Ruth Kelly
  Statistical information about senior civil servants with disabilities is available on the civil service statistics website at http://www.civil-service.gov.uk/ statistics/documents/pdf/disability-oct03.pdf.

  This information is also made available in the Library of the House. The latest statistics show staffing data as at 1 April 2003. The data shows that in my department there are no senior civil servants who have declared a disability. The Treasury target for the proportion of people in senior posts who have declared a disability is 3 per cent.

  Tim Loughton
  To ask the Chancellor of the Exchequer how many senior civil servants in his Department are disabled, expressed in(a) numbers and (1)) as a percentage of whole-time equivalents. [144984]

  Ruth Kelly
  The information requested is available on the Civil Service Statistics website at: http://www. civil-service.gov.uk/statistics/documents/pdf/disabilityoct03.pdf

  This information is also available in the Library of the House. The latest statistics show staffing data as at 1 April 2003. The data show that:

  in the Inland Revenue there are 10 senior civil servants with a disability, 3.1 per cent. of the total number of senior civil servants in that Department;

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  in Customs and Excise there is a number less than five, which is 2.9 per cent. of the total number of senior civil servants; and in the Treasury there are no senior civil servants with a disability.

  Equity Release Schemes
  Mr. Gardiner
  To ask the Chancellor of the Exchequer what research his Department has undertaken to assess the benefits consumers perceive if financial products, with particular reference to equity release policies, are regulated by the Government. [145717]

  Ruth Kelly
  A regulatory impact assessment was published on 5 June 2003 that set out the costs and benefits of giving the Financial Services Authority (FSA) responsibility for regulating mortgages, including mortgage-based equity release schemes. This is available from the Treasury website: www.hm-treasury.gov.uk

  The purpose of the consultation paper, "Regulating Home Reversion Plans", is to arrive at a more in-depth analysis of the costs and benefits of the regulation of home reversion equity release plans. A draft regulatory impact assessment was included as Annex B to that document and we look forward to receiving views on that, as well as other aspects of the consultation.

  European Investment Services Directive
  Mr. Gardiner
  To ask the Chancellor of the Exchequer (1) what discussions he has had with business organisations about the impact the European Investment Services Directive will have on their companies, with specific reference to the impact that the end of execution-only sales will have; [145706]

  (2) what assessment he has made of how the European Investment Services Directive and the end of execution-only sales will affect (a) banks, (b) internet companies, (c) consumers and (d) the City of London. [145709]

  Ruth Kelly
  The Government were disappointed with the position adopted by the European Council of Ministers on the proposed new Investment Services Directive. We believe that in several areas the Council text misses opportunities to create a competitive, integrated European financial market and instead will harm competition.

  An area of particular concern for the Government during negotiations was the treatment of "execution-only" business in the Directive. We believe that it is important to ensure that execution-only business is not compromised by unnecessary regulation. Such business can provide low-cost access to share trading, for example, for a wider range of investors.

  During negotiations, the Government successfully ensured that execution-only business will be exempt from full "suitability testing" obligations.

  The Government will work hard with the Financial Services Authority to ensure that the provision relating to execution-only business is not implemented in the UK in a way which restricts normal marketing activity or direct offer promotions.

  The Investment Services Directive is one of the topics discussed when Treasury Ministers meet members of the financial services industry.
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  At official level, the Treasury has frequent contact with representatives of financial services businesses, trade associations and consumer groups. Recent contacts have involved discussions of the potential impact of the Directive on activities including on execution-only sales of financial instruments.

  Financial Education
  Mr. Gardiner
  To ask the Chancellor of the Exchequer what tax incentives are available to companies providing free financial education for(a) children and (b) adults; and how these fit into the Government's policy to reduce financial illiteracy. [145710]

  Ruth Kelly
  There are no specific tax incentives in place aimed at encouraging companies to provide free financial education to children or adults.

  Improving basic financial literacy is a key element of the Government's strategy to reduce social and financial exclusion, while tackling over-indebtedness, and promoting saving. We are doing this across government to help people identify and meet their financial needs. Key initiatives include:
  the Saving Gateway, a transparent savings account with tailored financial advice and education;

  a framework for Personal, Social and Health Education (PSHE) that provides for personal finance education to be taught throughout Key Stages 1 to 4 of the school curriculum; and

  pension reforms that will help people make better informed choices about their retirement.

  We also work closely with the Financial Services Authority, which has rightly taken the lead in developing a national strategy for financial capability.

  Islamic Home Finance Initiatives
  Mr. Gardiner
  To ask the Chancellor of the Exchequer what regulation there is to protect Muslims from mis-selling of housing finance that complies with Sharia law. [145720]

  Ruth Kelly
  I understand that some Islamic home finance arrangements may already fall within the definition of a regulated mortgage contract under the Financial Services and Markets Act 2000 (Regulated Activities) Order 2001 (SI/2001 No. 544) and would therefore be covered by the regime that the Financial Services Authority (FSA) will be implementing from 31 October 2004.

  However, as explained in paragraph 36 of the consultation document 'Regulating home reversion plans', we are seeking information on arrangements that are not reversion plans but which might nevertheless be caught by any legislative definition of a reversion plan if we decide to regulate home reversion plans. These might include alternative property financing arrangements that may be used by banks to provide housing finance which complies with Sharia law.

  Gershon Review
  Mr. Flight
  To ask the Chancellor of the Exchequer whether savings expected from implementation of the findings of the Gershon Review have been taken into account in the public expenditure totals for future years published in the pre-Budget report 2003. [145945]
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  Mr. Boateng
  Paragraph B27 of the pre-Budget report sets out the assumptions on which the fiscal projections, including public expenditure projections, are based.

  National Statistics
  Mr. Burstow
  To ask the Chancellor of the Exchequer how many deaths from(a) chronic obstructive pulmonary disease and (b) lung cancer were recorded in each year since 1996, broken down by age; and how many deaths per 100,000 population there were in each case. [146210]

  Ruth Kelly
  The information requested falls within the responsibility of the National Statistician, who has been asked to reply.

  Letter from John Pullinger to Mr. Paul Burstow, dated 7 January 2004:

  The National Statistician has been asked to reply to your recent question asking how many deaths from (a) chronic obstructive pulmonary disease and (b) lung cancer were recorded in each year since 1996, broken down by age; and how many deaths per 100,000 population there were in each case. 1 am replying in his absence. (146210)

  All the figures requested can be found in the annual series, published by ONS, Mortality Statistics: Cause. Series DH2. Copies of these publications are available from the House of Commons Library. This publication is also available on the internet at: http://www.statistics.gov.uk/ST ATBASE/Product. asp?vink = 618

  The most recent volume in the series, DH2 No. 29, contains the latest available data, for 2002. Table 5 of this publication shows death rates for 1996 to 2002 for lung cancer (1CD-10 C33-C34; 1CD-9 162) and chronic obstructive pulmonary disease (1CD-10 J40,144; ICD-9 490-492, 496). The number of deaths by sex and age can be found in Table 2 of each annual volume.

  Home Reversion Products
  Mr. Gardiner
  To ask the Chancellor of the Exchequer (1) what support he has received from consumer organisations for his plan for the Financial Services Authority to require a valuation of properties used as collateral for home reversion plans; [145721]

  (2) if he will draw up tables of guidance on the amount of money people should expect when taking out home reversion products; and if he will discuss this with (a) consumer groups, (b) mortgage companies and (c) financial advisers. 1145722]

  Ruth Kelly
  The Government are carrying out an open consultation on whether the Financial Services Authority (FSA) should regulate home reversion plans. We published a consultation paper 'Regulating home reversion plans' on 11 November and responses are due to be returned by 13 February 2004.

  The issue of property valuation and pricing of reversion plans is considered in paragraphs 21 to 23 of the consultation document. If it is decided that the Financial Services Authority (FSA) should regulate home reversion plans, the details of the regime will be decided by the FSA on the basis of a separate consultation and cost/benefit analysis.

  IT Contracts
  Mr. Sayeed
  To ask the Chancellor of the Exchequer if he will list information technology contracts in his 352W
  Department with a value of above £20 million in each of the last 10 years; what the inception date for each system was; when it became fully functional; when it became fully debugged; and what the cost of over-runs has been. [146200]

  Mr. Boateng
  HM Treasury has never had an information technology contract above £20 million.

  HM Customs and Excise has let two IT Contracts in excess of £20 million in the past 10 years. An outsourcing contract was signed on 25 August 1999 with Fujitsu C&E Services Ltd., for the provision of IT and telephony infrastructure services. Because this was a services contract, there was no debugging. The Transfer of Undertaking was achieved to target without any overrun. A second contract was awarded to BT/ Syntegra in 1989 for the provision of the CHIEF (Customs Handling of Import and Export freight) service. The contract was extended to January 2007 to recognise new strategic business requirements and allow sufficient time for the CIPR (Customs Information Processing Requirement) procurement process. To date, there have been no cost overruns.

  The Inland Revenue has three IT contracts whose budgets exceed £20 million. First, it has a strategic contract with EDS, which commenced on 1 July 1994. This contract covers all IT services for Inland Revenue systems, their enhancement, day to day maintenance and new systems development. It is not a fixed price contract. Major systems are delivered within their own individual internal budgets, and the contract with EDS has supported the development and delivery of these systems since 1994.

  The contract was extended to January 2007 to recognise new strategic business requirements and allow sufficient time for the CIPR (Customs Information Processing Requirement) procurement process. To date, there have been no cost overruns. The Inland Revenue has three IT contracts whose budgets exceed £20 million. First, it has a strategic contract with EDS, which commenced on 1 July 1994. This contract covers all IT services for Inland Revenue systems, their enhancement, day to day maintenance and new systems development. It is not a fixed price contract. Major systems are delivered within their own individual internal budgets, and the contract with EDS has supported the development and delivery of these systems since 1994.

  In 1998 the Inland Revenue inherited a contract from the Department of Social Security for the provision of the NIRS2 Services run by Accenture (formerly Andersen Consulting). The system went live in July 1998 and has been stable since April 2000. The NIRS2 service was provided under a PEI contract which has since been adjusted to allow for the unprecedented level of change required of the system by new legislation. There were some well documented delays in introducing the N IR S system, involving extra development costs, paid for by Andersen Consulting. The Inland Revenue has also incurred business recovery costs, enabling the introduction of more modern and automated business processes.

  The E-IROS contract was awarded to Computacenter in June 2000 for the provision of desktop hardware, software and related services. This is not a fixed price

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  contract and consequently the value of the contract depends on the annual demand for desktop services. It has, however, exceeded £20 million in each of the last four years.

  Economic Activity (Leeds, North-West)
  Mr. Best
  To ask the Chancellor of the Exchequer what the rate of economic activity was in the Leeds North-West constituency in(a) 1997 and (b) 2002–03. [146204]

  Ruth Kelly
  The information requested falls within the responsibility of the National Statistician, who has been asked to reply.

  Letter from Colin Mowl to Mr. Harold Best, dated 7 January 2004:
  The National Statistician has been asked to reply to your recent Parliamentary Question about economic activity rates. I am replying in his absence. (146204)

  The attached table shows the working age economic activity rates for the Leeds North West constituency in successive twelve month periods ending from February 1998 to February 2002. These estimates are from the annual local area Labour Force Survey (LFS). Comparable information for the twelve month period ending February 2003 is not yet available. Working age is defined as ages 16–64 for men and 16–59 for women.

  The series of annual activity rates from 1997/98 to 2000/01 is fairly stable, and the sharp fall in the estimate for 2001/02 may have arisen partly from sampling variability. As with any sample survey, estimates from the LFS are subject to this source of variation.

  Working age1 economic activity rates2 in the Leeds North West constituency

  March to February

  Percentage

  1997–98

  83.5

  1998–99

  79.9

  1999–2000

  82.0

  2000–01

  84.0

  2001–02

  73.9

  1 Men aged 16–64 and women aged 16–59

  2Economically active as a percentage of the working age population

  Note:

  These Labour Force Survey estimates have not been interim-adjusted to reflect the 2001 Census results

  Source:

  ONS Labour Force Survey

  Ministerial Meetings
  Mr. Russell Brown
  To ask the Chancellor of the Exchequer how often he has met on a one-to-one basis senior representatives from(a) major industrial companies and (b) oil and gas companies. [145653]

  John Healey
  Ministers and civil servants have meetings with a wide range of organisations and individuals as part of the process of policy development and analysis. As with previous Administrations, it is not this Government's practice to provide details of all such meetings. All such contacts are conducted in accordance with the Ministerial Code, the Civil Service Code and Guidance for Civil Servants: Contact with Lobbyists.

  Pre-Budget Report 2003
  Mr. Flight
  To ask the Chancellor of the Exchequer (1) how much of the sum spent on policy, funding and regulation activity which impacts on the private sector,354W
  referred to in paragraph 6.47 of the pre-Budget report 2003, was spent on each category; and if he will make a statement; [145923]

  (2) how the £9 billion referred to in paragraph 6.47 of the pre-Budget report 2003 is broken down between (a) policy, (b) funding and (c) regulation activity; [145942]

  (3) how much of the annual spend on hospitals, schools and police forces referred to in paragraph 6.47 of the pre-Budget report 2003 is spent on each category; [145952]

  (4) what assessment he has made of the cost to the private sector of the (a) policy, (b) funding and (c) regulation activity which impacts on the private sector as referred to in paragraph 6.47 of the pre-Budget report 2003; and if he will make a statement; [145954]

  (5) how the £11 billion of payments for transactional services referred to in paragraph 6.46 of the pre-Budget report 2003 is composed by (a) sector, (b) benefits, (c) tax collection, (d) tax credits and (e) other services. [146019]

  Mr. Boateng
  These are working estimates and a breakdown is therefore not available for publication.

  Public Sector Pay
  Adam Price
  To ask the Chancellor of the Exchequer what account public sector pay review bodies take of rates of(a) staff turnover and (b) vacancies in assessing benefit packages offered by public sector bodies in different regions and localities. [146706]

  Mr. Boateng
  Pay Review Bodies are independent bodies. They weigh the evidence they receive from interested parties and their own independent research to formulate recommendations on the remuneration of their remit groups. The Terms of Reference for each Review Body differ and are available from the Office of Manpower Economics, the secretariat to the Review Bodies.

  Stamp Duty
  Harry Cohen
  To ask the Chancellor of the Exchequer how many(a) homebuyers and (b) businesses in Leyton have benefited from the exemption from stamp duty on premises purchased in disadvantaged areas since the exemption was introduced; and if he will make a statement. [146365]

  Ruth Kelly
  Between the introduction of the exemption at the end of November 2001 and the end of October 2003, there were 133 residential transactions and two commercial transactions recorded as taking place in the ward of Leyton which benefited from the exemption. In the same period there were 398 residential transactions and nine commercial transactions recorded as taking place in all exempt wards in the Leyton and Wanstead parliamentary constituency.

TRANSPORT

  Air Transport
  Mrs. May
  To ask the Secretary of State for Transport what discussions he has had with(a) BAA and

  355W
  (b) major airlines on the proposals which will form the basis of the forthcoming consultation on a new night noise regime at (i) Heathrow, (ii) Gatwick and (iii) Stansted. [145637]

  Mr. Darling
  As yet, no discussions have been held with any interested parties to assist in drawing up proposals for the next consultation on a new night restrictions regime for Heathrow, Gatwick or Stansted. We expect the consultation to commence in the first half of this year.

  Tim Loughton
  To ask the Secretary of State for Transport whether local authority grant financing will be available to local authorities who own airports in the South East to develop those airports. [145893]

  Mr. McNulty
  Under the new prudential capital finance system, which comes into force on 1 April 2004, a small amount of local authority airport investment will attract revenue support grant. In allocating this investment approval, the Department will give priority to health, safety, security and environmental projects required by the regulatory authorities. Local authorities will be free to make their own decisions on additional borrowing for airport development purposes, providing they can afford it. A further option would be to seek a private sector partner.

  Mr. Kenneth Clarke
  To ask the Secretary of State for Transport if he will use his statutory powers to control the(a) time and (b) volume of night flights in and out of East Midlands Airport. [145957]

  Dr. Howells
  The Government consider that existing measures to control noise from night flight operations at East Midlands Airport are adequate. Their policy towards night noise and East Midlands Airport is set out in the Government's White Paper, "The Future of Air Transport", chapters 3 and 9 respectively.

  Fuel Efficiency (Road Transport)
  Mr. Challen
  To ask the Secretary of State for Transport how many tonnes of carbon dioxide emissions he estimates have been saved as a result of the liquid petroleum gas duty rebate; and at what cost to public funds. [145734]

  Mr. Jamieson
  The Department estimates that favourable duty rates for LPG since 1996 have saved around 343.3 thousand tonnes of carbon dioxide at a cost of around £160.7 million in terms of duty forgone. This estimate assumes that all LPG has replaced petrol and not diesel.

  Government Consultation Paper
  Mr. Chope
  To ask the Secretary of State for Transport how many responses were received to the consultation paper, "On the Move: By Foot"; and when the Government will arrive at their conclusions. [145544]

  Mr. Jamieson
  We received 130 responses. We aim to publish an action plan document in the spring.

  New Roads and Street Works Act
  Mr. Chope
  To ask the Secretary of State for Transport how many convictions there have been in each of the last five years for contraventions of(a) section 51, (b) section 56, (c) section 58, (d) section 60, (e) section 66, (f) section 67 and (g) section 71 of the New Roads and Street Works Act 1991; and what the (i) maximum and (ii) average fines were imposed for each category of offence. [145541]

  Mr. Jamieson
  Comprehensive information is not held centrally on the number of offences or level of fines. Based on information collected by local authorities, the Regulatory Impact Assessment for the Traffic Management Bill showed that the number of prosecutions under the 1991 Act has been small, less than 200 over the 10 years since the Act came into force, and that the average fine has been less than half the maximum permitted, the latter being £1,000 for all the categories listed.

  Road Traffic Accidents
  Mr. Blunt
  To ask the Secretary of State for Transport how many deaths in road traffic accidents involved(a) the use of hand held mobile phones and (b) drivers smoking in (i) 2000, (ii) 2001 and (iii) 2002. [143836]

  Mr. Jamieson
  Research has shown that using a mobile phone while driving is distracting and drivers are four times more likely to have an accident if they do so. While many other activities may also be distracting, we are not aware of a similar risk from the effects of smoking while driving.

  Traffic Management Bill
  Mr. Chope
  To ask the Secretary of State for Transport if he will set out the minimum qualifications which will be required by persons seeking appointment as traffic officers under the Traffic Management Bill. [145536]

  Mr. Jamieson
  The Highways Agency is placing significant importance on appointing the right people to traffic officer posts. Persons applying for a position as a traffic officer will be required to have two years of relevant experience or one year of relevant experience with a minimum of 5 0 Levels/GCSEs at grade C or above.

  Applications will also be considered against a set of stringent competencies, aptitudes and essential criteria. A copy of the competences required has been placed in the House of Commons Library.

  Mr. Chope
  To ask the Secretary of State for Transport if he will list by police authority the number of police officers that will be displaced as a result of the provisions of the Traffic Management Bill, and the proposed timescale for such displacement. [145542]

  Mr. Jamieson
  Once implemented, the provisions within the Traffic Management Bill will free up police time from some traffic management duties. While the police will still patrol the network, they will be able to spend more time and resources dealing with vehicle, road and other crime including detection and enforcement against bad driving, vehicle theft and licensing offences.
  357W
  The plans for Highways Agency Traffic Officers will free up the equivalent of more than 500 police officers, as they are phased in over a period of three years. The information is not broken down by police authority. The effect of civil enforcement of further traffic offences by local authorities will depend on the take up of the new powers and the level of current enforcement activity in respect of those offences by the police. The manner in which any resources released are re-deployed will be a matter for the police.

  Mr. Chope
  To ask the Secretary of State for Transport how many convictions there have been in each of the last five years for offences under section 36 of the Road Traffic Act 1988 for failing to comply with the indication given by a traffic sign; and how many convictions there were in respect of traffic signs that would be subject to civil enforcement under the Traffic Management Bill. [145545]

  Mr. Jamieson
  Supplementary tables to annual Home Office Statistical Bulletins on offences relating to motor vehicles give numbers by offence type that were the subject of police action in England and Wales. The number of fixed penalty notices and convictions for "neglect of traffic directions", the offence type which includes failing to comply with the indication given by a traffic sign, in the last five years for which statistics have been published were as follows:

  Fixed penalty notices

  Magistrates court findings of guilt

  Crown court findings of guilt

  2001

  162,885

  29,034

  42

  2000

  168,234

  30,844

  43

  1999

  175,793

  30,891

  32

  1998

  189,921

  31,946

  53

  1997

  191,923

  33,144

  63

  A detailed breakdown of these numbers by the types of traffic signs contravened is not held centrally. but the figures include fixed penalties and prosecutions for traffic light offences detected by cameras. They accounted for a quarter of the fixed penalties and convictions for neglect of traffic directions over the five years. Traffic light offences will not be subject to civil enforcement under the powers contained in the Traffic Management Bill.

  Mr. Chope
  To ask the Secretary of State for Transport (1) what proportion of police time in 2002–03 expended on traffic duty on motorways and trunk roads is represented by 550 full-time equivalent police officers; [145547]

  (2) if he will give the data underlying the statement in the regulatory impact assessment for the Traffic Management Bill that the equivalent of 550 full-time police officers will be released as a result of creating traffic officers, and the number of police officers to be released by each police authority. [145549]

  Mr. Jamieson
  The Highways Agency and Association of Chief Police Officers "Roles and Responsibilities Report" identified plans that could free 358W
  up the equivalent of about 540 full-time equivalent police officers. Based on figures from Her Majesty's Inspectorate of Constabulary of 6,540 designated roads police in 2001–02, the report estimated that a transfer of non-core police activities to the Highways Agency enabled approximately 8½ per cent. of police time to work on other key tasks. Resources will be freed up over a period of about three years as Highways Agency Traffic Officers are phased in across all motorways and some key trunk roads.

  Calculations for the number of police officers to be released by each police force were made at a national level and have not been translated into resources for individual police authorities. The manner in which resources are redeployed is a matter for the police and will depend on, among other things, the current resources available and policing priorities. This does not mean that police will stop patrolling the network. instead they will be able to spend more time dealing with vehicle, road and other crime.

  Mr. Steen
  To ask the Secretary of State for Transport how many regional control centres will be established under the Traffic Management Bill; what their annual cost will be; and how many new positions will be created. [145823]

  Mr. Jamieson
  There will be seven regional control centres with an annual cost of about £15 million. It is currently envisaged that the number of new posts created will be about 300.

  Mr. Steen
  To ask the Secretary of State for Transport what the estimated cost is of each additional traffic manager as proposed in the Traffic Management Bill. [145824]

  Mr. Jamieson
  While the Traffic Management Bill proposes that each local traffic authority will be required to appoint a traffic manager, it is for each authority to decide who should carry out the role and precisely what duties they should have. The traffic manager could be an existing member of staff and/or could have other duties as well, so there could be no increase in costs. Taking the Bill measures as a whole, the Government consider that, on average, there should be no net cost to authorities.

ELECTORAL COMMISSION

  Speaker's Committee
  Mr. Blunt
  To ask the hon. Member for Gosport, representing the Speaker's Committee on the Electoral Commission when the Speaker's Committee last made a report to the House on the exercise by it of its functions. [146485]

  Mr. Viggers
  The Speaker's Committee has a statutory obligation to make a report to the House on the exercise by it of its functions at least once in each year. Its most recent report, the First Report, 2003, was laid before the House and published on 18 December 2003 as House of Commons Paper 140. Copies have been placed in the Library and the Vote Office.

ENVIRONMENT, FOOD AND RURAL AFFAIRS

  Badgers
  Mr. Paterson
  To ask the Secretary of State for Environment, Food and Rural Affairs whether the Government plans to remove the protected status from badgers. [142462]

  Mr. Bradshaw
  No.

  Climate Change
  Norman Baker
  To ask the Secretary of State for Environment, Food and Rural Affairs what position the Government took at the recent climate change meeting in Italy in respect of GM trees. [145135]

  Mr. Morley
  The UK's position at the recent negotiations on the use of sinks (afforestation and reforestation projects) in the Clean Development Mechanism at the Conference of the Parties negotiations held in Milan was that any proposal to use GMO trees should be consistent with the objective and provisions of the Cartagena Protocol on Biosafety, under the Convention on Biological Diversity. This includes a risk assessment and an advanced informed agreement procedure for GMOs intended for intentional introduction into the environment (such as seeds for planting). This was the position agreed by consensus.

  Common Agricultural Policy
  Mr. Wills
  To ask the Secretary of State for Environment, Food and Rural Affairs what estimate she has made of the cost per person per week of the Common Agricultural Policy in the United Kingdom in the most recent year for which figures are available. [144460]

  Mr. Bradshaw
  The consumer cost of the CAP can be estimated by examining the difference between UK and world prices for agricultural food products. The notional taxpayer contribution to CAP expenditure can also be estimated though, in practice, UK taxpayers contribute to the whole EU budget rather than to specific components. Our provisional estimates for 2002 show an average cost of the CAP per person of just over £2 per week.

  Correspondence
  Alistair Burt
  To ask the Secretary of State for Environment, Food and Rural Affairs when she will make a substantive reply to the letter from the hon. Member for North-East Bedfordshire of 23 October, and his fax of 16 November to the hon. Member for Scunthorpe in relation to his constituent Mr. Ross Donovan. [143883]

  Mr. Morley
  I responded to the hon. Member in full on 1 January 2004.

  Environmental Sustainability
  Norman Baker
  To ask the Secretary of State for Environment, Food and Rural Affairs where the UK ranks in the Environmental Sustainability Index; and if she will list the rankings of other EU countries. [145146]
  360W
  Mr. Morley
  [holding answer 5 January 2004]: The UK ranks 91st internationally in the 2002 Environmental Sustainability Index compiled by the Global Leaders of Tomorrow Task Force of the World Economic Forum in association with the Yale Center for Environmental Law and Policy and Columbia University. The rankings of other EU member states are shown in the following table. However, the UK and other countries believe this index is profoundly flawed and therefore potentially misleading, for the following reasons. It is an aggregated indicator which aims to weight together many components into a single overall measure of 'environmental Sustainability', an approach which as yet is not scientifically robust. The choice of components, and the way in which they are weighted together, is largely subjective. A different choice of components or weights would give different results, amply illustrated by the fact that the previous edition of this index, based on a different selection of components, placed the UK 16th.

  Furthermore, there are still many areas where data are not sufficiently comparable between countries, or are simply not available. The values of many of the variables used to compile this index are imputed. It should also be noted that the variables used in this index tend to measure circumstances at a single point in time rather than trends or changes, therefore to the extent the index measures anything at all, it measures the environmental situation which a country faces rather than its progress or performance in improving environmental sustainability.

  2002 ESI rankings by country

  Rank

  Country

  ESI

  1

  Finland

  73.9

  3

  Sweden

  72.6

  7

  Austria

  64.2

  28

  Portugal

  57.1

  31

  Denmark

  56.2

  33

  France

  55.5

  34

  Netherlands

  55.4

  37

  Ireland

  54.1

  44

  Spain

  54.1

  50

  Germany

  52.5

  60

  Greece

  50.9

  84

  Italy

  47.2

  91

  United Kingdom

  46.1

  125

  Belgium

  39.1

  Note:

  Luxemburg is not ranked

  Source:

  Global Leaders of Tomorrow Task Force of the World Economic Forum in association with Yale Center for Environmental Law and Policy and Columbia University

  Grey Squirrels
  Mr. Peter Atkinson
  To ask the Secretary of State for Environment, Food and Rural Affairs when she expects to receive the report from the Forestry Commission England on the control of grey squirrels. [144116]

  Mr. Bradshaw
  [holding answer 18 December 2003]The Forestry Commission has not been asked to prepare a report on the control of grey squirrels. They are however currently engaged in the preparation of a policy statement on this subject. This is one of the commitments
  361W
  made in the response to the recommendations contained in the "Sustaining England's Woodlands" review. There is no firm timetable for the presentation of the statement.

  Identity Cards
  Mr. Webb
  To ask the Secretary of State for Environment, Food and Rural Affairs what assessment she has made of the implications of the introduction of compulsory identity cards for her Department. [143355]

  Alun Michael
  The introduction of compulsory identity cards is a long-term undertaking on which interdepartmental discussions are led by the Home Office. This Department has an interest in tackling illegal working at an acceptable compliance cost to business (for example, in the agriculture and fresh produce sectors) and in providing a means to encourage legal routes of migration to the UK.

  Katherine Bryan
  Llew Smith
  To ask the Secretary of State for Environment, Food and Rural Affairs whether it was known by Ministers in her Department that Katherine Bryan had applied for the post of Chief Executive of Water Services at the Northern Ireland Department for Regional Development at the time when she was appointed to chair the Committee on Radioactive Waste Management (CoRWM); on what date she tendered her resignation as CoRWM chair; what considerations was given to the other shortlisted candidates for the Chair of CoRWM in the appointment of her replacement; and who has been chosen as a replacement for Katherine Bryan on the Committee. [143513]

  Mr. Morley
  [holding answer 10 December 2003]: No. Ministers knew of Mrs. Bryan's intention to resign on 26 November 2003. With the agreement of the Environment Ministers for Northern Ireland, Scotland and Wales, and after consultation with the Office of the Commissioner for Public Appointments, an announcement was made on 5 December that Gordon MacKerron, an existing member of CoRWM, was to be appointed as the new Chair. Among those candidates originally interviewed for the post of Chair, he was considered the most suitable replacement for Mrs. Bryan. No other appointment to CoRWM has been made.

  Pesticides
  Andrew George
  To ask the Secretary of State for Environment, Food and Rural Affairs what(a) sources and (b) methodology was used to calculate (i) buffer zone sizes, (ii) grassland area affected and (iii) arable area affected in the Pesticides Safety Directorate discussion paper proposals for the Introduction of No-Spray Buffer Zones Around Residential Properties in England and Wales. [145984]

  Alun Michael
  The consultation document included four possible buffer zone sizes. These were 6 metres (reflecting a quarter section of a typical spray boom), 1.0 metres (the minimum set-aside width); 100 metres; and 300 metres.
  362W
  For the purpose of the consultation comparisons of the economic effects of introducing these various sizes of buffer zones were made. Information was sought from the Rural Development Service's Geographic Information Unit. The Unit estimated the area of both arable and improved grassland adjacent to built-up areas in five selected areas. This was done utilising the Land Cover Map 2000 which is derived from the analysis of Earth observational satellite imagery. The resulting data was then extrapolated to provide a total figure for England and Wales.

  It was always acknowledged that these figures were illustrative, and one of the purposes of going to consultation was to see if these estimates could be refined further.

  A decision is yet to be made of what size, if any, buffer zone will be introduced. Further work is being carried out to determine more accurately the areas affected.

  Andrew George
  To ask the Secretary of State for Environment, Food and Rural Affairs from how many of the organisations and individuals invited by the Pesticide Safety Directorate to the stakeholder meeting on 13 October about the consultation on plans for greater access to information about crop spraying written responses were received(a) by the official deadline and (b) after the deadline. [146018]

  Alun Michael
  The meeting on 13 October was held with rural residents' interest groups to discuss the issues raised by the informal consultation exercise on public access to information on pesticide use and to identify how practical measures might be introduced.

  Those who attended were invited because it was felt they would be in a position to address the practical issues raised, rather than solely on the basis of having submitted a written response to the informal consultation.

  Of the 33 representative organisations and individuals who were invited, five attended, 10 submitted written responses to the informal consultation by the official deadline; the remaining 23 did not submit a response. The official deadline was extended from 31 August to 30 September to take account of the summer holiday period.

EDUCATION AND SKILLS

  CAFCASS
  Tim Loughton
  To ask the Secretary of State for Education and Skills for what reason there are no plans to publish Sir Clive Booth's report on CAFCASS. [144972]

  Margaret Hodge
  There are no plans to publish Professor Sir Clive Booth's review as it contains confidential information about individual Board members.

  The central recommendation of Professor Sir Clive Booth's review was to make a fresh start with the Board. Ministers accepted his proposal that all Board members should be asked to submit their resignations.

  Children's Minister
  Tim Loughton
  To ask the Secretary of State for Education and Skills which quangos come under the remit of the Children's Minister; and how they are accountable. [145025]

  Margaret Hodge
  I am responsible for the Independent Advisory Group on Teenage Pregnancy. The Lord Chancellor is currently the Minister responsible for the Children and Family Court Advisory and Support Service (CAFCASS). However, Ministerial responsibility for CAFCASS will transfer to me in this Year. Baroness Ashton of Upholland is Minister responsible for the Special Educational Needs and Disability Tribunal, although I have a working interest in the Tribunal's operation.

  Responsibility for the day-to-day work of these Non-Departmental Public Bodies (NDPBs) rests with their Executive Team and Board or President, although Ministers provide the overall strategic direction. Ministers appoint NDPBs' Board members or Presidents, and are answerable to Parliament for the NDPBs' stewardship of public funds; for their overall economy, effectiveness and efficiency; and for the general manner in which they carry out their remit.

  School and College League Performance Tables
  Harry Cohen
  To ask the Secretary of State for Education and Skills what plans he has to show A levels and vocational course qualifications separately in college league tables; and if he will make a statement. [146357]

  Mr. Miliband
  We have no plans to show A levels and vocational course qualifications separately in performance tables. The school and college performance tables will show combined results for General (GCE) and/or Vocational (VCE) A levels, Advanced Subsidiary (AS) qualifications and key skills at level 3. This practice recognises the qualifications as equal in worth and does not undermine the achievements in any particular qualification in any way. We are, though, currently consulting on future measures of success which will take account of the diverse curriculum offer in post 16 learning. "Measuring success in the Learning and Skills Sector" can be found at www.successforall.gov.uk. Following that consultation we will consider whether any changes in presentation should be introduced in future years' tables.

  Commonwealth Universities
  Mr. Boswell
  To ask the Secretary of State for Education and Skills what recent representations he has received concerning the possibility of a common entrance qualification for Commonwealth universities; and if he will make a statement. [145087]

  Alan Johnson
  I have received no representations on this subject. Policies on admissions decisions for Commonwealth Universities are for their respective Governments.

  Directorate Staff
  Mr. Hoban
  To ask the Secretary of State for Education and Skills pursuant to his answer of 16 December 2003,Official Report, column 833W, on
  364W
  Directorate Staff, if he will make a statement on the change in staff numbers in the (a) schools and (b) Lifelong Learning Directorates in 2003; and to which directorates the staff employed within the Youth Directorate have been transferred. [145971]

  Mr. Charles Clarke
  [holding answer 6 January2003]: Following the Machinery of Government changed in June 2003 the DfES assumed lead responsibility in Whitehall for policy on children and the family. As a result of the changes, around 120 staff from the Home Office, the Department of Health and the Department for Constitutional Affairs, who were engaged in a range of work on children and family issues, transferred to DfES. To support its enhanced role, the Department created a new Directorate: Children, Young People and Families, drawing together all those who were employed in these areas to improve the coordination of policy development and service delivery. Around 600 staff in Schools Directorate working on Sure Start and children's issues were moved to the new Directorate, accounting for the significant change in staff numbers in Schools Directorate during the latter part of 2003.

  The increase in staff numbers in Lifelong Learning Directorate during the second half of 2003 resulted from the transfer of 200 staff from the former Youth Directorate. The majority of the remaining staff in Youth Directorate transferred to the Children, Young People and Families Directorate, while a small number moved to Strategy and Communications Directorate.

  Earned Autonomy Scheme
  Mr. Gibb
  To ask the Secretary of State for Education and Skills what recent assessment he has made of the effects of introducing an earned autonomy scheme, as provided for in the Education Act 2002; and if he will make a statement. [146185]

  Mr. Miliband
  I refer the hon. Member to the answer given to the hon. Member for Fareham (Mr. Hoban) on 3 December 2003,Official Report, column 92W.

  Excellence in Cities Programme
  Mr. Luff
  To ask the Secretary of State for Education and Skills pursuant to his answer of 17 December 2003, ref.143373, for what reason he has not provided the information on the Excellence in Cities programme in the form requested. [145429]

  Mr. Charles Clarke
  We did not provide the reply in the same format as the answers relating to Leadership Incentive Grant, Education Action Zones and Excellence Clusters because the funds that are allocated to Excellence in Cities (EiC) authorities are intended for all the schools in the authority. Funds provided for the other named programmes are targeted resources for individual schools as identified by my Department and local education authorities. However, we have now provided a table in the required format, listing the total schools in each authority. It is not possible to provide a meaningful breakdown of primary and secondary schools, as we do not know exactly where individual authorities will target their EiC funds.
  365W

  Standards find 2003–04

  LEA number

  LEA

  Allocation (£)

  Number of schools

  201

  City of London

  —

  —

  202

  Camden

  298,639

  224

  203

  Greenwich

  788,775

  234

  204

  Hackney

  550,040

  274

  205

  Hammersmith

  250,500

  188

  206

  Islington

  841,633

  231

  207

  Kensington and Chelsea

  —

  —

  208

  Lambeth

  255,721

  283

  209

  Lewisham

  274,579

  244

  210

  Southwark

  560,000

  263

  211

  Tower Hamlets

  811,652

  194

  212

  Wandsworth

  250,000

  326

  213

  Westminster

  —

  —

  301

  Barking

  631,427

  134

  302

  Barnet

  —

  ߞ

  303

  Bexley

  —

  —

  304

  Brent

  312,710

  246

  305

  Bromley

  —

  —

  306

  Croydon

  —

  —

  307

  Ealing

  256,510

  297

  308

  Enfield

  319,203

  250

  309

  Haringey

  250,000

  231

  310

  Harrow

  —

  —

  311

  Havering

  —

  —

  312

  Hillingdon

  —

  —

  313

  Hounslow

  290,503

  179

  314

  Kingston upon Thames

  —

  —

  315

  Merton

  —

  —

  316

  Newham

  250,000

  213

  317

  Redbridge

  —

  —

  318

  Richmond upon Thames

  —

  —

  319

  Sutton

  —

  —

  320

  Waltham Forest

  602,958

  207

  330

  Birmingham

  1,452,020

  967

  331

  Coventry

  —

  —

  332

  Dudley

  —

  —

  333

  Sandwell

  250,000

  229

  334

  Solihull

  —

  —

  335

  Walsall

  —

  —

  336

  Wolverhampton

  295,785

  235

  340

  Knowsley

  270,833

  129

  341

  Liverpool

  1,092,361

  558

  342

  St Helens

  599,139

  175

  343

  Sefton

  815,628

  250

  344

  Wirral

  584,352

  316

  350

  Bolton

  —

  —

  351

  Bury

  —

  —

  352

  Manchester

  843,879

  451

  353

  Oldham

  250,000

  243

  354

  Rochdale

  547,987

  243

  355

  Salford

  867,664

  259

  356

  Stockport

  —

  —

  357

  Tameside

  —

  —

  358

  Trafford

  —

  —

  359

  Wigan

  —

  —

  370

  Barnsley

  258,441

  208

  371

  Doncaster

  250,000

  267

  372

  Rotherham

  837,876

  236

  373

  Sheffield

  827,240

  494

  380

  Bradford

  611,489

  489

  381

  Calderdale

  —

  —

  382

  Kirklees

  —

  —

  383

  Leeds

  1,147,048

  823

  384

  Wakefield

  —

  —

  390

  Gateshead

  864,819

  200

  391

  Newcastle upon Tyne

  550,000

  265

  392

  North Tyneside

  571,682

  159

  393

  South Tyneside

  539,954

  124

  394

  Sunderland

  854,018

  225

  420

  Isles of Scilly

  —

  —

  800

  Bath and NE Somerset

  —

  —

  801

  City of Bristol

  590,944

  374

  802

  North Somerset

  —

  —

  803

  South Gloucestershire

  —

  —

  805

  Hartlepool

  250,000

  61

  806

  Middlesbrough

  595,259

  111

  807

  Redcar and Cleveland

  279,036

  91

  808

  Stockton-on-Tees

  559,627

  127

  810

  Kingston-upon-Hull

  561,136

  200

  811

  East Riding of Yorkshire

  —

  —

  812

  North East Lincolnshire

  —

  —

  813

  North Lincolnshire

  —

  —

  815

  North Yorkshire

  —

  —

  816

  York

  —

  —

  366W

  Standards find 2003–04

  LEA number

  LEA

  Allocation (£)

  Number of schools

  820

  Bedfordshire

  —

  —

  821

  Luton

  250,000

  165

  825

  Buckinghamshire

  —

  —

  826

  Milton Keynes

  —

  —

  830

  Derbyshire

  —

  —

  831

  Derby

  —

  —

  835

  Dorset

  —

  —

  836

  Poole

  —

  —

  837

  Bournemouth

  —

  —

  840

  Durham

  —

  —

  841

  Darlington

  —

  —

  845

  East Sussex

  —

  —

  846

  Brighton & Hove

  —

  —

  850

  Hampshire

  —

  —

  851

  Portsmouth

  —

  —

  852

  Southampton

  —

  —

  855

  Leicestershire

  —

  —

  856

  Leicester

  500,000

  271

  857

  Rutland

  —

  —

  860

  Staffordshire

  —

  —

  861

  Stoke-on-Trent

  583,255

  214

  865

  Wiltshire

  —

  —

  866

  Swindon

  —

  —

  867

  Bracknell Forest

  —

  —

  868

  Windsor and Maidenhead

  —

  —

  869

  West Berkshire

  —

  —

  870

  Reading

  —

  —

  871

  Slough

  —

  —

  872

  Wokingham

  —

  —

  873

  Cambridgeshire

  —

  —

  874

  Peterborough

  —

  —

  875

  Cheshire

  —

  —

  876

  Halton

  554,366

  130

  877

  Warrington

  —

  —

  878

  Devon

  —

  —

  879

  Plymouth

  —

  —

  880

  Torbay

  —

  —

  881

  Essex

  —

  —

  882

  Southend-on-Sea

  —

  —

  883

  Thurrock

  —

  —

  884

  Herefordshire

  —

  —

  885

  Worcestershire

  —

  —

  886

  Kent

  —

  —

  887

  Medway Towns

  —

  —

  888

  Lancashire

  —

  —

  889

  Blackburn with Darwen

  297,727

  125

  890

  Blackpool

  253,384

  119

  891

  Nottinghamshire

  —

  —

  892

  Nottingham City

  608,555

  252

  893

  Shropshire

  —

  —

  894

  Telford and Wrekin

  —

  —

  908

  Cornwall

  —

  —

  909

  Cumbria

  —

  —

  916

  Gloucestershire

  —

  —

  919

  Hertfordshire

  —

  —

  921

  Isle of Wight

  —

  —

  925

  Lincolnshire

  —

  —

  926

  Norfolk

  —

  —

  928

  Northamptonshire

  —

  —

  929

  Northumberland

  —

  —

  931

  Oxfordshire

  —

  —

  933

  Somerset

  —

  —

  935

  Suffolk

  —

  —

  936

  Surrey

  —

  —

  937

  Warrington

  —

  —

  938

  West Sussex

  —

  —

  —

  Total

  28,860,350

  14,003

  Free School Meals
  Mr. Burstow
  To ask the Secretary of State for Education and Skills how many and what proportion of children received free school meals in each of the last five years; and what proportion of children were entitled to free school meals in each of the last five years. [146348]

  Mr. Miliband
  The information requested is given in the tables.
  367W

  Position in January each year—England

  1999

  2000

  Day Pupils2,32001

  2002

  20033

  Maintained nursery and primary schools1 school meal arrangements

  Number on roll

  4,507,663

  4,481,677

  4,451,224

  4,405,639

  4,350,260

  Number of pupils taking free school meals4

  690,321

  671,486

  631,638

  616,625

  604,911

  Percentage of pupil staking free school meals

  15.3

  15.0

  14.2

  14.0

  13.9

  Number of pupils known to be eligible for free meals5

  853,020

  821,521

  784,976

  754,511

  731,611

  Percentage of pupils known to be eligible for free meals

  18.9

  18.3

  17.6

  17.1

  16.8

  Maintained secondary schools 1: school meal arrangements

  Number on roll

  3,118,277

  3,177,998

  3,226,973

  3,260,931

  3,308.492

  Number of pupils taking free school meals4

  367,795

  368,303

  353,469

  354,256

  349.777

  Percentage of pupil staking free school meals

  11.8

  11.6

  11.0

  10.9

  10.6

  Number of pupils known to be eligible for free meals

  527,339

  523,630

  509,676

  486,353

  478,915

  Percentage of pupils known to be eligible for free meals5

  16.9

  16.5

  15.8

  14.9

  14.5

  1Includes middle schools as deemed.

  2Day pupils includes all full-time and part-time pupils who are solely or dually registered, excluding boarding pupils. See3 for 2003.

  3In 2003 boarding pupils are included.

  4 Number of pupils taking a free school meal on the day of the Census in January.

  5Prior to 2001 figures relate to the number of pupils known to be eligible for a free school meal. From 2001 this definition was expanded to include only pupils who were known to be eligible for and claiming a free school meal.

  Source:

  Annual Schools' Census

  Further and Higher Education
  Chris Grayling
  To ask the Secretary of State for Education and Skills whether it is his intention to increase the overall total number of students aged 18 to 30 who study for courses in(a) higher education and (b) further education institutions by 2010. [144284]

  Alan Johnson
  The White Paper: The Future of Higher Education was published in January 2003. In this, the Government set out plans to increase participation in higher education towards 50 per cent. of those aged 18 to 30 by 2010.Although there are no numerical targets for expansion of student numbers in further education, funding will increase by £1.2 billion between 2002–03 and 2005–06, a 19 per cent. real terms increase. This will help to support increased participation in further education.

  Mr. Mahmood
  To ask the Secretary of State for Education and Skills what research his Department has carried out on the ability of(a) individual learners and (b) employers to pay increased fees for further education courses. [146233]

  Alan Johnson
  I refer the hon. Member to my reply to his earlier question, 16 December 2003,Official Report, column 835W, refers.

  Mr. Peter Duncan
  To ask the Secretary of State for Education and Skills what representations he has received from Scottish universities in respect of the proposed Higher Education Bill. [145681]

  Alan Johnson
  I have received representations from a wide range of sources since the White Paper was published. My Department has had discussions regarding the proposals in the Higher Education Bill with Universities UK which represents institutions across the UK.

  School Finance
  Mr. Hoban
  To ask the Secretary of State for Education and Skills what the level of(a) revenue funding and (b) school-based expenditure per school pupil was in each of the last five years, broken down by (i) capital expenditure, (ii) expenditure on special schools and (iii) central administration and support services. [141702]

  Mr. Miliband
  The bulk of capital funding is now allocated by formula to schools and local authorities, and investment decisions are made locally in the context of the Asset Management Plan. In the interests of reducing the bureaucratic burden, the Department does not collect data for capital expenditure from schools or authorities. The information requested on recurrent funding is contained in the following tables:

  (a) Total funding per pupil aged 3-19

  England

  £

  1997–98

  2,510

  1998–99

  2,620

  1999–2000

  2,800

  2000–01

  3,060

  2001–02

  3,280

  2002–03

  3.490

  2003–04

  3,690

  Notes:

  1.Figures reflect education SSA/EFS settlement (all sub-blocks). Total funding also includes all revenue grants in DIES departmental Expenditure Limits relevant to EPS pupils aged 3–19.

  2.Figures exclude EMAs and grants not allocated at LEA level and the pensions transfer to EPS and LSC for 2003–04.

  3.The pupil numbers used are those underlying the SSA/EFS settlement calculations plus PLASC 3 year olds maintained pupils, estimated 3–4 year olds funded through state support in maintained and other educational institutions where these are not included in the SSA pupil numbers.

  4.2003–04 and 2002–03 figures are provisional estimates as some grants have not yet been finalised/audited.

  5.Cash terms figures used are rounded to the nearest 10 so may not sum.
  369W

  (b) School based expenditure per pupil

  NIE

  Pupils

  NIE per pupil

  (ii) Expenditure on special schools1

  1997–98

  882,132,000

  91,870

  9,602

  1998–99

  910,015,000

  91,837

  9,909

  1999–2000

  986,451,471

  90,980

  10,843

  2000–01

  1,071,331,814

  90,055

  11,896

  2001–02

  1,151,146,785

  89,083

  12,922

  (iii) Central administration and support services2

  1997–98

  1,206,130,000

  7,473,985

  161

  1998–99

  1,330,466,000

  7,526,071

  177

  1999–2000

  1,302.341,279

  7,565,844

  172

  2000–01

  1,408,239,708

  7,592,711

  185

  2001–02

  1,444,640.500

  7,595,137

  190

  1 Net institutional expenditure includes all school-recurrent funding, including teaching staff and non-teaching staff salaries, school premises costs, equipment and supplies, and unspent balances held by schools at the year end. Excludes spending on central administration and support services such as transport and school meals as well as capital expenditure.

  2 For 1997–98 and 1998–99 management and support expenditure comprises of spending on management and administration, inspection and advisory services, other education support services and school catering services. For 1999–2000, 2000–01 and 2001–02 management and support expenditure comprises of statutory/regulatory duties and other support services.

  Notes:

  1.Figures are in cash terms as reported by the LEA.

  2.The expenditure data for 1997–98 and 1998–99 is drawn from the annual `RO1' spending returns which local authorities submitted to the Department of Environment, Transport and the Regions. From 1999–2000 onwards, data is taken from local education authorities' Section 52 Outturn Statements submitted to the DfES. The pupil data are drawn from the DfES Annual Schools' Census.

  Language Study
  Mr. Gibb
  To ask the Secretary of State for Education and Skills pursuant to his answer of 17 December 2003,Official Report, column 958W, on language study, what measures he is taking to reverse the decline in the number of schools offering Latin at (a) GCSE and (b) A-level. [146186]

  Mr. Miliband
  It is for individual schools and colleges to decide which subjects they are to provide, aside from those in the National Curriculum. From October 2003, we have expanded the Specialist School programme to include Specialist Humanities Colleges, through which schools may focus on Latin alongside other humanities subjects. We have introduced an Advanced Extension Award in Latin which has been available since 2002.

  School Streaming
  Mr. Gibb
  To ask the Secretary of State for Education and Skills pursuant to his answer of 15 December 2003,Official Report, column 669W, on streaming, if he will assess the extent to which the practices of (a) personalised learning and (b) teaching tailored to the needs of pupils are endorsed by the conclusions of the research review conducted by the National Foundation for Educational Research. [145472]

  Mr. Miliband
  The practices of(a) personalised learning and (b) teaching tailored to the needs of pupils are fully endorsed by the research review conducted by the National Foundation for Educational Research, which concludes that "schools need to take account of
  370W
  what is most appropriate for their staff, pupils, parents and community, in the context of their particular circumstances (such as class size, pupil ability range and resources) and national developments such as the requirements of the National Curriculum."

  Schools (Leadership)
  Mr. Hoban
  To ask the Secretary of State for Education and Skills (1) what discussions he has had with the Chief Inspector of Schools about measuring effective leadership and management in schools; and what actions were taken as a consequence; [144906]

  (2) what discussions he has had with the Chief Inspector of Schools about measures to improve the performance of schools, where that performance is assessed as being adequate; [144907]

  (3) what discussions he has had with the Chief Inspector of Schools on (a) the consistency of reports on particular schools and their staff and (b) the grading of schools; [144909]

  (4) what discussions he has had with the Chief Inspector of Schools concerning the number of (a) schools, (b) teachers and (c) lessons rated satisfactory; and what the consequences of these discussions were. [144910]

  Mr. Miliband
  My right hon. Friend has frequent discussions with HM Chief Inspector of Schools, David Bell, about a range of matters relating to standards in schools.

  Specialist Colleges
  Mr. Gibb
  To ask the Secretary of State for Education and Skills pursuant to his answer of 17 December 2003,Official Report, column 967W, on specialist colleges, what the (a) Key Stage 3 and (b) GCSE/GNVQ value-added scores were in 2002–03 for those non-grammar specialist schools that select more than 10 per cent. of their pupils on the basis of aptitude; and if he will make a statement. [146187]

  Mr. Miliband
  The information requested is set out in the following table1

  School

  LEA

  Key Stage 2—3 value added measure 2003

  Chaucer Technology School

  Kent

  100.4

  Chestnut Grove School

  Wandsworth

  98.9

  Deacon's School

  Peterborough, City of

  100.9

  Glyn Technology School

  Surrey

  100.4

  Lynn Grove VA High School

  Norfolk

  100.5

  St. Margaret's C of E High School

  Liverpool

  100.5

  Key Stage 3-4 value added measures for 2003 have not yet been published. They are due to be published on 15 January 2004 in the "Secondary School (GCSE/ GNVQ) Performance Tables 2003"2.
  1 Source: "Secondary School (Key Stage 3) Performance Tables 2003" http://www.dfes.gov.uk/performancetables/ks3_03.shtml

  2 Information will be published on the following website: http:// www.dfes.gov.uk/performancetables/

  Student Finance
  Mr. Drew
  To ask the Secretary of State for Education and Skills what assessment he has made of the impact on(a) mature students and (b) part-time students of (i) the proposed changes in tuition fees and (ii) contingent loan repayments. [143106]

  Alan Johnson
  [holding answer 9 December 2003]: Mature students will be treated in the same way as younger students both as far as the proposed changes to tuition fees and to income contingent loans are concerned: where they are studying full time, up front fees would be abolished and they will be subject to variable fees of between £0 and £3,000 per year from 2006; re-payable following graduation and for any loans they take out with the Student Loans Company, they will benefit from the raising of the income threshold above which repayments are made from £10,000 to £15,000 from 2005. Part time students are already subject to variable fees: where they have taken out loans with the Student Loans Company, they too will benefit from the raising of the income threshold from £10,000 to £15,000 from 2005. We are introducing a new package of support for part time students in 2004/05, including a grant for fees of up to £575 and a course grant, neither of which are repayable. Mature students are also particularly likely to benefit from the new HE Grant of £1,000, being introduced from 2004/05. We expect around a third of all those getting the full grant of £1,000 to be independent, despite such students making up only around 15 per cent of the total student population.

  Teachers
  Mr. Simmonds
  To ask the Secretary of State for Education and Skills how much funding was made available for(a) primary schools and (b) all schools in England and Wales to pay for in-service training for teachers in each year since 1997. [145270]

  Mr. Miliband
  It is not possible to disaggregate funding solely for in-service training. Schools have the autonomy within their overall school budgets to determine how much they make available for training purposes in the light of their own priorities and needs.

  Volunteering
  Tim Loughton
  To ask the Secretary of State for Education and Skills (1) what plans he has to respond to(a) the European Commission and (b) the EU presidency on the joint statement and conclusions from the November 2003 Conference on Youth Volunteering and Civic Service; [145035]

  (2) whether he intends to take an active part in developing full time civic service and transnational volunteering programmes for young people (a) in the UK and (b) with other EU member states and accession countries; [145036]

  (3) how he will involve the experience and contribution of UK youth volunteering organisations in the process of exchanging information, research, cooperation and development of civic service. [145037]
  372W
  Mr. Ivan Lewis
  We are committed to promoting opportunities for young people not only to volunteer in their local communities through such programmes as Millennium Volunteers and the Young Volunteer Challenge but also in Europe through the European Voluntary Service. During the Irish Presidency of the European Union (EU) we will seek to influence the continuing discussions on youth volunteering, building on the European Commission's White Paper on Youth Policy and the Conclusions from the Commission and EU Presidency presented to the Rome Conference in November. Within the spirit of the Compact with the voluntary and community sector and the EU Open Method of Consultation on Youth we will continue to work closely with organisations with experience of volunteering to develop and deliver our policies and influence European-level activity.

  York Schools
  Miss McIntosh
  To ask the Secretary of State for Education and Skills what his policy is on how to bridge the funding shortfall for schools in the City of York. [145134]

  Mr. Miliband
  On 29 October my right hon. Friend announced proposals to restore stability to school funding. Amongst the package of measures, we are ensuring that for 2004–05 all schools will see a guaranteed minimum increase in their per pupil budget amounting to 4 per cent. per pupil where pupil numbers remain the same. In addition, we have ensured that schools will receive an increase in the amounts of Standards Fund, School Standards Grant and funding from the LSC for sixth forms in line with the minimum guarantee.

  We are increasing the School Formula Spending Share by a minimum of 5 per cent. per pupil— the City of York's increase is 6.8 per cent. This will give the Authority the headroom and flexibility to deliver the guarantee and provide support to help schools facing additional pressures.

  On 10 December, the Chancellor of the Exchequer announced that a further £317 million will be going to local authorities in their Revenue Support Grant for 2004–05 for authorities with education and social services functions. This is on top of the increases already announced in the provisional settlement. For almost all authorities the additional grant will reduce the pressure on services and council tax, and will make it easier for authorities to meet education passporting targets. In the case of the City of York the additional grant amounts to £1.2 million.

  However, if the City of York or any other LEA is able to put forward a compelling case that additional, transitional funds are needed in the short term—above and beyond those already available to the LEA—my right hon. Friend will be prepared to consider bringing forward grant payments from my Department, so that the LEA will have funds available in 2004–05 for this purpose, with the expectation of a consequential reduction to what they will receive in future years. The maximum amount that the City of York might be able to bring forward in this way would be £300,000.

TRADE AND INDUSTRY

  Age Discrimination
  Miss McIntosh
  To ask the Secretary of State for Trade and Industry if she will ensure that those who choose to work after 65 enjoy the same employment rights as those under 65. [145128]

  Mr. Sutcliffe
  The great majority of employment protection legislation already applies to older workers, whatever their age. We will review upper age limits on statutory redundancy payments and general unfair dismissal claims, and make final decisions on them, in the light of responses to the recent public consultation on age "discrimination, Equality and Diversity: Age Matters".

  Regional Development Agencies
  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry how much has been spent by each of the Regional Development Agencies, in each of the last four years, on corporate plans. [146080]

  Jacqui Smith
  As set out in Quangos: Opening the Doors (1998) www.cabinet-office.gov.uk/centra1/198/ pb/open/od main.htm, the Government believe that non-departmental public bodies should disclose as much information as possible including information on their role and achievements. England's Regional Development Agencies are required to prepare and publish Corporate Plans with a three year planning horizon, which are revised every two years, to synchronise planning and funding horizons with the Spending Review process. The current Corporate Plans cover the period 2003–06.

  The amount spent by RDAs in each of the last four years on printing and distribution of such plans is set out in the following table. The figures do not include the cost of staff resources in developing the detail of the plans where they are produced in-house, consulting stakeholders on the policies and activities reflected in the plans, nor the cost of departmental resources in approving them, which could be obtained only at disproportionate cost. Expenditure also varies for many reasons such as the number of copies produced, whether consultants were used or whether the plans were only made available on the internet.

  £

  2000–01

  2001–02

  2002–03

  2003–04

  AWM

  3,500

  3,500

  19,405

  29,629

  EEDA

  4,477

  8,268

  8,051

  8,416

  emda

  10,000

  LDA

  —

  500

  20,038

  27,162

  NWDA

  9,375

  8,326

  2,452

  3,058

  ONE

  50,000

  2,500

  2,500

  2,653

  SEEDA1

  SWRDA

  500

  500

  4,580

  14,568

  Yorkshire Forward1

  1 No printing and distribution costs were incurred as the Corporate Plan is only available on the internet.

  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry what has been the average length of time taken for the Government to approve projects(a) projected to cost more than £1 million and (b) projected to cost less than £1 million, that are
  374W
  proposed by each of the regional development agencies, following the issuing of a corporate plan, in the last year for which figures are available. [146081]

  Jacqui Smith
  Under Section 5(2)(a) of the Regional Development Agencies Act 1998 the Agencies may not give financial assistance without the consent of the Secretary of State. However, the consent of the Secretary of State has been given to each Agency to give such assistance subject to a specific financial limit and other conditions set out in its Financial Memorandum. Any proposed expenditure or guarantee that is in any way novel or contentious, regardless of its cost, also requires the specific approval of the Treasury.

  During 2002–03, the average time taken for DTI to approve RDA proposals for expenditure exceeding the financial limit (£5 million during 2002–03) was 3-4 weeks. The average time taken to approve projects that required additional approval from the Treasury was nine weeks.

  Mr. Andrew Turner
  To ask the Secretary of State for Trade and Industry who appoints board members of regional development agencies. [145061]

  Jacqui Smith
  The Secretary of State for Trade and Industry appoints the Chairs of England's Regional Development Agencies, while responsibility for appointing Board members is delegated to me, as Minister for Industry and the Regions.

  The process for appointing both the Regional Development Agency Chairs and Board Members is run according to the Code of Practice issued by the Commissioner for Public Appointments (this can be found at www.ocpa.gov.uk).

  Appointments are made on merit, following open competition, application and formal interviews. Each applicant is assessed against the selection criteria, as set out in the person specification for the post.

  Company Directors (Disqualifications)
  Malcolm Bruce
  To ask the Secretary of State for Trade and Industry whether a target has been set for the number of proceedings to be brought in the public interest for disqualification of company directors. [145380]

  Mr. Sutcliffe
  As announced by my predecessor, the Member for Welwyn Hatfield (Miss Johnson), to the House on 28 March 2003,Official Report, column 30-31WS, no numerical targets are set for the disqualification of company directors.

  The Insolvency Service is expected to bring proceedings in every case where it is in the public interest.

  Departmental Grants
  Brian Cotter
  To ask the Secretary of State for Trade and Industry what funding is provided in financial year 2003–04 by her Department to finance the Enterprising Solutions Award. [145489]

  Nigel Griffiths
  Approximately £35,000 this financial year.

  Departmental Staff
  Mr. Russell Brown
  To ask the Secretary of State for Trade and Industry what percentage of staff employed within her Department are over 55 years of age; and what(a) number and (b) percentage of staff recruited over the last 12 months are over 55 years of age. [145926]

  Jacqui Smith
  13.5 per cent. of staff employed within DTI HQ are over 55 years of age. Of those staff recruited over the last 12 months (1 January-31 December 2003), eight were over 55, representing 3.8 per cent. of those recruited during that period.

  Export Credits Guarantee Department
  Malcohn Bruce
  To ask the Secretary of State for Trade and Industry what value of guarantees have been issued by the Export Credits Guarantee Department since 1997 which

  £ million

  Market

  Military and Defence

  Aerospace

  Oil, Petrochemical and Gas

  Environmental

  Telecomms and Transport

  Education and Medical

  Mining

  Other

  Grand Total

  Abu Dhabi

  —

  —

  8

  —

  —

  —

  —

  48

  56

  Algeria

  —

  —

  84

  —

  —

  —

  —

  84

  Anguilla

  —

  —

  —

  —

  —

  —

  —

  1

  1

  Argentina

  —

  —

  —

  —

  —

  —

  1

  1

  Australia

  —

  57

  —

  —

  2

  —

  —

  8

  67

  Austria

  —

  13

  —

  —

  —

  —

  —

  —

  13

  Azerbaijan

  —

  13

  —

  —

  12

  —

  —

  —

  25

  Bahrain

  —

  157

  —

  —

  —

  —

  —

  —

  157

  Bangladesh

  —

  —

  —

  —

  80

  —

  —

  —

  80

  Barbados

  —

  —

  —

  —

  11

  —

  —

  —

  11

  Belgium

  —

  45

  —

  —

  10

  —

  —

  —

  54

  Botswana

  —

  —

  9

  —

  —

  —

  —

  9

  Brazil

  74

  55

  110

  —

  1

  —

  —

  151

  391

  Brunei Darussalam

  590

  —

  —

  —

  —

  —

  —

  —

  590

  Canada

  —

  345

  —

  —

  —

  —

  —

  3

  348

  Chile

  2

  173

  —

  —

  —

  —

  —

  175

  China

  —

  496

  —

  16

  36

  —

  —

  584

  1,133

  Colombia

  —

  19

  —

  —

  —

  —

  —

  19

  Costa Rica

  —

  —

  —

  —

  —

  —

  —

  —

  —

  Croatia

  —

  38

  —

  —

  —

  —

  —

  21

  59

  Cyprus

  —

  15

  —

  —

  8

  —

  —

  7

  30

  Denmark

  —

  —

  34

  —

  —

  —

  —

  —

  24

  Dominica

  —

  —

  —

  —

  —

  —

  —

  9

  9

  Dominican Republic

  —

  —

  —

  —

  27

  —

  —

  20

  47

  EC Market n/k

  —

  —

  —

  —

  —

  —

  —

  32

  32

  Egypt

  16

  43

  7

  89

  2

  —

  —

  62

  220

  El Salvador

  —

  82

  —

  —

  —

  —

  82

  Finland

  —

  32

  —

  —

  —

  —

  —

  32

  France

  —

  —

  8

  —

  10

  —

  —

  —

  18

  Germany

  1

  —

  —

  —

  17

  —

  —

  —

  19

  Ghana

  —

  —

  —

  17

  14

  —

  —

  31

  63

  Greece

  79

  77

  —

  —

  —

  8

  —

  —

  165

  Hong Kong

  —

  194

  66

  —

  192

  —

  —

  42

  494

  Iceland

  —

  31

  —

  —

  —

  —

  —

  —

  31

  India

  14

  —

  —

  —

  14

  —

  —

  77

  106

  Indonesia

  67

  142

  —

  —

  7

  —

  —

  65

  281

  Iran (Islamic Republic of)

  —

  —

  37

  —

  —

  —

  37

  115

  193

  Israel

  —

  5

  —

  —

  —

  —

  —

  16

  21

  Italy

  4

  —

  —

  —

  10

  —

  —

  —

  15

  Jamaica

  —

  —

  —

  —

  22

  —

  —

  20

  42

  Japan.

  —

  —

  —

  —

  2

  —

  —

  25

  27

  Kazakhstan

  —

  —

  —

  —

  38

  46

  —

  —

  84

  Korea Republic of

  82

  231

  —

  —

  5

  —

  20

  34

  372

  Kuwait

  8

  —

  —

  9

  —

  —

  —

  —

  94

  Lebanon

  —

  —

  —

  —

  —

  —

  —

  26

  26

  Lesotho

  —

  —

  —

  —

  —

  —

  —

  1

  1

  Lithuania

  3

  —

  —

  —

  —

  —

  —

  —

  3

  Luxembourg

  —

  84

  —

  —

  —

  —

  —

  —

  84

  Malaysia

  363

  —

  40

  —

  10

  —

  —

  773

  1,185

  Maldives

  —

  —

  —

  —

  3

  —

  —

  9

  12

  376W
  relate to (a) military and defence projects, (b) aerospace projects, (c) oil, petrochemical and gas projects, (d) environmental projects, (e) telecommunications and transport projects, (f) education and medical projects and (g) mining projects, broken down by country. [144806]

  Mr. Mike O'Brien
  The information requested is in the following table, except for(d) environmental projects. While projects may have environmental benefits, for example: water treatment plants, or paper mills that use recycled paper as raw material, it would not be appropriate to class these as primarily 'environmental'.

  ECGD has, since 2001, assessed the potential environmental and social impacts of all projects it has been asked to support, except for defence and aerospace, which are subject to separate processes.

  The currency values of ECGDs Guarantees have been converted at the exchange rates at the end of November.
  377W

  £ million

  Market

  Military and Defence

  Aerospace

  Oil, Petrochemical and Gas

  Environmental

  Telecomms and Transport

  Education and Medical

  Mining

  Other

  Grand Total

  Mauritius

  —

  44

  —

  —

  —

  —

  —

  —

  44

  Mexico

  —

  —

  68

  1

  4

  —

  2

  77

  151

  Morocco

  —

  11

  —

  —

  6

  —

  —

  —

  17

  Netherlands

  —

  178

  —

  —

  —

  —

  —

  —

  178

  Nigeria

  —

  —

  148

  —

  —

  —

  —

  —

  148

  Oman

  535

  —

  429

  —

  6

  —

  —

  35

  1,005

  Pakistan

  —

  —

  —

  10

  10

  —

  —

  2

  22

  Panama

  —

  —

  —

  5

  21

  —

  —

  —

  26

  Papua New Guinea

  —

  —

  —

  —

  —

  —

  —

  36

  36

  Peru

  —

  —

  —

  —

  —

  —

  —

  1

  1

  Philippines

  —

  151

  —

  —

  21 2

  —

  —

  142

  506

  Portugal

  —

  46

  —

  —

  2

  —

  —

  —

  48

  Qatar

  178

  148

  —

  —

  —

  —

  —

  —

  326

  Romania

  106

  —

  —

  —

  7

  —

  —

  86

  199

  Russian Federation

  —

  18

  128

  —

  184

  —

  —

  82

  412

  Saint Kitts and Nevis

  —

  —

  7

  6

  —

  —

  1

  2

  16

  Saint Lucia

  —

  —

  —

  —

  —

  —

  —

  —

  —

  Saudi Arabia

  6,225

  —

  —

  —

  8

  —

  —

  13

  6, 247

  Singapore

  19

  11 8

  —

  —

  10

  —

  —

  8

  155

  Slovakia

  —

  —

  —

  —

  —

  —

  —

  —

  —

  South Africa

  1,270

  —

  249

  —

  —

  —

  —

  84

  1,603

  Sri Lanka

  —

  129

  —

  —

  13

  —

  —

  23

  165

  Sweden

  4

  171

  —

  —

  —

  —

  —

  —

  175

  Switzerland

  —

  21 0

  —

  —

  —

  —

  —

  —

  210

  Syrian Arab Republic

  —

  —

  —

  —

  —

  —

  —

  —

  —

  Taiwan

  —

  83

  —

  —

  —

  —

  —

  141

  224

  Thailand

  30

  122

  —

  —

  76

  —

  —

  16

  244

  Trinidad and Tobago

  —

  —

  —

  —

  1

  —

  —

  —

  1

  Tunisia

  —

  50

  —

  —

  —

  —

  —

  —

  51

  Turkey

  253

  70

  33

  23

  25

  —

  —

  88

  493

  United Arab Emirates

  49

  551

  —

  —

  18

  —

  —

  11

  630

  United States

  65

  937

  —

  —

  —

  —

  —

  46

  1,048

  Uzbekistan

  —

  43

  —

  —

  —

  —

  —

  1

  45

  Vanuatu

  —

  —

  —

  —

  3

  —

  —

  —

  3

  Venezuela

  —

  10

  —

  49

  —

  —

  —

  37

  96

  Vietnam

  —

  20

  —

  —

  —

  —

  —

  30

  50

  Zimbabwe

  —

  —

  —

  —

  77

  —

  —

  12

  89

  Grand Total

  10,115

  5,480

  1,43 1

  230

  1,226

  46

  60

  3, 386

  21,744

  Ink Industry
  Andrew Mackinlay
  To ask the Secretary of State for Trade and Industry if she will ask the Competition Commission to investigate the share of Sun Chemicals, and its subsidiaries, in the printing ink industry within the United Kingdom. [141739]

  Mr. Sutcliffe
  [holding answer 8 December 2003]Decisions whether or not to investigate competition related matters are for the Office of Fair Trading.

  Media Takeovers
  Mr. Letwin
  To ask the Secretary of State for Trade and Industry if she will make it her policy to ensure that, in relation to any takeover of a major national newspaper or media group, the procedures adopted by the regulatory authorities are transparent and impartial and that there is no ministerial involvement. [R] [145244]

  Mr. Sutcliffe
  [holding answer 5 January 2004]:My right hon. Friend the Secretary of State for Trade and Industry published a consultation document on 15 December 2003 seeking views on draft guidance which she proposes to issue on the consideration of media public interest cases under the Enterprise Act 2002 (as amended by the Communications Act 2003). The new regime is substantially deregulatory compared to the old, with a small number of narrowly defined public interest considerations approved by Parliament.
  378W
  In relation to the newspaper public interest considerations (accurate presentation of news, free expression of opinion and plurality of views), new legislation recognises that, for newspapers, there have historically been a small number of cases that have raised public interest issues beyond those that would have been considered as part of a competition assessment. It therefore allows the Secretary of State to intervene in certain newspaper mergers on these public interest grounds. The draft guidance sets out some indications of the general approach she expects to adopt in deciding whether or not to intervene in a particular newspaper case. However each case will be decided on its own facts.

  In relation to the scope of the broadcasting and cross-media public interest considerations, whilst in principle the Secretary of State may intervene on these public interest grounds in any media merger case where these considerations are relevant, the draft guidance notes that as a matter of policy she expects that intervention on these public interest grounds will normally only be considered in those areas where media ownership rules have been removed by the Communications Act.

  The assessment of newspaper and other media mergers on competition grounds will be the responsibility of the competition authorities.
  379W
  All of the procedures for all parts of the process will be transparent and impartial. Copies of the consultation document have been placed in the House Libraries.

  Patents
  Adam Price
  To ask the Secretary of State for Trade and Industry how many patents involving life forms have been granted in the last five years. [145352]

  Mr. Timms
  Within the five year period from the beginning of 1999 to the end of 2003, 233 UK patents were granted which relate to life forms in general. This includes 47 patents relating to higher life forms, such as plants or animals, of which 13 specifically relate to animals.

  Post Office
  Jon Trickett
  To ask the Secretary of State for Trade and Industry what criteria are used by the Post Office to define a community for the purposes of the network reinvention scheme. [145916]

  Mr. Timms
  The development of closure proposals under the urban reinvention programme is an operational matter for Post Office Ltd.

  The programme relates only to post office branches that are defined by Post Office Ltd. as 'urban'. I understand that the company classifies as urban any post office within a community of more than 10,000 inhabitants. The Post Office has carried out detailed planning to establish which of its branches should be classified as either rural or urban and has developed a geographical mapping computer model, which measures population in terms of contiguous or very close agglomeration. Thus where a number of villages or small communities adjoin each other or adjoin a larger town, and the aggregate population of the area exceeds 10,000, the model reflects that fact and classifies it as urban.

  Jon Trickett
  To ask the Secretary of State for Trade and Industry which communities within the Hemsworth constituency are classified as urban, under the Post Office criteria. [145917]

  Mr. Timms
  I understand from Post Office Ltd that the following six post offices in the Hemsworth constituency are classified as urban, being located in communities of more than 10,000 residents:

  Kettlethorpe

  Moorthorpe, South Elmsall

  Sandal

  South Elmsall

  South Kirkby

  The Common, South Kirkby

  Jon Trickett
  To ask the Secretary of State for Trade and Industry what data source she has recommended that the Post Office use to determine whether a community has more than 10,000 inhabitants. [145920]

  Mr. Timms
  The decision to classify a post office branch as urban or rural is an operational matter for Post Office Ltd. I understand that the company uses a sophisticated geographical mapping model called the 380W
  Geographic Information System (GIS) in conjunction with a number of external and internal data sets including census data and Ordnance Survey data.

  Posting of Workers Directive
  Mr. Hancock
  To ask the Secretary of State for Trade and Industry what assessment she has made of the effect that the Government stance on the Posted Workers Directive is having on(a) the job prospects for British workers in the United Kingdom and (b) the wage levels of migrant workers in the United Kingdom; and if she will make a statement. [145486]

  Mr. Sutcliffe
  The UK fully implemented the Posting of Workers Directive in 1999, providing all workers temporarily posted to the UK from another state with certain minimum conditions of employment as laid down by law. We have no reason to believe that its implementation has adversely affected the job prospects of British workers in the UK. Unemployment in the UK fell from 5.9 per cent. in the three months ending October 1999 to 5.0 per cent. in the three months ending October 2003 (ILO Unemployment Figure, Labour Force Survey, ONS).

  UK employment rights are applicable to all workers, regardless of country of origin, so migrant workers are protected in the same way as other workers by the National Minimum Wage.

  Shareholder Participation
  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry what steps the Government is taking to encourage shareholders to vote at the Annual General meetings of FTSE All-Share companies. [146150]

  Mr. Sutcliffe
  The Government regards shareholder voting at company meetings as an integral part of shareholder engagement with the companies in which they invest.

  We fully support the continuing work of the Shareholder Voting Working Group, which has recently embarked upon a new project to identify, and propose practical solutions to, the impediments to casting proxy votes successfully at company meetings. The objective is for there to be a noticeable improvement in time for the 2004 AGM voting season.

  The Government has already enabled shareholders, through the Companies Act 1985 (Electronic Communications) Order 2000 implemented in December 2000, to use electronic communications to appoint a proxy. This enables shareholders to issue voting instructions electronically. As stated in our White Paper in July 2002, we also propose to introduce legislative measures to improve the rights of proxies. This will enable investors and others holding shares through intermediaries to ensure more easily that the voting rights in a company are exercised.

  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry what the Government's target is for average voting levels by shareholders in Annual General meetings for companies in the FTSE All-Share index; and what the average voting levels were in each of the last five years. [146151]
  381W
  Mr. Sutcliffe
  The Government regards voting at company meetings as an integral part of shareholder engagement with the companies in which they invest. The Government believes that it is the responsibility of all those involved in the voting process to ensure that it works effectively, in order that shareholders have confidence that their voting intentions are registered at company meetings.

  The Government does not collect data on shareholder voting levels centrally. Such information is available from a variety of sources, and shows that shareholder voting has increased gradually over the past five years, and now stands at around 53 per cent.

  Small Business
  Mr. Robert Jackson
  To ask the Secretary of State for Trade and Industry how many of the portfolio companies receiving Regional Venture Capital Funds have been Small Business Service SMART award winners. [146314]

  Nigel Griffiths
  The fund managers do not collect this information.

  Solar Power
  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry how many(a) individuals and (b) registered companies have applied for grants under the Clear Skies Initiative as a result of including solar power in their home design. [146119]

  Mr. Timms
  The information is as follows:

  (a) Currently, 1,445 applications for solar hot water heating systems have been received and 1,368 have been accepted, with a total grant value of £684,000.

  (b) For community/not-for-profit organisations, 90 applications have been received and 67 projects have been offered grants totalling £955,766.02 for the installation of solar hot water heating systems.

  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry how many homes in the United Kingdom have solar panels. [146120]

  Mr. Timms
  The DTI does not keep a record of all solar installations but according to figures from the Building Research Establishment there are approximately 60,000 solar thermal systems installed in the UK.

  We estimate that approximately 1,000 homes currently have PV installed.

  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry how much money has been spent under the Clear Skies Initiative on grants to homebuilders that include solar power in their home design. [146122]

  Mr. Timms
  The Clear Skies initiative offers grants only to individual householders and community/notfor-profit organisations. No grants have been given directly to homebuilders.

  Mr. Stephen O'Brien
  To ask the Secretary of State for Trade and Industry what steps her Department is taking to encourage the use of solar energy cells. [146123]
  382W
  Mr. Timms
  The DTI is supporting the demonstration of photovoltaics (PV) in housing and large public buildings through the Domestic Field Trial (DFT) and Large Scale Field Trial (LSFT). A combined budget of £10 million is supporting the installation and monitoring of PV systems in around 500 houses (30 projects) and 12–15 large-scale public buildings. The Field Trials aim to raise awareness of PV technology, create confidence in its applications, and provide opportunities for the UK photovoltaics industry.

  The Government is committed to a major initiative with industry and others to achieve a UK solar PV demonstration programme in line with our main competitors. The current programme, which started in April 2002 and is worth £20 million over three years, is the first stage of this process. At the halfway stage, over half the funding has been allocated.

  The DTI is also putting effort into removing a number of barriers to the deployment of very small generators, such as PV. These include reduction of VAT to 5 per cent. for professionally installed systems, a new PV Annex to Planning Policy Guidance Note (PPG22), simplified connection agreements to the local network (G77 and G83/1) and Installer Training and Accreditation Schemes. In addition, the Government plans to amend the Renewables Obligation to enable very small generators like PV to accumulate their production over a year, rather than a month, so as to qualify for ROCs.

MINISTER FOR WOMEN

  Female Prison Population
  Mrs. Curtis-Thomas
  To ask the Minister for Women what recent discussions she has had with the Secretary of State for the Home Department on the female prison population. [146261]

  Jacqui Smith
  I have had no recent meetings with the Secretary of State for the Home Office on this subject.

  Flexible Working
  Mrs. Curtis-Thomas
  To ask the Minister for Women what assessment has been made of the take-up by women of the right to request flexible working. [146256]

  Jacqui Smith
  Preliminary evidence, including hits on the DTI working parents website and requests for guidance, indicate that interest in the right to request flexible working by mothers, and fathers, is high. We recently published the top 10 questions asked by employees when calling the Acas helpline, and continue to gather evidence from a wide number of sources to build up a clear picture of the demand for, and uptake of, the new law.

  The Department undertook an employee Work-Life Balance survey in 2003 as a baseline for comparison with a repeat survey due in 2005. The results will contribute to the review of the law that the Government are committed to initiate in 2006. Preliminary employee findings are available on the internet, www.dti.gov.uk/ er/emar/, and we are expecting to publish the full report soon.
  383W
  We are working with key intermediaries, such as Working Families and Maternity Alliance, who are collating data through member/supporter surveys. These organisations are due to report their findings to coincide with the first anniversary of the new law to request flexible working in April this year. We are also working with Prima Baby magazine which is carrying out a reader survey, and aims to publish the results in the March edition.

  The Department has also commissioned questions on flexible working which currently appear in the Office of National Statistics monthly Omnibus survey. The results of these can be made gender specific and will be available in spring 2004.

  Gender Equality
  Mrs. Curtis-Thomas
  To ask the Minister for Women (1) what plans she has to introduce a public sector duty to promote gender equality; [146251]

  (2) what assessment has been made of the need for a public sector duty to promote gender equality. [146252]

  Jacqui Smith
  The Government are taking forward a significant legislative agenda on equality matters, and they have committed themselves to introduce a duty on public bodies to promote equality of opportunity for women and men generally when parliamentary time allows. In taking this forward, the Government will be considering the experience gained with the duty to promote race equality introduced in the Race Relations (Amendment) Act (2000).

  Pregnancy Discrimination
  Mrs. Curtis-Thomas
  To ask the Minister for Women what steps are being taken to tackle pregnancy discrimination in the workplace. [146255]

  Jacqui Smith
  Discrimination on the ground of pregnancy or maternity is a form of direct discrimination on the ground of sex. The courts have interpreted the Sex Discrimination Act as meaning that discrimination on the ground that a woman is, or might become, pregnant is unlawful. This is reinforced by the amended Equal Treatment Directive published on 5 October 2002 which says that less favourable treatment on the grounds of pregnancy and maternity within the meaning of the Pregnant Workers Directive constitutes sex discrimination.

  In 1999, the Government introduced specific protections to prevent women from suffering detriment and from being unfairly dismissed or selected for redundancy for reasons connected with their pregnancy, childbirth or maternity leave. We have also ensured a woman has a clear right to return to her job after maternity leave, on the same terms and conditions as if she had not been away.

PRIME MINISTER

  Iraq
  Llew Smith
  To ask the Prime Minister whether he or his officials have examined the transcript of the interview given by the Head of the Coalition Provisional Authority 384W
  in Iraq, on the Dimbleby Programme on 28 December 2003, with particular reference to Mr. Bremer's comments on Iraqi weapons of mass destruction; and whether he discussed Iraqi weapons of mass destruction with Mr. Bremer in his meeting with him in Basra on 4 January. [146583]

  The Prime Minister
  I follow developments in Iraq closely. When I saw Ambassador Bremer in Basra on 4 January, we had a wide-ranging discussion of the challenges facing us in Iraq, including the political process, reconstruction and the security situation.

WORK AND PENSIONS

  Incapacity Benefit
  Jane Griffiths
  To ask the Secretary of State for Work and Pensions if he will make it his policy to credit full-time students with National Insurance contributions in order to provide eligibility for incapacity benefit if they become ill. [145392]

  Maria Eagle
  Special provisions allow young sick and disabled people, who have not had the opportunity to work and build up a contribution record, to qualify for Incapacity Benefit (IB). Since 6 April 2001 young people who become incapable of work before age 20, or before age 25 if in education or training before age 20, may receive 1B without satisfying the contribution conditions.

  Pension Credit
  Mr. Willetts
  To ask the Secretary of State for Work and Pensions how many people have called the Pension Credit Helpline more than once since April, broken down by number of people making each number of calls. [146043]

  Malcolm Wicks
  The information is not currently available in the form requested.

  Mr. Willetts
  To ask the Secretary of State for Work and Pensions how many individuals received savings credit in the last period for which figures are available, broken down by declared savings of(a) less than £6,000, (b) between £6,000 and £10,000, (c) between £10,001 and £15,000, (d) between £15,001 to £30,000 and (e) over £30,000. [146052]

  Malcolm Wicks
  The information is not currently available in the form requested.

  Mr. Willetts
  To ask the Secretary of State for Work and Pensions how many households have received savings credit awards since 6 October, broken down by awards of(a) less than £5 a week, (b) between £5 and £10 a week, (c) between £10 and £15 a week and (d) over £15 a week. [146084]

  Malcolm Wicks
  Up to 30 November 2003 there were 193,000 awards of pension credit where the savings credit only is payable. Of these,(a) 41,000 were of less than £5.00 per week, (b) 59,000 were of between £5.00 and £10.00 per week and (c) 92,000 were of over £10.00 per week. In addition, there were 83,000 awards where both savings credit and guarantee credit are payable.

  385W
  Notes:

  Figures are currently available only for the three bands to which the reply refers.

  Figures have been rounded to the nearest thousand.

  Figures might not sum due to rounding.

  A monetary breakdown for households receiving both savings credit and guarantee credit will not be available until the November 2003 Quarterly Statistical Enquiry is published on 17 March 2004.

  Pensioners (Hemsworth)
  Jon Trickett
  To ask the Secretary of State for Work and Pensions how many pensioners in Hemsworth constituency are in receipt of pension credit. [145919]

  Malcolm Wicks
  I refer my hon. Friend to the written statement made by my right hon. Friend the Secretary of State (Andrew Smith) on 10 December 2003,Official Report, column 90WS, and to the accompanying tables placed in the Library.

  Pension Schemes
  Mr. Willetts
  To ask the Secretary of State for Work and Pensions how many pension schemes have started the winding-up process in each quarter since 2001; and how many pension scheme members have been affected each quarter, broken down by(a) pensioners and (b) people who had not retired when the winding-up began. [146021]

  Malcolm Wicks
  The Pensions Schemes Registry, administered by the Occupational Pension Schemes Regulatory Authority (OPRA), holds information on the number of pension schemes which are currently in the winding up process. Figures showing the number of schemes that have entered winding up each quarter since 2001 and have not yet completed winding up are contained in the table, along with the number of members in those schemes.

  It is not possible to break these figures down by pensioner and pre-retirement numbers, as the registry only provides data on total membership numbers.

  Schemes that have started winding up in the relevant period and have not yet completed winding up

  All scheme types

  Defined-Benefit schemes only

  Quarter beginning

  Number of schemes

  Number of members

  Number of schemes

  Number of members

  1 January 2001

  423

  11,365

  44

  4,744

  1 April 2001

  699

  19,829

  94

  11,827

  1 July 2001

  443

  18,138

  70

  10,805

  1 October 2001

  384

  17,782

  64

  10,988

  1 January 2002

  511

  15,760

  66

  9,610

  1 April 2002

  327

  16,245

  53

  9,745

  1 July 2002

  394

  14,674

  54

  9,735

  1 October 2002

  426

  28,340

  90

  15,232

  1 January 2003

  451

  18,877

  59

  8,118

  1 April 2003

  375

  17,024

  46

  7,472

  Notes:

  1.The table does not contain schemes that started winding up in the time period given and have since completed wind up. The Pensions Schemes Registry only records the present status of a scheme so only those winding up at the moment are captured. This is unlikely to bias the figures extensively as the winding up process can take many years to complete, particularly for large firms.

  The "All scheme type" column contains Defined-Contribution, Hybrid and Unknown Type schemes as well as Defined-Benefit schemes.
  386W
  3. A winding up scheme is one which has notified OPRA that it has commenced winding up procedures.

  4. Schemes have up to 12 months to notify OPRA of any status change, so the data for the current year is provisional.

  Data is not available for periods after the quarter beginning 1 April 2003.

  State Pension
  Steve Webb
  To ask the Secretary of State for Work and Pensions if he will estimate the annual cost to the Exchequer, net of savings in means-tested benefits and additional income tax revenue, of paying state pensions in full at the rate of a Category A pension to every UK pensioner aged(a) 80 or over and (b) 75 or over, regardless of their contribution record. [145437]

  Malcolm Wicks
  The annual cost to the Exchequer from April 2004, net of savings in income related benefits and additional income tax revenue, of paying the state pension in full at the rate of a Category A pension to every UK pensioner aged:

  80 or over is £0.66 billion

  75 or over is £1.20 billion

  Figures are in 2003–04 price terms rounded to the nearest £10 million.

  Gross costs are estimated by the Government Actuary's Department and are consistent with Budget 2003 assumptions.

  The additional costs take into account income related benefit offsets, which are calculated using the DWP policy simulation model and April 2004 benefit rates.

  Additional income tax revenue is estimated by the Inland Revenue using 2004 tax rates

  Recruitment Advertisements
  Miss Kirkbride
  To ask the Secretary of State for Work and Pensions how much has been spent on recruitment advertisements in the press, broken down by publication, by(a) his Department, (b) quangos under the Department and (c) non-departmental Government bodies under the Department (i) in the last year and (ii) since 1997. [145810]

  Maria Eagle
  Information about recruitment advertising costs is not collected centrally and could be obtained only at disproportionate cost.

HEALTH

  Alzheimer's Disease
  Mr. Baron
  To ask the Secretary of State for Health (1) how much the NHS spent on anticholinesterase inhibitors for people with Alzheimer's disease in each year since 1997; [144843]

  (2) what steps are being taken to ensure that people in long-term care with Alzheimer's disease are assessed for use of anticholinesterase inhibitors; [144844]

  (3) what plans he has to re-issue guidance to trusts to ensure that local decisions about whether to prescribe Ebixa on the NHS for people with moderate to severe Alzheimer's disease are not postponed in the absence of guidance from the National Institute for Clinical Excellence. [144845]
  387W
  Dr. Ladvman
  [holding answer 18 December 2003]The number of prescription items dispensed in the community for drugs for dementia and the associated net ingredient cost, for each year since 1997, are shown

  Number of prescription items and the associated net ingredient cost for drugs for dementia, dispensed in the community in England, 1997 to September 2003

  Drugs for dementia

  April to December 1997

  1998

  1999

  2000

  2001

  2002

  January to September 2003

  Net ingredient cost (£000)

  BNF chemical name

  Donepezil Hydrochloride

  656.8

  1,919.2

  2,917.4

  4,178.2

  8,815.3

  16,078.3

  16,829.7

  Galantamine

  —

  —

  —

  13.6

  880.2

  2,469.9

  2,834.8

  Memantine Hydrochloride

  —

  —

  —

  —

  —

  21.1

  392.9

  Rivastigmine

  —

  29.2

  297.0

  681.0

  1,309.2

  1,997.9

  2,262.3

  All drugs for dementia

  656.8

  1,948.4

  3,214.4

  4,872.8

  11,004.6

  20,567.1

  22,319.8

  Number of prescription items (Thousand)

  Donepezil Hydrochloride

  7.2

  20.2

  30.4

  43.6

  91.2

  169.3

  181.3

  Galantamine

  —

  —

  —

  0.2

  11.3

  31.1

  36.2

  Memantine Hydrochloride

  —

  —

  —

  —

  —

  0.3

  4.7

  Rivastigmine

  0.4

  4.2

  9.9

  19.7

  30.5

  32.3

  All drugs for dementia

  7.2

  20.7

  34.6

  53.8

  122.1

  231.3

  254.5

  Notes:

  1.The prescription information was obtained from the Prescription Cost Analysis (PCA) system and is based on a full analysis of all prescriptions dispensed in the community, i.e. by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Total prescriptions include not only prescriptions originating from general medical practitioners in England but also from hospital doctors, nurses, and dentists, provided they were dispensed in the community. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospital or private prescriptions.

  2.Drugs for dementia are those defined in the British National Formulary (BNF) section 4.11.

  3.The Net Ingredient Cost refers to the cost (which the dispenser is reimbursed) of the drug before discounts and does not include any dispensing costs or fees. It does not include any adjustment for income obtained where a prescription charge is paid at the time the prescription is dispensed, or where the patient has purchased a pre-payment certificate.

  People in long-term care with Alzheimer's disease have the same access to drugs for dementia as people living elsewhere. If appropriate, those involved in their care will refer them as necessary for assessment by specialist mental health teams.

  In August 1999 the Department issued Health Service Circular 1999/176 which asks national health service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from the National Institute for Clinical Excellence (NICE) is not available. These arrangements should involve an assessment of all the available evidence. Funding for treatments, such as Ebixa, should not be withheld simply because of an absence of guidance from NICE.

  Autism
  Tim Loughton
  To ask the Secretary of State for Health how many children in(a) England and (b) Wales have been diagnosed with autism on the latest date for which figures are available. [145690]

  Dr. Ladyman
  Details of the number of children diagnosed with autism are not available. The Medical Research Council (MRC) published a comprehensive review of autism research in December 2001 which provides an authoritative overview of the current state of knowledge on the prevalence, incidence and causes of autism. The report was commissioned by the Department of Health. It is available on the MRC website at: http://www.mrc.ac.uk/pdf-autism-report.pdf
  388W
  in the table. Information is not collected about the number and costs of drugs for dementia dispensed in acute and mental health trusts.

  The report says that according to recent reviews, there appears fairly good agreement that autism spectrum disorders affect approximately 60, and more narrowly defined autism 10-30 per 10,000 children under eight.

  In February 2002, we allocated a further £2.5 million to the MRC to help them to take forward their programme of work on autism. Between December 2002 and July 2003, the MRC held a series of four seminars to encourage the development of good quality applications for autism research funding. Topics covered in the seminars were gut and the developing child; brain and mind (neuropsychology and neuroimaging); autism in populations and outcome measures for interventions in children and adults. On 11 July 2003, the MRC held the first of their annual for a for autism research "Breaking barriers, building bridges", in conjunction with the National Autistic Society, to bring together ideas stimulated by the previous four seminars.

  The MRC will be taking decisions on the allocation of research project funding for further autism studies in early 2004.

  Questions on the numbers of autistic children in Wales are a matter for the National Assembly for Wales.

  Blood Products
  Nick Harvey
  To ask the Secretary of State for Health (1) what the Government's objective was in purchasing an American blood bank; and if he will make a statement; [144110]
  389W
  (2) what factors led to the Government's decision to purchase an American blood bank; and if he will make a statement; [144111]

  (3) what comparisons he has made between the safety of blood available from the American blood bank it has purchased and blood available in the UK; and if he will make a statement. [144112]

  Miss Melanie Johnson
  On 17 December 2002, following thorough options analysis work and detailed market research, the Department purchased the largest remaining independent United States plasma collector Life Resources Incorporated. The objective was to secure long-term supplies of non-United Kingdom blood plasma to ensure that the global plasma shortage would not reduce the availability to National Health Service patients of life-saving plasma products such as immunoglobulins and clotting factors. Large volumes of plasma are required for medicinal product manufacture, especially immunoglobulm

  The NHS has been using US-sourced plasma since 1998 because of the unknown and unquantifiable risk of transmission of vCJD through blood. At the time Life Resources Inc. was purchased, the US had no reported cases of BSE or CJD and was the only country able to supply the quality and quantity of plasma required. The US also has a well-established pool of donors, a well-regulated environment and a developed collection industry. The Government are aware of the one case of BSE reported in the US and considers this to be a negligible risk to the safety of the blood supply. This case is not in itself a reason to alter current arrangements but we will continue to monitor the situation closely.

  It is standard in both the UK and the US that, in addition to screening donors for the major blood borne viruses of HIV, Hepatitis B and C, all blood products are heat treated or chemically treated to remove any viral contamination that may have escaped the screening process

  In the UK, expert advice is that if vCJD is transmissible through blood, the infection is most likely to be contained in the white cells and plasma. As a precautionary measure, we instituted universal leucodepletion (removal of the white cells) of all blood for transfusion from 31 October 1999.

  Jane Griffiths
  To ask the Secretary of State for Health what guidance his Department gives to the National Blood Service on the questions which may be asked of potential blood donors; and if he will make a statement.[144861]

  Miss Melanie Johnson
  The National Blood Authority (NBA) undertakes a rigorous selection of blood donors as the first step in ensuring the safety of the blood supply. The questionnaire and accompanying interview of potential blood donors have been developed to elicit appropriate information relevant to donation. There are two important aims, which are to ensure as far as possible that the donated blood is safe for transfusion to patients and that blood donation is not detrimental to the donor's health
  390W
  Donors are accepted or deferred on the basis of the information they give the NBA using the United Kingdom donor selection guidelines developed by the Joint UK Blood Transfusion Services and National Institute of Biological Standards and Control which are used throughout the UK. All donors are asked to read a blood safety leaflet, which outlines key lifestyle risk factors

  The donor selection procedures and questions used in the UK are in line with the recommendations of the Council of Europe and will be in line with the proposed European Union Directive 2002/98/EC (Article 29) on setting standards of quality and safety for the collection, testing, processing, storage and distribution of human blood and blood components.

  Tim Loughton
  To ask the Secretary of State for Health (1) how many pints of(a) blood and (b) plasma were used by the NHS in each of the last five years;[145938]

  (2) how much donated blood was used in (a) cancer operations and (b) transfusions in each of the last five years.[145940]

  Miss Melanie Johnson
  [holding answer 5 January 2004]Information on the number of units of blood and plasma used by the national health service in the last five years is not collected centrally.

  Tim Loughton
  To ask the Secretary of State for Health what the main uses are to which donated blood is put; and what proportion of donated blood was discarded in each of the last five years.[145939]

  Miss Melanie Johnson
  [holding answer 5 January 2004]Approximately half of red cell transfusions are used for medicinal purposes including anaemia, haematology and gastro-intestinal bleeding. The remaining half is used mainly in surgery, but also in obstetrics and gynaecology

  Figures provided by the National Blood Authority (NBA) show the proportion of red blood cells that the NBA has discarded over the last three years

  Percentage

  Time expired

  Collection discards

  Testing related discards

  Breakages and leaks discard

  Processing discards

  Total

  2000–01

  0.1

  2.8

  1.3

  0.6

  1.2

  6.0

  2001–02

  0.2

  2.6

  1.2

  0.5

  1.4

  5.9

  2002–03

  0.5

  2.6

  1.3

  0.6

  1.1

  6.1

  The NBA does not have data for previous years.

  The NBA strives to hold enough stocks of blood to meet extra or excess demand for blood in the event of any emergencies or major incidents.

  Tim Loughton
  To ask the Secretary of State for Health how many pints of blood have been donated in each of the last five years.[145941]

  Miss Melanie Johnson
  [holding answer 5 January 2004]Figures in the table supplied by the National Blood Authority show number of units of blood donated in each of the last five years.
  391W

  Number of units donated

  1998–99

  2,389,622

  1999–2000

  2,427,052

  2000–01

  2,357,568

  2001–02

  2,379,784

  2002–03

  2,332,371

  Child Mental Health
  Tim Loughton
  To ask the Secretary of State for Health what the prevalence of mental health problems is in children aged(a) five to 10, (b) 11 to 15 and (c) 16 to 19 in England, broken down by gender.[145689]

  Dr. Ladyman
  Information is not available in the form requested. The tables show the prevalence of mental disorders in young people aged five to 15 years and neurotic disorder in young people 16 to 19 years

  Prevalence of mental disorders among five to 15-year-olds

  Percentage

  Five to 10 years

  11 to 15 years

  Boys

  10.4

  12.8

  Girls

  5.9

  9.6

  All children

  8.2

  11.2

  Source:

  Office for National Statistics survey—Mental health of children and adolescents in Great Britain (2000)

  Prevalence of neurotic disorder among 16 to 19-year-olds

  Percentage

  16 to 19-year-olds

  Men

  8.6

  Women

  19.2

  All adults

  13.3

  Source:

  Office for National Statistics survey—Psychiatric morbidity among adults living in private households (2000)

  Dentists
  Mr. Burstow
  To ask the Secretary of State for Health what assessment he has made of the reasons for the change in the number of(a) adults and (b) children registered with a dentist in the last three years. [142061]

  Ms Rosie Winterton
  Adult registrations in the general dental service fell by 160,000 in the three years between September 2000 and September 2003 from 16.81 million to 16.65 million, a fall of 1.0 per cent. Children's registrations fell by 170,000 from 6.84 million to 6.67 million, a fall of 2.5 per cent

  During the same period, there has been an increase in National Health Service dental services provided by the personal dental services; the number of patients increased by 340,000 in the three years between 1999–2000 and 2002–03

  Some of the drop in registration numbers is due to improved procedures at the Dental Practice Board in removing duplicate patient records
  392W
  General population figures are not yet available for this period on a consistent basis that is based on the 2001 Census. However it is estimated that between 2001 and 2002 the adult population in England rose by 0.5 per cent. with the children's population falling by 0.4 per cent

  We recognise that dentists in some areas have reduced their NHS commitment and there has been considerable dissatisfaction since 1992 with remuneration system which is now seen as a disincentive to provide NHS dental care. Proposals in the Health and Social Care (Community Health and Standards) Act 2003 will underpin a modernised, high-quality primary dental service provided through contracts between primary care trusts and dental practices and properly integrated with the rest of the NHS providing better access to services and an improved patient experience. With these new responsilbilities will go the £1.2 billion resources currently held centrally.

  Diabetes (Amputations)
  Mr. Burstow
  To ask the Secretary of State for Health what the cost of amputations due to diabetes was in each year since 1996 in(a) England and (b) each strategic health authority; how many people in each case have had amputations due to diabetes in each year since 1996; and what assessment his Department has made of the proportion of amputations due to diabetes that could have been prevented.[144776]

  Ms Rosie Winterton
  Data on the cost of lower limb amputations is not collected in the format requested. The table shows how many lower-limb amputations were performed in the years 1996–2003 in national health service hospital trusts in England.

  Primary Diagnosis Diabetes (ICD10 codes E10–E14), With main operation of Lower Limb Amputation (OPCS4 codes X09–X11), Finished Consultant Episodes (FCEs)

  NHS hospital trusts in England, 1996–97 to 2002–03

  Amputation of:

  Leg(X09)

  Foot(X10)

  Toe(X11)

  Total

  1996–97

  914

  154

  921

  1,989

  1997–98

  79

  476

  634

  1,189

  1998–99

  89

  490

  660

  1,239

  1999–2000

  120

  504

  677

  1,301

  2000–01

  97

  457

  621

  1,175

  2001–02

  434

  100

  596

  1, l 30

  2002–03

  384

  115

  621

  1,120

  Notes:

  1.An FCE is defined as a period of patient care under one consultant in one health care provider. The figures do not represent the number of patients, as one person may have several episodes within the year

  2. The main operation is the first of four operation fields in the HES data set, and is usually the most resource intensive procedure performed during the episode

  3. The primary diagnosis is the first of seven diagnosis fields in the HES data set, and provides the main reason why the patient was in hospital

  4. Data in this table are adjusted for both coverage and unknown/ invalid clinical data, except for 2001–02 and 2002–03 which are not yet adjusted for shortfalls

  5. 2002–03 data are provisional and subject to change

  Source:

  Hospital Episode Statistics (HES), Department of Health.

  393W
  The Department of Health's Hospital Episode Statistics (HES) system provides information on inpatient care in England. With the clinical information given by hospital providers it is not possible to determine how many amputations due to diabetes could have been prevented. The national service framework for diabetes standards document noted that all people with diabetes should receive high-quality care throughout their lifetime, including support to optimise the control of blood glucose, blood pressure and other risk factors for developing the complications of diabetes. The standards document also noted that the impact of microvascular complications could be reduced if they are detected and treated at an early stage and states that all young people and adults with diabetes should receive regular surveillance for the long-term complications of diabetes

  Health Development Agency
  Mr. Burstow
  To ask the Secretary of State for Health if he will list the(a) budget allocations and (b) actual spending of the Health Development Agency in each year since 2000.[144785]

  Miss Melanie Johnson
  The information requested is shown in the followin2 table.

  Health development agency allocations and expenditure1

  £000

  2000–01 2

  2001–02

  2002–03

  Total Allocations/Income from Governments Sources3

  11,288

  12,261

  11,015

  Net resource outturn4

  11,462

  11,960

  11,024

  1Information taken from HDA published accounts.

  2 The 2000–01 figures used are as per the 2001–02 accounts(restated as a comparator).

  3 Total expenditure may exceed the allocation or other payments to the HDA from Government because the HDA may earnincome from other sources to cover that expenditure.

  4 Net Resource Outturn is the Operating Cost less other Income. This does not include Capital interest charges.

  Healthy Living Programmes
  Mr. Burstow
  To ask the Secretary of State for Health what plans he has to evaluate New Opportunity-funded healthy living programmes; and what arrangements have been made to ensure that the lessons from such evaluations are disseminated.[145080]

  Miss Melanie Johnson
  The New Opportunities Fund is supporting a number of healthy living programmes, each of which will be formally evaluated. The Department of Health will study the evaluation findings carefully, and will work with the New Opportunities Fund to help ensure that lessons learned are effectively disseminated

  In addition, the Department of Health has commissioned its own evaluation of the health living centre programme through the Tavistock Institute against key health priorities such as cancer and coronary heart disease prevention. The Institute will be encouraged to publish their findings and the Health Development Agency will incorporate the findings into evidence and practice reviews.

  Maternity Units
  Mr. Baron
  To ask the Secretary of State for Health pursuant to his Answer of 15 December,Official Report, column 772W, on maternity services, to what extent women are able to choose whether they will be seen in a midwifery-led maternity unit; and what effect the policy of their local health authority has on choice.[146324]

  Dr. Ladyman
  We expect midwife led maternity care to be one of the options available to women and their families. A woman's decision to give birth in a midwife led unit should be a matter for informed discussion between the woman and the health professionals responsible for providing her care

  It is up to local health organisations, working with their communities and other local partners, to provide high quality maternity services that are both as safe and as accessible as possible to women and their families.

  Mr. Baron
  To ask the Secretary of State for Health whether it is the Government's policy that women should be able to choose to be treated in a midwife-led maternity unit.[146325]

  Dr. Ladyman
  It is Government policy that women should be able to choose to have midwife led maternity care. A woman's decision to give birth in a midwife led maternity unit should be a matter for informed discussion between the woman and the health professionals responsible for providing her care.

  Parliamentary Questions
  Mr. Burstow
  To ask the Secretary of State for Health when he will reply to the questions from the hon. Member for Sutton and Cheam, tabled on 1 December, references 140640 and 140642.[145738]

  Dr. Ladyman
  I replied to the hon. Member's questions on Monday 5 January.

  PET Scans
  Tim Loughton
  To ask the Secretary of State for Health what price is paid for each dose of radioactive, positron tracers used by each PET scanner centre.[145003]

  Miss Melanie Johnson
  The costs of isotope production are dependent on a number of factors, including whether the production is on a commercial basis and the costs of transportation to the Positron Emission Tomography (PET) centre. However, a report of the Intercollegiate Standing Committee on Nuclear Medicine, published by the Royal College of Physicians in January 2003, details that typical costs are around £315 for each dose of tracer.

  Tim Loughton
  To ask the Secretary of State for Health (1) what assessment he has made of the benefits of PET scans;[1 45004]

  (2) if he will list the most common uses of PET scans;[145005]

  (3) what plans he has to expand the provision of PET scanners over the next five years.[145019]
  395W
  Miss Melanie Johnson
  Positron Emission Tomography (PET) scanning enables highly sensitive and specific functional imaging of metabolic processes involved in oncology, cardiology and neurology. It holds particular promise for cancer services

  In response to requests from National Health Service and research stakeholders the Department of Health will shortly publish a framework for PET scanning for consultation. This framework will enable the NHS to develop a clear national policy position which will set out, from the evidence, which tumour groups would benefit from PET scanning, likely future demand, and the optimal configuration and location of PET scanners. This would ensure that access to PET facilities was available to patients from all cancer networks and that high quality research could also be undertaken on the future applications of PET.

  Tim Loughton
  To ask the Secretary of State for Health what assessment he has made of the number of PET scanners per head of the population in(a) England and (b) other EU countries.[145013]

  Miss Melanie Johnson
  There are five Positron Emission Tomography (PET) scanners operating in the national health service in England. The Department has made no assessment of the relative numbers of PET scanners in England and other European Union countries.

  Tim Loughton
  To ask the Secretary of State for Health what the cost of each PET scan to the NHS was in each of the five centres operating PET scanners in the last 12 months.[145014]

  Miss Melanie Johnson
  The cost of each Positron Emission Tomography (PET) scan depends on a number of factors, such as the condition the patient is being scanned for, the type of isotope used, transportation costs and the isotope supplier. This information is not held centrally.

  Tim Loughton
  To ask the Secretary of State for Health how many staff are(a) trained to operate PET scanners and (b) work in PET scanner departments in the NHS.[145015]

  Miss Melanie Johnson
  A number of professional staff are needed to run a Positron Emission Tomography (PET) facility. These include radiographers/nuclear medicine technicians; consultant radiologist/physicians, medical physicists, medical physics technicians; radiochemists and; radiopharmacy technicians.

  Figures on numbers of staff trained to operate or work in PET scanner Departments are not collected centrally

  Tim Loughton
  To ask the Secretary of State for Health how many PET scans were carried out in each of the last five years funded(a) privately and (b) by the NHS.[145020]

  Miss Melanie Johnson
  The numbers of Positron Emission Tomography (PET) scans carried out each year varies from centre to centre and this information is not held centrally.

  Public Health
  Mr. Burstow
  To ask the Secretary of State for Health whether each(a) region, (b) strategic health authority and (c) primary care trust has a director of public health post and whether the post is filled in each case. [144783]

  Miss Melanie Johnson
  The information requested has been placed in the Library.

  Mr. Burstow
  To ask the Secretary of State for Health what the arrangements are for ensuring that in every part of England an annual report on the health of the population is produced by a director of public health.[144791]

  Miss Melanie Johnson
  The 2003–06 Planning and Priorities Framework issued by the Department of Health requires service planning in the national health service to be supported by an annual public health report by the Director of Public Health. Strategic health authorities are responsible for ensuring compliance with, and delivery of, the framework.

  Tim Loughton
  To ask the Secretary of State for Health what his policy is on recruitment of chief executives of the Public Health Laboratory Service, with particular reference to the merits of recruiting(a) deputy chief medical officers and (b) microbiologists with experience of clinical practice.[145165]

  Miss Melanie Johnson
  The Public Health Laboratory Service (PHLS) is a non-departmental public body (NDPB) with a board which appoints its own chief executive, in the same way as other NDPBs and in accordance with Cabinet Office guidance.

  Mr. Burstow
  To ask the Secretary of State for Health if he will place in the Library a copy of the results of the Public Health Skills Audit referred to in the Department's memorandum of evidence to the Health Committee inquiry into public health.[144781]

  Miss Melanie Johnson
  The report of the Skills Audit has been placed in the Library.

  Respiratory Disease
  Mr. Burstow
  To ask the Secretary of State for Health what assessment he has made of the extent to which children under five years with respiratory problems are misdiagnosed with asthma.[146212]

  Dr. Ladyman
  The information requested is not collected centrally.

  Mr. Burstow
  To ask the Secretary of State for Health how many finished consultant episodes there have been for respiratory syncytial virus in(a) England, (b) each NHS region and (c) each strategic health authority in each year since 1996, broken down by age. [146211]

  Dr. Ladyman
  The information that is available has been placed in the Library.

  Ritalin
  Mrs. Calton
  To ask the Secretary of State for Health how many young people(a) under 11 and (b) over 11 have been prescribed Ritalin by a health authority in each of the last five years.[145815]

  Dr. Ladyman
  Information is not available in the form requested. However the figures in the table following show the total number of prescription items of methylphenidate hydrochloride dispensed in the community in England in each of the last five years. The majority of prescription items of methylphenidate hydrochloride are for the brand Ritalin

  Number of prescription items of methylphenidate hydrochloride dispensed in the community in England—1998 to 2002

  Thousand

  Total

  1998

  126.6

  1999

  158.0

  2000

  186.2

  2001

  208.5

  2002

  254.0

  Source:

  Prescription Cost Analysis data from the Prescription Pricing Authority

  In 2002, around 91 per cent. of the 254,000 prescription items were dispensed in the community to children (children under 16 and young people aged 16 to 18 in full time education). An estimated 1 per cent. of the items were dispensed to people aged 60 and over with the remainder being dispensed to other adults. These proportions have been similar in recent years.

  Mrs. Calton
  To ask the Secretary of State for Health what assessment he has made of the long-term effects of Ritalin.[145816]

  Dr. Ladyman
  Ritalin is indicated as a part of a comprehensive treatment programme for attention-deficit hyperactivity disorder (ADHD) in children over six years of age where remedial measures alone prove insufficient. In October 2000 the National Institute for Clinical Excellence (NICE) published an appraisal of the use of the drug methylphenidate (main brand name Ritalin) in the treatment of childhood ADHD and issued clinical guidelines for its use, including the need for regular monitoring of children receiving this therapy. NICE recommended long-term follow-up of adverse effects and the potential for misuse of the drug in assessing long-term benefits and health gain into adulthood

  As with all medicines, the safety of methylphenidate is continually monitored by the Medicines and Healthcare products Regulatory Agency and the independent advisory body the Committee on the Safety of Medicines. Comprehensive information on the use of methylphenidate, including possible side effects, contraindications and precautions is contained in the summary of product characteristics produced by the manufacturer and approved by the licensing authority.

  Smoking
  Mr. Burstow
  To ask the Secretary of State for Health if he will set out for each year of the programme the(a) total number of people who took part in smoking
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  cessation programmes and (b) number of four week quitters; and what assessment he has made of the number and proportion of four week quitters who subsequently recommenced smoking.[145078]

  Miss Melanie Johnson
  We do not have the information in the form requested.

  The table shows the number of people setting a quit date through the national health service stop smoking services, and the number of those who remain quit at four week follow up

  People setting a quit date and outcome at four weeks (based on self report) England 1999–2000 to Q1 2003–04

  Number setting a quit date

  Number successful (self report)

  1999–2000

  14,598

  5,760

  2000–01

  132,544

  64,554

  2001–02

  227,335

  119,834

  2002–03

  234,858

  124,082

  Q1 2003–04 April-June

  64,691

  33,926

  Source:

  Department of Health Smoking Cessation Monitoring Returns

  The monitoring of the NHS stop smoking services establishes success four weeks after the client's quit date. This method was chosen as a viable, practical way to ascertain initial success

  Smoking is an addictive behaviour and it is difficult for smokers to stop. From the evidence of clinical trials, we expect that around 65 per cent., of clients successful at four weeks will relapse to smoking. The Department of Health has commissioned a research project to investigate further the success of the NHS Stop Smoking Services in helping smokers to stop in the longer-term. This is due to report in the new year

  The huge health benefit from smokers stopping means that services, such as the NHS stop smoking services, are highly cost effective.

  Strategic Health Authorities
  Mr. Burstow
  To ask the Secretary of State for Health if he will set out for each Strategic Health Authority the(a) budget and (b) spending on (i) language support, (ii) interpreting services and (iii) ethnic monitoring in 2002–03.[145081]

  Miss Melanie Johnson
  The information requested is not collected centrally.

  The NHS Plan sets out a commitment to make available a national translation and interpreting service through NHS Direct. NHS Direct is currently involved in procuring a national interpreting and translation service by March 2004. This will provide access for all national health service organisations to a telephone-based interpretation and translation service. Information on the costs of local arrangements for language support and interpreting services cannot be disaggregated in the financial returns

  The Department has made a commitment to the collection of ethnic origin information using the 2001 Census categories for all statistical data sets collected from the national health service for England
  399W
  While the Department has promoted ethnic monitoring in response to the Race Relations (Amendment) Act 2000 (and highlighted examples of good practice), the collection of ethnic data is largely incorporated as additional data items within existing collections, to minimise both the burden and cost related to the collection of such information on the NHS. This is consistent with the Department's procedures to ensure that the value of all centrally collected information fully justifies the burden and cost it places on those who provide it.

  "Valuing People"
  Mr. Burstow
  To ask the Secretary of State for Health pursuant to his answer of 8 December 2003,Official Report, column 320W, on Valuing People, if he will list the other centrally funded projects which were funded through the £3.3 million.[144948]

  Dr. Ladyman
  The unused £3.3 million capital was not directly transferred from the Learning Disability Development Fund to another project. It contributed to the overall budget available for other capital projects, which were delivered in 2002–03 but which did not have funding set aside for them at the start of the year. An example of a project funded in this way was the refurbishment of psychiatric wards.

DEPUTY PRIME MINISTER

  Council Tax
  Mr. Barnes
  To ask the Deputy Prime Minister, what recent assessment he has made of the effectiveness and fairness of the council tax banding system; and if he will make a statement.[145889]

  Mr. Raynsford
  The Government acknowledged the criticisms of council tax in the 2001 White Paper, "Strong Local Leadership, Quality Public Services". Consequently we have established the Balance of Funding review which has been giving detailed consideration to key issues affecting the funding of local government. The review will be considering proposals for change in the course of the next few months.

  Brownfield Land
  Mrs. Humble
  To ask the Deputy Prime Minister, if he will make a statement on progress in bringing more brownfield land into use.[145891]

  Mr. Prescott
  Through English Partnerships and the Regional Development Agencies we are reclaiming brownfield land at a rate of over 1400 hectares a year. This has enabled us to achieve our national brownfield target eight years early. By 2000 60 per cent. of new housing development was on brownfield land. By 2002 this proportion had increased to 64 per cent.

  Regional Assemblies
  Mr. Grogan
  To ask the Deputy Prime Minister, what assessment he has made of the benefits to the Yorkshire and Humber economy of an elected regional assembly.[145892]
  400W
  Yvette Cooper
  An elected assembly for Yorkshire and the Humber will enhance regional prosperity, pride and democracy. It will control or influence key elements impacting on the regional economy, including the work of Yorkshire Forward and policies affecting planning, housing, transport and skills. Similarly it will improve people's safety and quality of life through work on the environment, fire prevention, culture and sport and the promotion of public health.

  Mr. Curry
  To ask the Deputy Prime Minister what the estimated annual Government grant is to the proposed regional assemblies in(a) the North West, (b) the North East and (c) Yorkshire and the Humber.[146039]

  Mr. Raynsford
  Based on figures for 2002–03, and on existing programmes, elected regional assemblies would receive grants of around £780 million in the North West, £350 million in the North East and £570 million in Yorkshire and the Humber. Assemblies would also have influence—through consultation with, and making appointments to specified bodies—over budgets totalling £1,600 million in the North West, £600 million in the North East and £1,100 million in Yorkshire and the Humber

  In addition, the White Paper "Our Fire and Rescue Service" published in June 2003 said "we envisage that, eventually, where there are elected regional assemblies, fire and rescue authorities will be regional bodies". In 2001–02, the existing local fire and rescue authorities spent around £238 million in the North West, £103 million in the North East and £159 million in Yorkshire and Humberside. These are the latest figures available. Broadly speaking, three quarters of the Fire and Rescue Service's overall budget spending is met by revenue support grant and national non- domestic rates and the balance from council tax.

  Regeneration
  James Purnell
  To ask the Deputy Prime Minister if he will make a statement on his policy on involving English Partnerships in regeneration.[145894]

  Keith Hill
  English Partnerships is the National Regeneration Agency. It leads on the development of Urban Regeneration Companies. It works closely with the Housing Market Renewal Pathfinders to regenerate areas of low demand and abandoned housing. Through the £400 million coalfields programme it is actively regenerating former coalfield areas and their communities. We are also proposing that EP take a leading role in overseeing development in the wider Milton Keynes area through close co-operation with the local council and other key stakeholders.

  Standards Board
  Mr. Heathcoat-Amory
  To ask the Deputy Prime Minister if he will make a statement on the performance of the Standards Board.[145895]

  Phil Hope
  Ensuring high standards in public life—including in local government—remains a firm commitment of the Government. The Standards Board for England continues to command the Government's full support as it develops to meet the challenges set for
  401W
  it by the Local Government Act 2000. Copies of the Boards Annual Report are available in the Library, and on the Board's website.

  Building Regulations
  Norman Baker
  To ask the Deputy Prime Minister what plans he has to amend building regulations to improve environmental performance in respect of water consumption.[145896]

  Phil Hope
  In response to statements made by my right hon. Friend the Deputy Prime Minister and the Secretary of State for Environment, Food and Rural Affairs at the Better Buildings Summit, proposals to amend the Building Regulations to include the conservation of water will be taken forward early in the New Year

  It is anticipated that amended regulations will be laid in the latter part of 2005

  Telecommunications Masts
  Mr. Gibb
  To ask the Deputy Prime Minister if he will make a statement on his Department's code of best practice on the siting of TETRA telecommunications masts in the vicinity of schools and hospitals. [145897]

  Keith Hill
  The Code of Best Practice on Mobile Network Development does not distinguish between different types of mobile communications base stations. The Code lists the factors that should be taken into account by network operators and local planning authorities in determining whether a school or college should be consulted. The Code makes no reference to hospitals.

  Mobile Phones
  Colin Burgon
  To ask the Deputy Prime Minister what recent discussions he has had with the Mobile Phone Operators Association about their voluntary code.[145898]

  Keith Hill
  I have not had any recent discussions with the Mobile Operators' Association. My hon. Friend for Pontefract and Castleford will be meeting representatives of the Mobile Operators' Association and the five commercial network operators on the 19 January 2003.

  Area Partnerships
  Mr. Steen
  To ask the Deputy Prime Minister how many area partnerships have been established in England; what their terms of reference are; and what funding has been awarded to each partnership, broken down by(a) county council, (b) district council, (c) town or parish council, (d) regional development agency, (e) market and coastal towns initiative and (f) other sources of funding.[145817]

  Yvette Cooper
  The key partnership in any area is the Local Strategic Partnership (LSP). A survey in summer 2002, as part of the Government's research into LSPs, showed that the vast majority of areas, at county and 402W
  district local authority level, either had an LSP in place or were in the process of forming one. There are now approximately 365 LSPs across England

  LSPs must include representatives from and reflect an appropriate balance between the public sector including local authorities and other public services, and private, voluntary and community sectors. LSPs will operate by consensus, in order to reflect and retain the buy-in of partners

  The Government guidance, published in March 2001. states that it will be for local partners to decide the full range of work of their LSP. However, it does set out four core tasks
  Prepare and implement a community strategy for the area

  Bring together local plans, partnerships and initiatives to provide a forum through which mainstream public service providers work effectively together to meet local needs and priorities

  Work with local authorities that are developing a local public service agreement to help devise and then meet suitable targets

  Develop and deliver a local neighbourhood renewal strategy (in the 88 districts receiving Neighbourhood Renewal Fund)

  LSPs are not statutory bodies and as such do not receive funding directly. However the Neighbourhood Renewal Fund (NRF) enables the 88 most deprived authorities, in collaboration with their Local Strategic Partnership (LSP), to improve services, narrowing the gap between deprived areas and the rest of England. £1,875,000 has been allocated for the period 2001 to 2006 and a full breakdown by local authority district is available

  More generally LSPs will work collaboratively with and through partners to access sources of funding to meet local needs

  Planning and Compulsory Purchase Bill
  Mr. Beggs
  To ask the Deputy Prime Minister what plans he has to extend the Planning and Compulsory Purchase Bill to Northern Ireland.[145315]

  Keith Hill
  There are no plans to extend the Planning and Compulsory Purchase Bill to Northern Ireland.

  Fire Service College
  Mr. Clifton-Brown
  To ask the Deputy Prime Minister if he will list the commandants and chief executives of the Fire Service College, Moreton-in-Marsh, since 1992, stating whether they were a temporary or permanent appointment; what steps he is taking to secure a permanent appointment as Chief Executive; and whether payments have been made in respect of(a) early retirement and (b) unfair dismissal of senior officers at the college in the last 10 years.[145791]

  Phil Hope
  Details of Fire Service College Chief Executives and Commandants are given in the table. The post of Chief Executive is to be advertised shortly on open competition

  No payments have been made either in respect of unfair dismissal or early retirement. In one case, a post holder received a payment (details of which are confidential) on leaving office, in accordance with his employment law rights.

  403W

  Fire Service Chief Executives and Commands from 1992

  Name

  Position

  Dates of service

  Status

  Notes

  Brian Fuller

  Chief Executive

  Until April 1994

  Permanent

  (and Commandant)

  Nigel Finlayson

  Chief Executive

  May 1994 to November 1997

  Permanent

  Posts to Chief Executive and

  Commandant split

  Frank David

  Commandant

  May 1994 to May 1996

  Two-year secondment

  —

  Terry Glossop

  Commandant

  June 1996 to November 1997

  Fixed-term contract

  Terry Glossop

  Chief Executive

  1 December 1997 to 19 December

  Permanent

  Posts re-combined

  (and Commandant)

  2002

  Robin Currie

  Chief Executive

  1 February 2002 to 20 December

  Secondment

  Terry Glossop suspended on

  2003

  1 February 2002

  Anne Frost

  Chief Executive

  20 December 2003 to date

  Permanent member of

  Acting Chief Executive, pending

  College stall

  open competition

  Buildings (Energy Performance)
  Sir Sydney Chapman
  To ask the Deputy Prime Minister whether he plans to implement the requirements of Directive 2002/91 on the energy performance of buildings under the European Communities Act 1972.[145750]

  Phil Hope
  The Government are still considering how implementation may be best achieved. Present thoughts are that the way forward could be a combination of amendments to the Building Regulations made under the Building Act 1984, and new regulations, made under the European Communities Act 1972, where this is more appropriate.

  Public Land
  Dr. Whitehead
  To ask the Deputy Prime Minister what criteria his Department applies in respect of sustainability in the rules governing the sale or disposal of public land.[145753]

  Keith Hill
  Each Government Department assesses ways and means of delivering its objectives, and appraises the relevant options in line with the guidance in "The Green Book—Appraisal and Evaluation in Central Government"—including the costs of implementation. If, for example, a Department wishes to secure sustainability objectives, and in order to do so, has to dispose of assets, the disposal should be done in such a way that meets the requirements of Government Accounting chapter 24. This should ensure that overall value for money is achieved and that the disposal is effectively and properly done. Overall value for money goes beyond maximising proceeds by including the impact of effective public service delivery. Disposal of land by local authorities is governed by section 123 of the Local Government Act 1972. Local authorities may dispose of land in any manner they wish: my right hon. Friend The Deputy Prime Minister's only involvement is to grant or withhold consent where authorities wish to dispose of land at less than the best consideration reasonably obtainable and the proposed disposal falls outside the scope of the General Consent in The Office of the Deputy Prime Minister Circular 06/2003. The rules on disposal do not, therefore, directly address issues of sustainability. These would be considered as part of the project appraisal or reasons for disposing of the land.

CULTURE, MEDIA AND SPORT

  Historic Wrecks
  Mr. Steen
  To ask the Secretary of State for Culture, Media and Sport what steps she is taking to enlist the help of vocational divers in South Devon in investigating historic wrecks off the South Devon Coast.[145774]

  Mr. Caborn
  My right hon. Friend the Secretary of State has no specific plans for vocational divers in South Devon. The Department has enabled the development and implementation of English Heritage's initial policy for maritime archaeology, Taking to the Water, which clearly states the desirability of engaging with the sport diving and wider communities. Any proposals for initiatives can be made directly to English Heritage where they will be considered according to national priorities and subject to available resources. English Heritage are already encouraging sport diving initiatives in the Solent, the North East and the Isles of Scilly together with providing support for an England-wide training programme and shipwreck projects through the Nautical Archaeology Society.

  Mr. Steen
  To ask the Secretary of State for Culture, Media and Sport what considerations resulted in her Department stopping vocational divers investigating(a) the wreck of a suspected Barbary pirate ship off Gara rock in South Devon and (b) the Salcombe Canon site shipwreck.[145775]

  Mr. Caborn
  The sites referred to as(a) and (b) are the same site designated under the Statutory Instrument 1997/2536, known as the Salcombe Cannon Site. The reference to the suspected Barbary pirate ship has arisen after research has shown that Barbary pirates were active around the period of the ship wreck in the area of Salcombe. Since designation the Secretary of State has issued licences to survey, surface recover and excavate the site. At the time of writing there are no current licences on this site, as there has been no application made to the Secretary of State. The issuing of licences since 1997 has enabled continued investigation of this site by vocationally based teams backed up by professional archaeological advice. Over the last 18 months this system has been supported by English Heritage. The Government's contractor for archaeological services in support of the 1973 Act has also visited this site and

  405W
  others in South Devon this summer, managed by English Heritage and fully involving the divers licensed to investigate the sites.

  Mr. Steen
  To ask the Secretary of State for Culture, Media and Sport what the role is of English Heritage regarding applications for licences to investigate shipwrecks off the South Devon coast.[145819]

  Mr. Caborn
  English Heritage's role is to carry out administrative functions exercisable by my right hon. Friend the Secretary of State under the 1973 Act. English Heritage considers the merits of each case, consults the Advisory Committee on Historic Wreck Sites, the archaeological diving contractor and other interested parties as appropriate, before submitting a report and recommendation to the Secretary of State.

  Mr. Steen
  To ask the Secretary of State for Culture, Media and Sport what the additional cost to public funds is of involving English Heritage in the process of licensing historic wreck sites; and what the advantages are.[145820]

  Mr. Caborn
  The transfer of responsibility for licensing designated wreck sites and acting as secretariat to the Advisory Committee on Historic Wreck Sites to English Heritage has resulted in no additional cost to public funds. The administrative budget hitherto spent by this Department on these activities was transferred to English Heritage in 2003.

  Benefits from the transfer include greater specialist expertise in the decision-making process and the management of protected wreck sites. Underwater archaeology projects are also now able to compete on equal terms with land archaeological projects for English Heritage grants.

INTERNATIONAL DEVELOPMENT

  IT Contracts
  Mr. Sayeed
  To ask the Secretary of State for International Development if he will list information technology contracts in his Department with a value of above £20 million in each of the last 10 years; what the inception date for each system was; when it became fully functional; when it became fully debugged; and what the cost of over-runs has been.[146199]

  Hilary Benn
  The Department for International Development has had no information technology contracts above £20 million in the last 10 years. Our new systems and IT infrastructure upgrades have generally been modest in scope and incremental in nature. This has helped to reduce the potential risks and allowed us to stay generally on schedule and within budget.

  South Africa
  Hugh Bayley
  To ask the Secretary of State for International Development what assessment the Government have made of the impact of reducing aid to South Africa.[146162]

  Hilary Benn
  South Africa is not dependent on financial transfers from international donors—aid from all donors represents less than 1 per cent. of the 406W
  country's annual budget. Donors' contribution to development in South Africa is in the form of technical assistance to build capacity to develop and implement pro-poor policies. DFID has contributed more than £200 million in technical assistance to South Africa in the 10 years since the democratic transition there. Figures for annual spending since 1998–99 and plans up to 2005–06 are shown as follows. As shown, and in line with our overall strategy on assistance to middle income countries, we are planning a reduction in planned expenditure for the year beginning April 2005. We are discussing with the South African government how to manage this. We will continue to maintain a substantial programme there in recognition of the poverty problems inherited from the apartheid period, the growing spread of HIV/AIDS, and the critical importance of successful transition in South Africa for the prospects of sub-Saharan Africa as a whole.

  DFID-SA bilateral spending on Southern Africa MICs

  £ millions

  South Africa

  Botswana

  Namibia

  Swaziland

  Total

  1998–99

  28.9

  3.3

  3.9

  3.1

  39.1

  1999–2000

  29.6

  3.0

  3.6

  3.1

  39.3

  2000–01

  30.1

  2.5

  2.7

  1.6

  37.0

  2001–02

  25.5

  2.0

  2.0

  1.1

  30.6

  2002–03

  36.4

  1.1

  2.2

  0.8

  40.5

  Source:

  DFID (2003) Statistics on International Development 1998–99 to 2002–03. Table 7.1.

  Future framework allocation Jiff Southern African MICs

  £ million

  2003–04

  35

  2004–05

  35

  2005–06

  25

NORTHERN IRELAND

  Hospital Trolley Waits
  Mrs. Iris Robinson
  To ask the Secretary of State for Northern Ireland how many hospital trolley waits there were in Northern Ireland in(a) 2000, (b) 2001, (c) 2002 and (d) 2003; and how many there were in December of each year.[146305]

  Angela Smith
  Trolley wait information is returned to the Department in two different forms, on a quarterly basis and on a daily basis

  The total number of hospital trolley waits is reported to the Department by Trusts on a quarterly basis.

  Number of hospital trolley waits recorded in Northern Ireland––

  1999–2000

  2002–03

  Financial Year

  Trolley Waits

  1999–2000

  63,325

  2000–01

  75,879

  2001–02

  77,418

  2002–03

  96,382

  Note:

  In a small number of cases Trusts have returned data for are presentative sample of trolley waits.

  Source:

  Departmental Information Return CH 10

  407W
  The Department also receives daily returns (Monday to Friday) on the number of trolley waits based on a snapshot taken at 9.00 a.m. in each accident and emergency department across Northern Ireland

  Number of hospital trolley waits recorded in Northern Ireland

  each December 2000–03

  December

  Trolley wails

  2000

  Not available

  2001

  797

  2002

  915

  2003

  1,450

  Note:

  This information shows a snapshot of the number of trolley waits
  at 9.00 a.m. each week day morning.

  Source:

  Daily Service Pressures Report

  Ports
  Mr. Beggs
  To ask the Secretary of State for Northern Ireland how many tourists(a) in vehicles and (b) as foot passengers passed through (i) Larne and (ii) Belfast ports in each of the last five years.[144267]

  Mr. Pearson
  The information requested on the number of tourists passing through the Ports of Larne and Belfast is not available in the form requested in the question

  However, the Northern Ireland Tourist Board's Passenger Survey provides some information on the number of tourists passing through the Ports of Lame and Belfast. The survey identifies visitors (non-Northern Ireland/Republic of Ireland residents) who stay at least one night in Northern Ireland and exit via the Ports of Lame or Belfast. The survey does not break down the figures by foot and vehicle passengers. The results of the survey are provided in the following table:

  Visitors staying at least one night in Northern Ireland and exiting

  via the ports of Larne or Belfast 1998–2002

  Larne

  Belfast

  2002

  124,000

  288,000

  2001

  101,000

  357,000

  2000

  100,000

  375,000

  1999

  121,000

  375,000

  1998

  118,000

  296,000

CONSTITUTIONAL AFFAIRS

  Asylum
  Mr. John Burnett
  To ask the Secretary of State for the Home Department what discussions he has had with the judiciary about the power of Parliament to oust the jurisdiction of the courts in exercising a supervisory or other jurisdiction in relation to the Asylum and Immigration Tribunal.[145640]

  Mr. Lammy
  As part of the policy development process we have spoken to representatives of the senior 408W
  judiciary and they are aware of the changes we plan to make to the system. As with much policy development, this consultation was undertaken in confidence and so I am not in a position to make the discussions or the outcomes public.

  Mr. Russell Brown
  To ask the Parliamentary Secretary, Department for Constitutional Affairs what the(a) overall cost per annum and (h) average cost per case was for legal aid for asylum cases in each of the last five years.[145795]

  Mr. Lammy
  The Legal Services Commission is not able to provide the information in the format requested, as it does not differentiate asylum from wider immigration cases.

  The overall costs for immigration and asylum advice, assistance and representation over the last five years in England and Wales are as follows:

  Year

  £million

  1998–99

  53.3

  1999–2000

  61.4

  2000–01

  81.1

  2001–02

  129.4

  2002–03

  176.2

  The Commission's systems do not record expenditure in such a way as to enable a figure to be provided for the year-on-year, average costs per asylum case.

  Civil Servants
  Tim Loughton
  To ask the Parliamentary Secretary, Department for Constitutional Affairs how many senior civil servants in his Department are disabled, expressed in(a) numbers and (h) as a percentage of whole-time equivalents.[144975]

  Mr. Lammy
  Statistical information about senior civil servants with disabilities is available on the Civil Service Statistics web-site at http://www.civil-service.gov.uki statistics/documents/pdf/disability-oct03.pdf

  As there are fewer than 5 members of the senior civil service in my department with a disability, the actual number is not published in order to protect the privacy of the individual in line with exemption 12 of the 'Code of Practice on Access to Government Information'.

FOREIGN AND COMMONWEALTH AFFAIRS

  Departmental Advertising
  Miss Kirkbride
  To ask the Secretary of State for Foreign and Commonwealth Affairs how much has been spent on recruitment advertisements in the press, broken down by publication, by(a) his Department, (b) quangos under the Department and (c) non-departmental Government bodies under the Department (i) in the last year and (ii) since 1997.[145801]
  409W
  Mr. Rammell
  The information is as follows:

  Financial year to end March 2003

  FCO London

  Paper

  Cost (£)

  A1—Administrative Assistants—June 2002, September 2002,

  October 2002, March 2003

  South London Press

  19,348.80

  Metro and Evening Standard

  91,544.00

  www.thisislondon.co.uk

  144.00

  Total

  111,036.80

  A2—Executive Assistants —July 2002, October 2002,

  February 2003

  Evening Standard and Metro

  15,722.40

  Daily Mail

  35,713.44

  Ethnic Media Group

  8,510.00

  The Voice

  4,261.68

  Glasgow Herald

  10,858.40

  Scotsman (inc. Evening News)

  12,690.00

  Belfast Telegraph (inc. Sunday Life)

  7,354.71

  Cardiff Western Mail

  14,064.60

  Metro Manchester

  2,352.16

  Glasgow Evening Times

  2,856.80

  Edinburgh Evening News

  3,816.80

  Metro Scotland

  913.20

  Metro Birmingham

  2,536.64

  Total

  121,650.83

  B3—Operational Entry—September 2002, January 2003

  Belfast Telegraph

  4,832.97

  Cardiff Western Mail

  9,615.50

  Ethnic Media Group

  5,513.68

  Evening Standard and Metro

  10,872.00

  Glasgow Herald

  10,985.60

  Guardian

  9,355.84

  The Scotsman

  11,160.80

  The Voice

  2,837.12

  Total

  65,173.51

  Overseas Security Managers—January 2003

  Police Review

  3,816.24

  Pathfinder

  3,550.12

  Total

  7,366.36

  C4—DS General—September 2002

  Guardian

  3,920.40

  The Voice

  1,317.40

  Asian Times

  1,645.00

  Belfast Telegraph

  2,055.16

  Glasgow Herald

  4,342.00

  Scotsman

  5,281.00

  Cardiff Western Mail

  3,347.90

  Total

  21,908.86

  C4—DS Economists—September 2002, January 2003

  Guardian

  6,480.00

  Totaljobs.com

  275.00

  The Voice

  1,317.40

  Asian Times

  1,645.00

  Belfast Telegraph

  4,680.32

  Glasgow Herald

  9,554.00

  Scotsman

  10,706.00

  Economist

  17,575.00

  Cardiff Western Mail

  6,469.40

  Sunday Times Website

  340.00

  Ethnic Media Group

  2,908.00

  Total

  61,950.12

  Specialist Recruitment

  Accountancy Age

  3,000.00

  Asian Times Group

  1,506.00

  Bedfordshire Times

  950.00

  Ethnic Media Group

  19,764.00

  Evening Standard

  1,296.00

  Financial Times

  5,250.00

  Guardian

  33,612.00

  Luton and Dunstable Herald

  1,577.00

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  FCO London

  Milton Keynes Chronicle

  834.50

  Milton Keynes Citizen

  3,362.70

  New Scientist

  10,495.00

  Northampton Chronicle

  2,067.00

  Northampton Herald and Sport

  1,223.00

  Northants Curon and Echo

  1,587.00

  Sunday Times

  7,840.00

  The Times

  1,519.00

  THES

  3,165.00

  www.jobs.ac.uk

  470.00

  Total

  99.518.20

  Diversity Advertising

  Hobsons Career Guide for Women 2003

  82,500.00

  Hobsons Career Guide for Students with

  Disabilities 2003

  Hobsons Career Guide for Ethnic Minorities 2003

  Hobsons Diversity Handbook

  www.hobsons.com microsite

  Newsletters for Ethnic Minority students

  KAL—Careers Advice for Ethnic Minority

  81,114.00

  Graduates

  Number Ten—Careers Advice for Women

  Graduates

  Arberry Profile—Careers Advice for Disabled

  Graduates

  Recruitment Brochures

  Spectrum—Careers Advice for Ethnic Minority

  16-19 Year Olds

  Headstart

  3,850.00

  Doctor Job's Little Black Book

  4,450.00

  www.doctorjob.com employer profile

  National Guide to Black History Month

  3,100.00

  Futures/Network News

  5,600.00

  Employment Opportunities website and newsletter

  2,000.00

  Black and Asian Graduate website

  495.00

  Total

  183,109.00

  FCO Hanslope Park

  Paper

  Cost(£)

  C4 Contract Managers—April 2002

  Personnel Publications

  4,465.00

  Total

  4,465.00

  C4 Electrical Technician Officer—April 2002

  McMillan Scott

  705.00

  Premier Newspapers

  4,450.76

  Institution of Electrical Engineers

  4,624.80

  Total

  9,780.56

  D7 Head of Technical Security—May 2002

  Premier Newspapers

  4,450.76

  Express Newspapers

  9,987.50

  Total

  14,438.26

  C4 Investigating Officer—September 2002

  Daily Mail

  4,758.75

  Jane's Information Group

  3,877.50

  Total

  8,636.25

  A1 Mail Room Assistants—November 2002

  Evening Standard

  1,057.50

  Total

  1,057.50

  B3 Assistant Government Butler—March 2003

  Restaurant Magazine

  1,938.75

  Evening Standard

  2,350.00

  Caterer and Hotel Keeper

  1,854.16

  Total

  6,142.91

  Total cost of advertising April 2002 to March 2003:£716,234.16

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  Note:

  We advertise widely for jobs in the Diplomatic Service and specialist positions, as well as general careers advertisements placed in diversity publications and websites. The placement of adverts is reviewed regularly according to the nature of the position, cost and response from previous advertisements. The above breakdown for the years 1997–2002 could be provided only at disproportionate cost.

  Departmental Expenditure
  Mr. Ancram
  To ask the Secretary of State for Foreign and Commonwealth Affairs what the total expenditure on(a) information campaigns and (b) advertising was for his Department for each year since 1997.[145405]

  Mr. Straw
  [holding answer 6 January 2004]The Foreign and Commonwealth Office's planned expenditure on information campaigns in financial year 2003–04 is £6,485,000.00, which includes:
  £1.9 million on a "Think UK" campaign in China, plus £360,000 for the development of campaigns in Central Europe (partnerships with accession states) and North America (UK Science and Technology) to run in 2004;

  A £2.4 million public diplomacy challenge fund which will support 81 projects in 51 different countries;

  £825,000 on a major FCO web infrastructure project, which includes www.i-uk.com; a central portal site to promote the UK overseas jointly with our public diplomacy partners (British Council, UK Trade and Investment and VisitBritain);

  £600,000 on generic public diplomacy publications

  £200,000 for public diplomacy activity promoting the UK's science and technology achievements overseas.

  £200,000 to raise public awareness within the UK of the benefits and opportunities of EU enlargement.

  In addition, the FCO provides grant-in-aid of:

  £166.04 million to the British Council

  £220 million to the BBC World Service

  In the year 2002–03 the Foreign and Commonwealth Office's separately identifiable expenditure on advertising totalled £602,670. The bulk of this comprised of media spend for consular publicity campaigns, which are aimed at encouraging UK travellers to be better prepared before going overseas, and advertising for recruitment purposes

  In the year 2003–04 planned separately identifiable expenditure on advertising totals £317,000

  I refer the right hon. Gentleman to the answer my hon. Friend the Parliamentary Under-Secretary of State at the Foreign and Commonwealth Office (Bill Rammell) gave to the hon. Member for Bromsgrove (Julie Kirkbride) today (UIN 145801) for details of expenditure on recruitment advertisement between April 2002 and March 2003

  To provide a breakdown of expenditure each year since 1997 could be provided only at disproportionate costs.

  Israel
  Lynne Jones
  To ask the Secretary of State for Foreign and Commonwealth Affairs how the UK voted on UN General Assembly Resolution 144–4 which demanded that Israel stop and reverse construction of the separation wall.[146207]
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  Mr. Rammell
  The UK, in common with EU Partners, voted in favour of a UN General Assembly Resolution on 21 October 2003 demanding that Israel stop and reverse the construction of the wall.

DEFENCE

  Body Armour
  Mr. Gerald Howarth
  To ask the Secretary of State for Defence if he will make a statement on the whereabouts of the sets of body armour bought since 1999. [145642]

  Mr. Ingram
  I will write to the hon. Member and a copy of my letter will be placed in the Library of the House.

  HMS Bridport
  Mr. Gerald Howarth
  To ask the Secretary of State for Defence whether HMS Bridport will be made available for use by sea cadets.[145647]

  Mr. Ingram
  There are no plans to make HMS Bridport available for use by sea cadets.

  Iraq
  Dr. Murrison
  To ask the Secretary of State for Defence what plans he has to upgrade the living accommodation of service personnel in Iraq.[141061]

  Mr. Ingram
  A programme of improvements is underway. Hard-walled accommodation for 3,000 personnel who had previously been in tented accommodation has been moved to Iraq. We have also supplied and are in the process of installing air conditioning for all the accommodation used by UK forces personnel.

  Adam Price
  To ask the Secretary of State for Defence how much has been paid to Iraqi families by the Government following incidents involving fatalities allegedly involving British forces since 1 May 2003.[141690]

  Mr. Ingram
  United Kingdom authorities have paid £8,125 to Iraqi families following alleged fatalities involving British forces since the 1 May 2003.

  Medical Supplies Agency
  Bob Russell
  To ask the Secretary of State for Defence (1) what plans he has to change the system of budget and stock controls undertaken by(a) the Medical Supplies Agency and (b) military units whom they serve in the ordering, delivery, storage and use of materials, equipment, drugs and other medical items; and if he will make a statement;[145346]

  (2) what budget and stock controls are undertaken by (a) the Medical Supplies Agency and (b) military units whom they serve in the ordering, delivery, storage and use of materials, equipment, drugs and other medical items; and if he will make a statement.[145347]

  Mr. Caplin
  The Medical Supplies Agency (MSA) budget and stock controls are governed by HM Treasury direction on accounts prepared to comply with Government Resources and Accounts Act 2000, MOD
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  Financial Management Policy contained in JSP 462 and MOD Resource Accounting Policy contained in JSP 472. There are currently no plans to change these procedures

  MSA produce Agency Annual Accounts audited by the National Audit Office, the most recent Accounts for financial year 2002–03 were laid before Parliament on 16 July 2003 under reference number HC 805

  MSA is not responsible for the internal budget and stock controls in respect of the military units whom they serve

  Bob Russell
  To ask the Secretary of State for Defence what his proposals are for the future of(a) medical distribution centres and (b) the Medical Supplies Agency.[145348]

  Mr. Caplin
  No decisions or any proposals for the future of(a) medical distribution centres or (b) the Medical Supplies Agency have been taken.

  A review is being undertaken and is expected to conclude in the near future. A further announcement will be made to the House when appropriate.

  Reservists
  Mr. Hancock
  To ask the Secretary of State for Defence what briefings are given to reservists on the Reserve Forces (Safeguard of Employment) Act 1985.[146182]

  Mr. Caplin
  When called-out, reservists are provided with a copy of Joint Service Publication (JSP) 532 Guidance for reservists returning to civilian employment following a period of mobilised service. This publication explains the re- employment rights of reservists and, if necessary, how to go about formally seeking reinstatement under the Reserve Forces (Safeguard of Employment) Act 1985.

  SA80 Rifles
  Mr. Liddell-Grainger
  To ask the Secretary of State for Defence how many modifications have been carried out to the SA80 rifle in the last five years.[145743]

  Mr. Ingram
  In the last five years the SA80 has been subject to a major modification programme to improve its reliability by either replacing or reengineering components. Work began in 2001 and is scheduled to be completed by May 2006. Approximately 93,000 modified weapons have been issued to date. The basic design and concept of the modified SA80—the SA80 A2—remains the same, but there are significant engineering improvements to the internal gas systems, firing pin, bolt, hammer and barrel. The cocking lever has been redesigned to deflect spent cases and reduce the chance of stoppages, and the new magazine is more reliable and robust. Work has also been undertaken on the safety catch/plunger, and following successful trials of a revised safety plunger during Op TELIC, a contract will be let shortly to procure a sufficient quantity to modify all weapons

  The modification programme also includes enhanced ancillaries. An Operational Cleaning Kit has been developed which enables the user to undertake an
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  operational clean without dismantling the weapon. This is being issued to all troops deployed on Op TELIC in the infantry role

  Ships (Pay-off Dates)
  Mr. Gerald Howarth
  To ask the Secretary of State for Defence what the pay-off dates are for(a) HMS Sovereign, (b) HMS Superb, (c) HMS Spartan, (d) HMS Sceptre, (e) HMS Invincible, (f) HMS Newcastle, (g) HMS Cardiff, (h) HMS Glasgow, (i) HMS Liverpool, (j) HMS Exeter, (k) HMS Southampton, (I) HMS Nottingham, (m) HMS Manchester, (n) HMS Gloucester, (o) HMS Edinburgh and (p) HMS York[145652]

  Mr Ingram
  The present planned decommissioning dates for each of the Royal Navy vessels listed are given in the following table.

  HMS

  Year

  Swiftsure Class submarine:

  Sovereign

  2006

  Superb

  2008

  Spartan

  2006

  Sceptre

  2010

  Invincible Class aircraft carrier:

  Invincible

  2010

  Type 42 Destroyer:

  Newcastle

  2007

  Cardiff

  2008

  Glasgow

  2009

  Liverpool

  2009

  Exeter

  2010

  Southampton

  2011

  Nottingham

  2012

  Manchester

  2012

  Gloucester

  2013

  Edinburgh

  2014

  York

  2013

  Type-45 Destroyer
  Mr. Gerald Howarth
  To ask the Secretary of State for Defence what major design modifications have been made to the hull of the Type 45 destroyer in the past two years.[145643]

  Mr. Ingram
  None.

HOME DEPARTMENT

  Corporate Killing
  Chris Grayling
  To ask the Secretary of State for the Home Department whether it is his policy that the forthcoming Bill on corporate killing should encompass pharmacovigilance.[145220]

  Paul Goggins
  The Government is committed to reforming the law on involuntary manslaughter to make it more effective in convicting companies and other organisations of manslaughter where a death has occurred due to systemic management failure. We will publish our proposals in more detail in due course.

  Elder Abuse
  Sandra Gidley
  To ask the Secretary of State for the Home Department whether the Government uses a formal definition of elder abuse.[145630]

  Dr. Ladyman
  I have been asked to reply

  Statutory guidance, "No secrets", issued by the Home Office and the Department of Health in 2000 defines abuse of vulnerable adults as a violation of an individual's human and civil rights by any other person or persons. It goes on to say that abuse may consist of a single act or repeated acts and can manifest itself as physical abuse, sexual abuse, psychological abuse, financial or material abuse, neglect and acts of omission, and discriminatory abuse.

  Anti-social Behaviour Act
  Mrs. Curtis-Thomas
  To ask the Secretary of State for the Home Department when the powers contained in the Anti-social Behaviour Act 2003 will be available to the police.[146312]

  Ms Blears
  All of the measures in the Anti-social Behaviour Act 2003 will need to be commenced by Order.

  The first set of measures will be commenced under The Anti-social Behaviour Act 2003 (Commencement No. 1 and Transitional Provisions) Order 2003 (Statutory Instrument 2003 Number 3300 (C.130)) made on 17 December 2003. This brings into force a number of the provisions of the Anti-social Behaviour Act 2003 on 20 January 2004 and 27 February 2004

  Orders commencing the remaining measures in the Act will come into effect before the end of 2004. We will be publishing a detailed timetable giving the dates for the commencement of the remaining sections of the Anti-social Behaviour Act 2003 shortly.

  Asylum Seekers
  Mr. Love
  To ask the Secretary of State for the Home Department (1) what(a) services and (b) support the Government is providing to young female asylum seekers who are pregnant through (i) rape and (ii) sexual assault to (A) prevent their isolation and (B) aid their participation in community life;[144503]

  (2) what (a) services and (b) assistance the Government is providing for young female asylum seekers arriving in the United Kingdom who are pregnant as a result of (i) rape and (ii) sexual assault in their country of origin.[144504]

  Beverley Hughes
  Anyone who has lodged a formal application for asylum in the United Kingdom is entitled to access health services. Health assessments are offered in induction centres to allow early identification of health care needs and in the event that an asylum seeker is dispersed, they will take with them a patient handheld record which health professionals can access. Asylum seekers housed in emergency accommodation pending dispersal also have access to health services. If an individual case is referred to and accepted by the Medical Foundation then they will normally be able to remain in London to access the specialist care that only the Foundation can provide
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  On arrival in a dispersal area, advice is provided to help applicants access local services, including medical facilities. In the case of a pregnant woman she will be given appropriate ante-natal care by the local Primary Care Trust. She will also be entitled to access those services which are generally available to women who have been raped. NASS's policy of dispersal according to language seeks to ensure that individuals are not isolated without any support from their community. We also encourage the active participation of asylum seekers in community life through, for example, our Purposeful Activities Scheme and through volunteer and mentoring schemes

  People who arrive in the United Kingdom alone and are under 18 will be treated as unaccompanied asylum seeking children and will be cared for by local social services departments. There they will be entitled to the same care for pregnancy and trauma as any other child in that situation

  In the event that an asylum seeker is raped or sexually assaulted in the United Kingdom then she is entitled to the same protection under the law as anyone else. She would also be offered access to available victim support and counselling services to deal with the consequences of an assault, such as trauma and pregnancy.

  Domestic Violence
  Mrs. Curtis-Thomas
  To ask the Secretary of State for the Home Department if he will make a statement on the policies in place to tackle domestic violence.[146269]

  Mr. Blunkett
  This Government are determined to tackle domestic violence. As part of our overall strategy we have introduced the Domestic Violence, Crime and Victims Bill which will ensure an effective police response when victims report domestic violence, and make sure that the civil and criminal law offer the maximum protection to all victims to stop the violence recurring.

  The main measures relating to domestic violence in the Bill are: making breach of a non-molestation order a criminal offence; making common assault an arrestable offence; enabling courts to impose restraining orders when sentencing for any offence, and on acquittal for any offence if the courts consider it necessary to protect the victim; extending access to non-molestation and occupation orders to same-sex couples and couples who have never cohabited or been married; and issuing guidance to agencies on holding multi-agency reviews following domestic violence homicides

  We recognise that legislation alone cannot deliver improvements to services that victims need. The Inter-Ministerial Group on Domestic Violence will, over the next two years and beyond, oversee a programme of work which focuses on prevention, protection and justice, and support. Among other things, we will be looking at education and tackling risk factors, improving the police and CPS handling of domestic violence cases, delivering new refuge places and providing help and advice to those victims who wish to stay in their own homes. Further details can be found in the Summary of Responses to "Safety and Justice: the

  417W
  Government's Proposals on Domestic Violence", copies of which can be found in the House of Commons Library.

  Elderly Prisoners
  Sandra Gidley
  To ask the Secretary of State for the Home Department (1) what plans he has to develop a national strategy to deal with elderly prisoners; [145625]

  (2) if he will make a statement on prison resources directed at the rehabilitation of prisoners aged 65 years and above.[145632]

  Paul Goggins
  At the present time there are no plans for the Prison Service to put in place a separate national strategy for older prisoners. The current policy is to assess all prisoners' individual needs through sentence planning. This includes taking account of any requirements related to a prisoner's age.

  There are no specific resources allocated to the rehabilitation of older prisoners. However through a system of sentence planning, the Prison Service ensures that all prisoners undertake activities necessary to reduce their risk to the public on release and provides any necessary resettlement support

  Gloucester Prison
  Mr. Drew
  To ask the Secretary of State for the Home Department if he will make a statement on the reasons for admitting young offenders to HMP Gloucester following the announcement of closure of Ashfield Young Offender Institution.[144960]

  Paul Goggins
  The allocation of Young Adult Offenders (YAOs) aged 18–20, into Gloucester prison forms part of the ongoing programme to adjust the population mix of adult and young prisoners at a number of establishments. This is in response to the requirements of the Youth Justice Board for juvenile places and to increasing demand for spaces for adult male prisoners. This will be achieved through careful monitoring of population changes and the allocation of prisoners to establishments appropriate to their needs. It will also ensure maximum use of all available spaces in the prison estate, while minimising the distance of remand prisoners from the courts. This will enable the Prison Service to maintain its service to the courts despite the population pressures

  Ashfield prison is not being closed, but will instead only hold young prisoners, aged 15–17. Gloucester and other prisons in the area will hold remand and sentenced YAOs. Sentenced YAOs returning from court will be held at Gloucester for the minimum time possible before being transferred on to other establishments with YAO regimes.

  Mr. Drew
  To ask the Secretary of State for the Home Department what the reasons are for the delay by the Director General of the Prison Service in replying to correspondence from the Independent Monitoring Board Chairman following the decision to re-admit young offenders to Gloucester prison.[144961]

  Paul Goggins
  The Director General of the Prison Service replied to the Chairman of the Independent Monitoring Board for Gloucester prison on 2 December 2003.

  Juvenile Offenders (Education)
  Dr. Vis
  To ask the Secretary of State for the Home Department how many children in prison were awarded GCSEs in 2003.[145091]

  Paul Goggins
  In 2003 young people in juvenile establishments achieved 189 GCSEs.

  Because the majority of learners in juvenile establishments have very low levels of basic skills, a national curriculum model is not necessarily appropriate for them.

  Prisons
  Mr. Oaten
  To ask the Secretary of State for the Home Department how many seizures of alcohol were made in prisons in the last two years, broken down by month; and what estimate his Department has made of the quantity of alcohol produced illicitly within prisons in that period.[144270]

  Paul Goggins
  This information is not recorded centrally and its collection could be achieved only at disproportionate cost.

  The Prison Service is currently developing an Alcohol Strategy, which is expected to be finalised by March 2004. This will include a system for appropriate data to be collected centrally in order to assist the effective monitoring of performance and security.

  Mr. Oaten
  To ask the Secretary of State for the Home Department what proportion of(a) men and (b) women received into prisons in the last 12 months have been sentenced to immediate custody following breach of a community order.[144273]

  Paul Goggins
  According to sentencing data, 7,825 males were sentenced to immediate custody in England and Wales in 2002 following a breach of a community sentence which represents 9 per cent. of prison receptions under sentence during 2002. For females the corresponding figures are 904 and 12 per cent

  Information on the numbers received into prison because they have breached a community sentence is not comprehensively recorded in the prisons data, as prisoners may be recorded under the nature of their original offence.

  Mr. Oaten
  To ask the Secretary of State for the Home Department how many added days were awarded as punishment for(a) drug offences and (b) other disciplinary offences in prisons in England and Wales in each year since 1997; and at what cost.[143384]

  Paul Goggins
  Information on the use of added days awarded as punishment for drugs offences and other disciplinary offences in 1997 to 2002 is published in table 8.5 in Prison Statistics England and Wales, 1997 to 2002.

  Copies of Prison Statistics England and Wales are available in the Library

  Costs of adjudications are not held centrally

  Sentencing Guidelines Council
  Dr. Kumar
  To ask the Secretary of State for the Home Department if he will make a statement on the membership, role and functions of the proposed Sentencing Guidelines Council; and what plans he has to ensure that there are representatives on the Council from all Government regions.[144743]

  Paul Goggins
  The composition and functions of the Sentencing Guidelines Council are defined by the Criminal Justice Act 2003. The Council will be responsible for setting guidelines for the full range of criminal offences and on general sentencing matters. These guidelines will apply to all courts

  The range of offending behaviour covered by an offence is usually very wide. The guidelines will help to ensure that there is a clear starting point for sentence and agreed aggravating and mitigating factors. The purpose of creating the Council is to achieve greater consistency of sentencing throughout England and Wales

  The Council will consist of the Lord Chief Justice, seven judicial members appointed by the Lord Chancellor and four non judicial members appointed by the Home Secretary. Non-judicial members are eligible for appointment if they have experience in one or more of the following areas:

  Policing

  Criminal prosecution

  Criminal defence

  The promotion of the Welfare victims

  The criteria for membership are defined in the Act; these do not include any reference to Government Regions.

  Sexual Assaults
  Mr. Cousins
  To ask the Secretary of State for the Home Department how many sexual assault referral centre pilots there are; what assessment has been made of them; if he will make a statement on the new round of bids for support for such centres; and whether existing pilot sites can apply for expansion.[141197]

  Paul Goggins
  The Government are aware of seven existing sexual assault referral centres (SARCs). These are not pilot schemes; but are local initiatives that have been established jointly by the police and local health organisations.

  The Home Office has funded research to establish the effectiveness of SARCs by evaluating three existing centres. Research findings will be available in spring of next year

  The Home Office recently made funds available from the crime reduction programme to support the development of sexual assault referral centres. In September, police forces were invited to bid for this funding

  Funding was prioritised for the establishment of new SARCs, however forces with existing SARCs were also eligible to apply
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  Bids were received from 18 police forces. Successful police forces have been notified

  Allocations will be announced in the near future.

  Sudbury Prison
  Mr. McLoughlin
  To ask the Secretary of State for the Home Department (1) how many prisoners at HM Prison Sudbury have absconded during(a) 2003 and (b) 2002.[141398]

  (2) how many prisoners who absconded from HM Prison Sudbury during (a) 2003 and (b) 2002 have not been recaptured;[141263]

  (3) how long it took to recapture each prisoner who absconded from HM Prison Sudbury during (a) 2003 and (b) 2002;[141264]

  (4) how many of the prisoners at HM Prison Sudbury who absconded during (a) 2003 and (b) 2002 were convicted of (i) murder, (ii) grievous bodily harm and (iii) sexual offences;[141400]

  (5) how many of those who absconded from HM Prison Sudbury during (a) 2003 and (b) 2002 committed further offences for which they have been charged during the period of time they were away from the prison; and with what offences they were charged.[141262]

  Paul Goggins
  The figures given relate to financial years. In 2002–03 the number of prisoners who absconded from HMP Sudbury was 67. Of these seven have not yet been recaptured. As at 1 December 2003,56 prisoners had absconded from Sudbury during 2003–04. Of these, 14 have not yet been recaptured. All prisoners who are recaptured after absconding from open prisons like Sudbury are immediately returned to closed establishments

  The following two tables set out the length of time taken to recapture these prisoners, and the number of abscondees serving sentences for murder, grievous bodily harm and sex offences

  Unlawfully at large

  April 2002–03

  April 2003 to date

  1 day

  7

  11

  2–5 days

  12

  10

  6–10 days

  3

  3

  11–20 days

  6

  5

  21–30 days

  7

  3

  31–50 days

  11

  6

  51–100 days

  10

  2

  101–200 days

  4

  1

  201–300 days

  0

  1

  Over 300 days

  0

  0

  Still unlawfully at large

  7

  14

  Total

  67

  56

  Offence

  2002–03

  2003–04 to date

  Murder

  2

  5

  GBH

  3

  6

  Sex offences

  0

  0

  Information on offences committed by prisoners during their period at large is not held in the form requested. As prisoners recaptured after absconding

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  from Sudbury would immediately be sent to a closed establishment, Sudbury would not be informed of the subsequent convictions of those who had previously absconded

  Restraining Orders
  Mr. Mark Oaten
  To ask the Secretary of State for the Home Department how many restraining orders have been issued by the courts in each of the last five years.[143389]

  Paul Goggins
  Restraining orders for sexual offenders came into force on 1 June 2001 under the Sex Offenders Act 1997 as amended by the Criminal Justice and Court Services Act 2000. 17 restraining orders were issued by the courts between 1 June 2001 and 31 December 2002. Figures for 2003 will not be available until next year.

  Suicide
  Dr. Vis
  To ask the Secretary of State for the Home Department (1) how many people have been prevented from committing suicide in 2003;[145088]

  (2) how many people are in a persistent vegetative state as a result of attempting to hang themselves in prisons.[145092]

  Paul Goggins
  The Prison Service is aware of one case of a prisoner in a persistent vegetative state as a result of attempting to hang themselves in prison. Prison Health (now a part of the Department of Health) do not collate this information centrally

  In 2003 (to 31 October), 176 prisoners in England and Wales have been resuscitated following acts of self-harm, which reflect a considerable amount of staff effort and expertise. Many more prisoners are supported through periods of crisis with the help of numerous agencies and support mechanisms available to them in custody. All prisons offer access to the Samaritans, and most prisons operate peer support schemes, most commonly the Samaritans Listener Scheme. Further
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  avenues of support include counselling and help with a range of issues including: substance misuse, healthcare, mental health problems and contact with home.

  Young Offenders
  Miss McIntosh
  To ask the Secretary of State for the Home Department how many(a) assaults on officers and (b) other assaults took place at Her Majesty's Young Offenders Institution Wetherby was in (i) 1999–2000 and (ii) 2000–01.[145651]

  Paul Goggins
  The numbers of assaults on staff, on trainees and on others at Wetherby for each of the two years are shown in the table below. The figures held for assaults on staff do not distinguish how many of the assaults were on Prison Officers specifically

  The figures for serious assaults, i.e. those resulting in the victim receiving medical treatment, are shown in brackets.

  Figures for serious assaults

  Number of assaults on staff

  Number of assaults on trainees

  Number of assaults on others

  April 1999 to

  March 2000

  24 (0)

  119 (4)

  2 (0)

  April 2000 to

  March 2001

  45 (2)

  84 (2)

  6 (0)

  Dr. Vis
  To ask the Secretary of State for the Home Department what steps are being taken to ensure six hours of purposeful activity and a minimum of 10 hours out of cell per day for child prisoners held in segregation.[145095]

  Paul Goggins
  Children held in segregation units in young offender institutions must be given access to education, training, work and physical education. They will be given as much access to those and other out-of cell activities as is practicable, taking into account the reasons for the segregation and the risks in each case as well as the facilities and resources available locally.

NORTHERN IRELAND

  Independent Monitoring Commission
  The Secretary of State for Northern Ireland (Mr. Paul Murphy)
  The Government have today exchanged letters with the Irish Government to bring the agreement establishing the Independent Monitoring Commission into force. The final draft of the agreement was placed in the Library of the House on 4 September 2003. Following signature on 25 November 2003 the agreement was published as Command Paper Cm 6068 and laid before Parliament on 3 December 2003 in accordance with the Ponsonby "rule".

  Both Governments have been committed to doing all they can to ensure that the Commission can begin its work as early as possible. We are confident that in agreeing an early date for entry into force with the Irish Government—before the 21 days required by the Ponsonby "rule" have elapsed—we have acted with the will of the House.

DEFENCE

  Reserve Forces
  The Parliamentary Under-Secretary of State for Defence (Mr. Ivor Caplin)
  Following the expiry of the call-out Order made last January, I am informing the House that a new Order has been made under the 10WS
  Reserve Forces Act 1996 so that reservists may continue to be called out into service to support operations in Iraq. The new Order is effective until 6 January 2005.

  Some 8,500 reservists were called out and accepted into service under the Order made last year. The proportion of reservists deployed with the UK force in theatre is currently just under 20 per cent. but this is expected to reduce to just over 10 per cent. during the course of the year. The next tranche of reservists, involving some 1,100 personnel, will shortly be called out for mobilisation and then deployed in early April where the majority will complete six month tours. We will continue to keep the size and mix of forces in theatre under careful review. We are very appreciative of the continuing support and commitment shown by both reservists and their employers.

CABINET OFFICE

  Civil Contingencies Bill
  The Minister for the Cabinet Office and Chancellor of the Duchy of Lancaster (Mr. Douglas Alexander)
  I am today publishing the "Government's response to the report of the Joint Committee on the draft Civil Contingencies Bill (incorporating the Government's response to the House of Commons Defence Committee on the draft Civil Contingencies Bill)" (Cm 6078).

  The Government are grateful for the contribution of the Joint Committee and the Defence Committee to the development of the thinking on the draft Bill as set out in their reports of 2 July and 28 November. We have considered in detail the recommendations put forward. Copies of the Government's response are available in the Libraries of both Houses and can also be viewed on the UK Resilience website http://www.ukresilience.info/

  I am also today publishing the Cabinet Office report on The Government's Response to the Public Consultation on the Draft Civil Contingencies Bill, that was carried out last summer from 19 June until 11 September. This is also available in the Libraries of both Houses and can be viewed at http:// www.ukresilience.info/

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

Schools: Fire Safety
Lord Harrison Lord Harrison asked Her Majesty's Government:
What more they can do to reduce school fires, both caused by arson and accidental.
Baroness Andrews: My Lords, the Office of the Deputy Prime Minister and the Department for Education and Skills are working together closely on this very important issue of fire safety in schools. The ODPM will begin work on a major revision of the fire safety aspects of the building regulations early in 2004 and that will cover schools. The DfES issued the guide Fire Safety in 2000 and is currently working on new and more comprehensive fire safety guidance for schools. This covers risk assessment and will include advice on security and the prevention of arson.
Lord Harrison: My Lords, I thank my noble friend for that Answer. Given that school fires have doubled in the past 10 years, costing education authorities £96 million and losing us the opportunity of having 3,000 extra teachers, will the Government redouble their efforts by publishing the statistics for fires that are accidental and those started by arson; by better protection of buildings by the greater use of CCTV and non-flammable building materials; and by supporting initiatives such as that taken by Cheshire County Council to target schoolchildren who believe that schools are there more for torching than teaching?
Baroness Andrews: My Lords, I think that the Government's record in recent years has been excellent. We have gone for stronger regulation, more effective guidance, significant investment in safety in schools and closer partnership. However, the noble Lord is correct—this is an important matter. Some 60 per cent of fires started in schools are thought to have been set deliberately. We are very keen to reduce that figure. As for CCTV and other intelligent alarm systems, the extra funding that has gone into capital investment—£3 billion as of this year—is making a big difference. Schools are certainly making use of those new systems. As for young people, it was very interesting to hear about the Cheshire initiative. We need far more of those sorts of initiative.
Baroness Gardner of Parkes: My Lords, can the Minister tell us whether schools have automatic sprinkler systems and, if so, how effective they are? If
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they are effective, are they being used wrongly, so that people deliberately light fires under them to drench the school?
Baroness Andrews: My Lords, sprinkler systems are used by some schools. The fire safety advice given to schools suggests that if the school is at high risk, a sprinkler system is good value. However, they are extremely expensive; if we were to put them into all schools, it would cost about £3 billion. In some cases sprinklers would not be appropriate. When fires start in roof spaces—in the Tiffin Girls' School, for example—sprinklers make no difference. Ironically, sprinklers also become targets for vandalism.
Baroness Thomas of Walliswood: My Lords, the Minister has not told us whether the Government have decided to install sprinklers in all new school buildings, where presumably the installation cost would be a good deal lower than it would be after the building has been built.
On a different subject, detection rates for arson are generally extremely low—about 8 per cent, compared with 23 per cent of crime in general. Presumably the very large proportion of fires that are started in schools by pupils can be detected more easily. Has the department issued guidance to head teachers on how they should deal with pupils who are thought to be, or prove to be, the culprits in these matters? When are they sent to the police, and are they brought before courts?
Baroness Andrews: My Lords, we have not given, and we do not intend to give, general guidance on installing sprinklers in new schools. The building regulations do not require it and we do not intend to change them. As new schools are subject to building regulations, they have better compartmentation, for example, which makes a difference to safety overall. The figure which the noble Baroness cites is quite correct: arson detection rates are low. We know that about 65 per cent of fires in schools are started by pupils; so that detection rate is quite high. Although head teachers are the best possible people to deal with troublemakers, the DfES has recently issued guidance on dealing with troublemakers in schools. It is a fairly fat document and sets out a whole range of initiatives.
Lord Laming: My Lords, does the Minister agree that matters of this kind lend weight to the importance of proper resourcing for the youth service in this country? In particular, young people, especially those in deprived areas, should have access to good sports facilities to occupy them in more constructive ways.
Baroness Andrews: My Lords, I entirely agree with the noble Lord, but I would go further. By enabling schools to stay open longer and by developing sports and arts programmes after school, we are seeing a reduction in vandalism. It is a very cost-effective programme. We want to see more of that, and also more schemes such as the Splash Scheme, which the

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police have been actively and successfully promoting. I believe they have seen a significant drop in vandalism. So we want more of the same.
Baroness Trumpington: My Lords, does the Minister realise that one does not have to be in a deprived area to have arson? My husband was headmaster of University College School, which was burnt down through arson in 1976. The culprit was never caught.
Baroness Andrews: Yes, my Lords; it is a very sad fact and absolutely true. So far as I know, the figures that we have do not break down the type of school that has been subject to an arson attack. There are also different types of arsonist. There are opportunists, for whom arson is another form of delinquency, and then there are pathological children for whom fire has a great attraction. It is difficult to deal with both of those types.

Websites: Personal Details
2.42 p.m.
Lord Greaves Lord Greaves asked Her Majesty's Government:
Whether they intend to take action to deal with threats and intimidation arising from websites which provide personal details of active opponents of fascist and racist parties.
The Minister of State, Home Office (Baroness Scotland of Asthal): My Lords, we have discussed this with the police, the Information Commissioner and the Internet Watch Foundation, all of whom are aware of these websites. It is important that the provisions of the Public Order Act 1986 and the Protection from Harassment Act 1997 be used when breaches occur. Anyone with concerns should make them known to the relevant authorities and to the Internet Watch Foundation. We are currently working on an e-crime strategy that will include consideration of issues such as these.
Lord Greaves: My Lords, I thank the Minister for that helpful reply. The website concerned, Red Watch, was set up about two years ago by Combat 18, a Nazi hit group. It is registered by the National Front and the White Nationalist Party. A great deal of the material upon the website appears to be posted on it and sent to it by active and leading members of the British National Party. The material consists of more than 1,000 photographs of anti-Nazi, anti-racist activists with their addresses, telephone numbers and, where applicable, car registration numbers. I believe that the Minister confirmed that the security and police forces are looking at the matter. Will she reconfirm that? Will she also tell us whether they are devoting sufficient resources to this particular problem which quite clearly involves breaches of the law, incitement to violence against individuals and their property and incitement to racial hatred? This is a serious matter. Just because the people concerned are on the Left does
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not mean that they deserve less protection than if they were businessmen or other people. Will the Minister confirm that?
Baroness Scotland of Asthal: My Lords, I confirm that all proper steps will be taken if any person is found to be in breach of the law. The difficulty that we have experienced is that operators of certain websites have sought to avoid overstepping the conduct that the legislation defines as criminal. They fly very close to the wind. I reassure the House that although we intend to keep the position under review we do not believe that the absence of charges so far against any particular website has yet established that we need new offences or safeguards. However, I confirm that the matter will be kept under close scrutiny.
The Lord Bishop of Portsmouth: My Lords, I am very grateful for the noble Lord's Question. The Chief Rabbi drew attention to the growing threat of racism on Radio 4 last November following the bombing of synagogues in Istanbul. It seems to me that the matter goes beyond present legislative abilities. Do the Government agree that the precious gift of freedom of speech is being abused and that action needs to be taken to protect very vulnerable people, including some young people, and to make clear to those who are just getting on the thither side of existing legislation, but not quite, that there are limits to the toleration that the rest of the community can extend to them?
Baroness Scotland of Asthal: My Lords, I certainly empathise with the thrust of what the right reverend Prelate said. However, the current legislation is fairly robust. The right reverend Prelate will know that the 1997 Act provides for victims of harassment to apply to the High Court for a civil restraining order. In the past such orders have successfully been obtained by victims of animal rights extremists. They include a requirement for the removal of information about individuals from websites. We shall reconsider the matter to see whether there is anything further that needs to be done although obviously I cannot guarantee what the outcome of that review will be.
Lord Janner of Braunstone: My Lords, following what the right reverend Prelate said, with all of which I fully agree, are Her Majesty's Government taking positive steps to engage and bring together people of all faiths, whether they are Christians, Muslims, Jews, Hindus, Sikhs or other, to recognise the danger that is emerging from the far Right, the fascists and Nazis, and to fight against that growing racism?
Baroness Scotland of Asthal: My Lords, I certainly reassure my noble friend that there are many initiatives which seek to bring together people of different faiths to talk about issues of this kind. I refer not just to government initiatives but also to those instigated by non-governmental agencies. Opportunities to continue that process must be seized by us all as it is a

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matter of real importance. I certainly guarantee that this issue will continue to concern the Government and will be addressed.
Lord Renton: My Lords, have the Government no intention of ensuring that websites should exist only for lawful purposes?
Baroness Scotland of Asthal: My Lords, we have. The whole point of what many people seek to do is to fly very close to the wind so that they keep just inside whichever barrier is set for them. As I say, we shall continue to consider what we can do to make it increasingly difficult for them to adopt those positions with the facility that applies at present.
Baroness Sharples: My Lords—
Lord McNally: My Lords, is the Minister aware of the study carried out by the chairman of the Internet Watch Foundation, Roger Darlington, into extremism on the Internet in which he draws attention to the fact that much of this poison comes from the United States where providers are protected by the First Amendment? As the Minister may be aware, Mr Darlington draws attention to the fact that the Council of Europe brought forward a convention on cyber-crime with which the United States and Japan were associated. However, a number of countries are now pressing for a protocol to the convention covering racism and xenophobia. Is that a matter that Her Majesty's Government would support and is it a matter that Her Majesty's Government would take up with the United States given that they want co-operation on other matters?
Baroness Scotland of Asthal: My Lords, we have initiated inquiries of the United States authorities to establish whether hosting such websites constitutes a breach of US law, regulations or industry good practice. We shall continue to work with all those who are engaged in this work in a positive way to create better security. I shall certainly consider what the noble Lord said about the convention. I cannot give the noble Lord an answer from the Dispatch Box; I do not think that he expected me so to do.
Lord Hodgson of Astley Abbotts: My Lords, is the Minister aware that in the early 1990s information similar to that now being put on the website we are discussing was produced in printed form and had to be stopped through criminal proceedings? As she says that the law is robust, why cannot the law now be used to inhibit similar material being produced on a website?
Baroness Scotland of Asthal: My Lords, noble Lords will know that it is for the CPS and the prosecution authorities to make a decision in any individual case, whether breaches of the law have or have not occurred. I cannot second guess the judgments. That is why I said earlier that although there have not been any prosecutions to date, that does not mean that the law
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is not efficacious. It may simply mean that, in the given case, there was insufficient evidence. There is nothing to indicate that what was unlawful before is lawful now.
Lord Hunt of Kings Heath: My Lords, my noble friend mentioned the activities of animal rights terrorist groups in particular using the web. Will she give an assurance that, as part of her department's work in the area, efforts will be redoubled to protect lawful businesses, which necessarily undertake well regulated research using animals?
Baroness Scotland of Asthal: My Lords, I can certainly tell my noble friend that we have made huge efforts to protect lawful businesses. He will be very familiar with our work on abuse by animal rights extremists in relation to Huntingdon Life Sciences and others. Those efforts will continue. The amendments that we made in the Criminal Justice Act are helpful, and we hope that they will be used in future.
Baroness Sharples: My Lords, what is the estimate of the number of people involved in this situation, both those who receive and send the threats?
Baroness Scotland of Asthal: My Lords, we do not have figures. The noble Lord outlined the nature of the site and the number of people put on it. We are not able to quantify how many are engaged in the activity. If we have the figures, I shall certainly write to the noble Baroness.
The Earl of Northesk: My Lords, would the noble Baroness care to comment on whether websites that publish personal data without consent could be in breach of the Data Protection Act and therefore prosecutable?
Baroness Scotland of Asthal: My Lords, the Data Protection Act may not precisely cover such issues. It has been very helpful that the UK ISPs have been robust in terms of together putting forward contracts that tend to exclude such data. We absolutely endorse that good practice and encourage all ISPs to continue to look at it.

Sudden Infant Deaths
2.52 p.m.
Lord Lamont of Lerwick Lord Lamont of Lerwick asked Her Majesty's Government:
Whether the Lord Chancellor will discuss with the Lord Chief Justice the recent overturning of certain convictions in relation to babies in cot deaths.
The Attorney-General (Lord Goldsmith): My Lords, acute public concern has been raised about prosecutions for homicide offences in relation to cases of sudden infant deaths, particularly in the light of three recent high profile cases. While the Lord

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Chancellor has regular discussions with the Lord Chief Justice about the proper administration of justice throughout the courts, he has no role in reviewing judicial decisions, whether generally or specifically in relation to cot deaths.
However, as Attorney-General, I have taken action to review the implications of the cases, with the support of the Director of Public Prosecutions. The action that I have taken includes establishing an interdepartmental group that is identifying and has already started to review relevant past cases.
Lord Lamont of Lerwick: My Lords, I thank the Attorney-General for that helpful reply. Does he agree that it is a poor reflection on British justice that Sally Clark, Trupti Patel and Angela Cannings should have gone through hell for child murders that they did not commit? They were put through hell on the basis of the evidence of the expert witness Sir Roy Meadows, and statistical evidence that the Royal Statistical Society wrote to the Lord Chancellor to say had no statistical basis.
How many cases are there of women in prison convicted in relation to cot deaths, and of women who have been through the family courts and been separated from their children, with both categories being based on evidence by Sir Roy Meadows or experts using similar methods? Some people have said that there could be up to 250 cases. Is it not vital that the review that the Attorney-General is undertaking happens very quickly? Does there not appear to be some need to advise the courts that convictions need to be based on hard evidence, not statistical probabilities or checklists of psychological symptoms?
Lord Goldsmith: My Lords, I of course entirely agree that the effects on mothers and their families of tragically losing children and then being accused or—worse still—convicted, in the event wrongly, of their murder are devastating. Obviously, it is the job of our police and child protection agencies to protect vulnerable children who are unable to protect themselves. The consequences of not acting or acting without due cause can be devastating, which is why it is so important to look very thoroughly at the implications of the cases.
That is why I moved swiftly after the Sally Clark verdict to establish the group. It is already reviewing 50 cases that concern the evidence of Dr Williams. We have not had the judgment yet in the Cannings case—it is expected shortly—but I have already asked the group to identify cases of sudden deaths of infants in the past 10 years. However, there is no central database.
There are different issues in relation to family cases, as the Crown is not a party to those. My interdepartmental review is concerned with criminal cases, and I cannot at the moment say how many cases
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there are. I shall try to write to the noble Lord when I can. However, I entirely agree that the issue is very important, which is why I have taken such action.
The Countess of Mar: My Lords, will the noble and learned Lord look very seriously at the matter? He knows that I have raised it a number of times in the House. We estimate that about 5,000 parents have had their children removed from them, with accusations of Munchausen syndrome by proxy held over their heads. The noble Baroness, Lady Ashton, said that there was no connection between the death cases that came up in court and of which the mothers have been exonerated and the cases of Munchausen syndrome by proxy. However, there is: Professor Sir Roy Meadows invented Munchausen syndrome by proxy.
In view of the tenuous stickability of Professor Meadows's evidence, will the noble and learned Lord look at the cases and at the functioning of the family courts, which is behind closed doors with no appeal? The women are absolutely desperate, because they cannot get employment. That is what is so dreadful.
Lord Goldsmith: My Lords, I am very well aware of the close and important interest that the noble Countess has in the issue. We need to consider the findings of the interdepartmental review into the criminal cases, to which I have referred. The Ministers responsible for family cases—the Minister for Children and the Ministers from the Department for Constitutional Affairs—will look very carefully at that, too. They will look carefully at the judgment in the Cannings case, which will be very important when it comes out shortly. They will consider what, if anything, can and should be done in relation to any family cases, particularly those in which evidence from Professor Meadows was adduced.
The noble Countess said that there was no appeal in family cases. As I said a moment ago, the Crown is not usually a party, but a local authority might be. Evidence will normally have been called by a private party. Where a private party believes that evidence was given that was determinative and affected the outcome, it may very well be open to that person to bring an appeal even now against the order. However, I have noted the noble Countess's comments, and so have other Ministers.
Lord Ackner: My Lords—
Lord Carlile of Berriew: My Lords, does the noble and learned Lord agree that the three criminal cases raised by the noble Lord, Lord Lamont, highlight particular issues about the quality, peer review and disclosure of evidence of pathologists and other medical scientists in criminal cases? In the light of that, will the noble and learned Lord assure the House that the Crown Prosecution Service is urgently reviewing its pre-trial scrutiny of the quality of such evidence? Will the Government consider inviting the judges to exercise stronger case-management disciplines in dealing with such evidence before it ever reaches a jury?
Lord Goldsmith: My Lords, the issues that the noble Lord raises are certainly very important. I can make

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three comments. First, the Home Office pathology advisory board will publish new codes of practice that will deal with the judicial comments made in the Sally Clark case. That relates particularly to the noble Lord's disclosure question. Secondly, I have asked my group to consider the general implications of the cases. Thirdly, noble Lords are aware of the intercollegiate working group on which the Department of Health sits, but which is chaired by my noble friend Lady Kennedy of The Shaws. It is also looking at the issues. Regarding the Crown Prosecution Service, it will of course continue to operate on the basis of looking for real evidence—that is the code that is required. Regarding case management, as a Government we are very much in favour of judicial case management. I assure the noble Lord that, in any event, where judges see evidence before them which they do not think is adequate, they are not slow to make that point.

Sky Marshals
3 p.m.
Lord Clinton-Davis: My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as president of the British Air Line Pilots Association.
The Question was as follows:
To ask Her Majesty's Government what instructions have been given to United Kingdom airlines concerning sky marshals.
Lord Davies of Oldham: My Lords, sky marshals may be deployed on UK aircraft in response to the threat assessment where it is judged that their deployment will contribute to the overall security of a flight or flights. Deployment will be with the agreement of the airline or airlines concerned.
Lord Clinton-Davis: My Lords, I thank the noble Lord for that reply. What is being done to improve efficiency on the ground? Will he confirm that in the air the pilot must have ultimate responsibility? Finally, should there not be a debate in government time on the matter as soon as possible? It is very important.
Lord Davies of Oldham: My Lords, I confirm the point of principle that the pilot of the aircraft will remain in command at all times. Regarding my noble friend's request for a debate in government time, that is a matter for the usual channels. He will also be aware that there are numerous other opportunities that he might wish to take up with regard to a debate. I also bring to his attention—as he and all noble Lords are aware—that security issues are involved in the matter and, therefore, there are some difficulties in responding to certain questions.
Viscount Astor: My Lords, will the Minister tell us whether protocols on the deployment of sky marshals have been agreed with the pilots' union? Their original
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deployment was announced by the Secretary of State on 19 December 2002 and he made a further announcement in December last year. Is it not of public concern that the protocols have not yet been agreed, although I understand that the Secretary of State met the pilots' union yesterday? Will not UK airlines be put at a competitive disadvantage by the introduction of sky marshals because the United States Government are funding their cost?
Lord Davies of Oldham: My Lords, as the noble Viscount has recognised, there was a meeting yesterday with the Secretary of State after which BALPA expressed satisfaction with the broad outcome of the meeting, although there are some further details to be attended to. But since the announcement that we had the capacity to deploy sky marshals there have been discussions with the airlines and protocols have been agreed. There are some outstanding details and yesterday's meeting was an advance towards concluding those matters. The costs of sky marshals is borne by the Government.
Lord Hogg of Cumbernauld: My Lords, will my noble friend confirm that steps will be taken to consult passenger bodies? While I recognise that BALPA is important, as are those who represent cabin staff, there seems to be a body of people who are never consulted on any matter concerning aviation policy: the passengers. What steps are being taken to consult passenger bodies on the introduction of sky marshals, which I think would be welcomed by passengers?
Lord Davies of Oldham: My Lords, my noble friend will recognise that the issues that needed to be discussed were the protocols and the basis on which sky marshals would be deployed in aircraft—that has been the subject of the discussions in the past year. He is right that passengers have major interests in the matter and the Secretary of State is mightily concerned to ensure that they are reassured that the deployment of sky marshals obtains only in those circumstances where clear evidence of a threat is manifest. The airline still has the choice of not proceeding with the flight if it regards the threat to be of such dimensions. But the Government are pursuing the whole issue of sky marshals with the sole intent of guaranteeing the safety of the travelling public.
Lord Campbell of Croy: My Lords, have the Government decided that sky marshals should he armed? If so, will they insist on the use of special bullets to reduce the danger in pressurised interiors of aircraft?
Lord Davies of Oldham: My Lords, it is the case that sky marshals, or the British equivalent—which is armed police on aircraft—are armed with weapons and, of course, the intent is that those weapons should enable the sky marshal to deal with any emergency.

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But it is borne in mind that the discharge of firearms in an aircraft has great safety implications and the point to which the noble Lord alludes is important.
Baroness Thomas of Walliswood: My Lords, can the Minister assure us—his Answer was partly reassuring—that the people who are chosen for this sensitive work have been suitably trained, including training with the air crew, and that they are using weapons that are safe within aircraft? Can he also say whether the Government have considered the danger that the knowledge that some flights may regularly have sky marshals will divert the attention of would-be terrorists to other lines and routes that are less rigorously monitored?
Lord Davies of Oldham: My Lords, no one has any intention of indicating when and where sky marshals are to be deployed. Therefore, there will not be evidence on which to base switching attention to less well guarded aircraft. Regarding training, I assure the noble Baroness that the Government's announcement that sky marshals were available for use when there were threats to particular flights was a reflection of the fact that we had put in place the necessary police training—these are armed police deployed to a different location.

Social Security Benefits: Numeracy and Literacy Tests
3.7 p.m.
Baroness Barker: My Lords, on behalf of my noble friend Lord Russell, and at his request, I beg leave to ask the Question standing in his name on the Order Paper. The Question was as follows:
Whether Her Majesty's Government will confirm that the levels of social security benefits will remain independent of any numeracy or literacy tests.
The Parliamentary Under-Secretary of State, Department for Work and Pensions (Baroness Hollis of Heigham): My Lords, one third of people on jobseeker's allowance, which is a benefit for those actively seeking work, are functionally illiterate—one third. Even the most modest jobs can be closed to them—for example, stacking shelves or cleaning public buildings—if they cannot read the safety instructions that protect both the worker and the customer.
We are planning to introduce mandatory training pilots to help jobseekers to overcome their lack of basic skills. Sanctions would be applicable, not, as the Question suggests, if someone fails the literacy or numeracy test, but to those who refuse to attend training courses to help to address their problems.
Baroness Barker: My Lords, I thank the Minister for her Answer. She will be aware that her own department has said that jobseekers will be sanctioned
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if they do not complete the training that it thinks they need to undertake to make them ready for work. Will there be any independent appeal against DWP judgments in those matters? What steps will the Government take to assess the sufficiency of income of anyone who fails to complete a course?
Baroness Hollis of Heigham: My Lords, in answer to the noble Baroness's first point, there is an appeal procedure and, following assessment, people will be entitled to hardship payments if they are eligible. However, perhaps I may go back a step to the substance of the question. How can we he confident that we are getting this right?
When those who receive the jobseeker's allowance have their work-focused interviews, they undergo a basic screening test. Essentially, they are shown an advertisement for an assistant caretaker's job setting out the pay rate or the minimum wage and they are asked whether they can read it and understand it and so on. If, as a result, they are shown to be functionally illiterate, they are then referred to professional, independent expert assessors, who screen for dyslexia and possibly refer people on to an educational psychologist. The psychologist can, for example, screen for a learning difficulty, which may suggest that individuals should not even be receiving the jobseeker's allowance but instead, say, incapacity benefit. Following that, those who the independent assessor considers would benefit go on to attend a training course. It is only if, following those interviews, people fail to complete the training course that the question of sanctions arises.
A third of people who receive JSA are functionally illiterate. Most are white males and a third are parents, who are therefore unable to read the prescription labels on medicine bottles for their children and cannot take their children to swimming pools and be sure about the safety rules. It is no kindness to allow people to conceal their illiteracy for 20 or 30 years and, indeed, to hand their illiteracy down to their children.
Lord Higgins: My Lords, do not the Government rather have this issue back to front? They are threatening to withdraw benefit from people because they are illiterate when illiterate people, like many others, do not receive benefit in the first place because they do not understand government forms. However, does the noble Baroness agree that the use of benefit withdrawal as a weapon to secure unrelated policy objectives is objectionable? If we go along with this proposal, where will she draw the line so far as concerns using withdrawal of benefits as a weapon to obtain other objectives?
Baroness Hollis of Heigham: My Lords, the noble Lord raised two points. First, clearly, ideally one tackles the problem at school. Already, compared with 1996, when only 57 per cent of children of the age of 11 had reached the appropriate standard, that figure is now 75 per cent. Therefore, I am sure we all hope that this is a declining problem and I am sure we all agree that a voluntary approach is desirable. However, for

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all kinds of reasons, many illiterate people—perhaps those with substance abuse problems or the like—will spend their lives concealing their problems rather than seeking help to address them, and we must overcome that.
The noble Lord then asked how far we would go in terms of unrelated issues. This is not an unrelated matter. We are not sanctioning people because they are illiterate, but we would sanction people if they consistently failed to attend a training course to overcome the illiteracy which is at the core of their unemployability. In Haringey only 28 per cent of people with basic literacy problems have jobs and the figure is 30 per cent for Hackney. Therefore, what kindness is it to say to those people, "You can live your lives on the margins, unemployed and unemployable and your children, in turn, will inherit that"?
The Countess of Mar: My Lords, is the Minister in a position to give an undertaking that people suffering from myalgic encephalomyelitis—ME—will not be forced to undergo cognitive behaviour therapy and graded exercise programmes as a basis for obtaining benefit? There are rumours that that is about to happen and that those people's benefits will be reduced progressively while they refuse to undergo such therapy and programmes. Adequate information is also available to show that this is an organic and not a psychological illness.
Baroness Hollis of Heigham: My Lords, the noble Countess may well be right on the last point and I would not wish to challenge her statement on that. However, I am a little puzzled. My understanding is that someone who has ME—whatever the cause, the symptoms are clinically recognised—would normally be entitled to incapacity benefit. He would not be expected to claim the jobseeker's allowance, which is intended for those who actively seek work, and therefore this issue would not affect such a person at all.
Lord Morris of Manchester: My Lords, can my noble friend say what consultation over this policy area has taken place with disability organisations?
Baroness Hollis of Heigham: My Lords, again, this matter will not affect disabled people because disabled people in this policy area would not receive the jobseeker's allowance but would receive incapacity benefit, a severe disablement allowance or other appropriate disability benefits. These measures are for people who actively seek work but who cannot take the first step in holding down a job—that is, they lack functional literacy. You cannot even be a car park attendant if you cannot calculate the fee; you cannot clean a public building safely if you cannot read the word "bleach"; and you cannot stack shelves if you do not know whether what you are doing is safe for your customers. That is the matter with which we are dealing.
Baroness Thomas of Walliswood: My Lords, will the Minister take this opportunity to dispel an
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unfortunate impression that she gave in her first Answer: that people with a moderate learning difficulty are incapable of work? I know of a number of such cases. I also know of a school for children with moderate learning difficulties which has a 100 per cent success rate in obtaining jobs for its children. On my daily rounds in my own home town, I meet several workers who clearly have learning difficulties.
Baroness Hollis of Heigham: My Lords, I said that a third of those on jobseeker's allowance—that is, those who do not have work; those are the people to whom the Baroness refers—are functionally illiterate. They may also have multiple problems but they are functionally illiterate. The question is: how can we bring them into the mainstream of society both as workers and as effective parents if they do not have the basic skills needed in today's society?

Cancer Registration
3.15 p.m.
Baroness Finlay of Llandaff Baroness Finlay of Llandaff rose to call attention to the arrangements for cancer registration in England and their role in support of the National Health Service Cancer Plan; and to move for Papers.
The noble Baroness said: My Lords, I am grateful for the opportunity for this debate. I had the honour to serve on the expert advisory committee on cancers under the joint chairmanship of Sir Kenneth Calman and Dame Deirdre Hine. My interests now relate to my position as a consultant in palliative medicine at Velindre NHS Trust and Marie Curie Cancer Care. I have received secretarial help for this debate through support from Johnson & Johnson.
I hope to outline the importance of UK cancer registration and to explain why I feel that the process and the funding need to be secured through legislation. The UK has had a national, population-based cancer registration service for more than 30 years. The 12 cancer registries—nine in England, together with Scotland, Wales and Northern Ireland—record a core data set of information on nearly every new patient diagnosed with cancer. More than a quarter of a million new patients are added to the database annually, so details are now available on almost 9 million cancer patients.
The United Kingdom Association of Cancer Registries co-ordinates the 12 registries, with data for England and Wales published by the Office for National Statistics. Cancer registry information monitors trends in incidence and survival, helps to understand the causes of cancer, supports audit of NHS cancer services, evaluates the impact of screening programmes and contributes to the care process. No other country has such a large cancer registration data set, with 100 per cent national coverage. In the UK, no other disease has such a large population-based register.
Although in the USA some cancer registries receive specific federal funding, overall only 26 per cent of the population is covered. Similarly, many larger

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European countries, such as France, Germany, Italy and Spain, have cancer registries covering only relatively small localities, sometimes confined to centres of clinical excellence. By contrast, legislation in the Scandinavian countries has led to excellent registration systems since the 1950s. In those countries, legislation has been the reason for completion.
Registries monitor trends in cancer against time, geography and socio-economic status. Such epidemiological information is crucial in order to investigate systematically reported clusters of cancer. Recent examples include studies on the pattern of cancers around the Fylingdales airforce base in North Yorkshire, the Hinkley Point nuclear power station in Somerset, the Wishaw phone mast in the West Midlands, and the children's bone cancers that occurred in the Cornish village of Helston. To detect any significant correlation, the national data must be complete. If one or two cases are missing, that can skew the data sufficiently to miss significant effects.
Registry information is also essential to public health initiatives. Currently, a clinical trial is evaluating flexible sigmoidoscopy in screening for bowel cancer. Another example is the current action to contact women treated with mediastinal radiotherapy for Hodgkin's disease, who may now be at increased risk of breast cancer. Here, the patient is benefiting directly from her registered data, clearly demonstrating the importance of identifiable data.
The information from registries also supports counselling of the increasing number of families concerned about their genetic risk of cancer. Registry databases can help rapidly to establish the familial risk of disease so that those who could benefit from screening and early intervention are offered a choice and have appropriate counselling.
In October 1999 Professor Mike Richards was appointed National Cancer Director. In this key appointment he has achieved much as he has carried the confidence of professionals and government. The NHS Cancer Plan, published in 2000, aims to develop the fastest improvement in cancer services anywhere in Europe over the next five years. It is the first national cancer programme for England and provides a comprehensive strategy to bring together prevention, screening, diagnosis, treatment and care for cancer and the investment needed to deliver these services in terms of improved staffing, equipment, drugs, treatment and information systems.
Last year the Government invested an extra £406 million over their baseline spending in 2000. There are now more CT and M RI scanners for diagnosis and treatment, more patients are treated by multi-disciplinary teams to ensure each patient gets the best treatment by the best people, waiting times are indeed falling, good information for patients is more accessible and, crucially, the patient's experience seems to be improving. But the interim report on the cancer plan Maintaining the momentum provides a motivational half-time analysis; that although the
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infrastructure has improved, there still needs to be a concerted effort to get the investment to where it is needed and tackle remaining inequalities.
Delivery of the cancer plan by trusts and cancer networks is audited by peer review against detailed standards, using core information on performance from cancer registries. Such data also support the National Clinical Audit Support Programme projects on cancer. Currently, complete UK data are publicly available for cancer diagnosed in 2000. That shows 3,000 more cancer cases were diagnosed than in 1999.
The recorded cases of prostate cancer have doubled in the past 10 years through accurate diagnosis with prostate specific antigen testing. As the Prostate Cancer Charity highlights, such data give early warnings to government for service planning to cope with increased patient numbers. Data such as the big increases in malignant melanoma are also key drivers to research initiatives by Cancer Research UK.
English cancer registries originated in the former NHS regions, leading to differences between registries. Some aspects of data capture, such as non-melanoma skin cancers which are linked to sun exposure, still need great improvements.
Following Professor Gilles's report on English registries in 2001, extensive reforms are set to make the UK system the most sophisticated in the world. The cancer registration data set will collect much more detail on the staging of cancer and the treatment received by patients. A common automated system will compile a clearly defined dataset in real time, tracking key events and linking closely to the electronic integrated patient record. These developments are breaking new ground on the automated capture of clinical information about a specific patient group; cancer will become a model for other disease datasets to ensure equity in quality care provision.
Across England, the registries will use a single web-based "Cancer Information System" over the NHS net, enabling providers and commissioners down to local PCT level to obtain completely anonymised analyses on incidence, mortality, treatment and survival in their locality. The programme of modernisation in England will share developments with the cancer registries in Scotland, Wales and Northern Ireland to strengthen current collaborative working. Comparative UK information has shown the impact of smoking cessation policies in Scotland. where lung cancer cases are now at last falling.
I am concerned about funding. The cancer registries in Scotland, Wales and Northern Ireland have been funded by their respective governments and assemblies since their creation. Historically, English regions funded registries to varying extents and then local health authorities funded on a per capita basis. In 2002 Shifting the Balance of Power devolved budgets for cancer registries to PCTs without any ring-fencing or earmarking. Each registry now has contract negotiations with numerous PCTs, which have proven to be time-consuming and invidiously place the registry in direct competition with clinical services for

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resources. It has already become clear that most PCTs are unlikely to support further funding to continue the important programme of modernisation that I outlined earlier.
In the past two to three months regional directors of public health, supported by the Chief Medical Officer, have sought a more centralised model to resource cancer registries, similar to that used to fund the regional public health observatories. I hope the Minister will be able to confirm that this will be adopted as the preferred option for funding.
I have had discussions with more than 20 cancer charities. All support the drive for comprehensive registration data and recognise their importance to evaluate service provision overall, assess unmet need and steer research into cancer. They champion the need for the public to be educated to understand the importance of data collection. The charities themselves want to be able to obtain anonymised analyses to inform their strategy.
In collecting information on many millions of cancer patients, the registries are acutely aware of their responsibilities to maintain these data securely and to protect the confidentiality of the individual patient. Registries have adopted the high standards of data security and, in more than three decades of keeping such data sets, there has not been a single breach.
Cancer registries need to receive and process identifiable data for several reasons. To collate data from multiple sources over long periods of time, all information related to an individual patient must match, otherwise patients would be double counted and analyses would become unreliable. Registries are asked to link their information with information from other NHS services, notably to evaluate the national screening programmes for breast and cervical cancer. Personal identifiers must be checked to ensure accurate linkages.
Cancer genetic counselling clinics depend on registries to confirm cancer diagnoses in family members. The individuals concerned must first provide informed consent to the release of their information for this purpose, so registries need to be able to identify individuals.
Geographical studies, such as studies of cancer risk in people living near landfill sites, can be undertaken only if a full postcode is available. Mesothelioma and its link to asbestos exposure or clusters of childhood leukaemia around power stations are other examples of the need to identify individuals to alter the course of the nation's health in the long term.
In the future, linking registration data to routine hospital episode statistics will give information better to plan services and ensure equity of provision, such as access in different areas to thoracic surgery to resect lung cancer. Data on chemotherapy could reveal variations in drug use, particularly the adherence or non-adherence to NICE guidance. Currently, the pharmaceutical industry is the sole source of such important data.
The postcode is also required as boundaries change—for example, around primary care trusts, local authorities or cancer networks—to update and interrogate data so that service reorganisation can be evaluated and government policy held to account.
If, in the future, patients themselves could register their own verifiable details, then electronic filtering of their stories might well reveal rich information about common trends behind their cancers, for patients are keen to help others by sharing their experience for the common good, as the DIPEx website shows.
Evidence from other countries shows that full and complete registration is not possible under a system of explicit consent and that statutory cancer registration would best fulfil the public health responsibilities. No country operates an effective population-based cancer registration system in which explicit consent is required. In Germany, a requirement for explicit consent rapidly led to data less than 70 per cent complete, with bias in Hamburg and Saarland and unacceptably large gaps in data series. In Hungary the registry collapsed. In contrast, all the Nordic countries operate highly efficient and complete registration systems, which are backed by legislation, without explicit consent; and New Zealand, after exploring all other options, has enacted similar legislation.
Apart from the dangers of incomplete, biased or incorrect information, I know of no humane and caring doctor who could ask patients to consent to registration at the time of a devastating diagnosis of cancer, just as they are trying to come to terms with the information they have to take on board about their future. But of course patients should be informed that registration exists and that they have the absolute right to opt out of cancer registration and to request registries to delete identifiable data about themselves from databases.
The Patient Information Advisory Group recommended exemption from explicit consent for cancer registration. That was endorsed in Statutory Instrument 1438 in 2002. But PIAG was established as a transitory body and neither explicit consent nor full anonymisation will be feasible in the long term for a national system of cancer registration. That is why, despite the legal support brought about by the PIAG process, primary legislation to support cancer registration on a statutory basis will still be required.
The Cancer Campaigning Group, which represents 20 national cancer charities in the UK, has written to me in support of our debate. It feels that:
"While the UK undoubtedly has one of the most comprehensive cancer registration systems in the world, it is crucial that this is given long term protection through appropriate legislation".
I hope that the Government will heed that call. I beg to move for Papers.
3.30 p.m.
Lord Turnberg: My Lords, I congratulate the noble Baroness, Lady Finlay of Llandaff, on introducing an important topic in such an enlightening way. While I am in a congratulatory mood, I commend the Department of Health on setting up the NHS Cancer

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Plan, which has been so successful. It has developed a formal network of services, closely linked to a research network that incorporates the MRC and cancer research charities. It is a valuable model for other services and it is achieving results.
Of course, there is much to do, as the noble Baroness has described, but I shall focus on cancer registries and their role in research. There is no doubt that research using that type of information, collected over many years, has proved invaluable. One has only to remember the discovery by Sir Richard Doll of the link between smoking and lung cancer to recognise that. There are many other examples that I can quote. The suggestion that Gulf War syndrome predisposed veterans to cancer could be examined only by going back through cancer records and examining the incidence among Gulf War veterans and non-Gulf War veterans. Incidentally, that study disproved the relationship. Studies of whether cancer of the bowel has anything to do with diet could be carried out only on large populations of patients with cancer who could be questioned about their diet. The same could be said of the relationship between cancer of the bladder and the prostate and certain infections. Indeed, the relationship between any environmental hazard and cancer—from mobile phones to living near radio aerials—can be proven only by using the kind of data that cancer registries best provide.
How best can that type of research be conducted without betraying patients' confidences or invading their privacy? We have struggled with that question. Some would say that we have struggled far too hard. A few years ago, the Royal College of Physicians—I express an interest because I was its president at the time—published some recommendations about the ethical procedures for studies that use patients' personal data. It suggested that, given certain stringent conditions, research using medical records that did not require direct patient involvement should be possible without individual consent. Those robust conditions included the involvement of a senior clinician bound by professional codes of practice on confidentiality. There was a number of other important constraints, including ethics committees. All of that was thought to be reasonable at the time. The emphasis was on a duty to use information for the common good. The European directive of 1995 on the protection of individuals' personal data also relied heavily on professional codes of practice to guard against betrayals of confidence.
However, since then, we have accumulated such a confused and confusing mass of recommendations, guidance and regulation that many forms of epidemiological research are being inhibited, even though patients—especially those with cancer—are desperate to see more research carried out, particularly when it uses data that cannot possibly harm or embarrass them when treated confidentially. Such research is perfectly respectable, highly desirable and indeed essential.
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Somewhat conflicting advice has been provided by the Caldicott Guardians, ethics committees, the Data Protection Act 1998, Section 60 of the Health and Social Care Act 2001, PIAG, the GMC and even the Medical Defence Union. Is it any wonder then that there is room for confusion, and that Caldicott Guardians and ethics committees may be forgiven at times for erring on the side of presumed safety by refusing research when they fear that they may get on the wrong side of the law? And is it any wonder that busy clinicians are fearful of being brought before the GMC if, when they are baffled, as they usually are, they decide that it is not worth their bother and time to report their cases of cancer? Clinicians do not know whether they are doing right or wrong.
There has never, to my knowledge, been a case of a patient being harmed, embarrassed or discomfited by the types of research that we are discussing; that is, using data about them in the confidential way that professional regulation has long required. It must be rare for a patient to say to a doctor, "I'm concerned that you are doing research about me that I know has been for the good of future patients. Please desist". However, we seem to have developed a series of sledgehammers to crack the particular nut of patient confidentiality. If ever a case needed a fresh look, this is it.
PIAG seems to be doing a good job in making the work of cancer registries possible, but out in the field, there is a sense of uncertainty because of all the other players in the field and because of uncertainty over whether GMC advice or the Data Protection Act 1998 conflict with what is allowed by PIAG. Of course, PIAG is supposed to be a temporary affair. It was supposed to disappear when it was possible to anonymise everything and everyone was able to give consent. However, it will never be possible to carry out all epidemiological research without knowing who the patients are, so that, for example, information from two or more sources of data can be linked. Nor will it ever be possible to seek consent for future, unknown types of research when patients have died or have moved on or are untraceable. We will therefore always need some kind of system to allow such research to be carried out.
Furthermore, when the Bill that set up PIAG was passed, the Department of Health agreed that it would be accompanied by a mass-education exercise, so that patients and the public would know for what purpose data about them were being used and how important that information was, not only for their own care, but also for future patients' care through research. Unfortunately, little or none of that has happened. There has been no public education exercise. Patients are becoming increasingly suspicious when they hear about the elaborate precautions that have been set up. "Set up against what?" they may ask; "It must be something serious".
It is therefore clear that we desperately need that publicity campaign. I know that the Department of Health has been sorely denuded of officials, as we heard from the Minister earlier this week, but I know many who would gladly lend a hand, including, I am

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sure, Cancer Research UK, the MRC, the colleges and so on. I see little point in delaying still further until it is decided what kind of advice will be given about the uses to which patients' data will be put in general. That information about the importance of cancer registries needs to go out now.
We then need much greater clarity not only for clinicians and researchers, but also for ethics committees and Caldicott Guardians, who have to deal with the requests for research on the ground. For that to happen, we must have an agreed set of ground rules to which PIAG. the GMC in particular, and data protection commissioners can all sign up. We must have clarity and common sense when neither seems to be in abundance.
We need also to think now about what should be put in place to succeed PIAG when it comes to the end of its life. It does a good job and it has proved helpful, but we cannot have a vacuum at the end. There is much work still to be done.
This is not a trivial business. The type of research that we are discussing has important implications for healthcare. We cannot let it continue to drift.
3.39 p.m.
Baroness Greengross: My Lords, I add my congratulations to my noble friend Lady Finlay on securing this important debate, which highlights the importance of comprehensive data about cancer in helping us to improve the treatment and care of patients and to continue to make the progress that is so clearly demonstrated in the NHS Cancer Plan.
I shall intervene briefly as a non-medic, mostly to support my noble friend in her call for action and to welcome the plan, because I found it excellent and informative in many ways. However, I highlight an apparent gap in certain gynaecological cancers, where much progress is still needed and draw attention to cancer of the prostate, as my noble friend did.
Although the cancer services collaborative improvement partnership project has implemented changes to improve care in gynaecological cancers, there are, sadly, still high mortality rates even for cervical cancer, despite improvements and the excellent work that has been done. We know that 22 per cent of women with endometrial cancer, for example, which often occurs after the menopause, have been estimated to have died from it. Globally, there are 10 million registered cancer cases, 1 million of which are gynaecological cancers, where the worldwide mortality rate is almost 50 per cent. Sadly, survival rates for those cancers demonstrate the least improvements of any cancers during the past 30 years.
As my noble friend said, the standardised registration rate of prostate cancer was 70 per cent higher in 2000 than in 1990. That is an enormous cause for concern. As the medical specialists here will know, Professor Ian Jacobs is co-ordinating important research into ovarian cancer involving 200,000 women to determine whether a national screening programme should be established. We need to know whether
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screening for that type of cancer could lead to early diagnosis and reduced death rates, as has fortunately happened with breast and cervical cancer.
The work of Professor Jacobs demonstrates the opportunities that are now available through the use of new technology, among other things, to improve the chances of so many women who are unfortunate enough to suffer from those types of cancer. I declare an interest as having pledged my support to the work of the Eve Appeal, designed to make work in those fields as well known and, I hope, successful as has been the case with breast cancer.
The problems and uncertainties of prostate cancer are also worrying. More public awareness and a drive to overcome the reticence of many men to come forward to seek early diagnosis need to be highlighted and publicised if we are to fulfil the United Kingdom's potential to lead the world in cancer treatment and care.
3.43 p.m.
Lord Walton of Detchant: My Lords, the principle of medical confidentiality lies at the heart of the doctor/patient relationship. Indeed, in some societies, as in France under the Code Napoleon, medical confidentiality is absolute. But that is not the case in the United Kingdom. No privilege attaches in law to communication between doctors and patients, as it does between solicitors and clients. Indeed, a High Court judge can when he determines it right to do so compel a doctor to breach medical confidentiality and disclose information about an individual patient.
In the UK, the General Medical Council gives advice to members of the medical profession on the whole issue of confidentiality. Over the years, it has been well recognised by the GMC that confidential information may be disclosed for medical purposes when the patient concerned agrees by informed consent. A number of other exclusions have been accepted by the General Medical Council over the years. Thus, under the Police and Criminal Evidence Act 1984, it was made clear that in certain circumstances it was a doctor's duty to disclose to the police evidence relating to the medical condition of an individual accused of being involved in a serious crime.
Other exclusions have arisen over the years. For example, it was made clear that if a patient with epilepsy refused to give up driving a motor vehicle, despite being advised to do so by his or her doctor, if the doctor failed to persuade that individual to disclose his or her epilepsy to the licensing authority, the doctor had a duty so to report that individual patient.
From that, it may be assumed that the GMC would accept that breaching medical confidentiality may be appropriate when it is in the wider public interest, but, in the event, that is not the case. The GMC has over the years been specific in determining what information may or may not be disclosed and what exclusions there are to the principle of medical confidentiality. That is the problem at the core of the issues that are being considered in this debate. I, too, congratulate my noble friend Lady Finlay on initiating it.

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Epidemiology is a science that involves the study of disease as it affects populations, not individuals. Epidemiological research in cancer and related fields has, for example, as the noble Lord, Lord Turnberg, said, identified the clear link between smoking and cancer of the lung and other organs. It has also over the years identified relationships between, for example, asbestos exposure and the incidence of a tumour called mesothelioma on the surface of the lung. There have been many other examples, such as, many years ago, the high incidence of nasopharyngeal cancer in certain individuals working in the furniture industry. Those are important developments.
Over the years, cancer registries have been extremely important in disclosing information of epidemiological importance that has been used to improve the lives of cancer patients. Indeed, such information has also been helpful in preventive medicine. Two thirds of cancers are preventable and data from registries have been especially important in identifying some of the factors that put people at risk of cancer in the first place. As my noble friend Lady Finlay said, those data are also important in uncovering trends in cancer, such as that skin cancer rates have been increasing year on year and that lymphoma and oral cancer rates are higher among ethnic minorities. Data from cancer registries are also used to track and assess variations in treatment that cancer patients receive around the country.
Cancer registries operate strict policies to protect patient confidentiality. Anonymised data may be invaluable in determining and accepting some such trends, but in many cases data can be useful only if they include information that could be used to identify an individual patient. That issue became a matter of great public and professional concern after the passage of the Data Protection Act 1998 and after the GMC issued its guidance in September 2000. That guidance, issued to all doctors, required that no identifiable information be transferred to cancer registries without the patient's explicit consent.
Epidemiologists expressed grave concern about that, because they felt that obtaining explicit patient consent in every case would be difficult—not least for the reasons referred to by my noble friend Lady Finlay in the case of individuals most recently diagnosed with cancer. Uncertainty about the legality of using patient-identifiable information without consent led at that time to a fall in data flow to cancer registries, which in turn had a negative impact on associated research.
Section 60 of the Health and Social Care Act of May 2001 was put in place as a short-term solution. The section empowered the Secretary of State for Health to enable the collection and processing of identifiable health data, including cancer registration, without patient consent. The responsibility for overseeing those regulations falls to the Patient Information Advisory Group, a body required to review its guidance annually. It is clear that a longer-term solution is necessary both for the proper functioning of cancer registries and associated research.
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There is a particularly strong case for legally requiring the registration of every case of cancer, making it a statutorily reportable disease. Cancer registration is required by law in all or part of the USA, Canada, Australia, New Zealand, Israel, Finland, Denmark, Norway, Sweden and many other countries. In the Netherlands the president of the official privacy court acknowledged that written informed consent would make cancer registration impossible. In this country, the House of Commons Science and Technology Committee recommended in July 2000 that governments should introduce legislation to make the registration of cancer a legal requirement, to ensure both the completeness of cancer registry data and access to those data for legitimate research purposes. To date, Her Majesty's Government have been reluctant to follow the lead of many other countries in recommending that reporting of cancer cases becomes mandatory.
At present, in the absence of such legislation, doctors and healthcare professionals must be adequately informed of the current regulations by which data can be relayed to the registries without first having to obtain patient consent. Under Section 60, to use patient-identifiable data from cancer registries or other healthcare databases, researchers must apply for special approval from the Patient Information Advisory Group or be carrying out an activity governed by one of the class regulations of Section 60. That requirement is in addition to receiving ethics committee approval, and it imposes an additional administrative burden on researchers in gaining access to data.
The House of Commons Advisory Committee strongly recommended that cancer be made a notifiable disease and that it be compulsory to register every case, as happens at present with other notifiable diseases. Many years ago the legal requirement to notify an appropriate body about certain diseases was introduced, but largely that involved infectious diseases as a means of preventing the spread of epidemics. Since then every proposal that other diseases should be notifiable under law has been met with the response that cancer is not an infectious disease and is not therefore a danger to other members of the community.
However, in the light of the evidence put forward today by the noble Baroness and others, which will no doubt be amplified by other noble Lords, I strongly believe that compulsory registration of cancer cases will be, in the long term, the only satisfactory approach if research into the epidemiological causes of cancer and ways of preventing and treating it under the NHS Cancer Plan are to be feasible.
3.54 p.m.
Baroness Hayman: My Lords, I shall intervene only briefly, not least because of the quality of the previous contributions in making clear the past and potential value of cancer registries and registration, and the difficulties of researchers and public health doctors. I record my gratitude to the noble Baroness, Lady Finlay of Llandaff, for introducing the debate

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and giving us the opportunity to probe the Government on the reluctance to put cancer registration on a statutory basis, which the noble Lord, Lord Walton of Detchant, referred to at the end of his contribution. I have a non-financial interest as chairman of Cancer Research UK, many of whose activities are hugely supported by the public. It puts its money where its mouth is regarding the value of research, particularly research into cancer prevention, which depends mainly on epidemiological research, and on the importance of having good information.
Over the past two years, I have been privileged to visit cancer hospitals and doctors in four African countries. It was fascinating to see how frustrated they were at the lack of a firm information base on which to build policies for cancer prevention, treatment and control. Those countries are trying to set up that precious asset, which we have, even in the most rudimentary form. We should be very wary of anything that endangers the quality of information. For that reason, I would support a new regime that removed uncertainties. The noble Lords, Lord Turnberg and Lord Walton of Detchant, made clear how many layers of advice that is not absolutely congruent have been laid on top of each other, and the effect of that on individual over-pressed clinicians.
We need clarity, which could be achieved by making cancer a notifiable disease. I was fascinated by the observation by the noble Lord, Lord Walton of Detchant. that the reason that we drew the distinction was the argument that cancer was not an infectious disease and therefore no danger to the population. Cancer may not be an infectious danger, but notification has an overwhelming public health benefit for the whole population. Examples such as childhood leukaemia, and smoking and health are manifold.
Cancer statistics for 2000 were released today. It is fascinating information that will point us in particular directions, looking at services, the effectiveness of the cancer plan, the future for research and the areas in which we could make progress on prevention. Professor David Forman, the chairman of the UK Association of Cancer Registries, said today:
"Keeping track of cancer trends is vital for research on the causes of cancer and to help focus prevention strategies and treatment resources".
When my 21 year-old son caught whooping cough last year, it was deemed important enough in the public interest not to ask him whether he was willing to give his details and to have them recorded publicly so that other university students with bizarre symptoms might be diagnosed. It is absurd to say that registration of that case was somehow more important than the potential benefits of cancer registration, which are firmly based. It is an important tool for public health, research and cancer policy, and we should put it on a firm legal basis that gives stability and clarity for all involved. That will need some additional work from the Information Commissioner regarding the Data Protection Act after that. Perhaps the time has come to reassess some of the consequences of the rush towards data protection in a number of fields.
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The noble Baroness, Lady O'Neill of Bengarve, is here today. She has spoken on many occasions, with great depth and analysis, on our reaction to problems and on a lack of trust, which create more and more complicated bureaucracy and regulatory systems that only hamper those who are sufficiently law-abiding to take part in them and make sure that they are absolutely scrupulous in every area, but do nothing for those who are badly motivated and wish to do wrong. Inadvertently, they cause much greater harm than the harm that they set out to prevent. In areas of data protection, in a number of fields—and we have seen a number of cases over the last few weeks—we must go back and reassess, in the round, the consequences of some of the things that we have done.
That is particularly true relating to consent. I first joined a research ethics committee in the early 1980s, and I was a member for nearly 10 years. At that time, attitudes towards patient information and patient consent left a great deal to be desired; they were rudimentary in many ways. We have seen vast improvements since that time, but I suspect that we have gone past the point where we are saving those involved from harm, and where we are often in fact causing them more problems and more difficulties. We are refusing to take responsibility, which as a society we should, for the public interest on issues like information on cancer registries. It is not possible to make all data anonymous if we are to do the sort of research that will save lives and underpin good policy for the future. Examples have been given of that already.
I spoke recently to a researcher, who told me about the difficulties that he had when trying to examine the thesis that there was a genetically based familial link in a particular site-specific cancer. Obviously, he wanted to look at names on cancer registries to try to make these connections. He had great difficulty, because there are different registries and different policies at different registries. I echo the noble Baroness in saying that this is a national resource that should be nationally resourced and have national standards. Because of these difficulties, he ended up having to go to individual clinicians at hospitals asking for a patient base and approaching the individual patients to track in to their family histories. In so doing, he discovered that the records of recorded deaths in the hospital were nothing like as up to date as the cancer registry. Therefore, he ended up contacting the widows of several men who had recently died of the disease where the hospital had no record of that information, and that caused great pain and distress to those people involved. Those are the sorts of things that happen when we look too much at process and too little at effect. Of course, we must have proper safeguards, but, as has been said, we have not, in nearly 40 years of cancer registration, seen any breaches of those safeguards.
It is within the wit of man to devise a system that provides comprehensive information that will be of long-lasting value to the health and well-being of the population of this country without breaching fundamental rights of privacy or taking away

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appropriate consent. It is time to step back and make sure that we are not throwing out several babies with the bathwater.
4.5 p.m.
Lord Chan: My Lords, I also congratulate my noble friend Lady Finlay of Llandaff on securing a debate on the arrangements for cancer registration and their role in supporting the NHS Cancer Plan launched in September 2000. The need for comprehensive cancer registration that will improve treatment and outcome has been demonstrated admirably by the cancer in children register that has been co-ordinated in Oxford for more than 50 years. Today, childhood leukaemia is curable in most children.
The NHS Cancer Plan set out four key aims: to save lives; to improve patients' experience of care; to reduce inequalities; and to build for the future. Without cancer registration, it would be exceedingly difficult, if not impossible, to measure progress towards the key aims over the past three years among the 200,000 people in England diagnosed with cancer and the 120,000 people who die every year from the disease. No plan to save lives and reduce health inequalities can succeed without knowledge of the types of cancer occurring in the local population and the fatality rates among men and women in different localities.
I shall therefore consider the importance of cancer registries in primary care. The information that I shall use comes from the Merseyside and Cheshire Cancer Registry, led by Dr Evelyn Williams, with whom I have worked since 1997. I am delighted to acknowledge her help. In the five years from 1996 to 2001,75, 600 cancers were registered in Merseyside and west Cheshire, an area with a population of 2 million. Of the 34,500 cancer deaths, 51 per cent—17,600—occurred in males. Of those, one third died from lung cancer. Lung cancer was also the main cause of death among women in the region, accounting for one in four deaths, compared with one in six due to breast cancer. Those figures reflect the high rate of cigarette smoking among residents of Merseyside and west Cheshire. Better screening and early detection of breast cancer in women have contributed to improved rates of survival.
Cancer statistics on incidence and mortality in English regions can be compared with figures from other parts of the UK and Europe, as was demonstrated by my noble friend Lady Finlay of Llandaff. The publication of such useful information assists doctors, nurses and support staff to improve access to care and the quality of the care provided by cancer services. In order to save lives, improve patients' experience and reduce inequalities in cancer care, details of patients with cancer must be collected, analysed and compared across geographical areas.
Primary care trusts require information on cancer incidence and mortality rates, in order to commission appropriate services and implement public health measures, as was said by other noble Lords, to reduce the number of new patients. The Merseyside and
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Cheshire Cancer Registry provides cancer information to all its 15 primary care trusts. The public health lead for cancer in every primary care trust uses the information to plan and to implement measures to reduce smoking among the population and to improve screening of breast and cervical cancer in women. In return, every primary care trust pays the cancer registry for that service. But that source of funding of cancer registries, although assured, is unlikely to increase proportionately with the needs of regional registries.
Cancer networks comprising specialist staff have been established in all regions to monitor the implementation of the national cancer action plan. The networks use data collected and analysed by cancer registries. Relevant information on cancer is also gathered by public health observatories and hospitals. Cancer registries are beginning to co-ordinate the analysis of all those sources of information on cancer and to make them available to primary care trusts, to hospitals, to strategic health authorities and to regional public health directorates.
To improve access to analysed data, a new computerised system of cancer registration across the north-west, called PRAXIS, funded by the national action plan, will be introduced this year. The system is being used in the Thames, the Trent and the Northern Ireland cancer registries and will soon be in use in the northern and Yorkshire registries. It will facilitate regional comparisons and will improve the monitoring of the national cancer action plan.
With the routine gathering of ethnic group data from NHS patients, cancer registries are able to analyse cancer prevalence among people from different ethnic backgrounds. For example, we have evidence, as quoted by my noble friend Lord Walton, that lymphoma and oral cancer rates are higher in ethnic minorities in England. In the 1980s, before hepatitis B vaccination became available for new-born babies, primary liver cancer in Chinese people from Hong Kong was common.
If cancer registration is fragmented, information on cancer in England will not be reliable and the national cancer action plan will not be monitored effectively. Vulnerable groups of people may not be identified and the key aims of the cancer plan will not be achieved. Regional cancer registries in England are therefore essential if the national cancer plan, with its long-term goals, is to be achieved. Therefore, if statutory legislation is the means for protecting the work of cancer registries, I would wholeheartedly support the proposals made by noble Lords and, in particular, the proposal made by my noble friend Lady Finlay.
4.12 p.m.
Baroness Masham of Ilton: My Lords, I congratulate my noble friend Lady Finlay of Llandaff on her very clear explanation and introduction of the need for up-to-date clear data for a cancer register in support of the National Health Service Cancer Plan. I can think of no better person than my noble friend, who is a professor

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of palliative care and works with real, living patients, to lead this important debate in your Lordships' House.
I hope that this debate will help make many people aware of the need for registration, which helps to show up the needs across the country of what treatment works best for cancer care. I am sure that your Lordships will agree that there should never be a postcode lottery for the treatment of cancer patients. A cancer register helps with research and better treatment when what works shows up in the data collected.
I live in North Yorkshire. In December, a friend of ours died of cancer, having continued with her life so well until the last few weeks. A few days before she died, I spoke to her partner who said that she was being looked after in a small hospital near her home. He told me that he could not have managed without that help. I take this opportunity to give a plug for small hospitals near patients' homes, which can give much needed help when everything else that could be done has been done.
Just before Christmas, a former Member of your Lordships' House, the Marquis of Downshire, died after a valiant fight over cancer. His memorial service is to be at Ripon Cathedral on 29 January. Last Friday, the wife of someone I know very well was told that she has cancer. She started treatment on Monday of this week. Her husband is devastated.
Another person who I know, who was about to go to work in Africa as a missionary with his wife, was delayed for a year when his wife was found to have breast cancer. The husband told me that having had the first part of her treatment in the north, near where I live, they moved to Birmingham. The dose of chemotherapy was changed. Different doses are used. If the data are collected and the patients monitored, the research will be useful for others when it is found which results are the most effective. I think that I live in a cancer cluster; there are many people who suffer from cancer in Masham.
I give these examples— I am sure that all your Lordships will have similar ones—to illustrate how important it is to find the best treatment and cure for these various cancers. With co-ordinated research and accurate data, it must be hoped for better results.
I attend various parliamentary groups. Lately, there have been some excellent presentations on different types of cancer. These groups are attended by Members from both Houses. Some years ago, an excellent presentation on a cancer overview was given by Professor Mike Richards. I was not at all surprised when he was made the cancer tsar and national cancer director of the NHS Cancer Plan. I congratulate the Government on his appointment. I am sure that his enthusiastic personality inspires others across the country and the world to do more for the fight against cancer.
On 2 December 2003, I attended a working dinner on prostate cancer with other Members of Parliament. Prostate cancer is now the most commonly diagnosed cancer in men in the UK due, in large part, to the
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increasing popularity of the PSA test. The epidemiological profile of the disease is changing rapidly, and it requires close monitoring. The increase in incidence in prostate cancer may represent an epidemic of diagnosis rather than a "genuine" epidemic of disease. But to the man with the disease, that is an academic argument. At diagnosis, there has to be enough capacity in the system to meet their needs.
Cancer registration data form the national picture to do this. Linking these changes in trends with data on outcomes, health services uptake and resources is most important. If cases are not registered efficiently, timely assessment of current and future demands for prostate cancer services is not achieved. Demand for health services for treatment of men with early prostate cancer, in particular, could quickly outstrip supply.
There is a delay in cancer registration and the annual figures being released. There will always be a need to modify entries, but is it possible to speed up the collation of cancer registry data? If the delay is due to inadequate funding, rather than any other logistic considerations, that must be addressed, otherwise assessment of future need will always mismatch demand as it is made on out-of-date data. Further, in the case of rapidly increasing diagnoses of prostate cancer there could be a considerable and rapidly increasing divergence between what is available and what is needed.
It is important that the public understand the value of epidemiological and cancer registries. There needs to be openness and a good PR strategy so that everyone involved knows that they are helping in this important research.
The Million Women Study, a confidential study on women's health concerned with hormone replacement therapy, recently came out. There is a balance to be found between the benefits and the risks involved. Women need to have understanding doctors who will help them reach their decisions. As the results of research present, there is more to he understood and people to be helped. Surely cancer prevention must be a top priority. I am sure that all your Lordships will listen with interest to the Minister's reply.
4.21 p.m.
Lord Rea: My Lords, as usual, my professional friend the noble Baroness, Lady Finlay, has chosen an important and topical problem for our consideration, one which is particularly relevant to her role as a palliative care physician. It also coincides with my own continuing interest in preventive medicine and epidemiology. My noble friend and other noble Lords who have spoken in the debate have described the important role played by the cancer registries in providing a complete and accurate database for the numerous studies that have thrown light on the incidence and prevalence of different cancers in the population, on possible causes of different cancers and on the effectiveness of different methods of treatment, all of which are essential to achieving the aims of the NHS Cancer Plan.

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Many examples of how data from the cancer registries have advanced knowledge and thus helped patients have been cited throughout the debate. I shall not repeat them, although I was going to do so. I should like to say, however, that data derived from the registries are becoming increasingly important as more patients are treated successfully. That is because studies based on mortality rates, which would be our main source of data without the registries, become less and less representative of the complete picture of cancer incidence and are a crude measure of the effectiveness of treatment.
Perhaps we can take it as read that cancer registries are desirable and provide a vital database for the epidemiological and other research on which preventive medicine and effective treatment are based. However, as the noble Baroness pointed out, the work of the cancer registries, which relies on a complete list of their data to be effective, has been under something of a cloud since the pronouncement made in 2000 by the General Medical Council in response to the Data Protection Act 1998 and the Human Rights Act 1998 that, in principle, the consent of NHS patients should always be obtained before any details can be used for research purposes. Following the general approach of the GMC regarding patient confidentiality, proposals were put forward in the 2001 Health and Social Care Bill.
However, at Third Reading in May 2001, a government amendment tabled only after very prolonged debate led to what eventually became Section 60. The amendment modified the original stance and set up the Patient Information Advisory Group—PIAG—which has already been described by several noble Lords. The group's remit involves a monitoring and advisory role on the use of NHS patient data for research purposes, even without patient consent in certain circumstances if that is necessary for the needs of the NHS and public health purposes. However, Section 60 and the creation of PIAG were compromise, transitional solutions based on an amendment originally proposed at Report stage by the noble Baroness, Lady Northover. So the government amendment setting up PIAG put forward by the noble Lord, Lord Hunt, at Third Reading was, in effect, a takeover from Northover.
Perhaps we should ask how the cancer registries have fared under PIAG. The group meets every three months and considers applications from researchers for access to patient data where the patient's permission is difficult or impossible to obtain. PIAG also undertakes a number of other functions which are well described in its first annual report published last October. The cancer registries, along with several other organisations, including the Public Health Laboratory Service—now the Health Protection Agency—have been given "specific support arrangements" which give them permission on an annual basis to continue collecting information without specific patient consent.
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This permission, which it is hoped will be reviewed and renewed each year, is dependent on certain conditions being fulfilled regarding, for example, consideration wherever possible of the anonymisation and pseudoanonymisation of data—employing two unpleasant neologisms that would rate high in any unpronounceability index. Thus a major part of PIAG's work is concerned with ensuring that the privacy of patients is still safeguarded even where the nature of the research concerned requires individual patients to be identified. During its first year, PIAG received 65 applications for support, of which 42—some two-thirds—were accepted.
As has already been explained, a patient's identity is necessary for research purposes where the effects of personal characteristics such as occupational history, place of residence, housing, diet or smoking habits on the incidence of cancer are being assessed, as well as when different treatment regimes are being compared. I gather that each research project arising from a cancer registry needs to be further individually assessed by PIAG. I am not sure why this is necessary when, for many years, every research proposal has had to be approved by a regional or local ethical committee. Perhaps my noble friend on the Front Bench will be able to help me on this point. It seems an unnecessary duplication of effort. However, I am informed that, under its current chair and members, PIAG has been extremely helpful and encouraging and so far has facilitated the work of the cancer registries.
But the price of this benign approach has been the submission of much paperwork justifying each and every aspect of data collection. That, too, seems an unfair bureaucratic burden given that, to my knowledge, the cancer registries have never been accused of breaches of confidentiality. However, according to the briefing produced by Cancer Research UK, some clinicians have withheld patient information from the cancer registries because they were uncertain about the legality of providing it, thus weakening the entire data-set. I would be grateful if my noble friend could tell us whether the Government have any information on this.
Initially the legislation and regulations setting up PIAG were regarded as interim measures. Can my noble friend say whether the Department of Health still regards PIAG as a temporary, transitional body? If it is eventually to be wound down, what criteria will inform the Government's decision to allow that? The organisation was set up largely to reassure public opinion that patient confidentiality would be respected in spite of some sensitive information being divulged. What is the evidence of incidents of past breaches of confidentiality on the part of, for example, the cancer registries, the Public Health Laboratory Service or the Health and Safety Executive, that made it necessary to create this benign but essentially bureaucratic organisation in the first place?
As the noble Baroness, Lady Hayman, and other noble Lords have said, Cancer Research UK is in favour of new diagnoses of cancer being notifiable. The importance of collecting this information is so great, it is implied, that considerations of

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confidentiality, while not being neglected, should take second place. If notification is made mandatory it is felt that few could then object. There would of course be a right for individuals to opt out, but under a mandatory framework these would perhaps be very few.
I am not sure that this is the right approach. Notification of diseases as at present practised is incomplete and imperfect. It also adds another layer of bureaucracy. The notifier receives a payment, at present so small as to be merely token. How this will be arranged—if it is ever arranged—when many different sources provide information to cancer registries, I do not know.
HIV/AIDS is an extremely serious disease. It is not statutorily notifiable but sexually transmitted disease practitioners are confident that the current statistics are quite accurate while collected through a system of voluntary confidential notification.
In conclusion, I ask my noble friend how successfully he feels that PIAG is working itself out of a job. If it reports that researchers using NHS patient information, with or without consent, are consistently doing so with discretion—as I am convinced they have been for many years—cannot the members of PIAG be congratulated on the careful work they have done in providing advice to the research community and then be allowed gracefully to step down?
4.32 p.m.
Lord Clement-Jones: My Lords, it has been an interesting and useful debate. I congratulate the noble Baroness, Lady Finlay, on initiating it and on setting the scene so well in her introduction.
All the relevant points have been made during the course of the debate. The common ground throughout has been the importance of cancer registries and cancer research. It is important that we deal not only with the issue of cancer registries but also with the wider issue referred to by a number of noble Lords.
Many noble Lords referred to the crucial nature of registry data in defining causal relationships between products, substances and cancer; environmental and geographical links in uncovering trends; in assessing variations in treatment; and, indeed, in the broad sense, in building prevention strategies. So there is absolutely no argument about the importance of cancer registries.
A number of noble Lords referred to the history of the cancer registration system and to the fact that it was more or less voluntary up until 1993 before the establishment of a cancer registration minimum data set. There then followed the Gillis review.
I do not believe that anyone has accused the Government of being unsupportive towards cancer registries—the nature of the debate is much more important than that. It relates to what is almost a cultural issue about the treatment of personal information and an organisational issue about the funding of cancer registries. Those are the crucial points that have emerged during the course of the debate.
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As to the establishment of the National Cancer Registration Advisory Group, I share the admiration of the noble Baroness, Lady Masham, for Professor Richards, the cancer tsar and chairman of the group. The Government's actions in this regard are welcome. Indeed, the national Cancer Plan itself is of course welcome.
As a number of noble Lords have said, the first fly in the ointment was the GMC's guidance issued in September 2000. As we discovered after some considerable confusion and debate, effectively that guidance was not so much built on the Data Protection Act—I take the point made by the noble Baroness, Lady Hayman, of the need to review that Act—but on the common law duty of confidentiality. The guidance gave rise to considerable confusion surrounding cancer registration and the protection of personal information.
At that time, the GMC guidance issued to doctors appeared to require that no identifiable information could be transferred to cancer registries without the patient's explicit consent. It is no wonder that the cancer registries became extremely concerned. Uncertainty about the legality of using patient-identifiable information without consent led, as the noble Lord, Lord Walton, said, to a direct fall in data flow to the cancer registries.
As a result—it was fortuitous that the Health and Social Care Bill was in the making at that time — Section 60 came into being. I was delighted when the noble Lord, Lord Rea, paid tribute to my noble friend Lady Northover because the establishment of PIAG was the crucial element which enabled that particular clause to pass through the House. It was the debate and discussion started by an amendment from these Benches that enabled that to happen.
The section empowered the Secretary of State to enable the collection and processing of identifiable health data. That was absolutely crucial for the cancer registries and for the establishment of PIAG, which is required to review the guidance on an annual basis. Thereafter the Health Service (Control of Patient Information) Regulations 2002 were debated in the House.
In consequence, the GMC is publishing new guidance in February which builds on the Section 60 regulations as regards the national and regional disease registries. But, again, the regulations do not adequately cover local research and review of data. They may cover adequately the national disease registries on a temporary basis—I shall come to that later—but, as the noble Baroness, Lady Hayman, and the noble Lord, Lord Turnberg, pointed out, they do not cover local research.
So, despite the GMC guidance, there will still be a good deal of uncertainty, which may well be perpetuated. It is not the GMC's fault that the guidance is as it is; it builds basically on the provisions as they stand.
It is even more complicated because when Section 60 was passed Ministers explicitly stated—a number of noble Lords have mentioned this—that it was

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regarded only as a temporary interim solution. Indeed, the GMC explicitly referred to it as a temporary solution. So today's debate about what should form the basis of a longer-term solution is very timely.
A number of noble Lords referred to the impracticability—"impossibility" is perhaps the word that one might use—of being required to obtain the specific consent of all patients to their data being transferred. Certainly none of us is as unrealistic as to suggest that that is a long-term possibility or practicability.
The second option, the anonymisation—or, as the noble Lord, Lord Rea, referred to it, the "pseudoanonymisation"—using NHS numbers is put forward as another possibility. Certainly at the time we debated the Section 60 provisions and the regulations it was proposed as a possible way forward. From talking to those who know about these matters—indeed, we have heard from noble Lords who do know about them—it is clear that very few people believe it is a realistic possibility for all purposes in the future.
Of course registries are currently making efforts to reduce the processing and availability of names and addresses and so on, and of course postcodes are used to a huge extent, but it seems to most of those in the field that personal identifiers will always be needed for verification purposes. There is the need to link records from different sources, which requires cancer registries to hold patient information in a form that identifies individuals. People may have put their faith, when discussing these matters, in electronic systems, but even those are not currently available, and, even if they were, it is unlikely that they would achieve the purpose that is being sought.
Many noble Lords have referred to the third major solution, recognising the problems of obtaining consent, problems with anonymisation and, crucially, the overwhelming public interest in a complete, high quality and timely cancer register which includes patient identifiers. In those circumstances, the arguments in favour of a solution which requires cancers to be notifiable seems overwhelming. I was a little surprised at what the noble Lord, Lord Rea, had to say. It seems to me that with the experience of notification of infectious diseases, that was a perfectly decent basis on which to build. Having it notifiable would mean that we would avoid these confidential data protection issues, since those constraints would not apply where there is a statutory requirement to collect the data. It would provide the right degree of permanence, settling the debate of whether cancer registration data should be collected. It seems to me that that is a very straightforward way forward.
If we do not have a permanent solution in place, we will have major problems. There is already a case against the Thames Cancer Registry, the outcome of which would be uncertain. That seems to be a distraction that the cancer registries need not at all.
The Alberman report, back in 1990, suggested that the Department of Health consider urgently whether legislative or contractual means should be utilised to
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ensure its cancer registration data. That has been a live issue for quite some time, and it is time that the department took a view on it. We have heard about other jurisdictions such as the USA, Canada, Australia, New Zealand, Israel and all the Nordic countries. We have heard about the recommendations of the Commons Select Committee on Science and Technology in July 2000.
I am at one with the noble Lord, Lord Turnberg, and the noble Lord, Lord Rea, on local research and review of data. We are building a massive bureaucracy—indeed, the noble Lord, Lord Turnberg, added further layers of bureaucracy which I was unaware of in terms of Caldicott, and so on. I very much support the Cancer Research UK in asking PIAG to endorse a statement allowing, even in the absence of consent, the use of data from noncommercial medical research which has no effect on the individuals being studied and which has been approved by an accredited research ethics committee. We need a solution like that, and it is high time we came up with one, otherwise we will simply not have the research we need.
The noble Baroness, Lady Finlay, raised the extremely important issue of funding. The noble Earl, Lord Howe, made some very pertinent points in Monday's debate about public health and the fact that we need a more broadly based organisation and system of funding for public health. The same arguments apply to cancer registries, where we are talking about the surveillance and monitoring of disease. If the department is, as the indications seem to suggest, adopting a more centralised model for resourcing the cancer registries, this must be welcome. I very much hope that the Minister will indicate whether that is the case.
The noble Baroness, Lady Hayman, struck a great chord with me. If we are not careful, we will see the result of the law of unintended consequences in the area of cancer registries or cancer research if we restrict the imparting of personal information. That may be a virtuous idea, but it could give rise to problems.
Our system needs clarification and legal recognition to ensure that we can continue to collate the data that underpin ongoing research. If we are to make sure that the national Cancer Plan is implemented, that is what we need to do.
4.44 p.m.
Lord Skelmersdale: My Lords, it is my habit, in starting my remarks in debates such as this, to use the words, "The House will be grateful to the noble Lord, Lord X, for calling our attention to" whatever the subject of the debate may be. This is not a flip comment. After all, the major part of the value of this House is to research and comment on the problems and successes of the day and, by doing so, offer advice to government, from people with practical experience in a whole range of fields. I hope your Lordships will not object to being called "people"—the reason will become clear in a minute. And who better to introduce a debate on cancer registration and its role in support

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of the Government's NHS cancer plan than the noble Baroness, Lady Finlay, an expert in palliative medicine?
On this occasion, however. it is not only the House that should be grateful. It was, I recall, a Member of another place—the Prime Minister, no less—who, in answer to an interruption by one of my honourable friends in a debate on the Queen's Speech, responded, I thought rather sharply:
"I suggest that the hon. Gentleman and other Opposition Members talk to people in cancer services, who will tell them that they are improving as a result of the extra investment". —[Official Report, Commons, 26/11/03; col.25.]
Well, my Lords, what is sauce for the goose is sauce for the gander. Will the noble Lord, Lord Warner, refer the Hansard report of this debate to his right honourable friend? Will he be brave enough to tell him what the all-important cancer registers reveal? He probably will want to tell him that cancer survival in children has improved dramatically over the past 30 years. It will come in handy, perhaps, for a bit of selective spin. But what about skin melanoma rates increasing year on year? What about lymphoma and oral cancer rates being higher in ethnic minorities? What about cancer survival for patients living in poor areas being lower than for those living in richer areas? What about survival rates from all cancers being the lowest in Europe outside Poland and Slovenia? Last but not least, there is a wide variation in how cancer is treated around the country—the postcode lottery referred to by the noble Baroness, Lady Masham.
Much of this debate has centred on compulsory cancer registration to make cancer a statutorily reportable disease, where every case must be recorded. This would indeed remove the ambiguity about the legal status of cancer registration. It would also provide legal stability to the national cancer registration system and would reflect its national importance as a tool for public health cancer research and, of course, the NHS cancer policy. Legislation would be required.
Like other noble Lords, I ask the Minister what is the Government's current thinking on this proposal? As has been pointed out, in the absence of such legislation, it is essential that doctors and healthcare professionals are adequately informed about the current regulations by which data can be relayed to the registries without first having to obtain patient consent. It is important that people reporting data to registries are confident that in doing so they are acting entirely within the law and, of course, within the circumscription of medical ethics.
As the noble Lord, Lord Turnberg, said, it is almost impossible for clinicians to cut through the myriad guidelines. But if there is one message to come out of this debate, it is that the Gordian knot must be cut. I agree with the noble Lord, Lord Clement-Jones, that it is time to bite the bullet.
To be fair, what the registers currently show is indeed known to the department, which is presumably why it produced the NHS Cancer Plan in September
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2000. Surprisingly, we have not heard as much about the Cancer Plan as we have about the cancer registries. In launching the plan, the then Secretary of State said:
"The plan will develop cancer services in this country that compare with the best in Europe. By 2010, our five-year survival rates for cancer will compare with the best in Europe".
I got that from the Guardian of 9 November 2000.
The plan says that now,
"for the first time, there is a comprehensive strategy bringing together: research; prevention; screening; diagnosis: treatment; and care for cancer as well as the investment needed to deliver real improvements in all of these".
Those are worthy aims, but three years into the 10-year plan, what are the results?
An interim report, called Securing Good Health for the Whole Population, published by Derek Wanless last month, said that England,
"performs less well than comparator countries, particularly on those outcome measures most affected by healthcare expenditure. For example, it performs badly on the few specific measures of quality medical intervention that are available, such as survival rates for cancers".
In my 10 years as chairman of the Stroke Association—which are now finished, so I feel able to talk about it—if I learned nothing else it was that, however good the intervention may be, speed was of the essence. So it is with cancer. However, a careful look at the latest statistics from the Department of Health on hospital episodes reveals that there has been no improvement in waiting times for cancer treatment, with delays actually getting worse. Waiting times for prostate and skin cancer are the longest, while the treatment of brain cancer has witnessed the largest growth in delays since 2000. I, for one, would like to see the correlation between waiting times and survival rates, and I challenge the department to publish them.
One reason for the delays is, no doubt, radiography. The plan promised another 500 radiographers by 2005. How far have we got in achieving that? It also calls for 4.2 linear accelerators for every million of the population. Considering all the hype, that is a surprisingly modest target, as France already has 6.1 machines per million and the Netherlands 7.1. Where do we stand today? On top of that, we have the problem of ageing and out of date machines. In 1997, according to the BBC, 25 per cent of linear accelerators were 10 years old. That proportion had increased to 38 per cent by 2002. Was the BBC correct in its analysis? The plan says that over the next three years there will be more scanners and other equipment to treat cancers. What is the figure today?
To sum up, 10-year plans have one great weakness: they raise hope over expectancy. Furthermore, the Cancer Plan could never have been envisaged without the cancer registers. Without them, we shall not know whether the plan is achievable. Most importantly, without them we would not be able to judge its success or failure. I am, and the Prime Minister should be, grateful to the noble Baroness, Lady Finlay, for raising this subject today.
4.53 p.m.
The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, as noble Lords have said, we are all grateful to the noble Baroness, Lady Finlay, for raising this important issue and giving us a chance to debate it. I am grateful, too, for her fair-minded description of the improvements made in cancer services under this Government.
I was mildly surprised to hear the noble Lord, Lord Skelmersdale, trotting back in history, given the situation that we inherited. I can give him some reassurance. For example, he raised the subject of radiotherapy waits and radiographers. We know that there are difficulties in that area, and the Royal College of Radiologists is considering ways in which to increase the workforce, along with the Society of Radiographers. However, it is worth putting on record that we have increased the number of therapy radiographers by 10 per cent since 1997. To ensure future growth, we have more than doubled the number of training places at university—so we have taken some practical action in those areas, which contrasts occasionally with the situation before 1997.
I shall outline briefly the context in which cancer registries work, before turning to many of the points raised, and responding to many of them. It is easy to overlook the scale of the challenge that the NHS has to face on cancer. In England alone, around 225,000 people are diagnosed with the disease every year. Cancer covers around 200 different diseases, requiring different treatments delivered by different groups of skilled staff, in almost every specialty.
Years of underfunding meant that, at the end of the 1990s, the NHS had too few staff and inadequate facilities. Cancer services in England lagged behind those in the rest of Europe. The 2000 NHS Cancer Plan, to which a number of noble Lords referred, provides for the first time a national strategy to prevent, diagnose and treat cancer; to reform the way cancer services are delivered; to standardise care and improve patient experience; to co-ordinate research; and to invest in equipment and the cancer workforce. It is a long-term strategy but, as the three-year progress report published by my right honourable friend the Secretary of State for Health in October last year shows, implementation of that plan is already delivering real improvements that affect the lives of many of our fellow citizens.
Thanks to a clear set of priorities, extra investment and the superb efforts of staff, including doctors, nurses, managers—yes, managers as well—allied health professionals, scientific staff, pharmacists, social workers, and a wide range of other administrative and support staff throughout the country, patients are benefiting from the good progress that is being made, as the noble Baroness, Lady Finlay, and others acknowledged.
The noble Lord, Lord Skelmersdale, wants some indicators of progress. The death rate from cancer is falling. Britain has the world's sharpest decrease in premature deaths from breast cancer and a substantial decrease in lung cancer deaths, especially in men. We
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are committed to reducing the mortality rate from cancer by at least 20 per cent in people under 75 by 2010, against a 1995–97 baseline. The most recent figures, for 2000–02, show that the death rate has fallen by 10.3 per cent, so we are well on track.
The noble Baroness, Lady Greengross, mentioned screening. The NHS Cancer Plan made a commitment to extend screening and to introduce new programmes when it is clear that that will save lives. The noble Lords, Lord Chan and Lord Walton, drew attention to the evidence that there are higher rates of lymphoma and oral cancers in ethnic minorities. We are committed to combating those inequalities. We share the wish of the noble Lord, Lord Chan, to strengthen regional comparisons in that area. Information is not always collected consistently on a national basis by ethnic minority groups. However, with the development of the national programme for IT, to which I shall return, registries will be in a position to collect data on ethnicity of patients. Once the IT is available, registries will be in a much better position to help to facilitate effective research in this area.
In recognising the progress that has been made, none of us is complacent. We still have a long way to go. In order to achieve our objective of being among the best in Europe, we must continue the good work on smoking cessation and reducing waiting times. We must fully implement national guidance on cancer services and drugs. We must prepare for the implementation of a national bowel screening programme, further develop cancer services in the community and ensure that patients are given good information about treatment and services. We must also ensure that patients who are dying from cancer are given the best care possible at the end of their lives.
A number of noble Lords have raised the issue of palliative care, and I should like to draw attention to the work undertaken by the national partnership group for palliative care, which is an excellent example of partnership working between the voluntary sector, the NHS and the Department of Health. Last year we allocated an extra £50 million to ensure consistently high standards nationally. That has enabled cancer networks to invest in 70 additional consultants in palliative care, 162 more nurse specialists and extra Marie Curie nurses to provide practical care to patients.
The investment is making a difference, and the NHS Cancer Plan has accelerated improvements in cancer services across the country by delivering faster treatment, higher standards and a better patient experience. Three years on, cancer remains a top priority for the Government and the NHS. I know that the noble Baroness, Lady Finlay, has concerns about whether the additional resources that the Government are allocating to cancer are reaching the parts that it should reach—to cite an advertisement. In the Government's view, ring fencing a specific programme for cancer or any other disease is not the way forward. Our overall approach is to devolve greater freedom to front-line staff and organisations and to give them the freedom to innovate and improve care for patients, based on local needs and circumstances. The NHS is

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receiving £12.7 billion extra over the next three years. It is for primary care trusts, in partnership with their strategic health authorities and other local stakeholders, to determine how best to use their funds to meet national priorities, including cancer.
Like other noble Lords, I pay tribute to the work done by the National Cancer Director, Professor Mike Richards. He published a report last May showing that. after some initial problems, the new money for cancer services that was announced as part of the NHS Cancer Plan is now reaching those services. We will repeat that exercise to ensure that the extra £570 million promised in the Cancer Plan for 2003–04 reaches front-line services. From that experience, we know that good quality national data are essential for monitoring delivery of the NHS Cancer Plan and identifying where performance needs to improve. As my noble friend Lady Hayman said, keeping track of trends is critical for focusing our effort on prevention and treatment and determining where we direct our research effort. That is why the work of the cancer registries is so critical.
We welcome the work undertaken by the regional cancer registries since they started collecting population-based data on cancer more than 40 years ago. They have come a long way, most particularly in recent years. They now operate within a national core contract, work to common standards and will shortly be subjecting their work to scrutiny by a process of peer review. We now have a national co-ordinator for cancer registries, working directly to Mike Richards, in supporting the cancer registries as they continue to develop. Professor Richards personally chairs the National Cancer Registry Advisory Group to oversee their development.
In particular, we have been pleased with the action taken by the registries in England to modernise the ways in which they collect data on cancer incidence and to ensure that those data are fit for purpose. Over the past three years, we have invested £6 million in the cancer registries to enable them to deliver action plans for new technology and new ways of working, which they developed in line with the recommendations made by Professor Charles Gillis in 2001 in his review of cancer registration, to which a number of noble Lords have referred.
The noble Baroness, Lady Masham, raised the issue of the speed of registration of cancer patients. At present, registration is a highly manually intensive process. A wide-ranging process of technical reform is now being undertaken to try to make the UK system a much more sophisticated one. This process is closely aligned with the NHS national programme for information technology. A common system of automated electronic messages will contain all the relevant information about cancer patients to be sent from NHS trusts to cancer registries. These messages will allow the cancer registry data set to be constructed and available almost in real time, tracking events during the patient's journey. That will in time ensure greater consistency, accuracy and timeliness in the
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data they collect and publish. It will allow further developments in their ability to support local and national health communities in monitoring cancer trends; to evaluate the success of, for example, prevention and screening programmes; and to inform planning of services.
I recognise that there is still some way to go to ensure that the data which registries collect are uniform and consistent across the country. Things will improve as cancer registries modernise and as the national programme for information technology rolls out, incorporating collection of the national cancer data set.
Registries themselves are becoming more focused on monitoring information for local health economies, looking at inequalities and influencing local and national service planning. Through more timely information collected through the national system, cancer registries will provide better support for health service research, genetic counselling, evaluation of screening programmes, and national and local clinical audits.
Each regional registry currently works closely with a regional director for public health. In order to provide a more strategic surveillance and information service at a regional level, which will enable the regional directors of public health to obtain a broader picture of disease trends across their areas, the regional cancer registries and the public health observatories will develop protocols for joint working over the next year. To achieve that, the next stage of modernisation for cancer registries will be to review their boundaries, where some realignment may be necessary in some places, and their funding arrangements with the Department of Health's Chief Medical Officer and the regional directors of public health. I hope that that is of interest and some reassurance. I will develop it a bit more for the noble Lord, Lord Clement-Jones, and other noble Lords who touched on the issue.
At a national level, it is important that cancer registries continue to provide data, which enable the UK to compare its position on cancer survival over time within Europe and with the rest of the world.
Before moving on to funding, I take this opportunity to commend the work of the UK Association of Cancer Registries and the Office for National Statistics, which both play key roles in the development of data collection systems and the processing and analysis of the data from the nine cancer registries.
A number of noble Lords mentioned the issue of funding for cancer registries, which has been included in the overall expenditure on cancer services through local commissioning arrangements. We are aware that the nine cancer registries in England have been providing a range of different services for their local health communities and have been funded by local commissioners of those services through local agreements. Consequently, there are differences across the country in the funding received by cancer registries. When I was briefed for this debate, I

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discovered a rather complex system for getting money to the registries, which the noble Baroness, Lady Finlay, and others have identified.
The registries also provide national data. We need a funding system for the future that will be more equitable and also support their regional and national roles. This new funding arrangement will be consistent with the moves towards providing a regional and national cancer intelligence service that works with other disease surveillance done by the public health observatories. We intend to implement a new funding system for cancer registries in the coming year.
I well understand the concern about the potential impact of patient confidentiality on the ability of cancer registries to collect scientifically valid data. The noble Baroness, Lady Finlay, and others have drawn attention to the need to link records from different sources. That requires cancer registries to hold patient information in a form that identifies individuals—information which is held in confidence by the NHS. Information is provided to them by many sources. It would not be practicable at the present time to ask each and every patient whether they consent to this important use of their information, as confidentiality law might require. This system has operated successfully for many years, and has led to the UK having one of the best cancer registration databases in the world, with 100 per cent national coverage, as the noble Baroness, Lady Finlay, recognised. We need to continue to make strenuous efforts to protect patient confidentiality wherever possible. We believe that it is necessary to explore all available avenues before seeking to introduce legislation that would, in effect, make cancer a notifiable disease.
As noble Lords have acknowledged, Section 60 of the Health and Social Care Act 2001 provides cancer registries with interim arrangements that allow them to collect patient-identifiable data without consent, while we seek to implement technologies through the national programme for IT in the NHS that would allow the registries to process anonymised information. Those arrangements are overseen by an independent statutory body, the Patient Information Advisory Group, as noble Lords have indicated. It will review the powers available under Section 60 on an annual basis and will advise the Secretary of State for Health if and when it is appropriate to reduce the support available to cancer registries or, indeed, recommend that it is appropriate to give registers a permanent statutory basis. At present the body is not working itself out of a job, as I think my noble friend Lord Rea seemed to suggest, or certainly inquired about. I share his and other noble Lords' view that PIAG has done a very good job in maintaining public confidence.
According to the advice I have been given, eventually electronic systems will support the linkage of anonymised records so that cancer registries no longer need to hold information that identifies individuals. As my noble friend Lord Turnberg suggested, it remains to be seen whether the wonders of IT will ultimately remove the need for identifiable
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data for the purposes of epidemiology. I share some of his scepticism about whether that is achievable. We shall have to see. But certainly for the next few years while the technology is not available to achieve that, cancer registries are permitted to collect and hold the data by regulations made under Section 60, so they have a secure statutory basis on which to do their work. It is aggregated before any publication to ensure that patients cannot be identified from the data.
The good practice required of those supported by Section 60 has actually improved the level of safeguards for patients. The support provided under Section 60 to the cancer registries has been through an annual review by PIAG, and the registries were commended on their progress in developing new practices and meeting the requirements set by PIAG. At this stage we see no need for further legislation to protect the confidentiality of patient information held by cancer registries at this time.
I am aware of the argument expressed by a number of noble Lords that cancer should have similar legal status for reporting purposes as infectious diseases. I am sure that my ministerial colleagues in the Department of Health will want to consider the very authoritative remarks made by noble Lords in the debate, particularly those of my noble friends Lady Hayman and Lord Turnberg and the noble Lord, Lord Walton. I believe that my noble friend Lord Rea touched on the following matter. It is well known from the infectious diseases field that simply making returns statutory does not necessarily guarantee 100 per cent ascertainment, or good quality, or acceptable timeliness.
The question of the effect on research was raised by my noble friend Lord Turnberg and others. Researchers can apply for PIAG support. We accept that there has been a degree of confusion within the clinical community regarding the legality of data submission to cancer registries. The Department of Health and the UK Association of Cancer Registries have worked hard with PIAG and bodies such as the GMC to provide a clearer statement of legality. Clear guidance is provided on the DH website and at the UK Association of Cancer Registries site. We understand that further guidance is shortly to be issued by the GMC.
A number of noble Lords referred to the need to clear applications with PIAG. My understanding is that the majority of applications—as I believe my noble friend Lord Rea said—have been approved. I understand that PIAG approved the cancer registries' application to collect and hold patient-identifiable data but that researchers need to apply to PIAG to use identifiable data collected elsewhere for specific research, so there is a certain bind in that area. We are not altogether aware that that has been an insuperable problem but I should be glad to consider any evidence that my noble friends Lord Turnberg and Lord Rea and any others have in that regard.
I hope that the cancer registries will continue to undertake their important function, and continue to develop and extend the services they provide, to ensure

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that we can all deliver the improvements in cancer services needed to reduce the number of deaths from cancer, and to improve the care of cancer patients.
This has been an important debate with impressive contributions. I am sure that my ministerial colleagues in the Department of Health who have responsibility in this area will study the debate very carefully in view of the authority of the contributions to it. I shall certainly study Hansard and if I have overlooked any points I shall write to the relevant noble Lords.
Baroness Finlay of Llandaff: My Lords, I thank all noble Lords who contributed to this very interesting debate. It has felt a little like a rich kaleidoscope—we have all been looking in the same direction but each from a slightly different angle.
I thank the Minister for his reply regarding funding of the important national resource of our registries. Unlike the Minister, I believe that we shall soon need clarification through legislation to enable secure data supply to cancer registries and to foster crucial research in the long term. In the mean time, I beg leave to withdraw the Motion for Papers.
Motion for Papers, by leave, withdrawn.

Electricity Supply
5.16 p.m.
Lord Tombs Lord Tombs rose to call attention to the possibility of power interruptions in the electricity supply industry; and to move for Papers.
The noble Lord said: My Lords, this debate takes place exactly one year after a similar one on 8 January 2003, during which contributions were made by a number of noble Lords present here today. During that year little has happened to relieve the anxieties which I then expressed concerning the reliability of electricity supply in the United Kingdom in coming years as a result of the fragmented organisation which followed privatisation of the industry and a consequent lack of any coherent planning for the future of this long-term industry. Instead, the Government have shown a touching faith in the ability of the market mechanism, supplemented by a raft of committees, to provide for the future. This faith persists, despite the virtual expropriation of British Energy following the 40 per cent fluctuation in wholesale electricity prices and serious difficulties for other generators although it is only fair to acknowledge the Government's own contributions to the British Energy debacle through imposition of the climate change levy, disproportionately high rates and high fuel reprocessing costs. Incidentally, this last burden suddenly became negotiable after the financial collapse of British Energy.
I want to set aside transmission failures such as those that occurred in London and the Midlands during last August and September. While serious in their impact, affecting hundreds of thousands of people, they were essentially one-off and short-term. I shall speak today of interruptions that are likely to
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arise as a result of inadequate reserves of generating plant. Such inadequacies are not at present recognised and, when that hurdle is surmounted, will take several years to repair because of the planning and construction times required to provide new generating capacity even if generators can be induced to invest on the scale required.
Operating margins today are substantially lower than those obtaining prior to privatisation. This is so partly because the higher margins of yesteryear were required to allow for the very rapid development of generating plant size, with the consequent risk of type faults arising from installation of large numbers of similar units without prior operating experience.
A second reason was to allow flexibility in fuel use to deal with violent changes in the price and availability of competing fuels; in this way we were able to deal with two major coal strikes and serious dislocations in oil supply. That flexibility has now been abandoned in present and planned new generation capacity.
The third and most important reason was to provide for plant breakdown and the possibility of severe weather conditions. Those needs remain, of course, and we should remember that we have enjoyed a series of mild winters which may have induced a false sense of security.
The diversity of plant to accommodate fluctuations in the fuel market has been largely abandoned over the past 15 years. Today, coal plays a much reduced part in the industry's portfolio and we are becoming steadily more dependent upon supplies of gas. In so far as it is possible to draw any conclusions from the energy White Paper, that trend seems likely to continue to a point where future electricity supplies will be vulnerable to events largely outside our control. I shall return to that topic later.
The need for an operating margin to cope with plant breakdowns and severe weather conditions is brought to the attention of government, electricity companies and the public by National Grid Transco through its annual seven-year statement and subsequent updating reports. In doing that National Grid Transco, although not itself responsible for the figures, draw the attention of Ofgem and DTI to current and future trends. Ofgem seeks to devise market controls that are essentially short-term, and DTI, through a wealth of advisory bodies, seeks to peer into the future.
In a long-term and capital-intensive industry, that does not provide a satisfactory framework for development. Since the role of electricity in the domestic, commercial and industrial sectors is essential to national prosperity and stability, it must be a matter of the greatest concern. To say that is not to denigrate the efforts of those involved in what passes for forecasting. But the remit of National Grid Transco is to operate and plan the gas and electricity transmission systems; that of Ofgem is to control competition and safeguard consumers interests; and that of DTI is to shape government influence on policy and performance.
In matters of future strategy Ofgem and DTI can and do provide useful background advice and they could do a great deal more to create a useful climate in which the generating companies could plan their future. But neither Ofgem nor DTI will build new generating plant. That responsibility lies with the generating companies which operate in a short-term environment dictated by the demands of the City and the signals provided by Ofgem through its control of trading. Nowhere is the long-term balance of fuels and the associated generating plant or security of supply considered in a committed way. That responsibility is dissipated between bodies without the authority or the ability to fill the vacuum arising from the form in which the industry was privatised and the somewhat haphazard, and frequently damaging, regulation and policy-forming that has resulted.
The present situation is illustrated by the National Grid Transco seven-year statement, of which the latest edition is that for 2003. I shall return to its view of operating margin over the coming years in a moment. First, let us note that the winter operations report, published by National Grid Transco in October 2003, stated that the peak demand for the previous winter occurred at 17.30 hours on Tuesday, 10 December 2002. The demand after load management reductions was 54.8 gigawatts. The available generating plant totalled 55.7gw, resulting in an effective operating margin of 0.9gw—less than 2 per cent. That uncomfortable situation prompted Ofgem to arrange with generators to return some mothballed plant totalling about 2gw in time for the current winter. But the narrow squeak last winter itself illustrates the fragile nature of the plant margin and of the measures which are available to address it effectively, even in the short term.
So, looking further ahead, the seven-year statement for 2003 indicates possible plant margins varying between 18.7 per cent and 26.7 per cent for the years 2003–04 to 2009–10. Those figures would be encouraging if they could be regarded as realistic. But the seven-year statement itself points out that the figures are not reliable for the following reasons.
First, they include 7gw of new gas turbine plant for which there are no firmly committed commissioning dates. Past dates indicated by some generating companies have slipped by several years from those indicated and cannot be regarded as reliable. No doubt some of that plant, and perhaps some not already declared, may be commissioned in the period under review, but the figures are not secure and construction times make them increasingly doubtful within the period surveyed.
Secondly, the statement makes no assumptions about plant being withdrawn from service. Much of our existing coal and oil-fired plant is more than 30 years old so that the likelihood of that happening is considerable and is made more likely by the forthcoming European directive on carbon emissions. But, since the companies can give as little as six months' notice of such intentions, no sensible provision is made.
Thirdly, some 8.6gw of installed CCGT plant is contractually subject to interruption of gas supply and only 5.9gw—about two-thirds of that plant—has standby distillate oil provision.
Fourthly, the statement makes some optimistic assumptions about interconnector capacity at time of peak demand. It must be born in mind that the French interconnectors were installed for trading purposes and that there is no guarantee of their supplying their maximum capacity at the time of our peak demand. Indeed, at the time of the last winter peak they were unable to do so. On these grounds, the winter operations report suggests that it might be prudent to reduce the combined imports at peak from France and Scotland by 1.2gw. But we must bear in mind that this still assumes import of about 1gw from France for which there is no contractual requirement.
Fifthly, the seven-year statement assumes additional import capacity of 1.2gw with Norway in 2006 and a further 1.2gw from an interconnector with the Netherlands in 2007. Of these, the Norwegian interconnector has since been turned down by the Norwegian Government and the Netherlands interconnector remains in the planning stage. As a result, the Norwegian import of 1.2gw will not be available and it would be imprudent to assume that the import capacity from the Netherlands will be available at the time of our peak demand even if that interconnector goes ahead.
In my view, based like that of the seven-year statement, on insecure data but on some considerable experience, the plant margins may be below those projected by some seven to 10gw, reducing the plant margins over the period to single figures which would be inadequate and would bring a serious risk of prolonged load disconnections.
So where does this leave the medium-term future of an industry on whose reliability the prosperity and standard of living of our country depends? That the industry is fragmented is beyond doubt and the mechanisms for obtaining an overall view are consequently diffuse. National Grid Transco has tried bravely to fill the gap with its seven-year statement, but has to rely on uncertain information from the participants. The results of the exercise are highly speculative and do not survive critical examination. The industry is running on a strictly short-term view shaped by market forces which are averse to risk and uncertainty—two factors inescapable in planning for a long-term industry.
The medium-term picture, seven years ahead, is a worrying one, with the likelihood of power interruptions, but the longer term provides grounds for even greater concern. Market pressures on generating companies will ensure that future generating plant will be gas-fired. This will cause a steady drift towards dependence on imported gas from distant fields and consequent exposure to rapidly rising prices and risk of interruption. These risks will, of course, be increased by the diminishing contribution of our coal and nuclear plant.
The equanimity of the Government in the face of these trends is staggering and is epitomised in the energy White Paper. It can arise only from a lack of familiarity with the factors involved, coupled with the fact that responsibility for energy supply is now disseminated among a number of departments with no clear focus of responsibility. It may be that the highly subsidised "clash for wind", itself an unreliable resource, stems in part from a desire to be seen to be doing something to which none of those disparate departments objects. But it will contribute little to the major problems which I have outlined.
I ventured some suggestions to rectify this unhappy situation in the previous debate a year ago. They received a dismissive response from the Minister charged with replying, the noble Lord, Lord Sainsbury, and I do not intend to repeat them today. If the Minister is so minded, he can refer to Hansard for 8 January 2003.
It gives me no pleasure to describe the unhappy situation which now besets a great industry to which I have devoted much of my working life and for which I was responsible for some years. I fervently hope that today's debate will concentrate minds on the risks which we are running and provoke an urgent search for an informed solution. The problem will worsen with the passage of time unless the control mechanisms are fundamentally changed and made more effective. In this situation, procrastination is indeed the thief of time. My Lords, I beg to move for Papers.
5.30 p.m.
Lord Peyton of Yeovil: My Lords, it is a very great pleasure to support the noble Lord, Lord Tombs, who, this year as well as last, has placed this House in his debt. He has spent a great deal of his life in the industry; he knows what he is talking about; and he tells the truth. I suggest—I have no hope of this sensible suggestion being taken up—that Ministers have that speech before them as compulsory reading because it is clear to me that they have not yet understood what this matter is all about.
Unhappily, as the noble Lord, Lord Tombs, himself said, his reward for last year's speech was to be virtually ignored. I am of a slightly less kind disposition than he is and therefore I shall read out a section of the bromide-studded reply of the noble Lord, Lord Sainsbury, which was obviously decorated for him by the department:
"I hope that, overall, noble Lords will take comfort from the fact that we continue to address the strategic issues that face the electricity industry. Strategic analysis continues to be carried out, and the Government, the regulators and the industry are all fully engaged"
What a terrible prospect.
"We also need to prepare policies for the coming century".
There is an original thought for your Lordships!
"The Government's energy White Paper will outline the key energy policy issues for the future. It will be published in the spring"— [Official Report 8/1/03; col.1050.]
I have absolutely no doubt that it left the noble Lord, Lord Tombs, full of hope that an enlightening White Paper would follow. Imagine his despair, which we all
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shared, when a glossy, colour-printed but bromide paper appeared telling us nothing of what the Government intended.
The debate has centred around two anxieties. The first is the insufficient margin of generating capacity. The noble Lord, Lord Tombs, dealt with that issue at length and I shall not enlarge upon it, but it is a desperately serious matter. It seems to me that, at present, any suggestion that the margins are inadequate is met with something approaching ridicule or just bare-faced surprise.
The other problem is one of totally muddled organisation. Overall responsibility for ensuring the security of electricity supply is of absolutely paramount importance. Such is the organisation that no one—no body, no Minister, no one—is responsible for this extremely important matter.
I fear that Ministers have entrenched themselves behind ill conceived policies and, from that position, they are not good listeners. They have pinned some hopes on renewables, but I believe that those hopes, if realised at all, will not come in time. I certainly share the belief that Ministers have made a cardinal error in disregarding the need to keep the nuclear option open. They shelter behind the phrase "keeping the nuclear option open". One asks them what they mean, and I have twice asked the noble Lord opposite that question. Of course, I recognise that he is not a Minister in the Department of Trade and Industry, which I imagine he will take as a blessing rather than a misfortune. Nevertheless, he was not privileged to be the bearer of anything like an answer from his department. It was a very disappointing exchange—so disappointing, in fact, that a week or so later I renewed the attempt with equally little success.
I do not wish to go on at length. However, my conclusion is that Ministers have entrenched themselves behind a thoroughly wrong-headed policy and that they have not understood the catastrophic consequences of a breakdown of supply. I recall a speech made by the noble Lord, Lord Stoddart, in last year's debate. It showed that he very clearly understood, as I do not believe Ministers do, how such a breakdown would affect every individual and every home in this land and how it would threaten business and the economy and do untold harm. I hope that the Minister who is to reply to the debate will try to drum into such audience as he can find in the Department of Trade and Industry some measure of the concern that we, here, feel about those catastrophic consequences and our fear that the department has not yet seen fit to acquaint Ministers with them.
What I fear most is that the speech made today by the noble Lord, Lord Tombs, will receive the same degree of attention from Ministers as did his equally meritorious speech last year. That is an uncomfortable position for the noble Lord, Lord Tombs, but it is a disastrous position for us all. I hope that the noble Lord will not take this as a measure of party stance or an indication that we are anxious to stick a knife into the Government. It is a measure of deep concern about

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a problem which we feel the Government are skating round and neglecting almost totally. I am happy to support the noble Lord.
5.37 p.m.
Lord Jenkin of Roding: My Lords, we are all very indebted to the noble Lord, Lord Tombs, for deciding once again to bring this important issue before the House. Our acquaintance goes back a great many years. I have never forgotten the time when he and I crawled up between the inner and outer skins of the Hunterston nuclear power station so that he could demonstrate to me the effects on stainless steel of carbon dioxide at, I believe if I remember correctly, 600 degrees centigrade. It was not a pretty picture. Our paths have crossed on a number of occasions since then and, as my noble friend Lord Peyton said, we are very much indebted to him for again bringing this important issue before the House.
The debate is very well timed in some respects, although I believe that it puts some of us under some constraint because we are already deeply involved in the Energy Bill. No doubt some of these issues will be aired when we reach Grand Committee on that Bill. However, I believe that there is a distinction here between the short term and the long term, and the Energy Bill will address principally the longer-term issues. It is therefore appropriate that I confine my remarks today to the relatively short-term issue of the immediate dangers to the security of our electricity supply.
Noble Lords will recollect that in 2003 there were several major power interruptions in this country and also across the world and several minor blackouts in more limited areas. That brought home to many people that it is all very well placing huge emphasis on reducing carbon emissions for the benefit of the environment, or increasing output from renewable sources, or seeking to maintain low electricity prices in order to protect the fuel-poor. But in fact these events have reinforced my view that security of supply in an advanced industrial country such as ours must now be seen as a—or possibly the—primary policy objective.
We are today an electricity-dependent society. It will be no answer for the authorities, when confronted with major blackouts—and after all last year was but a foretaste of what might come—to argue that they are cutting carbon emissions, promoting wind farms and phasing down nuclear plants, because in fact maintaining the security of supply will increasingly be seen by people as being the highest priority.
I should like to draw the attention of the House to two documents which bear directly on the subject matter of the debate. The first has already been referred to by the noble Lord, Lord Tombs; it is the Winter Operations Report of National Grid Transco, which was published on 14 October last year. It is the latest in a whole series of annual reports covering last winter—2002–03—and an overview of this winter,
"covering both electricity and gas transmission systems".
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It also contains analyses of wider supply security. It is a technical document, produced by skilled professional people and aimed at the main professional players in this field—the Government, the regulators, the generators, the distributors and the suppliers.
Despite a number of apparently bland assurances that we shall be okay in all but one in 50 cases, a careful reading of the document indicates that the real situation is a good deal less reassuring than appears at first sight. There are all kinds of things that may go wrong. It starts with a comfortable 6-gigawatt margin of capacity above average peak winter demand for electricity. A number of scenarios are postulated which could in prolonged cold conditions—and after all these are not unusual in this country—reduce this margin of 6 gigawatts,
"to between a deficit of 0. I GW and a surplus of 0.7 GW".
It is true that that is a "worst case" scenario, but it is, for goodness' sake, the job of the authorities to plan for the worst case.
The authors put forward a number of changes to existing arrangements to provide for what they call,
"an added level of security in such worst case scenarios".
There are nine specific proposals put forward in the document. They are all technical and not easy to summarise within a limited period such as we have. However, I think that I can give the House the essence of what the report recommends. It states:
"National Grid Transco remains strongly committed to supporting market processes"—
in general one supports that—
"that will facilitate an appropriate level of energy security".
But it recommends that electricity supply security would be enhanced if a number of market changes were to be introduced. The changes are then numbered one to nine. They commend:
"NGT's proposals to strengthen the Electricity Market Imbalance Price…This should encourage a further return",
to activity of what they call,
"mothballed generation and encourage increased availability of generation and interconnector imports.
That is only the first change. The second change sees a need for the,
"proposed new Maximum Generation Service for this winter. This would give NGT access to"—
what they call—
"'reasonable endeavours' generating capability of the order of a further 0.6 GW".
The report continues in similar vein: there are a number of quite specific, very technical improvements on how the generating market works in order to provide enhanced security for the supply of electricity to this country.
The report points out that there should be a new process to enable,
"trading of interruptible rights, allowing shippers to substitute interruption sites with other shippers and hence…when the electricity market is tight [to] enable some market priority to be given to sustaining gas fuelled generation".

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I have only reached the first seven and I have not mentioned them all.
"However"—
the report states—
"we remain concerned that there may be circumstances in which security of supply cannot be maintained by market mechanisms alone".
I have always been a supporter of markets as an effective way of ensuring the supply and distribution of goods and services, but, as the noble Lord, Lord Tombs, pointed out, one is dealing here with very long timescales. The time needed to bring a new power station from design to generating can sometimes be as long as 20 years. In these circumstances, the normal market mechanisms find it difficult to work properly. The report therefore proposes a number of other solutions for the problems of interruptible combined cycle gas turbines over the peak electricity demand period, where market mechanisms have not already achieved this, and so on.
These are all minor and technical changes. I am sure that the Minister will be aware of the report, but I hope that he will be able to answer the question: how many of the nine measures listed in the report are currently being taken? If not all of them, why not? This report has been on the Minister's desk since October when it was published. I do not believe that National Grid Transco would have put this document into the public domain if it had not intended it to be taken very seriously by the authorities. That is the first issue about which we need answers from the Government.
The second document is the recently prepared report for the Adam Smith Institute, written by Professor M A Laughton, a Fellow of the Royal Academy of Engineering. He is a leading authority in the field of energy in general and electricity in particular and is a key adviser to the Government on these matters. That report looks a little further ahead than the NGT report. But it contains some quite disturbing messages. Perhaps I may read to the House one or two of those which have caused me concern as to where we are going in the future.
The heading in the Executive Summary is "Prioritising Security of Supply". It states:
"According to the International Chamber of Commerce (ICC) security of supply will be the biggest energy challenge for EU and OECD industries during this century. Therefore, to build a strong energy policy around this premise, it must be recognised that security means both security of primary energy supplies (from oil, gas, coal, nuclear and renewable resources) as well as of power supplies to the final consumers".
The report points out that the one does not necessarily guarantee the other. If one runs out of generating capacity, regardless of how much fuel one has, one cannot supply people with electricity.
The report turns to the way forward. It states:
"A rethink regarding investment in generating plant is also required. Britain is facing a shortage of generating capacity in the next few years as unfavorable market conditions see mothballing of much existing plant and discourage new investment".
The report goes on to discuss the longer term. In light of his analysis of the situation, Professor Laughton's recommendation should not surprise us; namely, "a balanced mixed energy policy".
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The House will remember that the Government's policy during the next 20 to 30 years may result in up to 80 per cent of our electricity supplies being met by imported gas, much of it from very unstable countries. Professor Laughton therefore states:
"It is essential that Britain's energy policy is reviewed as a matter of urgency with the primary remit of ensuring security of power supplies".
He continues,
"significant questions are raised concerning the increasing vulnerability of the UK electricity supply industry".
I do not want to risk straying into the area of the Energy Bill, but Her Majesty's Ministers will fail in their duty to the country if they do not pay heed to these authoritative and compelling judgments of Professor Laughton. His warnings are clear. The consequences of failing to heed them could lead to disaster. In the end, it is the responsibility of government to see that the lights stay on. I would welcome assurances from the noble Lord, Lord Davies of Oldham, that the Power to the People paper will he treated with the utmost seriousness that it certainly deserves.
Our people will not lightly forgive the Government if, in the face of the warnings that are implicit in the National Grid Transco report and explicit in the Laughton report, large areas of the UK are repeatedly plunged into darkness.
5.53 p.m.
Lord Stoddart of Swindon: My Lords, I join the noble Lords, Lord Peyton and Lord Jen kin, in congratulating the noble Lord, Lord Tombs, on once again introducing this subject. As all those who have spoken so far have pointed out, it is vital to the interests of this country.
I wish the Government would take notice of people such as the noble Lord, Lord Tombs, who has wide experience not only of the electricity industry, but of other industries as well. When he worked in the electricity supply industry, particularly when he was the chairman of the Electricity Council, he was not only well respected, but also well liked and admired. I can also say from personal experience that he was a livewire and a dynamo in that role. He and I used to negotiate across the table when he was chairman of the Electricity Council and I was a member of the national joint council, representing NALGO. I know he thinks that I was a bit of a pest then, because I was always demanding more money than he and his colleagues were prepared to grant to us, but, nevertheless, we were very good friends and always finished our meetings with a good lunch just along the road in Millbank. Therefore, the noble Lord really must he listened to and I wish the Government would do so.
After our previous debate on the matter on 8 January 2003, I had some correspondence with the noble Lord, Lord Sainsbury. He wrote that spare capacity amounted to 17.5 per cent. The total available plant was 64.9 gigawatts, of which 17.5 per cent was spare capacity. The predicted peak winter demand was 55.3 gigawatts. That was roughly confirmed in a letter

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from the noble Lord, Lord Davies of Oldham, to the noble Lord, Lord Jenkin, on 23 October when the July update of the plant margin was 16.5 per cent for the coming winter rising to 18.1 per cent when the Isle of Grain and Deeside power plants came on stream.
The noble Lord, Lord Tombs, said that those figures are overstated and that, far from having 17.5 per cent spare capacity, we have far less. That is very worrying indeed. My view remains that those figures—not those of the noble Lord, Lord Tombs, but those that were given to me and to the noble Lord, Lord Jenkin of Roding, by the Minister—represent the barest minimum to ensure security of supply. Security of supply means the absence of power interruptions or significant voltage reductions.
I worry also about whether the National Grid is completely up to scratch in dealing with abnormal loads or serious breakdowns in the network. Recent experience has shown that that is perhaps not so. That is another matter to which the Government should give their attention.
I reiterate what I said previously about maximum demand. The noble Lord, Lord Jenkin, also touched on that matter. It is some years since we suffered a severe and prolonged winter, with low temperatures over an extended period of time. Last winter's maximum demand figure of 55.3 gigawatts could well be significantly exceeded, since people have added to their stock of electrical appliances over the years. The Government and the electricity supply industry seem not to have taken due note of that fact. People keep on buying appliances and adding to the potential load. That potential load has not been tested for a very long time. That is why the Government and the electricity supply industry should be wary. Under those circumstances, the plant margin could be quite inadequate. The plant itself—I know about it because I worked at a power station—would be under greater mechanical strain, resulting in a greater number of outages than anticipated. That is another risk that has not been tested in the past few years.
I am aware that working power stations and plant are supplemented by mothballed capacity. It mainly consists of oil and, as the noble Lord, Lord Tombs, said, old-fashioned and outdated plant, which could not in fact be brought in to use at short notice. Indeed, to put it in working order and on-stream would take at least weeks; and probably many months before it could deliver power to the grid. It would be useful to hear the comments of the noble Lord, Lord Davies, on those points.
Can the Minister also tell us whether renewable energy—mainly wind turbines—is or will be included in the total plant availability and taken into account when calculating the plant margin? That is an important question that should be answered. I sincerely hope that it is not, as the vagaries of wind, even at sea, are well known. All too often, when icy conditions prevail, wind speeds are at their lowest. If that capacity is taken into account, that is dangerous for security of supply. If not, it shows the futility of relying on windmills to supply 10 per cent of
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electricity, as back-up capacity will have to be provided. That makes wind power unreliable and expensive as well as environmentally damaging.
Finally, I must reiterate my regret that we no longer have a department of energy to oversee what is a vital service to the health, safety and wellbeing of our people and to industry and commerce. I hope that the Government will reconsider their attitude. I am sure that I and other noble Lords could suggest some departments that could be slimmed down or even abolished to pay for a new department of energy. That department could give leadership to the industry, which, as everyone knows, is too fragmented and lacks a proper co-ordinated way to provide electricity supply and, above all, security of supply.
6.2 p.m.
Lord Gray of Contin: My Lords, I join other noble Lords in thanking the noble Lord, Lord Tombs, for giving us the opportunity to discuss this subject. We are extremely fortunate to have in this House someone with the noble Lord's vast experience and knowledge of the whole energy industry. Indeed, as I listened to his address, it emphasised to me how important it is to have Members of his calibre. We would be deprived of many such contributions were we ever to change into a House that consisted of directly elected and only elected Members.
Electricity is the lifeblood of the country and safe and sound security of supply is of paramount importance. It is, after all, a vital part of ensuring the very existence of our transport system and all our industries are dependent on it. Our homes and offices without electricity become miserable to say the least. Little wonder then that the public has become alarmed, not to mention irritated, at any suggestion of power cuts.
The Institution of Civil Engineers recently produced a short but useful assessment of the state of the UK infrastructure which contained a passage on power generation. That drew attention to the fact that no country has achieved significant reductions in energy demand through conservation and that renewables can make only a limited contribution. Yet the Government hope to increase the contribution from renewables to 20 per cent by 2020.
Our current mix for electricity generation is 32 per cent coal, which will disappear by 2016 if emission constraints are enforced; 23 per cent from nuclear power—by 2020 only one nuclear power station will be operating—and 38 per cent from gas. However, after 2006, we shall become a net importer of gas, while by 2013 our dependency on imported gas will have risen to almost 70 per cent. Those imports will come initially from Norway and later from West Africa, the Middle East, and former Soviet republics—hardly encouraging in terms of security of supply. The present mix is completed by 4 per cent from oil and 3 per cent from renewables.
So, after 100 years of self-sufficiency in energy resources, we are facing the future in a cavalier fashion, producing a White Paper that makes

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hopelessly over-optimistic forecasts and places an unrealistic reliance on renewables, especially wind power. All the renewables are dependent to varying degrees on weather, but as so much is expected of wind power, it is the adverse effect of high pressure and flat calms that cause most concern. To place such faith in a source of energy subject to intermittency is highly irresponsible.
I recall expressing disappointment when a Conservative Government decided to discontinue research into the fast breeder reactor. I remember well being told then that the need for the fast reactor was still 40 years away. Almost 20 of those years have already passed. What a wonderful opportunity has been missed in the White Paper. Renewables could still have been given a role to play—no one denies that they have a useful role—but the real challenge was ignored. The White Paper should have proclaimed wholehearted support for nuclear power now, with a positive declaration that existing nuclear power stations would be replaced.
Keeping the nuclear option open is simply not good enough. Nuclear power's carbon-free qualities should have been built on in the White Paper. Global warming is a threat to the world that has been played down for far too long. The resolution of disposal of nuclear waste is not insurmountable: it has been resolved in other parts of the world, most recently in Finland. The White Paper should have highlighted the advantages of nuclear power as recognised in so many countries worldwide. There are 27 nuclear reactors under construction in nine different countries and the total number of reactors now approaches 450. Are we to be left behind yet again?
The White Paper pays only lip service to the nuclear industry, instead of using it as the centrepiece of our energy policy for the future. It is still not too late, but the present Government show little sign of accepting the challenge.
6.10 p.m.
Lord Lea of Crondall: My Lords, I beg the leave of the House to speak briefly during the gap. Earlier, I was at a meeting that I could not avoid. I wish to follow the theme covered by the noble Lord, Lord Gray, as it is the most crucial question of energy policy introduced by the noble Lord, Lord Tombs, today. The problem is that electricity is unlike any other commodity; you cannot store it. There is a system in north Wales to take water to the top of a hill so that it can come down again, but that cannot be done in any other part of the country.
That brings us to the problem of measuring base load. In my first question I shall paraphrase the remarks of the noble Lord, Lord Stoddart:are we supposed to be counting renewables in the base-load requirement? If so, it is a very odd definition of base-load requirement, because it is not reliable. If we are not counting renewables, we need a margin—15 per cent or whatever—on top of the current customary margins for a set of stations where we are asking investors to believe that there is a rate of return on
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investment for capacity that is used only occasionally. That will not be nuclear capacity, as it is not technically possible to use nuclear energy as compensating capacity. I will be corrected if I am wrong, but I understand that one cannot use it as compensating capacity relative to wind energy.
That means that the whole base-load capacity that we have to rely on must include even more imported gas capacity, in which people will have to invest. Where is the incentive to invest in that capacity if it will be used only intermittently? It is not therefore a question of being against wind power, but about reminding ourselves of the nature of wind power and its unreliability, which leads to greater difficulty in security of supply than we already have. It is perhaps useful to consider security of supply in two separate senses of the term: the first is relying on Azerbaijan, the Middle East or elsewhere, and the second is technical security.
I conclude by echoing many other speakers. Not only must we pay lip service to keeping open the nuclear option, we must ask our friends in the Government to think seriously about the timescale. It is a bit like joining the euro, on which I shall not be echoed by the noble Lord, Lord Stoddart. Do we not need to make clearer the timescales and ensure that the arithmetic adds up to a greater extent than in the White Paper?
6.14 p.m.
Lord Ezra: My Lords, I declare that I have been actively involved in the energy sector for some years and am currently chairman of Micropower. which promotes the small-scale generation of electricity.
Together with all noble Lords who have spoken, pay tribute to the noble Lord, Lord Tombs, for initiating, yet again after a year's interval, a debate on this important issue, and for repeating what he said before—it bears repetition. Like the noble Lord, Lord Stoddart, I had dealings with the noble Lord, Lord Tombs, when he was chairman of the Electricity Council. But whereas the noble Lord, Lord Stoddart, was trying to extract from him the maximum amount of money possible for the members of his union, I was trying to get a fair price for the excellent coal that we supplied to the power stations. The noble Lord, Lord Tombs, and his colleagues stood up to that twin onslaught with much fortitude.
The current energy position calls for very careful thought. We have had the White Paper, but it was basically an aspirational document. To pay it a tribute, it set out the problems fairly clearly. But many of the actions are still to come.
As other noble Lords have said, the question of interruptions in the electricity supply sector divides itself into two parts—the short and longer term. In the short term, attention has been focused on two issues: first, the reliability of the transmission and distribution network, and, secondly, the reserve capacity of electricity generation to meet untoward conditions, both of which have caused concern. The DTI and Ofgem have claimed that there is no real risk

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of power interruptions this winter, apart from exceptional circumstances. Nevertheless, as the noble Lords, Lord Tombs, Lord Jenkin of Roding and Lord Stoddart, have pointed out, the reserve of generating capacity is now at a lower level than it has been for many years. What is stated to be the reserve could well be lower in the event because of outages at the time, to which the noble Lord, Lord Stoddart, referred from his great experience of operating power stations.
The short-term problem of possible interruptions of energy supply is serious, but the longer-term issue is even more serious. As matters now stand, over the next 10 to 15 years, a large part of the present nuclear and coal-fired capacity is likely to be closed down. That will start to happen in the intermediate term, not in the distant future. At the same time, as the noble Lord, Lord Tombs, pointed out so clearly, there is doubt about new investment in gas-fired generation. That is due to major increases in gas prices compared with wholesale electricity prices. The future trend in gas prices will undoubtedly go upwards as increasingly we become importers and put pressure on supplies.
The energy White Paper sets out four objectives of energy policy: competitiveness, security, diversity and sustainability. It is not possible to keep those four balls in the air at the same time. It has emerged clearly, and was emphasised in today's debate, particularly by the noble Lord, Lord Jenkin, and others, that security of supply is undoubtedly the most important energy issue that we now face. The reason is that for the first time in our economic history we shall become increasingly dependent on imports. Coal supplied us with all our energy needs for centuries; then we found gas and oil in the North Sea and we developed our nuclear capacity. Although we have had to import a certain amount of oil, we have never been in the situation that is likely to arise in the next decade or so. That is one risk. It has been emphasised in this debate, and it is well known, that we stand at the end of the European transmission line for gas. The specific problem that we are addressing today is that there will be an increasing gap in the availability of electricity capacity.
The Government have emphasised renewables and energy efficiency as the principal means of achieving their energy objectives, that is of making good the possible shortages in electricity supply and in meeting their Kyoto objectives. The trouble is that under neither of these headings has the headway been made that would give us reason to think that the Government will achieve their aims. Renewables' performance so far has been much less than anticipated, and the prospects are uncertain. However, as far as energy efficiency is concerned—particularly in the domestic sector, where the biggest savings remain to be made—while the Treasury has carried out two consultations, little has been done to bring about the great surge in saving that is required. We are left with the prospect of an impending electricity generation gap of substantial magnitude.
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As I understand it, next year the Government hope to produce proposals to deal with hazardous nuclear waste. It may be that in the light of the proposals made then, they will finally decide on the future of nuclear capacity, the great uncertainty emerging from the White Paper. Even if they did decide—which is uncertain—to go ahead with new nuclear capacity, we are still left with a major problem, because it would take at least 10 years before new nuclear could come on stream, allowing for consultation, planning and safety procedures. It could be even longer if it was decided to adopt new technologies that are in the process of development. Whatever decision is taken on nuclear, the prospect of a generation gap in the intermediate term remains. It calls for urgent action. The Government must now review their policy of exclusively concentrating on renewables as the means of filling that gap. This is just not feasible, as has been pointed out by previous speakers.
I will mention other steps that could be taken. I have pointed out that the White Paper was pretty good at analysing the problem, and all these steps are indicated in the White Paper. What is lacking is the policy to carry them out. Coal remains our most important indigenous energy resource. We still have substantial reserves, but if we go on as we are, in the next 10 to 15 years there will be virtually no coal-fired stations in operation because of increasingly stringent emission standards, as well as the age of the stations. Clean coal technology offers a means of replacing existing coal-fired operations and together with carbon extraction can compete environmentally with renewables.
What should the Government do about this? There is a simple measure that they could take. An extension of the equivalent of the renewable obligation to clean coal technology could mean that the two or three projects that are now on the drawing board for such plants could start being constructed. In the United States, they have devoted 1 billion dollars to the development of clean coal technology. This compares with the few million pounds that are being spent in this country.
We must consider ways in which we can get good dividends from acting as they do in Germany on the recovery and treatment of methane from coal mines. If the methane escapes in the atmosphere, as the noble Lord, Lord Jenkin of Roding, and other Peers have frequently mentioned in debates, it can cause untold damage. Converting it to electricity by treating it can be extremely beneficial in comparison. It remains a mystery why the Government consider that methane from landfill sites is a renewable source of energy, but the same methane from coal mines is not. Yesterday, the noble Lord, Lord McIntosh of Haringey, referred to this as a nonsensical situation. In Germany, both are considered to be renewable, and there is support for both. The sooner we do that here, the better.
Perhaps the most important development in electricity generation would be to have a more decentralised system, with localised or distributed generation. It creates substantial advantages by reducing pressure on the National Grid and avoiding transmission losses, and by enabling waste heat to be

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used, virtually doubling the fuel conversion efficiency and thereby reducing the rate of emissions. The trouble is that the most effective way of doing it—through combined heat and power—is now in the doldrums because of the substantial increase in gas prices. In the case of CHP, as in the case of clean coal technology, there is a way out of the problem that is quite simple: extending a type of renewable obligation to support CHP. Such measures are within the compass of government, and I am sure that we shall propose relevant amendments to the current Energy Bill. The Government should consider such measures very seriously.
A new technology for micro-CHP or micropower has been developed, and I have declared my interest. It takes the form of a domestic boiler capable of producing heat and electricity, bringing all the advantages that I described to domestic users. The first such appliances are likely to be marketed during the next 12 months, but, if the full benefit is to be derived from this exciting new technology, we will need help during the build-up period. We should not repeat the mistake made over the condensing boiler, which has advantages over conventional boilers, just as micropower boilers mark an advance on condensing boilers. As the energy White Paper demonstrated, in Britain, in 2002, condensing boilers accounted for 12 per cent of the market, whereas, in the Netherlands, as a result of concerted and determined efforts, the figure was 75 per cent. That shows what can be done, if the will is there.
In conclusion, we face a major electricity generating gap in the next 10 to 15 years, due to the likely closure of nuclear and coal-fired stations, coupled with a slow rate of investment in new gas-fired stations. Even if the Government decided to go ahead with further nuclear stations, the inevitable time lag would necessitate other measures. The technology is available and was fully identified in the energy White Paper. Aspiration must be converted into action. A first step would be an urgent review of electricity generating prospects and a list of actions to be taken to safeguard the future security of supply.
6.28 p.m.
Earl Attlee: My Lords, I too am grateful to the noble Lord, Lord Tombs, for introducing this timely debate. We have been concerned about such matters for some time. The noble Lord paints an alarming picture of capacity shortfalls.
It is easy to forget how severe are the effects of power cuts of any duration or frequency. It is easy to forget what happened in the 1970s with the three-day week. The result was severe damage to the economy in the short term, and, in the longer term, many factories and organisations felt that they ought to have their own generating capability. That was a complete waste of resources, as the generators were rarely used.
I saw for myself the effect of power shortages in war-torn Bosnia in the 1990s. There, high-density urban housing was heated by coal or electricity, and it probably needed both for the systems to work.
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Because of the conflict, there was neither, but there was misery and suffering. The Bosnians installed an improvised stove in each apartment and burnt the wood that they collected from the forests round about. That would hardly be practical for the centre of Birmingham or Manchester.
My noble friend Lord Jenkin spoke about the need to have security of supply as a priority over other very desirable considerations, such as carbon emissions and low energy prices. The people of Birmingham or Manchester would be very unforgiving in the event of substantive power cuts. Our high-density urban housing is heated almost exclusively by gas. There will be no alternative fuel to be used by those households. The Government's White Paper rightly talks about fuel poverty. However, on these Benches, we believe that they are complacent about fuel famine.
As for industry, it would be the first victim of power allocation. We have always had interruptible power contracts for major industrial users, but in the event of a power famine we might have to return to the nightmare of regular brownouts, and not just for electricity.
We have seen the significant effects of power cuts on the public transport system. When I pursued the Minister on that, his body language was very revealing. There seemed to be something with which the Minister was not comfortable. With the demise of the Lots Road facility, is the Minister confident that there is no risk of disaster on the Underground or elsewhere on the rail system in the event of a significant failure of the electricity supply system?
The good news is that my information is that we are unlikely to see power cuts this winter unless the conditions are exceptional. I expect that the Minister will say something similar when he responds. But I think that your Lordships would feel even more comfortable if he put some flesh on his caveat when he calmly tells us not to worry ourselves.
What weather conditions does the Minister think constitute exceptional circumstances? For instance, how many days with a daytime temperature at however many degrees below zero would he exceptional? We have had several exceptionally mild winters; we do not want to be caught out by an average winter. The noble Lord, Lord Tombs, talked about a false sense of security. The noble Lord, Lord Stoddart, talked about the possibility that demand might be higher this winter than last winter. He also pointed out the difficulties of bringing plant out of mothballs quickly.
Your Lordships seem to have three strands of concern about power supplies. The first is the sources of primary fuel and the mix—or, rather, the lack of it. It seems that a large proportion eventually will be gas, as observed by many noble Lords. As a net exporter, we do not need to have much gas storage capacity. But, as an importer, we will be obliged to store gas under the EU energy directive. My understanding is that the French store 70 days worth of gas. How many days of gas supply does the Minister think that we should

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store? Are there the regulatory levers in place to make that happen? We also use vast amounts of oil for transport, but that is not relevant to today's debate.
The noble Lord, Lord Ezra, talked about coal and clean coal technology. I have no romantic ideas about UK deep-mined coal, but we should maintain a significant coal burn. The Minister will need to respond to the points made by the noble Lord. However, the EU large combustion plant directive clearly will have a big impact. I understand that a noncompliant plant can be used for a short while during a year. That would be useful if there was no wind for the UK wind farms. However, does the Minister have any plans to avoid non-complaint but fully serviceable plant being scrapped and to have it put in mothballs instead? If he did so, it would be available in the event of a crisis, but there would be a cost of maintaining it.
Many noble Lords, including my noble friends Lord Peyton and Lord Gray of Contin have talked today or recently about new nuclear build. I think that the people of the country are relaxed about nuclear power, but they have been convinced that the problems of nuclear waste are insurmountable. My noble friend Lord Gray briefly talked about the Finnish experience. My noble friend Lord Peyton talked about the cardinal errors being made regarding the Government's nuclear policy—or, perhaps, a lack of nuclear policy. I think that my noble friend is right.
The Select Committee of your Lordships' House has shown the way towards establishing a deep geological depository for the waste. As I observed at Second Reading of the Energy Bill, the Government have put that issue itself into a deep geological depository. I have asked the next question before, but I have not received a satisfactory answer. What possible conclusion could CoWRM come to other than to build a deep geological depository, as outlined in the Select Committee report?
Many noble Lords, including the noble Lord, Lord Stoddart, have identified the folly of relying on renewables when only wind seems to be effective, if expensive, and with its own difficulties. My noble friend Lord Gray said that the reliance on wind was "highly irresponsible" and that this was because there might be no wind due to meteorological conditions just at the point of maximum electricity demand.
The second strand is the transmission and distribution infrastructure, the failure of which caused the August 2003 blackout. It is to be hoped that that was a wake-up call for the Government. Can the Minister assure the House that the regulatory mechanisms that will be in place after the implementation of the Energy Bill will be sufficient to ensure that major failure cannot occur again?
The third and final strand is that of generating capacity, which is the excess of supply over demand rather than the mix, or lack of it, both now and in the future. Many noble Lords have focused on that, including my noble friend Lord Jenkin. He pointed out that the market mechanisms have many benefits, but they are not a panacea, especially in the long term. I hope that the Minister can respond to his questions.
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I can see how market signals can motivate generators to take plant out of mothballs and into service. What I do not understand is how the market can signal the need to build new plant. Even if those signals are received, the market might respond with the shortest lead-time solution, which would be gas fuelled, as mentioned by the noble Lord, Lord Tombs. That could be despite increasing pressure on gas supplies and prices.
I cannot see how the market could stimulate new nuclear or any other build given the long lead time, and the determination of the Government not to make progress on nuclear waste management. It may be that the Government are relaxed about the lack of a UK nuclear science base on the grounds that we can always import the necessary technology under licence, if necessary.
The problem is that in the future we may be struggling to find enough nuclear scientists and engineers to decommission our current nuclear infrastructure, let alone examine even the safety case of a new plant from a position of skill and experience. I share the concern of many noble Lords about the split in energy responsibilities between the two departments of state; namely, the DTI and Defra. Who is responsible for keeping the lights on? Which Secretary of State? In conclusion, we are not convinced that we have secure electricity supplies for the foreseeable future.
6.37 p.m.
Lord Davies of Oldham: My Lords, we are all grateful to the noble Lord, Lord Tombs, for introducing the debate. This time last year, he sent out signals to which the Government reacted at the time. I shall seek to identify areas in which action has been taken during the intervening 12 months in response to some of the short-term issues, also identified by the noble Lord, Lord Jenkin. Noble Lords will recognise that in this debate I have both to respond to short-term issues—anxieties have been expressed about last winter and the margins at that time and how well we will get through this winter—and, at the same time, to address intermediate and longer-term issues in terms of how we provide energy for the country in this decade and for decades to come.
I want to emphasise that I regard the noble Lord's introduction as most thought-provoking. We take the points that he made very seriously. I completely disavow any intention that the noble Lord, Lord Peyton, thought that I might have of engaging in party-political banter over such an issue. Far from it; this is an issue on which we are all united in recognising that the need of power for our country is as significant as any requirement could be. As the Government, it is our job to address ourselves to issues both in the short term where there have been one or two problem areas identified, and, of course, in the longer term.
In the international context, we are aware that in recent months others have suffered some severe shortages of electricity, which have brought home to us what, in advanced economies, a shortage of power

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supply really represents. We all recall the colossal problems in North America a few months ago. Of course, we have had minor problems ourselves. I say "minor" because the numbers of people affected have been relatively few or, if a large number of people have been affected. it has been for a very short period of time and in a very particular way.
Nevertheless, any shortage in our electricity supplies has a marked impact on the way people conduct their lives and that is why we need to set out to guarantee that power failures will not occur in this country. While we may not be able to give a 100 per cent guarantee—no system known to man can achieve perfection in such a complex area—we want a transmission system that meets the standards we have set in the past and want to see in the future, one that delivers power 99.9999 per cent of the time. When a failure occurs, we shall address the causes of that failure and learn lessons from it.
The noble Lord referred to the difficulties caused by the storms last winter and the breakdown in power supplies that occurred in certain areas. The then Minister for Energy immediately instigated a review by the consultants British Power International of how companies performed during that difficult period. The report indicated that some companies had performed better than others and the recommendations made were conveyed to each of the companies involved, asking them to take steps to improve their performance in the event of future storms.
In August 2003, my honourable friend the Minister for Energy, Stephen Timms, wrote to all the companies concerned inquiring about progress on implementation of the BPI recommendations. It is apparent that all of the companies have responded to the findings of the BPI report by implementing numerous initiatives aimed at better performance in the aftermath or future storms. Such initiatives include dedicated emergency planning managers, better facilities to predict resource requirements in view of weather forecasts, more rigorous testing of management contingency plans and better communications with local authorities and the media. While we cannot predict storms, we can ensure that reactive mechanisms are in place which are sufficiently robust to guarantee that the impact on people from any potential difficulties is reduced to the absolute minimum.
The BPI report also made certain generic recommendations. To consider these and further to encourage the distribution network operators towards best practice in storm performance, representatives from the DTI, Ofgem and the DNOs established the Network Resilience Working Group. Energywatch was subsequently invited to participate. That structure has been put in place to improve as best we can the response to the impact of these kinds of short-term problems. Although over recent years we have enjoyed mild winters, storms can have a devastating effect in certain areas, so we need to have in place robust measures in order to be able to respond in an effective manner.
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The noble Earl, Lord Attlee, referred to another short-term event; that is, the power cut on 28 August last year which affected the London Underground system. Let me assure the noble Earl that the Government acted quickly to meet concerns over the power cut. The Minister for Energy wrote to National Grid Transco registering his concerns and asked it to provide him with full reports on the nature of the breakdown. The reports outlined that the power failure appeared to be the result of isolated equipment problems rather than a general fault in the net work or a shortage of generation. However, I agree with the noble Earl that when a system as significant as the London Tube network is out of action for even a short period, it has a devastating effect on many hundreds of thousands of our fellow citizens. That is why we need to be as robust as possible in our response to such events.
Much of the debate has pursued an argument which has been presented to the House at Question Time, and in which I have been privileged to play a small and humble part; that is, operating margins. The noble Lord, Lord Peyton, addressed the matter with great eloquence and, at certain points, with a measure of dolefulness that I do not fully share with him as regards what the present operating margin represents.
Let me emphasise one point. Last October I wrote to the noble Lord, Lord Jenkin of Roding, and indicated that at that point there had been an improvement in the generating margin from 16 per cent to 18 per cent and that I hoped that the margin would improve further over the next few months. That has proved to be the case. We now have an operating margin of 20.9 per cent. While I recognise that that is a very different margin from those sustained in the mid-1980s, I thought that noble Lords opposite in particular had then engaged in a transformation of our energy supply industries on the basis that those margins were too wide and often concealed an uneconomic approach to energy supply. Today we have a system that is more market sensitive and works to more realistic operating margins.
The noble Lord, Lord Tombs, may disagree with the assessment of the position, but let me point out that it is clear that the market is responding to the signals being sent out and is increasing the necessary margin for this winter. I imagine that, for the foreseeable future, there will be considerable dispute about what the margin should be, but that should be set against the background of our assertion that, on recent experience, the margin has held up well enough to guarantee supplies to our people. If it is contended that we have been extraordinarily fortunate, that the weather has been particularly benign or that people have not been switching on their new-fangled technology and consumer goods to the same extent and that all these factors have to be taken into account, let me say that of course we recognise that increasing demands will be made for power supplies. The noble Lord, Lord Stoddart, identified the point. We are concerned to ensure that, in the longer term, those

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needs are met. However, in the context of the Kyoto agreements, we are quite properly addressing the ways in which energy production will shift over time.
I recognise that some noble Lords such as the noble Lord, Lord Gray of Contin, who expressed himself in gentle but stringent terms, believe that the generating margin can be met only in terms of nuclear generation. The Government do not have a closed mind on this issue. We recognise that if a gap was to emerge in our ability to sustain the necessary energy margins which could be filled only by increased nuclear generation, then that option is being kept open. That is why resources are being devoted to ensuring that we continue to produce people with the necessary research background and technical skills to sustain our nuclear industry—not only in the management of the run-down of the industry as projected in the White Paper, but also, if necessary, in order to enhance nuclear production. That was expressed quite clearly last year as government policy.
However, we do not foresee that nuclear generation will be necessary because we have several other strings to our bow. One of those is our commitment to renewable energy, which I do not think has been given as warm-hearted a response this evening as it might deserve. Derisive references were made to "windmills", suggesting Don Quixote and the 16th century. However, we are talking about sophisticated wind turbines. It has also been suggested that they will all fail at the same time because the wind is intermittent. The whole concept of wind turbine power generation is predicated on their very wide dispersal right across the United Kingdom. Only a brave person would attest that because it is calm in one part of the country, it would be calm in all parts. Obviously that is not the case.
There is of course an intermittency factor—I do not seek to underestimate that—and that is why we are devoting resources to the storage of electricity from such production units. We have not made the progress we would have wanted to make by this point but we have to recognise that if a resource has within it a factor of intermittency, a storage element is of importance. We cannot discount that factor.
Let me reassure the noble Lord, Lord Stoddart, that the contribution of renewables will be a part of the equation of the margin of capacity. Equally, it is not as certain a source of supply as various other energy sources. We will need to build in a greater unreliability and uncertainty factor because of the nature of the resource. But anyone who contends that, if we evaluated these figures over a certain number of days per year we could not guarantee that under most climatic circumstances the wind would blow sufficiently in order to guarantee that the turbines will produce a certain percentage of our electricity, underestimates the analysis undertaken when we seek to advance the contribution of renewables to the overall position.
If we fail to reach the target—which is not a modest one—of obtaining 10 per cent of our resources from renewables by 2010 we shall have to address the issue
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of filling that gap from other sources. It was indicated that "other sources" could be exceedingly unreliable. It is of course the case that the only safe and reliable energy resource is one which lies utterly and totally within one's boundaries, exploitable only by companies totally committed to selling only within the United Kingdom. That is the blessed state which was the basis of our glorious days of industrial revolution in the 19th century, and more recently to a degree.
However, in the 21st century, such a luxury is not vouchsafed to us or to any other country in the world. At the present time, with the exception of Canada, all G7 countries import energy. Noble Lords will be aware that one of the most significant economies—the Japanese economy—has had a bumpy ride of late, but I do not believe that any of your Lordships attributes that to a particular energy problem even though the Japanese economy is dependent totally upon the import of energy.
When we say that we will have a reliance upon gas imports and that the indications have been that these will be from unreliable sources, that will be true for every country in Europe. We will be dependent upon the supply lines that the rest of Europe is dependent upon. It is inconceivable that the Government would construct an energy policy without taking into account the huge amount of natural resources that have been developed in parts of the world distant from Europe. Efforts have been directed towards producing an adequate and successful pipeline capacity to deliver, and Germany, the Netherlands, Italy, central Europe, Poland and the United Kingdom are all in the same position. We are part of an economic framework which will be dependent upon the successful transmission of these resources.
When noble Lords indicate their anxieties about these resources, it is of course accurate to say that they are less reliable than indigenous resources. But if that had been the overwhelming case that ought to have obtained in regard to energy supplies, the history of the coal industry in this country would have been very different over the past three or four decades and we would not be in the position we are in today.
I recognise the properly articulated anxieties of noble Lords. The Government cannot be complacent about the issue of the electricity supply of a country and society which is totally dependent upon its effective distribution from the networks for its essential energy. I emphasise that the Government have learnt the lessons from last winter and from the issues introduced by the noble Lord in his contribution to the House. It is almost 12 months to the day since he first introduced them.
We shall consider the debate very seriously. The noble Lord, Lord Peyton, sometimes casts slight doubt on my effectiveness in the Department of Trade and Industry. I pay due regard to the fact that I am not there 90 per cent of the time as I have other obligations in the House. Nevertheless, an important debate has

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taken place in the House to which I am obliged to respond. In that context, the issues raised need to be addressed in a serious way.
Lord Jenkin of Roding: My Lords, I understand that in the time available the Minister may not be able to deal with all the points that have been raised. But I asked him a specific question about the nine-point recommendation in the National Grid Transco report. Perhaps he will be kind enough to write to me on how many of those nine points are being implemented.
Lord Davies of Oldham: My Lords, I intended to refer to that issue in my general response to the question about the lessons we are learning from developments over the past few months. The noble Lord will recognise the constraints of time. A number of specific questions have been asked but I have not been able to do justice to all of them. I shall write to the noble Lord on that point. I know the importance he attaches to it. If I am not effective in that respect, I suspect that he will use the forum of the Committee stage of the Energy Bill to address the issue. I am not neglecting the point. The noble Lord will recognise that in such a wide-ranging debate I am not able to respond to every particular point.
I hope that I have indicated to the House that the Government have acted promptly in areas where particular problems were identified last winter in regard to short-term factors. We have addressed those issues and they have been a part of the burden of the debate.
As to the more general issues in regard to energy policy, I can only state that the Government's policy has been well defined in recent months. Noble Lords have identified their anxieties about particular parts of that policy. I hope—I suspect it may be a forlorn hope—-that I have set parts of some minds at rest on these issues. I have no doubt that, either under the guidance of the noble Lord, Lord Tombs, or others, we shall return to these fundamental issues, which are basic to our society and our economy.
6.59 p.m.
Lord Tombs: My Lords, I thank noble Lords who have taken part in the debate for their contributions both this year and last in the case of those other patient souls.
Perhaps I may make some general remarks and then turn to the Minister's helpful reply. The common theme of all contributions is security of supply. I chose to make my speech about that today to try to highlight the fact that there is no reliable information available. That comes clearly through the seven-year statement. Because of the formation of the industry, there is no one able to collect reliable data—and unreliable data do not lead to reliable conclusions. This is a warning for the Government, as much as anything—I am trying very hard to be constructive. The collection of this data is not the National Grid/Transco's job. That is not its field of expertise, and never was. But it fills a vacuum which arises from the structure of the industry.
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I spend a fair amount of time talking to people who used to work for me in the industry. Some are still employed, some are retired. I find among all of them a great concern about the lack of clear direction in the industry. Morale is low.
There are problems, too, in the investment community. The Minister may know that the Carbon Trust recently commissioned a consultants' report on the attitude of investors to investing in renewable energy. The investors said that they had so far lost £4.5 billion on what they describe as conventional power stations, by which I think they mean non-renewable source power stations, probably including nuclear. That is a big hangover, and it does not fill them with enthusiasm when it comes to trusting the Government. Much of this arose, of course, from that unfortunate regulator error of NETA, which we discussed last year and which will haunt us for a long time.
On the general question of procrastination, I chaired a Select Committee inquiry into the disposal of nuclear waste almost exactly five years ago. For four and a half years, that gathered dust steadily in a number of departments. It has recently surfaced with the Nuclear Decommissioning Authority, but it still has made no progress on the construction of a long-term disposal facility. The problems are not real; the problems faced by other countries are just being kicked around by various departments, I fear.
Let me turn to a few points made by the Minister. First, I did not in fact refer to winter storms, although he was kind enough to say that I did. I excluded the question of distribution and transmission interruptions, and said that I wanted to concentrate on plant margin. If I have made my note correctly, I think he may have cause to regret his claim that the plant margin has improved to the point where we can guarantee supplies. I stand to be corrected, but I shall look at Hansard with more than usual interest.
My other point is a minor correction. Interconnected trading goes on all the time. Electricity is bought and sold. The point I sought to make is that it cannot be relied upon at peak by any country because there is no contract for exports at peak between countries. That is just a common thing.
I cannot expect—indeed, I did not expect—a detailed response to all my points because of course the Minister had no notice of those points and he cannot come here briefed about every possibility. But I hope that he has taken what I have said seriously and that the Government will realise the fragile ground on which they are standing in the seven-year statement. It is prepared with the best of intentions and done in the best way possible, but the information is duff and the results are duff. I do not know whether the Hansard reporter can spell that—it is D-U-F-F.

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I have enjoyed the debate. I cannot guarantee not to raise the subject again in a year's time. If I had more faith in governments listening hard and looking at the facts, I might, but I will not guarantee it. I beg leave to withdraw the Motion.
Motion for Papers, by leave, withdrawn.

Harbours Bill [H.L.]
7.4 p.m.
Lord Berkeley: My Lords, I beg to move that this Bill be now read a second time.
I can tell your Lordships that the Bill has the support of the ports industry, which has identified an anomaly in the Harbours Act 1964. This Bill is intended to remove that anomaly and is essentially a Bill to achieve a much needed degree of deregulation for the ports industry by applying the same rules to the maritime sector as are applied successfully to other transport modes.
I should remind your Lordships that I introduced a similar Bill into this House in the last Session. That Bill was debated and passed through all its stages in this House. During the passage of the earlier Bill through this House, the Government expressed their support for it, and so did the Opposition, the Liberal Democrats and some Cross-Benchers, for which I am very grateful.
Amendments were moved on behalf of the Government in Committee. Those amendments were made. They were drafted by parliamentary counsel. They did not alter the principle of the Bill but put it into a form which ensured that it would be fit to be enacted. I can assure your Lordships that the Bill before us is in the form of the earlier Bill as it was amended on behalf of the Government.
After the earlier Bill passed through all its stages in this House, it was introduced into another place where it was read a second time and referred to a Standing Committee. Unfortunately, there was insufficient time for that Bill to proceed any further in that Session. However, this Bill has made a much earlier start and, if it passes through all its stages in this House, I would expect it to arrive in another place in good time to be fully considered there.
The background of the Bill requires some technical explanation. Sections 14 to 16 of the Harbours Act 1964 empower the Secretary of State to make harbour orders. Such orders are required, for example, to establish or reconstitute harbour authorities or to confer on existing harbour authorities additional powers to construct harbour works or to manage their harbours.
The procedure for the making of harbour orders is set out in Schedule 3 to the 1964 Act. It provides for objections to the making of a proposed harbour order to be sent to the Secretary of State within a six-week period from the time the proposal is advertised. Where such an objection is made and not withdrawn, the Secretary of State must—and I emphasise "must"—hold a public inquiry to consider the proposal, unless he determines that the objection is trivial or frivolous. The result is that
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a public inquiry must be held even if there is only one outstanding objection, unless the Secretary of State determines that the objection is trivial or frivolous. The Secretary of State, quite rightly and properly, rarely categorises an objection as such; and an objection made by a local resident who expresses a concern is in practice very unlikely to be determined to be trivial or frivolous.
There have been a number of cases in which a single outstanding objection to an order has necessitated the holding of a public inquiry giving rise to considerable expense and delay. These cases include two examples which I will briefly summarise. The first is the Felixstowe Dock and Railway Harbour Revision Order. The port of Felixstowe is the largest container port in the UK and the fourth largest in Europe. It applied in October 2000 for a harbour revision order to authorise major new harbour works of considerable local and national significance. By November 2001, all but one of several objections had been withdrawn following the provision of appropriate assurances and undertakings to bodies such as the Environment Agency and the Royal Society for the Protection of Birds.
However, as a result of the single outstanding objection—lodged and maintained by a local resident—a public inquiry took place over seven sitting days, resulting in the making of the order being delayed until October 2002. In his decision, the Secretary of State stated:
The project should proceed for imperative reasons of overriding public interest".
It is the industry's view—and mine, too—that if the Secretary of State had been able to deal with the objection by written representations, as provided for in this Bill, it is likely that the order could have been made in or about February 2002, a saving of about seven months, and considerable delay and substantial costs would have been avoided.
My second example is the Whitehaven Harbour Revision Order 1996. Whitehaven, at the other end of the country, is a completely different, smaller harbour. In 1995, the Whitehaven Harbour Commissioners applied for a harbour revision order to authorise the construction of a lock and other harbour works as a key part of an urgently needed scheme for the regeneration of Whitehaven town and the local area.
Objections were made by holders of harbours bonds which had been issued in the 19th century to finance port expansion. The bonds had virtually no market value and Whitehaven harbour was, by the time of the order, very little used and heading towards insolvency. However, the bond holders objected to the order on the grounds that the effect of the works would be to undermine the commercial value of their bonds.
Following discussions with the Whitehaven Harbour Commissioners, three bond holders refused to withdraw their objections in the knowledge that their action would lead to a public inquiry, thereby resulting in a delay which could have led to the loss of European Community funding. As a condition of withdrawing their objections, they required that their bonds should be purchased at considerably more than their minimal market value. To resolve the issue, a number of private

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individuals contributed money to purchase the bonds—which is an interesting thing to do—and the order was eventually made in June 1996. In this example, the current system was used to hold to ransom a public project of considerable local economic significance. The situation would not have arisen if the Secretary of State had had the power to consider those objections by means of written representations.
The ports industry feels strongly that the present position is unsatisfactory and that the Harbours Act 1964 requires amendment. I understand that there is no proposal to include in the next parliamentary Session a transport Bill that could be a suitable vehicle for such an amendment, and officials have given no indication about when parliamentary time could be found for a government Bill. Hence, I have introduced this Bill.
The effect of the Bill would be to bring the procedure for the making of harbour orders into line with the procedures for making highways or transport and works orders. The Secretary of State would retain a discretion to hold a public inquiry in all cases. When an objection is made by a relevant local authority or by a person whose land is proposed to be compulsorily acquired and who requests a hearing, the Secretary of State would be required either to hold a public inquiry or a public hearing. In other cases, the Secretary of State would have the discretion, instead of holding a public inquiry or hearing, to deal with the objection by written representations.
Neither the Highways Act 1980 nor the Transport and Works Act 1992 expressly provides that, when objections have been made and sustained and the Secretary of State has decided to proceed without an inquiry or hearing, he must deal with those objections by means of written representations. However, both those Acts provide that, in such circumstances, the Secretary of State must consider those objections and, as a matter of practice, consider any further written representations made by the objectors and the applicant to the order when those representations are volunteered or made at his invitation A similar procedure for written representations would follow on the enactment of the Bill when read with paragraph 19(1)(d) of Schedule 3 to the Harbours Act 1964, which provides that the Secretary of State must consider any objections which are made and not withdrawn.
Before closing, there are two matters which I should mention. First, I believe that the Bill is consistent with the provisions of the Human Rights Act. In particular, in the case of a landowner whose land is to be subject to compulsory acquisition by means of a harbour order, his right to require a public inquiry will be retained.
Secondly, there have been consultations between the British Ports Association, the Department for Transport and stakeholder bodies such as the Environment Agency and the Royal Society for the Protection of Birds. The Department and those bodies have expressed support for the Bill. However, the RSPB feels that, to ensure that wildlife interests are fully protected, the Bill should be amended to provide that the Secretary of State would be required to hold an inquiry to consider objections when English Nature or
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the Countryside Council for Wales objects to an application for an order and informs the Secretary of State that the agency or the council wish their objection to be referred to a local inquiry. I am pleased to say that the ports industry welcomes the constructive approach of the RSPB and, if the Bill is given a Second Reading, I shall propose an amendment at Committee stage to meet the points raised by, and agreed with, the RSPB.
In conclusion, if the Bill is enacted it will enable the Secretary of State to exercise his discretion in appropriate circumstances to speed up the process for making orders under the Harbours Act. It will reduce red tape and be welcomed by the ports industry and many others. I ask your Lordships to give the Bill a Second Reading.
Moved, That the Bill be now read a second time. — (Lord Berkeley.)
7.14 p.m.
Lord Donaldson of Lymington: My Lords, I rise to give the Bill a hearty welcome as it simplifies and curtails the procedures necessary in the case of harbour revision orders. As your Lordships know, shipping is a highly competitive industry, not only in terms of ships themselves but in terms of ports and the facilities provided through ports, or in the context of ports. Furthermore, the competition between ports is international, except perhaps in Australia, where there is no alternative but to go to an Australian port.
In north-west Europe, the international competition is fierce—and I might single out a particular part of north-west Europe, along the shores of the English Channel and just beyond. Therefore, it is of national importance that we do not lose out. Time is money, not only in the sense that vast capital sums have to be spent in setting up new ports or altering ports, but also because the money is all up front. The sooner that income can be brought in to support that effort, the better.
I know that it does not normally follow but. as my name implies, I actually live in Lymington, so I have a distinct local interest in the port of Southampton and the efforts to establish a new terminal at Dibden Bay. I have no financial interest, but a considerable local interest. It seems to me that it has an unfortunate history compared to its rival, which is the port of Le Havre. The Dibden Bay application was made in October 2000, but it took more than a year for a public inquiry to be started. It began on 22 November 2001 and wound its weary way—and I read a great deal about it in the local papers—until 12 December 2002. That is 13 months. I do not know for certain, but rumour has it that the inquiry report was handed to the Secretary of State in October 2003, but still we do not know the answer.
Let us compare that to the situation in Le Havre. In that case, a public inquiry, or some form of inquiry, was held between 24 November and 23 March 2001, which is four months as compared with our 13 months. Dredging began in the following year, and the new container terminal is expected to open in the middle of this year.
There are undoubtedly major issues involved. For example, there is an issue about the need for the terminal in Dibden Bay. Personally—although I do not have any

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technical knowledge of the matter—I would be a bit surprised if ABP, the owners of the port, would be prepared to pour vast sums of money into the project if there was no need. However, that was one of the matters that was bandied about at the inquiry. There are also considerations of whether there are adequate communications into the hinterland. By that I do not mean the immediate hinterland, but rail communications up to the north and the Midlands. They are important issues. There are also issues of marine safety.
All those issues can be considered without a public inquiry, because they are technical in nature. However, they were being bandied about by people who, with the greatest respect to the objectors—if one really strips the matter down—were simply battening on to the issues on the general proposition, "Not in my back yard". That proposition was not actually put forward, but that is what it amounted to. As a nation, we cannot afford to have the nimbys of the world holding up economic progress. It may be that there is no case for Dibden Bay; I do not know, and that is not a matter for me. However, whether there is or is not, the time spent inquiring into it is something that we should curtail.
With those words of support, I express the hope that the Bill will go through virtually unamended. I should like to look at the amendment about the birds, mentioned by the noble Lord, Lord Berkeley. If the birds can force a public inquiry at any time, I am not sure how far we are down the road of improvement.
7.20 p.m.
Lord Greenway: My Lords, for the second time in under a year I rise to support the noble Lord, Lord Berkeley, on the Harbours Bill. I must declare an interest at the outset. I have been a consultant in the ports business for more than a dozen years, although I have not actually worked for any British port for three or four years.
As a result of my experience in the business, I am only too well aware of the frustration of those in the ports and the shipping industries concerning delays to harbour revision plans as a result of objections to orders, some of which, to put it politely, seem to lack any common sense at all.
I very much welcome this modest Bill's aim of simplifying the objection procedures in relation to port orders. This will not only bring ports into line with highways and other transport works but will, more importantly, save both time and money. I need hardly add that I fully concur with everything that the noble and learned Lord, Lord Donaldson, said about the competitiveness of the ports business, particularly in relation to Southampton and Le Havre, both of which I worked with some years ago. I know full well how frustrated the people in Southampton are. I wish the noble Lord, Lord Berkeley, well with this Bill and I hope his problems with the birds are sorted out.
7.21 p.m.
Lord Bradshaw: My Lords, like the two previous speakers, I was here less than a year ago to offer my support to the Bill. I should add a word of warning. I was present at a meeting this morning which was seeking a Transport and Works Act order. I was told that English Nature—not the Royal Society for the Protection of Birds; I believe that English Nature was mentioned—with which consultants have spent considerable time exploring different ways of meeting their objections, said that whatever is done, it is obliged by its constitution to object.
I fear—the Minister may care to take account of this—that we may be making a rod for our own backs by giving certain objectors extremely strong grounds for objecting. We may even be saying that they must object to a proposal even if the promoters have done their damnedest to employ consultants to meet the objections. Whatever scheme is being proposed, whether it is a port, a railway or a road, one is bound to do some damage while building it. There is a great case for restitution afterwards or for improving things, but you cannot make the proverbial omelette without cracking a few eggs at the outset. I wish the Bill good speed. We were discussing planning yesterday, and the noble Lord, Lord Rooker, was at pains to tell us that the Government's aim is to do everything possible to streamline planning. While I defend the right of a genuine objector, I recognise what the noble and learned Lord, Lord Donaldson, said. Some people become objectors—I would dismiss many of them as absolutely frivolous and trivial objectors—simply because, in many cases, they have nothing better to do than to stand in front of an inquiry talking absolute rubbish. We want to avoid that whenever we can.
I certainly support the Bill's aim, which is to promote an efficient ports industry. I wish the Bill all speed. I hope that the Government will ensure that when it goes to another place this year, it receives sufficient time to be passed.
7.24 p.m.
Viscount Astor: My Lords, we support the Bill in principle. I suppose that the big question is whether it has the Government's support and whether the Minister will back it and indeed encourage its passage through another place. Perhaps he can also confirm the statement by the noble Lord, Lord Berkeley, that it complies with the Human Rights Act.
The noble Lord, Lord Berkeley, raised an important point about the one amendment he proposes making after his conversations with the RSPB. I believe he said that if there were an objection from English Nature, the Government should consider holding a public inquiry. I agree with the comments of the noble Lord, Lord Bradshaw. The noble Lord, Lord Berkeley, may have fashioned a rod with which he could be beaten. I suspect that the RSPB will encourage English Nature to object on principle to every single proposal regardless of whether it is good or bad. Because of that pressure, English Nature also will feel obliged to object to every proposal on principle, so that a public inquiry is held.

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English Nature will feel that unless it does so, someone could come along and say, "There is an amendment to the Bill which says that if there is an objection, there should be a public inquiry; and if you do not object on principle, we will ask you to go to judicial review".
The noble Lord, Lord Bradshaw, is absolutely right about that. From my side, I advise the noble Lord, Lord Berkeley, to consider very carefully the terms of his amendment. I should be interested to hear what the Minister says about it. If the amendment has such consequences, I suspect that the noble Lord will have defeated the Bill's core aim. I see the noble and learned Lord nodding. for which I am grateful. I am grateful also for his support for the Bill. His comments on Southampton and Le Havre were very interesting.
I think we all agree that although we want local representation to be paramount in major planning issues, we also want—and I believe that this is the Government's aim—to ensure that major projects are not delayed as they have been. The Terminal 5 inquiry has been a testament to the failure of government on both sides. I am not being partisan by saying that the system has taken such a long time to come to a conclusion. That is not satisfactory from anyone's point of view, whether of the promoters or the objectors to the scheme. We certainly support the Government's intention of making make the planning system simpler and more effective. I noted the support of the noble Lord, Lord Greenway, who has expertise in these matters. We support the Bill. As I said, we are concerned about the amendment proposed by the noble Lord, Lord Berkeley. I hope that he and the Government will consider it carefully.
7.28 p.m.
Lord Bassam of Brighton: My Lords, the Government's intervention in this debate will be brief for two reasons. First, there is a large element of déjà vu in this debate; it is the second time that my noble friend Lord Berkeley has brought the measure before the House. Everyone has expressed support for the Bill. Perhaps we should all congratulate him on his persistence in pressing the measure.
The Bill also had the benefit of advice from parliamentary counsel during its previous passage. The Government make plain our support for its objective. I n the circumstances, as I am sure noble Lords will understand, my comments will be very similar to those relayed by my noble friend Lord McIntosh in the Second Reading debate in the previous Session.
As all speakers have averred, the Bill's objective is essentially to streamline—one could say to deregulate to a small degree—the procedure for handling objections to harbour orders. As my noble friend Lord Berkeley said, it is a simple technical measure which will bring harbour order procedures into line with more recent arrangements, for example, under the planning system. The noble Lord, Lord Berkeley, gave some interesting examples. I add one in the Brighton context, oddly enough, where moves towards the restoration of the West Pier have been held up by a commercial objector, in part using the harbour orders procedures to provoke
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a delay. We are all well aware of the potential adverse conditions that currently pertain and want to move on from that.
The House will know that harbours in this count ry are managed by harbour authorities, which act as statutory undertakers with powers conferred originally by private Act of Parliament. These powers have been used to authorise the original construction of the port and to enable the harbour authority to regulate the safe and efficient use of those facilities. Harbour authorities are, of course, also subject to a body of general legislation, but their local powers remain centrally important to the operation of our ports.
Harbour authorities need to be able to revise their powers from time to time to keep them up to date and to meet new needs, new pressures and new demands. It may be appropriate, for example, to change the constitution of a harbour authority, or to move the harbour limit, or to update the powers it has to make by-laws and other local regulations.
New powers are also needed to authorise harbour works, mainly because works in tidal waters interfere with rights of navigation, and because the authority's regulatory powers have to be statutorily extended to any new facilities. A harbour empowerment order is also occasionally proposed to create a new harbour authority.
As is well known, until 1964, a harbour authority's statutory powers could be revised only by private Act. The Harbours Act 1964 created a procedure to make harbour orders. These are statutory instruments made by the Department for Transport. The 1964 Act may have seemed modern in its day but it has been overtaken by procedural practice, notably by the Transport and Works Act 1992. This Bill would bring it back up to date.
The procedure for making a harbour order begins with an application from the harbour authority, or would-be harbour authority in the case of an empowerment order. Applications are advertised so that people have a chance to object or make representations. I emphasise that this is very important. It is entirely right that there should be this opportunity, and that it should be accessible. It should not be used mischievously. As we have heard, it can on occasion fall into that trap.
The 1964 Act makes provision for a public inquiry instead, and it says that one has to be held if there is just one outstanding objection—as a number of noble Lords have said— unless that objection is frivolous or too trivial.
As many noble Lords have said, inquiries are disproportionate in some cases. Harbour authorities can be deterred from making highly desirable changes by the delay, uncertainty and, as many noble Lords have said, cost. It is hard to plan a proposal without knowing if just one objection might lead to an inquiry.
Inquiries can be inaccessible to some objectors, especially ordinary members of the public, who would often find a hearing or written representations far less daunting. I believe that is part of the appeal of the Bill. Only highly organised and well resourced objectors can afford expert representation although that is not always

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a good use of their funds. If the promoter is a large enterprise, there is a risk of lack of balance in the way in which opposing cases are presented. Even when an objector is well resourced and able to afford representation, it is not necessarily a good use of their money.
The Town and Country Planning Act and the Transport and Works Act allow hearings and written representations as an alternative to an inquiry. As has been argued in this case, this simply brings the harbours and ports legislation into line. Importantly, these more modern procedures still give objectors a full right to be properly heard, but without the formality and expense of an inquiry where this is not appropriate. I am pleased to see that this Bill preserves the right to an inquiry where one's land is compulsorily acquired or the objector is a local authority. The Transport and Works Act does exactly the same. This is very important in relation to satisfying the Human Rights Act. That point was raised in today's debate.
I have also noted—the noble Viscount, Lord Astor, raised this point—that the noble Lord intends to move an amendment at a later stage to add the Government's statutory advisers on nature conservation issues to the list of those with a right to an inquiry. For reasons that have been expressed we shall have to reserve our position on the proposal until the time for its consideration. It has been brought forward understandably to ameliorate the concerns of nature conservation bodies but there may be an issue of consistency with other legislation to be taken into account.
The regulatory impact assessment shows that the change would cost nothing and would benefit ports—and objectors—of all sizes. I assure the House that appropriate use only would be made of the new discretion. The Secretary of State would not use it to avoid inquiries where they need to be held. We have plenty of precedents from the planning system to guide us on when discretion should he exercised. The Bill, if enacted, would make a useful contribution to the Government's overall policy of streamlining planning and related procedures. For all those reasons we give it our support and wish it well
7.35 p.m.
Lord Berkeley: My Lords, I am extremely grateful to noble Lords on all sides of the House who contributed so positively to the debate. I start by addressing the remarks of the noble and learned Lord, Lord Donaldson, who made an excellent point when comparing the timing of the Dibden Bay development with that of the Le Havre development. I did not give an example in that context but I shall mention one that may be relevant. I worked for 15 years on the Channel Tunnel. Permission was sought to construct it on this side of the Channel through a hybrid Bill. That process took over two years and cost heaven knows how many millions. The equivalent process in France took six weeks. It was said that if you want to build in a swamp, you do not consult the frogs and so on. However, the French people were consulted and the French authorities had a national policy.
I am not suggesting that we should introduce such dramatic changes here, but it is encouraging that the Government are now looking at the planning process as a whole and trying to speed it up. That is greatly to be welcomed, as the noble Lord, Lord Bradshaw, indicated.
It is clear that any Bill such as this will help harbours with developments on which general agreement is reached. As we heard in a debate just before Christmas, there is demand for extra port capacity. Several noble Lords referred to that. It is a question of providing that capacity in an acceptable fashion which costs as little as possible. I hope that the Bill will constitute a small contribution towards that.
Many noble Lords said that we need to reconsider the discussions we have had with the RSPB and others regarding their role in a public inquiry. I take on board comments made by many noble Lords that that may have other consequences that need to be looked at. I am sure that we can do that in the forthcoming stages of the Bill.
I again thank all noble Lords who have given the Bill such positive support.
On Question, Bill read a second time, and committed to a Committee of the Whole House.
House adjourned at twenty-one minutes before eight o'clock.

  Failed Asylum Seekers: Benefits and Employment
  Failed Asylum Seekers: Benefits and Employment
  Police Officers: Racist Behaviour
  Police Officers: Racist Behaviour
  Defence Equipment Requirements
  Defence Equipment Requirements
  Enduring Power of Attorney
  Enduring Power of Attorney
  NHS: Employment of South African Medical Personnel
  NHS: Employment of South African Medical Personnel
  Health Professions Council: Chiropody and Podiatry
  Health Professions Council: Chiropody and Podiatry
  Diabetic Patients: Chiropody and Podiatry
  Diabetic Patients: Chiropody and Podiatry
  Digital Hearing Aids
  Digital Hearing Aids
  Cochlear Implants
  Cochlear Implants
  Stem Cell Research
  Stem Cell Research
  Livestock: Worrying by Dogs
  Livestock: Worrying by Dogs

  Reserve Forces
  The Parliamentary Under-Secretary of State, Ministry of Defence (Lord Bach)
  Following the expiry of the call-out order made last January, I am informing the House that a new order has been made under the Reserve Forces Act 1996 so that Reservists may continue to be called out into service to support operations in Iraq. The new order is effective until 6 January 2005.

  Some 8,500 reservists were called out and accepted into service under the order made last year. The proportion of reservists deployed with the UK force in theatre is currently just under 20 per cent, but this is expected to reduce to just over 10 per cent during the course of the year. The next tranche of Reservists, involving some 1,100 personnel, will shortly be called out for mobilisation and then deployed in early April where the majority will complete six-month tours. We will continue to keep the size and mix of forces in theatre under careful review. We are very appreciative of the continuing support and commitment shown by Reservists and their employers.

  Civil Contingencies Bill
  Lord Bassam of Brighton
  The Minister for the Cabinet Office, Mr Douglas Alexander, has today published the Government's response to the report of the Joint Committee on the draft Civil Contingencies WS 10
  Bill (incorporating the Government's response to the House of Commons Defence Committee on the draft Civil Contingencies Bill) (Cm 6078)

  The Government are grateful for the contribution of the Joint Committee and the Defence Committee to the development of the thinking on the draft Bill as set out in their reports of 2 July and 28 November. We have considered in detail the recommendations put forward. Copies of the Government's response are available in the Libraries of both Houses and can also be viewed on the UK Resilience website (www.ukresilience.info).

  The Minister for the Cabinet Office has also today published the Cabinet Office report on the Government's response to the public consultation on the draft Civil Contingencies Bill, which was carried out last summer from 19 June until 11 September. This is also available in the Libraries of both Houses and can be viewed at www.ukresilience.info.

  Independent Monitoring Commission
  Baroness Farrington of Ribbleton
  The Government have today exchanged letters with the Irish Government to bring the agreement establishing the Independent Monitoring Commission into force. The final draft of the agreement was placed in the Library of the House on 4 September 2003. Following signature on 25 November 2003, the agreement was published as Command Paper Cm 6068 and laid before Parliament on 3 December 2003 in accordance with the Ponsonby "rule".

  Both Governments have been committed to doing all they can to ensure that the commission can begin its work as early as possible. We are confident that in agreeing an early date for entry into force with the Irish Government—before the 21 days required by the Ponsonby "rule" have elapsed—we have acted with the will of the House.