Westminster Hall Sitting of 6 February 2001

Preamble
[SIR ALAN HASELHURST in the Chair]

Hospices
Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. Jamieson.]
9.30 am
Mr. David Drew: I am delighted to be able to introduce this debate on the future of hospices. I do not intend to take more than my fair share of the time. It is good to see other hon. Members here and I am sure that the Minister will want the maximum time to respond to some of my questions. This is an important issue, which was covered, quite by chance, a couple of weeks ago on BBC television news. The way we treat very sick people is an important part of our health provision, our social care and our general humanity.
I should like to thank Jean-Luc Priez, the chief executive of my local hospice, Cotswold Care in Minchinhampton, and David Praill, the chief executive of Help the Hospices, for their help in preparing this speech. I do not want to spend long looking at the history of hospices, but it is important to put them into context. They have achieved greater prominence recently, but they have been with us for some considerable time. We can look back to the initiatives of the Duchess of Norfolk and the work of the different bodies that represent hospices, such as the National Council for Hospice and Specialist Palliative Care Services and the Independent Hospice Representative Committee, both of which are well known to the Minister.
I should like to make four key points. I shall consider the current position of the hospice movement and the problems that it faces, and perhaps come up with some solutions. I shall consider first the background to the hospice movement; secondly, Cotswold Care in my constituency, which is an exemplar of the best that the hospice movement can provide; thirdly, what the hospice movement has to offer more generally, and, finally, the problems that the hospice movement faces.
There are three types of hospice. There are the NHS hospices, of which Britain has about 20, and those organised and run by large national charities, such as Marie Curie Cancer Care and the Sue Ryder Care, both of which draw down a lot of money from the NHS. I wish to consider the third type of hospice, which is the voluntary or independent hospice. There are 200 such hospices in the country, 180 of which are independent charities in their own right. They receive much less largesse from the NHS and that is the root of their problems.
Independent hospices are essentially local, meeting local needs. They offer impressive care to their immediate community. For example, they provide 70 per cent. of all in-patient care, 87 per cent. of all day care and 44 per cent. of all home care. They are not some marginal group. In many respects they form the core of the hospice movement. The problem is that they tend to
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receive sporadic funding from the NHS. I am never sure whether it was a tablet-of-stone arrangement or one of those informal agreements, but the previous Government ended the 50:50 funding relationship between what the state tended to provide and voluntary or charitable donations back in October 1996. If my local hospice is anything to go by, there have been significant problems ever since.
The average funding from the NHS is about 30 per cent., but many hospices receive much less than that. That level of funding tends to be capped and has been declining over time. There is much evidence of differential funding from health authorities. The primary care trusts seem to be somewhat unclear on the position of hospices and certainly on how to fund them, if we are moving in that direction. I will deal with that later.
My local hospice, Cotswold Care, is amazingly successful and highly thought of in the community, with a high recognition factor. It opened about 12 years ago and is based on a good and well-organised site just outside Minchinhampton in my constituency. The workers, under Jean-Luc Priez, whether paid or voluntary, are very highly thought of in the community. They cope with about 15 patients a day on four days a week, providing them with all manner of support, such as counselling, therapy and so on. On the fifth day, there is specialist provision for people who suffer from particular diseases, such as multiple sclerosis. The hospice also has an out service to cater for patients who live in the community and the recently bereaved. The main social worker has a case load of about 60 patients.
As I said, the recognition factor is high. I have been involved in correspondence on the issue and was pleased to receive a reply from the Under-Secretary of State for Health, my hon. Friend the Member for Pontefract and Castleford (Yvette Cooper), in which she says that she
"greatly appreciates the valuable work undertaken by all hospices like Cotswold Care."
That is why I am using it as an exemplar of the very best in hospice care.
The health service increasingly uses hospices, whether it be the health authority or the primary health care teams that pay the money into them, and there are different referrals to those bodies. However, unless my local hospice is different from others, which I do not believe, the difficulty is that hospices are almost certainly working on an annual deficit. Cotswold Care has an annual budget of about £500,000 and runs, year on year, a deficit of about £60,000. The only way in which the hospice can do that is by drawing down its reserves, which have been good and of an order that has allowed it to maintain its service. However, those reserves will not exist for ever. The hospice is in the third year of an operational deficit and now has to consider whether to make cuts in its services. Given that 62 per cent. of its expenditure goes on direct patient care and that it must raise about £450,000 every year, it is obvious where cuts would have to be made, which everyone in the area would find reprehensible.
Last year, Cotswold Care received £48,000 from the NHS, which in effect represented no real increase in funding. It has been trying to obtain a service level agreement, but without success. It is reaching the stage at which it must think seriously about what it can afford and which part of the service it may have to withdraw.

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The staff consists of about 80 people, 22 of whom are formal members of staff while the rest are volunteers, which shows the high level of volunteering in the sector. People give hours of their time willingly and in different ways. They do not just drive people around, but contribute pretty high-level skills, such as counselling, to ensure that people receive the support service that they need.
Mr. Peter L. Pike: Is it not also important to remember the work done by volunteers in their continuous fund raising? My hon. Friend has referred to the deficits and difficulties that hospices face. The Pendleside hospice for Burnley and Pendle could not survive but for the dedicated day-by-day work done by volunteers in raising funds every year.
Mr. Drew: I totally agree. The point is that hospices would inevitably close without voluntary fund raising, so we should in no way underestimate its importance. One problem in fund raising, which my hon. Friend has helpfully mentioned, is the competition with various other fund raising activities, whether in the charitable sector or in the NHS. I have corresponded with Ministers on behalf of Cotswold Care hospice, which feels done down. The NHS is trying to raise money in different ways—for example for cobalt units and chest campaigns—and that money must come from sources that the hospice would also seek to tap.
Legacies are another problem. They are not necessarily in decline, but are ferociously fought over, and cannot by themselves provide an answer. St. Peters in Bristol has done wonderful work in that area, but legacies are not necessarily the answer.
I invite the Minister to come to see the excellent work done by the Cotswold Care hospice, particularly some of its new work. It has recently taken on hospices at home, a genuine partnership with the NHS that, although better funded, is not fully funded, which brings out my underlying point about what we need to do.
Independent hospices have five key advantages: first, they save the NHS money, and we should not pretend otherwise. Without them, their work would almost certainly have to be picked up by the NHS or by some inferior service. Secondly, hospices are the epitome of care and caring. Thirdly, they provide ultimate professionalism, but they also use volunteers to bolster that professionalism. That is the best use of the voluntary sector, which is of interest to many of my hon. Friends.
Fourthly, hospices deal with a Cinderella area that has traditionally been, if not ignored, certainly underfunded and isolated. It would be tragic if we lost some hospices because of funding difficulties. Fifthly, and never to be underestimated, they support individual carers and families who have suffered bereavements. We need to build on their work, rather than see that area decline.
What problems face hospices? I will ask my hon. Friend some questions on that as I finish my speech. Clearly, we recognise and welcome the uplift in cancer and palliative service funding. However, hospices do not seem to fit easily into the system. Discussions have been
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held between the hospice movement and the Department of Health on the cancer strategy, but there has been no concordat. The Government have come to an understanding with the private sector, but not with hospices. By 2004, the NHS will have invested an extra £50 million in palliative care. It would be good to see how that will be spread among hospices. We accept that it is difficult to give each hospice the same relative funding, but we need some yardstick so that we can know how funding will be invested, and who will receive it.
Hospices face the same cost pressures as every other part of the health service, and increased pressures are arising, principally from wage costs. In addition, if we need to bring people back to the NHS, they can come from a limited number of sources, and one of those sources would be hospices. We still have an on-going battle with some general practitioners. Thankfully, we have turned the corner in my area, but some GPs need to be persuaded that hospices have a valuable part to play and that they should commission care accordingly. I would welcome any comments from my hon. Friend on whether that is one of the ways in which we can provide resources.
We must, at all costs, prevent downsizing, which, as I have said, would take resources directly from patient care. We need to understand where hospices will stand in relation to primary care trusts, not just as regards mainstream hospice provision, but concerning minority groups, whether ethnic or socially disadvantaged, who must always have access to a range of services. It would be tragic if we were hamstrung by the problems that I have mentioned.
I do not expect the Minister to answer my questions in detail, but hope that she will consider them. First, will she voice the Government's support for the hospice movement, whether through the cancer strategy, palliative care or any other initiative, and will she say how valuable the Government consider hospices to be? In particular, how will the cancer strategy be funded in order to support the hospice movement and give it its fair share? Is it possible to see a model of what local health authorities would be expected to provide and what would be a minimum level of the extra funding?
Will my hon. Friend consider other means by which funding could be provided, including, principally, the new opportunities fund of the lottery, which I must say, is both an opportunity and an uncertainty. Some money has been set aside, and it has been suggested that £23.5 million will come from the opportunities fund initiative, but independent hospices will not necessarily receive that money. It would good to know what can be done to engineer some more funds from that source.
If there is an additional funding requirement, how can we build on the services that hospices already operate? I have mentioned the new development of hospices at home, and it would be good to see whether counselling and bereavement services, which have a locus in the health service, could be run more in tandem with the hospice movement. What form of concordat can delivered that would be similar to that for private health, about which I have talked already?
Given the current funding problems, how will hospices be able to struggle on, and is there a short-term solution to those problems, in addition to whatever may

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be developed in the medium to long term? Finally, will my hon. Friend spell out the role of hospices in the cancer strategy?
I have made a case for additional funding, and I make no apology for that. The debate is timely because of the problems that hospices will face in coming months as they make decisions on their budgets. I leave the Chamber with one thought: an adage always applied to hospices is that we should help them to help us, and it would be wonderful if that could provide the principle under which the Government applied funding to the movement.
9.46 am
Mr. David Ruffley: I congratulate the hon. Member for Stroud (Mr. Drew) on securing a truly important debate. I first discovered the importance of the hospice movement when I became a Member of Parliament in 1997; I had no previous experience of it. I have benefited from advice and many meetings with members of the St. Nicholas' hospice in the centre of Bury St. Edmunds, particularly Mr. Bob Jones, the chief executive, and Mr. Roger Curtis, the fund raising director. I am here to speak today, not just because of their prompting and helpful advice, but because of the people of Bury St. Edmunds, who are responsible for an absolutely colossal achievement in terms of the amount of voluntary effort and financial support that they put in to running St. Nicholas'. I will later give some indication of the magnitude of that achievement.
The hospice movement is important to my constituency because of the palliative care that it delivers. The importance of that specialist care has undoubtedly increased over the past 10 years. Ten or 15 years ago, people who would have died quick deaths after diagnosis—typically, though not exclusively, of cancer—now live longer because of improved treatments and medication. But that involves a compromise. Living longer, perhaps in difficult circumstances, requires greater support in a range of areas, socially, psychologically and medically. Sometimes, it requires support in an in-patient setting at St. Nicolas' hospice, and at other times it means support in a day setting at home. What is clear is that demand for those services is rising, if not exponentially then certainly massively. Successive Governments have acknowledged that, and the cancer plan unveiled last year by the current Government goes a long way to acknowledging the experience that I have had in my constituency.
The cancer plan acknowledges that our hospices are among the best in the world. It goes on to acknowledge that not enough is being done to meet unmet demand by stating that:
"The care of all dying patients must improve to the level of the best."
It is perfectly clear from what the Government have said that there is unmet demand. The cancer plan goes on to say:
"For too long, the NHS has regarded special palliative care as an optional extra. The NHS has relied upon the good will and funding of charities".
In paragraph 7.24 it continue:
"Hospices have rightly argued that the NHS should invest more in palliative care services."
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I acknowledge the Government's important statement in that part of the cancer plan.
Bob Jones, chief executive of the St. Nicholas' hospice in Bury St. Edmunds, wrote to me recently, saying:
"The contribution of hospices is now fully recognised, and clearly the Government wishes to involve them, the voluntary hospices, centrally in the development of cancer services and we applaud that. However, this must be on the basis of secure funding for the future. There cannot be reliance on ever increasing fundraising to meet the gap."
There is simply a limit to the amount of voluntary fund raising that can deliver sufficient funds to keep voluntary hospices such as St. Nicholas' going and doing the job that they want to do.
The importance of St. Nicholas' hospice is emphasised by some interesting statistics. The hospice runs five charity shops, which raise a net profit of £120,000 a year. The hospice's own lottery raises £120,000 a year, net profit. In addition, it holds many fund raising events and these, together with legacies, have brought in £500,000 a year. Those are colossal sums of money. Many local people have had members of their family or friends of friends receive care, assistance and—I do not think the word too strong—love at St. Nicholas' hospice.
Gifts also come, large and small. Of the 3,000 gifts received last year, including legacies and financial donations, 2,400 were of less than £100 and 600 were of more than £100. Some were significant bequests. St. Nicholas' hospice raises huge amounts of money. It receives 40 per cent. of what it needs from NHS grants, but it does magnificent work of its own. It serves a catchment area in south Norfolk and west Suffolk with 250,000 people. It has 160 volunteers, and I would endorse the comments of the hon. Member for Stroud. His experience is clearly the same as mine: there is a great deal of local support of a non-financial kind from volunteers. At St. Nicholas' hospice, we have a 10-bed in-patient unit, a 15-patient day hospice, a bereavement counselling service, and the Nicky's Way initiative, which is a separate bereavement counselling service for young children. The latter is an important innovation, and one of the first of its kind in the country. We have a team of six Macmillan nurses who undertake fine and dedicated work among local GPs and with terminal patients in their homes.
There is a great deal of ambition at the St. Nicholas' hospice. It moved into its current premises in 1993, but has wanted to grow. It had a new building project with a capital value of £920,000it does not let the grass grow under its feet. The management and governing body are innovative, and received £350,000 from the National Lottery Charities Board. They are working hard to raise additional money above the hospice's annual running costs to extend the in-patient and day centre areas, and to construct a new building called the Ark, which will house new counselling and bereavement services that are innovative not just in East Anglia, but throughout the country.
A huge amount of money is required to satisfy the ambitions of a hospice that wants to grow, not stand still, and I shall outline some of the pressures faced by the hospice this year. There is expenditure of £92,000, due mainly to medical price inflation, but also to an increased pay award for nurses, the new deal for junior doctors and pension contribution increases, amounting to an increase of at least £50,000.

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This financial year the hospice received a grant from the Suffolk health authority of £642,000—a 4 per cent. increase. That grant is welcome, but the hospice lacks a clear statement of the future path of grant via the NHS in the county. It is difficult to plan for years, rather than for one year, ahead. That problem becomes especially acute when a hospice is as ambitious as the one in Bury St. Edmunds. As a result of cumulative pressures, the hospice is running a deficit for the first time in several years. The trainee GP post runs out within a year and it seems unlikely that it will continue. The Macmillan community specialist nursing team is the only one in the eastern region not to be 100 per cent. NHS funded. We want future resourcing to secure the full complement of the excellent Macmillan nurses at St. Nicholas' hospice.
In a spirit of co-operation, I want to ask the Minister some questions. I believe that the present Government, in common with the previous Government, are listening to the hospice movement and recognise its huge importance. I endorse the powerful and detailed points made by the hon. Member for Stroud. The NHS benefits from the voluntary activity of hospices in Bury St. Edmunds. The NHS is incomparably better off for the hospices, which deliver palliative care that mainstream hospitals are insufficiently specialist to deliver, so to what extent will the £50 million extra announced under the cancer plan be targeted to purely NHS hospices? Will there be favouritism? Will the two NHS hospices in East Anglia get the lion's share of the £50 million allocated to the area? I hope not.
Is it intended that the £50 million should plug the gap where provision for palliative care is almost nonexistent? Only one third of health authorities have developed palliative care strategies, which is a surprisingly low figure. In my part of Suffolk, we benefit from good strategy, which includes good, co-operative relationships. Will success stories, such as St. Nicholas' hospice, be a victim of their own success because the areas without such good provision will get most of the new money? There is a new philosophy afoot in Whitehall and the Treasury in the public service agreements and the comprehensive spending review that suggests that the successful providers of public services might reap the reward of increased funding. It is hugely important that good performers such as St. Nicholas' hospice in Bury St. Edmunds should be encouraged by receiving increased funding; but under the Government's public spending regime, more money goes to plug the gaps in inadequate public service provision.
Areas such as Suffolk cannot draw down money from the new opportunities fund because, understandably and fairly, it is targeted at socially disadvantaged groups, especially those areas with large ethnic minorities where there is no tradition of palliative care. As west Suffolk has a very small ethnic minority population, it is unlikely that it will receive money from the new opportunities fund. Admirable though it is, the announcement about that fund will not help my constituency.
Does the Minister think that there should be a national funding agreement to take account of voluntary hospices' provision? Is she considering a concordat with the hospices, signed by the Government,
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similar to the agreement with the private sector for non-palliative services announced last year by the Secretary of State for Health? Does she think that the present regime, which leaves matters to local negotiation, is working satisfactorily? Does she believe that agreed service levels have been properly set and that there is adequate monitoring of service levels, taking into account the allocation of resources? Have she and her Dept measured the shortage of provision and compared it with funding shortages, and, if so, when will that work be published?
Finally, can the Minister give us some comfort about the allocation of the £50 million of national cancer plan money? This is a plea for the rural areas, which may not be economically disadvantaged or have a high concentration of ethnic minorities, but which nevertheless have great needs that are not being met. There is no reason why the demand for palliative care services should be overlooked merely because the area is rural.
I thank the Minister for taking copious notes on my speech, and I look forward to her response.
10.4 am
Mr. Keith Darvill: I congratulate my hon. Friend the Member for Stroud (Mr. Drew) on securing this important debate. I shall be brief, and shall echo the comments made by my hon. Friend and the hon. Member for Bury St. Edmunds (Mr. Ruffley).
I want to place on the record my admiration for all who work in the hospice movement. Like other hon. Members, my experience comes from my connections with my local hospice since the 1997 general election. St. Francis hospice, on the border of my constituency and that of my hon. Friend the Member for Romford (Mrs. Gordon), is held in the highest esteem by the community, and covers the Barking and Havering health authority area.
I want to concentrate on funding issues, which lie at the heart of this morning's debate. I visited the hospice recently to discuss funding, and wish to bring a few points to the Minister's attention. St. Francis hospice, with an annual budget of £3 million, is large in comparison with others. Out of that budget of £3 million, 38 per cent. of last year's income came from legacies, 6 per cent. from "in memory" donations, 10 per cent. from non-trading income from shops—there are 12 local St. Francis shops—18 per cent. from the local health authority, 3 per cent. from interest on other income, 8 per cent. from the Friends of St. Francis hospice, 14 per cent. from the development trust, and 3 per cent. from general donations. That highlights the uncertainty of that funding, which makes planning difficult.
Last year, the trust did well—in a manner of speaking—from legacies, one of which brought in more than £400,000, which was a tremendous boost to that year's funds. The budgets of previous years were exceeded, and there was even a spending deficit at a time when the hospice wants to develop services to meet the needs of the community, particularly in the innovative hospices at home sector, which has been supported by the community. The scheme not only provides important palliative care to the community, but does so where most people would like that care—at home. The service meets a popular demand, and we want to increase it, but to do so will require certainty of funding.

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In addition to the uncertainty to which I have referred, there is uncertainty in other areas, such as charitable donations. The hospice is in competition with other charities in the area. For example, several children's hospices in our area rightly earn support, but at times when public support goes to the children's hospices, support for the adult hospice may decline.
In addition, with the introduction of the national lottery, when more giving went to lottery funds—rightly, given the good causes that the lottery supports—there was a dip in charitable donations. Charities throughout Britain have had to cope with that, and it has led to uncertainty. The hospice movement, which combines public and voluntary service, needs certainty.
I echo what hon. Members have already said in that regard. The NHS cancer plan, which most Members welcome, will provide an additional £50 million for the service up to 2004, but how much of that allocation will go to the voluntary sector? The independent movement throughout the country awaits an answer to that question. There is also the question of whether we want a more national framework in this area, and I am sure that that point will be discussed, which will help to clear up some of the uncertainty.
Will my hon. Friend comment on funding through the new opportunities fund? Clearly the concept of additionality runs through lottery funding. The question arises of how the voluntary sector fits into that concept and whether hospices need to take that into account. Guidelines would be helpful.
I conclude by congratulating all volunteers in the hospice movement, particularly those at St. Francis in my constituency, on their sterling work. The care that they give their fellow citizens is much appreciated and we could not deliver the level of service without them. I am sure that all those hundreds of thousands of volunteers throughout the country would welcome a positive move from the Government that encourages them to give more commitment to a worthwhile concept.
10.10 am
Mrs. Jacqui Lait: I draw the Minister's attention to a situation that has arisen in my constituency. In Beckenham we have St. Christopher's hospice, which was the first hospice created by Dame Cicely Saunders, the founder of the modern hospice movement. St. Christopher's is very important within the constituency and funding raised locally is key to its success—a matter to which all hon. Members who have spoken have referred. It is significant that there is such a measure of agreement across all political parties about the future of hospices. All 659 Members of Parliament probably give generously to hospices and will continue to do so.
On Saturday morning I went out campaigning for the Conservatives in West Wickham high street and spotted three yellow Liberal Democrat rosettes. I thought, "Oh good, I will meet my opposition challenger"—whom I have not met, having heard only the announcement of his selection. However, I discovered that those Liberal Democrats were seeking names for a petition to help the hospices. Hospices are completely non-party political and it concerns me that they could be hijacked by one
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political party. It would certainly not help their funding if they were seen to be the creatures of a particular political party. It is also not very clever for any political party to get tied up with such a non-party political organisation. I therefore wanted to warn colleagues and the hospice movement that difficulties could be created for them if they were seen to become the flavour of the month of any political party—no matter which one.
Mr. George Stevenson (in the Chair): Order. I understand the hon. Lady's point, but I am seized by her comment that we should not make this a party political issue. I am sure that she would not want to do that.
Mrs. Lait: You are right, Mr. Stevenson. I have no intention of making it a party political issue. I hope that the future of the hospices will be guaranteed by firing that warning shot across the bows of any political party that might be trying to hijack the hospices. I want to ensure that the future of hospices is guaranteed, not just by increasing Government funding from the 30 per cent. to the 35 per cent. that it was three years ago, but by encouraging the British population to continue to fund the hospices in the same generous way that it always has.
10.13 am
Mr. Tony Baldry: I am glad that the debate is taking place. Around 1985 Jack Ashley and I set up the all-party hospice group, which is still going. With the Duchess of Norfolk, we had numerous meetings with the then Secretary of State my right hon. Friend the Member for South-West Surrey (Mrs. Bottomley). Our concern at that stage was to get some regularity and evenness into funding for hospices. At the time, some hospices were in the independent sector—historically they had been almost totally funded by public money—and received no funding whatever from the NHS. There was no rhyme or reason as to who was funded or why they were funded in a particular way. The Government introduced a measure of underpinning, with the aim of ensuring that all hospices received some state funding. It will always be accepted that hospices are part of the voluntary movement. Rightly, a large proportion of their money comes from the voluntary sector. We have heard of considerable fund raising efforts. It is no different in north Oxfordshire, where many people support the excellent Katherine House hospice.
Hospices want just two things from the Government. First, they want to be able to predict what the funding arrangements will be, not just for one year, but for a number of years. They do not expect to be 100 per cent. funded. Indeed, they would not want to be, but they do want predictability. Secondly, hospices want certainty in their relationships with local NHS hospital trusts, primary care trusts and the Department. If the Minister can provide the hospice movement with predictability on the level of funding over a range of years and with certainty in its relationships with the rest of health care provision, it will get on and provide an excellent palliative care service.
Cancer is now a larger killer than heart disease. Ironically, advances in medical care mean that, inevitably, more of our constituents will require the help, support and care that the hospice movement provides. The movement is a great tribute to a huge

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number of people. It will not require much for the Government to provide both predictability and certainty. I hope that the Minister can do that today.
10.16 am
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I congratulate my hon. Friend the Member for Stroud (Mr. Drew) on raising this issue. It is clear from the contributions that it is important to many of us. I take the point of the hon. Member for Beckenham (Mrs. Lait) that it is not a party political issue. I hope, therefore, that she will forgive me if I sometimes refer to the extra funding from the Labour Government. We know that we all support the hospices. I agree with the hon. Lady—it is questionable to campaign on the issue. People should be careful when they do their campaigning.
My hon. Friend the Member for Burnley (Mr. Pike) rightly paid tribute not only to the work of volunteers, but to their fund raising. The issues in relation to hospices include our relationship with the voluntary sector. That is an important issue. Several hon. Members made the point about the concordat and the type of relationship that we have with the sector. I hope that most of the specific questions raised will be covered in the speech itself.
The hon. Member for Bury St. Edmunds (Mr. Ruffley) paid tribute to his own hospice. Like my hon. Friend the Member for Upminster (Mr. Darvill), most of us learned about hospices through the good work that is being done on our patch. It is therefore understandable that, when we return to our constituencies and see that good work, we will make the case for that particular institution. Although we welcome extra money to deal with the inadequacies in some areas, we do not want our own areas to be punished. We hope that a balance can be struck between dealing with areas where there is no provision and supporting existing provision. It is a balancing act; it is not a question of either/or. Both those things must be done at the same time. I congratulate the hon. Member for Banbury (Mr. Baldry) on having had the foresight all those years ago, with Lord Ashley, to set up the all-party hospice group.
Like my hon. Friend the Member for Stroud, I put on record my appreciation of the work by Cotswold Care. He has invited me to visit the hospice, and I am happy to accept that invitation, provided diary requirements can be met. I should like to come very soon.
The hospice movement in the United Kingdom is widely recognised as the world leader. It is committed to working with the voluntary sector. It delivers something extremely valuable in a very challenging area.
A Government's relationship with the voluntary sector should be complementary. We should work in partnership; one should not take over the other. It is widely recognised that the voluntary sector is often capable of doing things that the NHS could not do on its own. The sector has been the driving force for many innovations. It was determined to move into areas which the NHS had not covered. I would not want to lose that innovative drive.
We need partnership, but it is a two-way process. We need to ensure that health authorities have an agreed strategy in place and the voluntary sector needs to
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ensure that the service developments that they are planning are developed and agreed with the local health authority and meet the agreed priorities for the area. The concordat that we signed with the independent sector was of that nature—it established a strategic long-term relationship. I hope that some of the other arrangements that we have in place in the hospice sector will convince hon. Members that we wish to have a longterm sustainable strategic relationship with hospices.
Hospices have shown many of us how care for patients who are approaching the end of their life and how support for them and their families should be provided. That involves both adult and children's services.l
I focus initially on what we are doing for adult services. For too long, the NHS has regarded palliative care as an optional extra. Hospices have suffered from a lack of long-term stability for too long. I know that some health authorities are aware of hospices facing particular financial pressures and have invested some short-term funding to ease current pressures. We also know that many hospices have only one-year, not three-year, agreements with health authorities. Two thirds of health authorities do not have an agreed palliative care strategy, despite guidance from the Department that states clearly their responsibilities in that area.
It is small wonder that the hospice movement feels that it has been taken for granted and has helped, as it puts it, to bail out the NHS by providing high-quality care at low cost. We do not think that that is good enough. We need and are determined to make rapid progress. I know that my hon. Friend the Minister for Public Health is working to ensure that health authorities take action and meet the guidance set.
As my hon. Friend the Member for Stroud said, funding is a real issue for hospices and some are facing financial difficulties. That is why we will invest an additional £50 million in adult hospices and specialist palliative care services to end the inequalities in access and to make a more realistic contribution to hospice costs.
The issue was raised as to whether some of the £50 million will go in preference to NHS hospices. It is a question of looking at the cancer networks, the strategic plans, who the providers are and how the provision fits in. Within that, I expect that significant amounts will go to the voluntary sector. It is a question not of the status of the organisation, but the care provided and the needs of the area. We have ensured that that is a priority within the NHS plan implementation project for 2001–02. We have asked the cancer networks to have costed, strategic plans for palliative care in partnership with the voluntary sector.
The £50 million invested in palliative care will ensure that the NHS makes a realistic contribution to the costs that hospices incur in providing agreed levels of service. Realistic funding must be based on a firm footing. That is why we need costed plans, benchmarking, performance indicators and standards. We will therefore monitor plans for palliative care strategic investment very closely. I am sure that all hon. Members will agree that, although we want partnerships, which we underpin by funding, it is not a question of taking control. We must ensure that minimum standards are met and that services fit in with the overall strategic provision.

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A particular concern has been raised by the hospice movement relating to keeping pace with NHS inflation uplifts. The £50 million that is going into the system will help to deal with that. That will be performance managed through service and financial framework processes monitored quarterly.
As I have said, the NHS has relied on the good will of the voluntary sector for too long. With the launch of the NHS cancer plan came the announcement of additional funding for hospices and specialist palliative care services. That move has been warmly welcomed in some quarters, but I acknowledge that there have been cries of too little too late in others. The additional money, however, is only part of the solution. As I see it, the future for hospices and cancer networks is in working together to identify current specialist palliative care provision and in planning for future investment.
There are several ways of achieving that. Hospices should not only play a full role in cancer networks, but establish a firmer strategic footing with health authorities. Funding will also be provided through the new opportunities fund. A total of £23 million will fund a new programme of partnership schemes for community palliative care projects for adults and children, including respite care breaks. I take the point about access to new opportunities funding in some areas, but all the other things that are being done must be considered, too.
I urge hon. Members to be careful when they talk about ethnic minority needs. In my Birmingham constituency, by 2005, in educational terms, white working class estates will be classified as minority groups. Therefore, we should not make assumptions about minority group in a particular setting. Groups need to be supported wherever they are. It is not an urban versus rural areas issue. We must consider the networks and the level of provision.
Hospices contribute immense support, training and advice to colleagues in primary care. My hon. Friend the Member for Stroud raised the issue of how the service fitted in with primary care. We are making £2 million available to support training district nurses in the general practice and principles of palliative care. We believe that that will enable more people to stay at home for longer.
It is worth mentioning the beacons programme for 2000–02, which supports eight palliative care beacons throughout the country. Those projects are examples of a partnership between the voluntary sector and the NHS and demonstrate good practice and innovation within particular aspects of palliative care services. The beacons are about sharing good practice. Although a lot
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of good work is being done throughout the country, we must ensure that the sectors learn from each other and share their experience.
Similarly, my hon. Friend will be aware that the forthcoming national service framework for older people will build on the supportive and palliative care strategy that was set out in the cancer plan. That will provide a framework for delivering further improvements in the care of older people
Children's services are often mentioned in such debates. Much of the driving force for improving those services—we have had little understanding of the needs of the children and their families—has been provided by the forceful work of the hospice movement. In future, the NHS will work with those families and provide quality support.
The movement to support children has grown considerably in recent years. Much of the driving force has come from painful personal experience, and I pay tribute to those concerned. New nurse-led teams have been established to care for children with life-threatening and limiting illnesses in the community. They are known as Diana community children's nursing teams. They commenced in March 1999 to fill gaps in the provision of care for children with life-threatening illnesses who were living in the community and to support their families.
That was a much-needed new provision. Those teams work in partnership with other statutory and voluntary agencies to provide holistic—physical, social and emotional—support to children and their families in their homes and in surroundings that are familiar to them, as an alternative to hospital-based care. It has long been recognised that children with such conditions often prefer to have care and support in the family home. The Diana teams offer a lot of help and are much valued by all parts of the NHS.
Provision has been made for funds for children's hospices to come from the NHS. I briefly mention the work done on health improvement programmes and the general funding that is available. Again, palliative care services and voluntary health care providers play an important part in the development of Himps. Further to that general provision, we are making available additional sources of funding from the new opportunities fund.
We all sign up to the principle of providing compassionate care and service for patients in the last few days or months of their lives. That is why all agencies must work together. We deeply appreciate the contribution of the hospice movement. We want a longterm strategic relationship that supports them and the NHS in the interests of the patients and their families wherever they may live.

NHS Cost of Living Supplement
10.30 am
Mr. Robert Syms: I want to discuss an important and complex subject. It used often to be said that the national health service, with 1 million employees, was the largest organisation except for the Red army. I do not think that anyone knows these days how large the Red army is, but dealing with pay and the various other areas of the NHS is difficult and complex, and all Governments struggle with that.
Health authorities that have been given the cost of living supplement and additional money£65 million from April—to supplement the pay of their staff, doubtless consider that good. However, those of us who fall below the line and do not get that benefit for our hard-working NHS staff feel a degree of difficulty and unfairness. At the moment, petitions are going around Poole and Bournemouth hospitals, because people feel that they should be entitled to the benefit and that the Government have got the formula wrong. The benefit, although worth perhaps 2.5 per cent.—somewhere between £400 and £600—is not to be sniffed at for many people in the NHS who are on not particularly high wages.
My hon. Friends in Dorset and I have written to the Secretary of State to make it clear that we are concerned about the implementation of the proposal. If one health authority or county is given the benefit, and the authority next door is not, there will be a knock-on effect. If London receives it, but Kent, Essex or Suffolk do not, there will be a knock-on effect. If Avon receives the benefit, but Somerset or Gloucestershire do not, there will be an effect on the neighbouring area. Indeed, we in Dorset see that Wiltshire and Hampshire will get the cost of living supplement, while we will not. That is a matter of great concern, particularly for the Royal College of Nursing, which has been responsible for some of the petitions.
There have been previous attempts to try to put cost of living supplements, or some market forces element, into NHS pay. I have reviewed the staff side evidence to the review body on cost of living supplements. In 1989, the Department of Health in England introduced pay supplements to address recruitment and retention problems for hard-to-fill posts. The scheme, according to the staff side, had little impact and did not impress the review body with its cost effectiveness. There were some industrial relations problems when it was introduced, and the review body ended it in 1992.
In 1995, the review body attempted to increase the pace of local pay through the X plus Y mechanism. That mechanism was pursued again in 1996, but once again, according to the staff side, it proved counter-productive to recruitment and retention. It had an impact on morale, increasing dissatisfaction with the NHS among nurses, midwives and health visitors. There is a positive side for those who receive the benefits, but a negative side for those who do not.
According to the staff side, the effect of the cost of living supplement on labour market behaviour cannot be predicted with any degree of accuracy. It remains to be seen what impact the supplement will have when it is implemented in April. However, the key issue is that, if shortages are a supply side problem, the cost of living
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supplement will simply move the shortages around the country. As the Government's NHS plan recognises, the health service has a real problem concerning human resources and the training of sufficiently qualified staff.
Nurses in areas with some of the highest vacancy rates will not qualify for the cost of living supplement. East Kent, for example, has one of the highest vacancy rates in the country, according to Department of Health statistics, and a number of hot spots in the west midlands do not qualify. There is a real problem. The Royal College of Nursing estimates that 22,000 nursing posts in the UK are vacant. If one starts with a fairly centralised pay structure and adds cost of living supplements that go to one county but not the next, it will have an impact on recruitment and retention in the neighbouring authority.
Equal pay for work of equal value has always been a principle in the NHS. There seems to be a move away from that. What is the Government's policy? Are they moving towards more regionalised pay as some in the nursing profession fear? Could the Minister explain the method on which the formula is based? The cut-off point seems to be 117 on the table. Those on or above that figure seem to get this benefit. How is the cost of living index calculated? What impact does housing have on that? What impact do vacancies have or the fact that staff in rural areas must travel and spend money on petrol? We need to know a lot more about how the Government arrived at those figures. Although it is obvious that Kensington and Chelsea and Westminster are the most expensive, other counties fall well below the line, including some near London where the cost of living is bound to be high.
In Dorset we have lived under one great disadvantage—the area cost adjustment, which means that we do not receive the same level of local government and police funds. It is perennial problem. This announcement from the NHS perhaps puts us at a further disadvantage in terms of how we will fund nurses' pay.One of my constituents, Mr. R. Bayldon MBE, TD, wrote to me. His wife works at Poole hospital. With the help of the internet, he compared the house prices in Poole and Southampton. Southampton is in Hampshire and so will receive the cost of living supplement, and Poole, being in Dorset, will not. It takes about half an hour to travel between the two by car, so they are within a relatively similar travel-towork area.
According to the Land Registry figures for the period between April and June 2000, the average price for a detached house in Poole was £191,772. The average price in Southampton was £154,206. The average price for a semi-detached house was £100,781 in Poole and £91,307 in Southampton. The average price for a terraced house was £86,589 in Poole and £80,790 in Southampton. The average price for a flat or maisonette was £102,475 in Poole and £68,731 in Southampton.
When one aggregates those figures, and I rather suspect that there are rather more detached houses in my constituency than in Southampton, the average house sale price between April and June 2000 in Poole was £132,396 and only £89,588 in Southampton. House prices are about 40 per cent. higher in Poole than in Southampton. The problem is that nurses who are deciding where to work can look at Southampton and see that they will get cheaper housing and more pay

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through the cost of living supplement. Staff are likely to be sucked out of the Poole and Bournemouth area and the quality of service that my constituents receive is in danger of deteriorating.
I therefore ask the Minister to reconsider the cost of living supplement and perhaps to review how the body has come to those figures because I fear that we will have an increased vacancy rate in Poole and a more difficult job retaining staff. The real value of the NHS lies in its staff and the quality of service it provides to my constituents, so a higher vacancy level will cause problems. There are currently 39 vacancies for fully trained, full-time nurses in Poole, and a further 24 vacancies for which job offers have been sent out, but currently await acceptance.
This small measure could be a step in the right direction. We need to recruit good, qualified staff who want to work in Poole, but housing and the cost of living there is expensive, so people—who obviously have to put themselves and their families first—often go elsewhere. The Salisbury area in Wiltshire and the Hampshire area receive the benefit, but Poole and south-east Dorset—also an expensive area—do not. The differential impact will be significant.
Will the Minister set out clearly how the formula has been applied? Will she give an assurance that further scrutiny will take place before we go down this particular road? It will cause difficulties for my constituents, many of whom believe that it is unfair and unjust. In the near future I expect to present a petition signed by nurses that expresses their concerns.
This is a difficult and complex subject. The Government's decision to start to implement cost of living supplements would no doubt be viewed as courageous by Sir Humphrey Appleby because it pleases some and displeases others. I am a Member of Parliament representing people in Dorset, making a case for good hard-working NHS staff in Dorset.
10.41 am
Mr. John Whittingdale: I begin by putting on record the fact that my wife is a practice nurse who works in the national health service in North Essex. I warmly congratulate my hon. Friend the Member for Poole (Mr. Syms) on securing the debate and setting out a powerful case. He has demonstrated that Dorset's failure to receive the cost of living supplement has caused serious problems for health care in the area.
My constituency in Essex is a long way from my hon. Friend's, but what he said applies equally to my area. Curiously, Essex has also been excluded from the list of health authorities eligible to receive the cost of living supplement. My first communication about the matter included a list of all authorities that the Government had decided were eligible for the supplement.
The 15 eligible health authorities outside London include Avon, Wiltshire, Oxfordshire and Cambridgeshire. Those areas doubtless face additional cost of living pressures, but fewer than counties such as Essex, which borders London. Travelling to Cambridgeshire where the supplement applies requires going through Essex, which does not qualify.
I am here today to represent my constituents in mid-Essex, but areas such as Kent and East Sussex feel equally strongly that they have been excluded unfairly
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from the supplement and will face real problems on account of it. The issue has been taken up by the Royal College of Nursing, which first brought it to my attention and is now mounting a campaign on behalf of all the excluded authorities.
The supplement applies in one part of Essex. Just a few miles down the road from the Broomfield hospital, which serves the majority of my constituents, is Brentwood. Staff living in that area qualify for London weighting, which has created a huge disparity between the earnings of staff working in Brentwood and those working a short distance away in Chelmsford and Malden. There is no doubt that that is having an impact on the recruitment and retention of nursing staff.
My hon. Friend talked about house prices in Dorset, and the same problem applies in Essex. Not long ago, I saw figures showing that house prices in Chelmsford were rising faster than anywhere else in the country. If the supplement is genuinely intended to recognise the additional cost of living in areas of the south-east, Essex has a very strong case for inclusion. I find it bizarre that the county has not been included in the published list.
People do not enter the nursing profession because they expect great riches or rewards, but because it is a vocation. They are utterly dedicated to their jobs and provide a fantastic service to the people whose health they look after. Those staff also have to live, however, and there is no doubt that being a nurse is a pretty tough task. If people are not going to receive recognition of the additional costs that face them, their lives will be made considerably more difficult.
We can make comparisons with all public services, because there are problems of recruitment across the public services. We have had great difficulty in recruiting the number of nurses that we need, but there are equally great problems in recruiting police officers. Indeed, in a directly parallel case, an additional supplement is paid to police officers in the Metropolitan police area, but that supplement is not available in Essex. The effect is that people who would normally look to join the Essex police, are travelling quite a distance in order to join the Metropolitan police, because of the quite considerable financial benefit. I fear that the same may apply to nurses when they see what salaries are available not too far away as a result of the cost of living supplement.
My hon. Friend powerfully set out the disparities that will be created in the labour market if an apparently arbitrary method of allocating the supplement is proceeded with. Let me quote to the Minister a letter that I received from Mr. Clive Mortimer, branch secretary of the mid-Essex branch of the Royal College of Nursing, who is based at Broomfield hospital. He wrote to me about the problems that will be created as a result of this policy, saying:
"In not receiving this supplement our already bad recruitment and retention problem will get even worse, a situation that the RCN locally does not wish to see, because of the many knock-on effects, staff shortages, high use of expensive agency nurses to cover the loss and the worst scenario, a potential for a decrease in patient care."
One must take seriously a warning of that kind from the Royal College of Nursing. I urge the Minister to reflect on the representations that she has received. I have sent a copy of the letter to the Secretary of State to ask him to reconsider his policy. There is no doubt that the reference to a potential decrease in patient care is serious.

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Not long ago, my constituents were alarmed by the publication of a survey that showed mortality rates in various hospitals across the country. It stated that Broomfield hospital had the second worst rate in the country. I do not believe that the shortage of nursing is contributing to that, and I want to know a lot more about the figures because there are questions about how they were compiled. However, there is no doubt that they raised serious concerns for local people. Alongside those figures, the survey showed that Broomfield had a lower ratio of nursing staff than other hospitals. I do not suggest that that has contributed to the mortality rate. I believe that that is not the case, and much more investigation is needed, but people are anxious about the figures and know that there is difficulty recruiting sufficient doctors and nurses.
The Government have tried to tackle the problem by introducing a supplement in certain areas. However, I ask the Minister to look again at the map and to consider whether the case for a cost of living supplement is equally strong in areas such as Dorset, which my hon. Friend mentioned, and my constituency in Essex.
10.50 am
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I congratulate the hon. Member for Poole (Mr. Syms) on his success in the ballot for the debate. Before I respond to the hon. Gentleman, I shall clarify for the record a point made in the previous debate on hospices. The £23 million of the new opportunities fund is for adult services, including respite care.
An equally important matter is the NHS cost of living supplement. Every Member of Parliament whose constituency was not on the list responded with great passion, which provoked a heated debate. The supplement is not the only solution to labour shortages in some parts of the country and I shall therefore outline the thinking behind the proposal and the problem that it addresses. If Members would like me to do so, I shall later explain the precise way in which factors including market forces are calculated.
The NHS plan set out a strategy to give staff a better deal in their working lives. It is not a question of money but of capacity; we do not have enough doctors and nurses. Staff who commit themselves to a career in the NHS do not expect an easy life, but they are, nevertheless, entitled to expect their contribution to be valued and fairly rewarded. We must get that right; as the hon. Members for Poole and for Maldon and East Chelmsford (Mr. Whittingdale) recognised, it is crucial to the task of providing high-quality services that meet the needs of patients. That is the fundamental rationale behind our plans to increase staff numbers. By 2004, there will be 7,500 more consultants, 2,000 more general practitioners, 20,000 more nurses and 6,500 more therapists and other health professionals, and that will be achieved by a variety of means. Some short-term problems have long-term solutions, but in the meantime we have to consider the short-term solutions that work in tandem with them.
For a start, we will provide more training places; by 2004, more than 45,000 nurses and 13,000 therapists and other health professionals will have finished training.
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Hon. Members said that they are afraid that shortages will be moved from one part of the country to another, and that will be prevented only if there is more training. In addition, there will be year-on-year increases in the number of training places available, so that by 2004 an extra 5,500 nurses, midwives and health visitors will be trained each year.
We will expand the number of training places: there will be an extra 4,450 therapists and other key professionals, plus an extra 1,000 specialist registrars—the feeder grade for future consultants—and 450 more doctors in training for general practice. We will expand the number of new medical school places allowing for a 40 per cent. increase in the numbers of medical students since the Government took office in 1997. When we decided where the extra training places would go, regional factors were taken into account because people tend to stay in the areas where they trained, particularly in the medical profession. The presence of a medical school attracts high-quality staff. Hon. Members who represent constituencies in the south-west will be aware of the new Peninsula medical school, which will not only provide training for extra doctors, but encourage high-quality staff to want to work there.
We will improve pay through our plans to modernise the outdated pay system, which has failed to keep pace with the demands of the NHS. We have acted to ensure that midwives have better access to progression. The decision to introduce cost of living supplements is another example of our intention to design and put in place targeted solutions to specific problems that need a new approach. In this instance, we intend to use cost of living supplements to top up the pay of key staff groups where there are labour market shortages.
Such targeted actions are in addition to above-inflation pay rises for all NHS staff from 1 April 2001. The latest awards will be worth at least 3.7 per cent.—0.8 per cent. ahead of the most recently announced inflation figures—with more for senior nurses, staff in the professions allied to medicine, health visitors, midwives and staff working in pathology. We have recognised the essential contribution of senior nurses and PAMs to delivery of the NHS plan. We have also recognised the particular problems experienced in recruiting and retaining suitably qualified pathology staff and have therefore singled them out for special treatment, as we did last year for cytology screening staff. Again, it is a question of long-term solutions, but in the short term we will pick off specific problems and see whether we can offer solutions to them.
We will improve working lives by making the way in which employers treat their staff a part of core performance measures, linked to the financial resources that they receive. We hope that staff retention will be much improved. To receive financial resources, employers will need to show how they are investing in training and development, tackling discrimination and harassment, and improving diversity.
Employers will also need to show how they are applying a policy of zero tolerance of violence against staff. Given the increase in attacks on NHS staff, that is important because we need to ensure that people want to continue working in the NHS. Employers will have to demonstrate how they are reducing accidents in the workplace and sick absences by providing better

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occupational health and counselling services, and conduct annual staff attitude surveys to obtain feedback on whether they are good employers.
By 2003, all employers will be assessed against the human resources performance framework and the new improving working lives standard, which will mean that they need to demonstrate their commitment to flexible working arrangements, providing for flexi-time, annual hours, child care support, flexible retirement, career breaks and a reduced hours option. Hon. Members have referred to the expense of hospitals having to use agency staff. One reason why staff in some areas have decided to work for agencies is that they allow people to work the flexible hours that they want. We need to ensure that hospitals take those real concerns on board.
We have invested some £9 million—£25,000 per trust—to improve the working environment for staff. In 2001–02 and beyond, money will be invested in the extension of occupational health services. By 2004, more than £30 million will be invested in better child care facilities for NHS staff, providing for subsidised nurseries in about 100 hospitals.
We are tackling entrenched and often long-standing problems, which are not amenable to quick-fix solutions. Many of the initiatives that I have outlined will need time to bear fruit. That is why we also feel the need for a more immediate approach where it can deliver results. For that reason, we are working to recruit additional suitably qualified staff from abroad where feasible and have recently appointed a director of international recruitment to drive that work forward. All that activity shows our determination to adopt and put in place a wide-ranging menu of initiatives and policies to tackle entrenched problems with recruitment and retention and to maximise the length of time that qualified staff work in the NHS. Staff at one of the London hospitals told me that turnover would be reduced if they could guarantee that every employee stayed an extra six months, so retention of staff is important.
Low levels of participation among qualified staff in some areas are part of the problem. The NHS needs more staff to do the job that we need it to do and it needs to hold on to its existing staff so that skills and expertise are not wasted. As I have said, we are taking action on a number of fronts to deal with that problem, combining short-term strategies with creating the right building blocks for the future. Part of the problem is that we experience much greater difficulty in recruiting and retaining nurses and other specialist staff in London and some parts of the south of England. That situation is worsened by relatively low levels of participation in the NHS where there are, nevertheless, a wide range of job opportunities available to qualified staff.
We know that pay is not necessarily the panacea. A range of factors affect our ability to recruit and retain staff and we are responding with a wide-ranging package of measures. The hon. Member for Poole referred to the size of the NHS as an employer. People who work within the NHS are extremely reluctant to leave that organisation. The Royal College of Nursing recently did a survey that showed that nurses find leaving the NHS a difficult decision to make; it is not something that they do lightly. Equally, I do not expect
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that staff who work in one hospital will look at a hospital 50 miles down the road and say, "I may get £400 extra, so I'll move there."
Mr. Syms: My concern is not the figures but whether that is the direction in which we are going. From day one, we are out and somewhere else is in. Will that be a trend?
Ms Stuart: As I said, this is a short, specific measure. It was an immediate response to an emerging immediate problem in some areas. We will see what happens as it develops.
An important unavoidable factor is that the cost of living in London and the south can be considerably higher than in other parts of the country. That has long been recognised for staff working in London and the fringe zone, who receive different scales of London weighting and fringe allowance to supplement their basic pay. That sometimes creates problems for employers trying to recruit staff in neighbouring areas where the cost of living is also relatively high but no London weighting or fringe allowance is available. I recognise the problem, outlined by the hon. Member for Maldon and East Chelmsford, that that affects not only the NHS but other public sector employers. The issue was raised when I recently visited Watford general hospital. Wherever we draw the boundaries there will be tensions but we need to keep a careful eye on how they play out.
As one of the ways of helping key staff in high-cost areas we have introduced a new cost of living supplement for London and parts of the south. As a brand new approach, it is bound to provoke interest and debate. We believe that it could make an important contribution to the raft of initiatives and make a real difference to our drive to increase the numbers of qualified staff in the key groups that I have identified. It will provide additional pay of between £600 and £1,000 per annum for qualified nurses, midwives, health visitors and PAMs in London health authorities and between £400 and £600 for equivalent staff in eligible health authorities outside London and the south of England.
We estimate that around 100,000 staff will benefit and have made £64 million available through allocations to health authorities. We accept that cliff edges are unhelpful and have done our best to minimise them in drawing up plans for the new supplements. However, it is difficult to get it right, given the vagaries of geography, travel-to-work zones and the choices that people make about where they live and work, and some staff and employers will find themselves on the wrong side of the line, wherever it is drawn, of the new allowance. We need to balance that against the need for a clear, transparent system.
The new allowance, by its nature, is perhaps the most precisely targeted of the range of new initiatives. We readily acknowledge that recruitment and retention problems exist beyond the areas eligible for cost of living supplements. That is why we will closely monitor the impact of the supplements on recruitment and retention rates and participation rates. We want to take an early view so as to be able to develop policy for the future. We shall announce details of additional funding that will be

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made available for other recruitment and retention initiatives; it will be made available on the basis of bids to parts of the service that do not receive cost of living supplements and where there is scope for action.
Clearly, the hon. Member for Poole feels that the supplement should have applied to Dorset as well as to Hampshire and Wiltshire. The straightforward reason why it does not is that Dorset health authority does not meet the criteria set out in relation to the staff market forces factor. We set the qualifying level at a factor of 117. Hon. Members may like to know how the factor works. MFF, as it is called, consists of evaluating the elements that are given the highest weight in the overall index: it takes into account staff medical and dental costs, London weighting, non-pay issues and capital. The aim of the staff MFF is to reflect the geographical variations in staff costs that NHS employers incur. It is necessary, despite national pay arrangements, because the geographical variation in labour markets results in some NHS trusts facing higher hidden staff costs due to recruitment and retention difficulties, grade drift and the use of agency staff.
The staff MFF is based on the three latest years of the new earnings survey panel data set. The 2001–02 allocations are based on 1997, 1998 and 1999. The analysis uses individual earnings of full-time employees aged 16 to 70 in the private sector whose pay was not affected by absence: all others are stripped out. The annual sample is about 75,000. The hon. Member for Poole may wish that he had never asked, but I shall continue. The data is then aggregated into 78 zones based on London boroughs and the former metropolitan and shire counties. Each year's data is used in a regression analysis, which isolates the effect of geography and staff costs in each zone by accounting for the effect of other factors such as age, sex, industry and occupation. I would be happy to write to the hon. Gentleman if he would like further precise details.
Mr. Whittingdale: I am sure that the formula is excellent, but if it demonstrates that authorities in Cambridgeshire and Bedfordshire face higher staff costs than the North Essex health authority, it may be flawed. I simply do not believe that that is the case.
Ms Stuart: It seems difficult to comprehend how the formula works, but I have been told by statisticians that the mechanism is well known and fully accepted. I would be pleased, as I said, to write to the hon. Gentleman with a more detailed analysis of the three authorities, explaining how the weightings were arrived at and establishing whether there were any flaws. I cannot deal with such statistical intricacies in this place. The qualifying level was set at a factor of 117, because it was the lowest score among London health authorities and represented the most natural break point. Dorset, in common with several other health authorities such as Bradford, Wakefield, Calderdale, Kirklees and Leicestershire, scored only 110. We recognise that Dorset has hot spots where the cost of living is high, but nearly 30 health authorities that do not meet the eligibility criteria overall score higher than Dorset.
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Some may question whether the staff market forces factor was the right tool for setting the criteria. We reviewed the options and decided that it was the best available. It is not perfect, but the methodology is widely known and accepted in the NHS as a means of identifying high-cost areas and is continuously subject to rigorous academic review. As I said earlier, the cost of living supplement is not a panacea that will solve our problems. It is a small part of a much bigger jigsaw.
The survey is calculated from earnings survey data and average hourly earnings. We used those data as a proxy to provide the best basis to make decisions on eligibility. We certainly would not have thought it appropriate to use a formula based solely on vacancy rates, which are often as much a measure of good or indifferent human resources management as of genuine recruitment and retention difficulties. Striking a balance between addressing inadequate provision and services and rewarding success is important in all debates relating to the NHS, including the debate on hospices. If a hospital has a high staff turnover and bad retention rates, and finds it difficult to recruit, that is not necessarily a sign of specific problems of high costs, which more money would solve. The same would be true if a hospital used many agency staff. Such a hospital's human resources strategy would need close examination. That is why we did not use vacancy rates.
Poole hospital NHS trust is considering ethical international recruitment as an interim measure to address its problems. The hospital is also addressing longer-term solutions, such as administrative support for ward posts to take away some of the administrative tasks undertaken by nurses and free their time for nursing care. Poole hospital NHS trust is considering a range of policies to retain existing staff and attract new staff.
To achieve the qualified work force that we need for the future, we need to be able to attract and keep staff of the right calibre. We also need to make sure that the NHS is hanging on to the highest possible proportion of the people whom it trains. To do that, we need a multifaceted approach that tackles all aspects of the problems through a mix of immediate action, where we believe that it can make a difference, and more long-term change. Cost of living supplements for some key groups of qualified staff are part of an innovative package of measures. Our willingness to apply a previously untried solution is testament to our determination to solve entrenched problems of recruitment and retention once and for all.
I know that the hon. Member for Poole is concerned about the situation in Dorset, not least as it compares with Hampshire and Wiltshire, which are eligible for the supplement. I hope that he is satisfied that a range of other ways exists to deal with recruitment and retention difficulties, as his own hospitals are showing. The challenge is to find innovative local ways to keep key professionals in the NHS. Help with that is available through the regional offices and through various initiatives from which Dorset can benefit.
We do not foresee a sudden haemorrhaging of staff out of Dorset as a result of the introduction of cost of living supplements, and the hon. Gentleman recognised that staff would not suddenly leave his hospital over the next couple of months. However, he was concerned about the possible long-term knock-on effects. We

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recognise that we need to keep an eye on that. There is no point robbing Peter to pay Paul, and we take the hon. Gentleman's point seriously.
I am sure that we all share the desire to resolve recruitment and retention problems in the NHS. However, we will not put all our eggs in one basket, and neither should the hon. Member for Poole. Pay is not the only answer, and using pay and the cost of living supplement is only one part of our response to a problem that we all need to approach with the widest possible perspective.
11.14 am
Sitting suspended.

Chile
11.30 am
Mr. Jeremy Corbyn: I welcome the opportunity to debate our relations with Chile and the situation in that country. First, I should declare an interest, which is in the Register of Members' Interests and is therefore openly on the record: I visited Chile last December and my fare was paid by human rights campaigners for Chile in this country; I was very grateful to them for that assistance.
Like other hon. Members, I have raised the issue of Chile in many debates since I was first elected in 1983. I visited Chile for the first time in 1970 and was inspired by much of what I saw there. I shared the hopes that were aroused by the election of the Popular Unity Government and, like millions around the world, I was appalled by the events of 1973, when British planes were used to bomb the presidential palace, which resulted in the death of President Allende, the rounding up of large numbers of people into the national stadium, and a reign of terror, including the caravan of death.
Many Members of Parliament worked tirelessly to help Chilean asylum seekers in the early 1970s. It would be wrong not to pause for a moment to remember the wonderful work by Dame Judith Hart and many other Members of Parliament in supporting Chilean people who came to this country. We should also recognise the enormous contribution by members of the Chilean exiled community, who have lived in this country ever since, as well as the work by the Chile Committee for Human Rights and the Chile Solidarity Campaign in raising support for victims of torture and showing the world the brutality committed during the Pinochet regime and during the coup.
That brutality was almost unparalleled in Latin America. After the planes bombed the palace, the police and the army went around systematically rounding up anyone who was believed to be a supporter of the Allende Government. The caravan of death went from town to town with groups of officers picking up anyone who was thought to be part of the Allende Government, who was then either summarily executed, or taken away for torture and later executed.
The bodies of many of those people have still not been recovered. That reign of terror did not stop after a few weeks; it went on for years. It had a strong foreign policy element: the Pinochet regime helped to establish Operation Condor, a process by which the military regimes of Chile, Argentina, Uruguay and Paraguay co-operated to round up their supposed opponents and to mete out unspeakable acts of torture against them.
The record of the west and other countries in relation to Chile is patchy. There was a United Nations programme to assist people to leave Chile to live in a place of safety. A number came to Britain and more went to Sweden, Mexico, Cuba and several other countries, where they contributed to the societies there. At the same time, the United States, which, through its multinational connections, was heavily involved in the 1973 coup—I look forward to reading the accurate memoirs of Henry Kissinger, when he finally gets around to publishing them—imposed on Chile an economic strategy known as the Chicago school. That highest form of monetarism led to massive

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unemployment, vast privatisation and the development of a yawning gap between rich and poor, which persists in Chile to this day.
The British contribution in the mid-1970s was to support human rights campaigners in Chile, but with the election of Margaret Thatcher as Prime Minister in 1979, British arms sales to Chile resumed. The Thatcher Government enjoyed close links with the Pinochet regime, as was amply demonstrated by visits to Pinochet while he was under house arrest in this country by Margaret Thatcher and Norman Lamont—and, indeed, by an hon. Member who is present today—and the Pinochet Foundation's presentation to Norman Lamont of a medal, which I am sure he is proud to wear.
Pinochet corrupted much of what went on throughout Latin America. For example, there was an interesting article in The Observer in December about the sale of drugs by the Pinochet regime. It stated:
"Twelve tons of the drug, with a street value of several billion pounds left Chile in 1986 and 1987 alone. The drugs, destined for Europe, have often been flown to Spanish territory by aircraft carrying Chilean-made arms for Iraq and Iran. Distribution to Britain and other European countries has been controlled by secret missions stationed in Chilean embassies in Stockholm and Madrid."
Such issues require examination because of the suggestion that the Pinochet regime, while in receipt of British military aid or arms, was involved in the international drugs trade.
It should be remembered that, throughout the time of the caravan of death and all its horrors, many people in Chile bravely stood up and campaigned for human rights to defend others from being imprisoned and tortured. I shall quote from a poem sent to me recently by a Chilean man, Tito Tricot—I shall not read it all as Mr. Tricot is quite loquacious and the poem is very long. It gives some idea of the feelings of people in Chile towards Pinochet and the caravan of death. It states:
"General Pinochet will be tried in relation to the massacre of 75 Chileans when a special army task force, known as 'Caravan of Death', toured the country executing prisoners. They all died a painful and slow death; their bodies were mutilated, their eyes carved up with knives, their limbs torn apart. How can a human being be capable of such horror? How could they inflict such pain on defenceless people? How could Pinochet and his henchmen transform the entire country into a Caravan of Death?"
The change of Government in 1990 came about not by accident, but because of international pressure following the campaign of the people in Chile and because of the sheer horror at what went on there. That led to the plebiscite in 1988 and, finally, to the election in 1990 of President Aylwin, whose inauguration I attended. It was a moving event, held in the national stadium. There was talk of reconciliation, of those things never again happening in Chile and of opening the history books, but the constitution that Pinochet bequeathed to the people of Chile protected him and his henchmen, gave them priority positions in the Senate and in the supreme court and granted them a high degree of immunity.
Although the Rettig commission did a lot of work and named a lot of people who had gone missing, there were few, if any, successful prosecutions as a result. Indeed, very little happened abroad other than the prosecution
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for the death in Washington of Orlando Letelier in 1976. The problem for the people of Chile after 1990 was not that they had got rid of Pinochet, but that there was a collective attempt to forget what had happened.
Some people, however, were not prepared to forget and recognised that justice could come about only by revealing the truth. In that sense, credit must be given to Baltazar Garzon and others in Spain for their efforts to have Pinochet extradited when he arrived in this country.
I remember 16 October 1998 as a day of enormous significance, when news came that Pinochet had been arrested by the Metropolitan police under extradition law on the basis of a warrant issued by a Spanish court. Pinochet was subsequently held in this country for 503 days. In December, I visited the Agrupacion de los Desaparecidos, the family centre for those who disappeared, which displays a large poster saying "503 days". Those 503 days were crucial to the history of Chile because they enabled people to campaign for legal and constitutional change and to bring about the real justice that had been denied for so long.
The arrest of Pinochet had obvious reverberations around the world. The right of a state, in this case Britain, to arrest a former head of state was confirmed. Pinochet claimed first that he had diplomatic immunity and then that he had immunity as a former head of state. Both those claims were overturned by the House of Lords. Even after the House of Lords reheard the case once Judge Hoffmann had been removed from the initial panel of judges, Pinochet still was not granted immunity. Although he was indicted on charges of torture after 1988, he was nevertheless indicted both as a former head of state and head of the armed forces. The role played by the judiciary in this country in the process of international law against dictators, torturers and murderers was extremely significant.
Those who campaigned ceaselessly in Britain to ensure that the world knew about that deserve a huge amount of praise. They helped the world to know that Pinochet, the man who claimed that nothing moved in Chile without his permission, was finally brought down. It was a humbling sight to see him being taken away from Belmarsh magistrates court under a blanket. He was allowed to return to Chile on the basis of medical evidence that had been prepared at the request of the Chilean embassy here. Many of us strongly questioned both the purpose of the medical examinations and the conclusions that were drawn from them. The pictures of Pinochet getting off the plane in Chile and suddenly, Lazarus-like, being able to walk, talk, smile and wave, were a great surprise to many people.
I ask the Home Office and the Foreign Office to look again at the medical evidence on which Pinochet was allowed to go. A military hospital in Chile has now adjudged that he is fit to face trial and competent to understand the case against him. We should think carefully about the medical evidence that we were offered. It was not released initially. It was made public only after the Belgian Government continued with the case in the British courts.
I should also like the Minister to comment on the pressure under which the British Government were placed and the discussions that took place between the representatives of the British, United States, Spanish

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and Chilean Governments during 1999. I understand that requests were made to find some form of words to allow Pinochet to return to Chile. Many of us were campaigning for a judicial process to take place against Pinochet in Europe, under extradition law to Spain, because we thought it unlikely at that stage that he would be tried in Chile. When the books are opened, it will be nice to know who put pressure on whom to ensure that Pinochet was allowed to leave these shores without going through the due judicial process.
When Pinochet returned to Chile, Judge Guzman and others who had worked hard during the intervening 10 years and more to uncover the bodies from the caravan of death began to assemble a massive case against him and the other military personnel. There is something deeply moving about talking to people who have been exhuming bodies from unmarked graves. Many of those bodies are now stored in the morgue in Santiago while the painful process of DNA testing to match bodies with relatives continues. Imagine the pain of people whose relatives disappeared after the coup in 1973 who still do not know their fate. Occasionally, someone goes along to the national memorial in the cemetery in Santiago and engraves another name, as another body is found and finally identified as yet another person who disappeared during the dictatorship.
During my visit, I went to the national stadium, the centre of torture to which many people were taken. I also went to the velodrome, where the worst torture took place. We walked around the velodrome, with victims of torture and others, and were struck by the stupidity, the horror and the arbitrariness of it. We stood on a concrete cycling track with beautiful mountains in the background, listening to a man talking about how he was tortured there. That man was just an attendant, a messenger, at the Chilean department of education, but someone—some fevered brain in the police or military—decided that he was central to some communist plot to subvert the whole of South America. He was unspeakably tortured, and he spoke about it with tears in his eyes, explaining what had been done to him and so many others.
I also attended international human rights day at Villa Grimaldi, in Santiago, the centre of interrogation and torture. It was a very moving event: more than 1,000 people took part to bear witness. I went to the national cemetery, and saw the names of the victims carved on the memorial—the brilliant, the famous and the almost unknown died equally. The name of Victor Jara was alongside those of less well known people.
At that time, there were high hopes in Chile that Pinochet would be put on trial. Unfortunately, the following day in the High Court, a writ for habeas corpus was successful, and Pinochet was de-arrested. Subsequently Judge Guzman and others managed to have a large number of other cases registered in the court in Chile. The medical examination has taken place, and Pinochet has been re-arrested and indicted. We have almost reached the point at which a legal process can begin against him.
Other issues are at stake. It must be obvious that a trial of Pinochet is not a trial of one individual. He did not act alone. He seized power in a conspiracy with other officers, supported by the military and by a number of multinational companies who had been waging economic warfare against Chile for years to
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destabilise the country and create chaos in which they could seize power with all the brutality that they displayed. We need to know what those pressures were, who said what and who did what.
The United States of America was clearly involved. The Central Intelligence Agency had a large station in Chile. Henry Kissinger was personally involved. That much we know. Various companies were involved, not just in Chile but in the economic warfare against Chile. Thanks to brilliant work in the United States, many thousands of documents have been released by the State Department, and they are now held in the national archives at the national library in Santiago. Some documents have been doctored by the CIA—I was there on the day when they were presented, and some pages have literally been blanked out. They were obviously CIA documents, and it will now be hard to understand what was in them, but many others were very revealing, The USA's freedom of information law allows us that kind of information.
I ask again the question, which I have asked in the House and have raised in early-day motions—why cannot the same information be released in this country? The documents for 1970, which have been released under the 30-year rule, raise interesting points. They reveal a proposal from the United States and some other sources, that Britain should take part in some form of pre-emptive strike—a coup—to prevent the election as President of Chile of Salvador Allende, the Popular Unity candidate. That plot would have destabilised Allende's Government before they had even taken office. Records of meetings show that Sir Alec Douglas-Home, who became Foreign Secretary after the June 1970 general election, was put under pressure in this respect. Those papers give us a soupcon, a taster of what may be in other documents.
The United Kingdom is an important trading partner with Chile. We were an important arms seller to Chile, and we received a great deal of military co-operation secretly from Chile during the Falklands war. I ask the Minister to explain clearly why documents can be released in the United States, such as those relating to Operation Condor in Buenos Aires, in Montevideo and in Asuncion, which are now held at the high court in Asuncion, but not here. What is so special about Britain that we cannot reveal the secrets that we hold?
When the trial of Pinochet and his military officers takes place, we will need to know the truth, and those documents will help to uncover the truth of how torture and murder took place. I ask the Minister, with the greatest respect, to look again at this issue. Although there is no international legal process against Pinochet and his generals in the same way that there is in the case of Rwanda or former Yugoslavia, or that there was in the case of former Nazi Germany, it is likely that a big case will be held in Chile, and those documents could provide an important part of it and could encourage other countries to release documents.
The cases of two British nationals and one American national could be included in the process. I will deal first with the American national. Charles Horman, a young American living in Chile in the 1970s, was taken away, tortured and killed. His story became the subject of the absolutely brilliant film "Missing", which demonstrated the arbitrary nature of military power and its vileness and brutality. Charlie Horman's widow came to this

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country to bear witness when the House of Lords case was going on, and I met her then. She also went to Chile and took part in a symbolic cleansing process of part of the national stadium. She has since issued an appeal, from which I will briefly quote:
"Charles' mother Elizabeth, now 96, and I thank you for your support of our efforts to get at the truth concerning the death of Charles Horman in Chile in 1973— in which we firmly believe, the United States played a shameful part. Your help will enable us to shed light on one of the darkest chapters in the history of Latin America and our own country and will contribute to ending the practice of impunity for crimes against humanity, which characterised so much of the last century."
Joyce Horman is asking for international help to ensure that her husband's case is taken through the Chilean courts, and she has already ensured that case is registered.
Two British nationals also died in Chile. William Beausire died in 1975 and Father Michael Woodward two years later. Both were tortured and killed for no good reason. Their families still grieve for them and are still in a very distressed state because of them.
I have constantly raised questions about these cases and there are two particular aspects that I would like to emphasise. First, when we had the opportunity to allow a private criminal case to take place against General Pinochet while he was being held in Britain, the then Attorney-General refused permission for that case to be deposited in the British courts. That was despite the fact that the Metropolitan police were undertaking an investigation into the circumstances surrounding the death of William Beausire, and despite the fact that a vast amount of evidence had been deposited with the Metropolitan police at that time by me and others. I asked the Solicitor-General about this at Question Time last week and the last part of his answer was:
"Under the Criminal Justice (International Co-operation) Act 1990, it is possible for authorities in this country to assist prosecution in Chile, and that might well happen."—[Official Report, 1 February 2001; Vol. 362, c. 442.]
I have also received a letter from the Minister concerning that matter and the case of Father Michael Woodward. The Minister is aware of Father Woodward's case, having met his sister and spoken with his family. Indeed, he raised the case when he went to the inauguration of President Lagos in Chile last year. I hope, therefore, that the Minister will be able to offer us some hope that, as with the case of Charles Horman, whose case has now been deposited in the courts in Chile, the British authorities will give all assistance they possibly can to uncover the truth of who was guilty of the murders of Beausire and Woodward, and that all Foreign Office documents relating to their disappearance and death, including cables and reports that came from the embassy at the time, will be revealed. Statements made at the time by the Foreign Secretary, David Owen, suggest that a great deal of knowledge should to be brought to light.
The process that has taken place in Chile can bring about justice. It cannot bring back the dead, turn the clock back or take the torches away, but it can indict the people who seized power and who destroyed so much of that country, murdered so many people and set such a terrible example around the world. It can and, I hope,
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will hasten the inauguration of the International Criminal Court that will mean the Pinochets of tomorrow will face justice more quickly and simply.
We have had more than 10 years of pursuit of Pinochet since he ceased to be president and he still has not faced justice. He offered no justice to his people but he has been offered every possible avenue of justice. We have a role to play. As a country, we played a role. I ask the Minister to ensure that we play our part in giving all the support we can to the people who are prosecuting in Chile. I ask him to open the books, to release the information to support the families of Beausire and Woodward, to tell us the truth about what happened and what the British arms sold to Chile were used for in the 1980s. Do we too, through our arms trade, have blood on our hands because of what happened in Chile?
I hope that that process can be a lesson for all of us about the dangers of the economic madness that went on in Chile after Pinochet seized power and the unbridled power of multinational capital, which was used to promote that coup and all the horrors that went with it, so that the world never again sees the likes of General Pinochet, Operation Condor and so many other things.
11.56 am
Mr. John Wilkinson: We owe a debt of gratitude to the hon. Member for Islington, North (Mr. Corbyn) for introducing this important debate on Britain's relations with Chile. We all recognise his long and deep interest in the country. My own interest does not go back quite as far as his, but I have been going to Chile every year since the mid 1980s for family reasons. My last visit was during the Christmas recess, when I spent a significant amount of time in the south of Chile and in the capital, Santiago.
I have tried to keep up to date and have the privilege of serving under the hon. Gentleman as vice-chairman of the British-Chile all-party group, which I founded when Chile regained a democracy. We try in the House to foster good relations with Chile. That is easy in the sense that Chile is an exemplary democracy: it scored a commendable success in effecting a difficult transition from a period of enforced military rule. The last presidential elections, closely fought, brought the socialist president Ricardo Lagos to power by an extremely narrow margin over Mr. Lavin. The campaign was peaceful and the institution of the new Administration was successful in every way.
The interesting thing is that although the hon. Gentleman criticises the Chicago school of economic reforms that were instituted at the time of the military government, those reforms have been largely maintained. Other Latin American economies have benefited from using these reforms as a model. Chile is a reasonably prosperous country: according to "Whitaker's Almanac" it has an unemployment rate of some 7 per cent. and an inflation rate of some 5 per cent, figures that compare favourably with many countries in the European Union. It has a diverse economy which is modernising rapidly.
As far as the United Kingdom is concerned Chile is, and always has been, an important trading partner. The United Kingdom was active at the time of Chile's liberation from the Spanish empire. The commander in

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chief of the Chilean navy at that time, Admiral Cochrane, was instrumental in the liberation of Chile. Moreover, through his assistance by seaborne interventions in the campaign of San Martin in Peru, he helped to liberate that country as well.
The first President of Chile, Bernardo O'Higgins, who was the bastard son of the viceroy of Peru, spent formative years at Richmond upon Thames. Those personal connections, reinforced by the Canning doctrine, whereby it was held that the new world was called into existence to redress the balance of the old, meant that the United Kingdom had an important relationship with the Chilean state from its beginning and throughout the 19th century, particularly in shipping, the development of Chile's railways, mining and the exploitation of the important nitrate deposits in the north.
As a consequence, there has been a significant Anglo-Chilean community in Chile. President Aylwin, the Christian Democrat who followed General Pinochet as head of state, can trace his roots back to the UK and has family connections, I believe, in Sussex. Such connections are not unusual among a large number of Chileans, which was brought home to me when I visited The Grange, a famous secondary school, where a plaque on the wall commemorated the casualties of the second world war. A large number of pupils had gone back to England to fight in the British armed forces, particularly as airmen; there were many names of those who perished on our behalf while fighting in the Royal Air Force.
In the post-war period, the trading relationship declined somewhat, but it has reasserted itself to the extent that the UK is the third biggest investor in Chile after the United States and Spain. Therefore, we have an important stake in Chile. Visible trade is also significant to us, although our trade is not in balance: the Chileans sell much more to us than we sell to them. Customs and Excise statistics show that UK exports to Chile in the first 11 months of last year were worth £106 million, whereas Chilean exports to the UK were worth £436 million. That is a remarkable achievement by the Chileans and shows how important it is for UK exporters to be even more active in the Chilean market. Only recently, there was a seminar in Santiago, which was attended by the Minister for Housing and Planning and European Union Commissioner Chris Patten. We are doing our best through the Latin American trade advisory group—which comes under the new trading arrangements instituted by Her Majesty's Government—and are hopeful that trade will grow and expand.
As I have said, Chilean democratic credentials are excellent, as is its tradition of the rule of law. The hon. Member for Islington, North referred to the case of Senator Pinochet, which is being dealt with in the Chilean courts. It is entirely appropriate that Chileans decide for themselves how they deal with citizens such as Senator Pinochet against whom serious allegations are levelled. It is often alleged that Chile has an imperfect democracy because of the appointed senators, of whom Pinochet is one. However, 38 of the senators are elected and only nine are appointed, whereas we have no directly elected members of the Upper House and a much larger number of appointed peers than those who remain in the Upper House by virtue of the indirect election. Chile has 120 deputies, who are elected for a
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four-year term. The presidential term is a single term of only six years, which is the maximum allowed under the Chilean constitution, whereas in this country one can be re-elected as Prime Minister for several terms. I do not think that the Chileans' democratic credentials are in question, nor is their adherence to the rule of law.
It is true and tragic that there was a period, dating from the assumption of power by the junta in 1973, when Chile was under military rule, but one must remember that the people of Chile largely urged the military to intervene: the Congress of Chile did so, as did the supreme court and the auditor general of Chile. Many more people were killed in Peru in that period, during the Sendero Luminoso terrorist campaign. Many more people were killed in the insurgencies in Colombia—we hope that the guerrilla problem there will be solved by President Pastrana's peace process. The same is true of the bitter civil wars in Nicaragua, El Salvador and Guatemala, which were largely fostered and stoked up by the intervention of the Cubans. At least the intervention of the armed forces in Chile in 1973 ensured that Marxist influence was checked in Latin America. It was a turning point in the cold war, like the Soviet invasion of Afghanistan and the assumption of power in Egypt by Anwar Sadat.
The Minister of State, Foreign and Commonwealth Office (Mr. John Battle): I believe passionately that a crucial distinction ought to be made in respect of some of the examples that the hon. Gentleman has given. If I recall rightly, President Allende was democratically elected—that is a vital difference.
Mr. Wilkinson: I have mentioned the fact that democratic institutions were being subverted in Chile at the time of Popular Unity Government of Salvador Allende. That was the tragedy of the situation.
No one understood the tragedy better than the Chilean people themselves. The economic position of the country was utterly disastrous, with an inflation rate of 500 per cent and acute shortages in the shops. Eventually, there were even attempts to generate mutinies in the armed forces, especially the Chilean navy. It was the attempt to engender mutiny in the Chilean navy that brought about the call by the commander in chief of the Chilean navy for the Chilean armed forces to intervene. It was not not something that people did lightly.
Now, the people of Chile, rightly, want to put all that behind them. They have had, as I have explained, a successful transition period and they wonder why, when people talk about Chile, they focus on such a relatively small period in that country's history. In 1988, there was referendum in which 44 per cent. voted for Senator Pinochet to stay in power—not a majority vote, but the same proportion of the electorate as the present Prime Minister in this country got at the last election. It was not a majority vote and General Pinochet relinquished power.
As I have explained, the transition was—thank God—exemplary and the Chileans rejoice in that fact. They want to move forward, to develop their economy and their institutions, improve social provision, eliminate poverty, improve the health services and do all

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the other things that a normal democratic Government would do. They deserve support and encouragement in this process, which is, by and large, going well.
Mr. Corbyn: Will the hon. Gentleman estimate how many people died or disappeared and how many were tortured in what he describes as a relatively minor period in Chilean history? Is he seriously suggesting that somehow the military was forced by a wave of public opinion to lock up people in the national stadium, institute the caravan of death and everything else? He is offering us a ludicrous perversion of history.
Mr. Wilkinson: I wish that it were a perversion of history. The hon. Gentleman referred to the documents that have been published by American sources. If those are read and studied, they reveal a catalogue of foreign involvement in Chile. The outgoing president, Salvador Allende, who was murdered, was toting a machine gun that he was given by Fidel Castro, his closest ally, who had provided a great many Cuban experts. There were floods of illegal arms into Chile; many members of the security forces were killed and the country was descending into anarchy. In those circumstances, the armed forces felt that they had to intervene. I stress again that those are aspects of the cold war: there was an intense ideological division, not only in Chile, but elsewhere in the world. Thank goodness that we have put that period of history behind us.
I have stressed that the Chilean economy is, broadly speaking, well run and diverse. Chile has good trading relations with the UK and with other countries—for example, it has trading agreements with the European Union and Mexico and is a member of Mercosur. Chile's is a liberal, open economy from which its people have benefited. Now, they want to use the increased prosperity that the reforms have produced to improve the standard of living of the people as a whole. Such an objective merits merits every encouragement from the United Kingdom and other countries that have always had a friendly relationship with Chile.
The hon. Member for Islington, North mentioned arms sales. In that respect, the pattern of purchases from Chile is broadly based: the latest submarines are Franco-Spanish Scorpenes submarines, which replace British Oberon submarines. The army is buying Leopard 1 tanks from Germany; and in the wake of the United States Government's more liberal policy towards arms sales to Latin America, the air force is closely examining the F16, although there could be a problem over the armaments. No one could suggest that we are interested in Chile only because of arms sales. Britain's investments in Chile are much more broadly based, in industries such as mining, agriculture, salmon farming, transportation and much else besides. This is all to the good. As I explained, we are the third biggest investor in that country.
I hope that the House recognises that Chile is a liberal democracy with rule of law and democratic institutions that have the full support of the Chilean people. The people hope that the good relations with the UK that have always been beneficial to both countries will be maintained. I am sure that Her Majesty's Government want that and that most hon. Members want it, too.
12.13
Mrs. Ray Michie rose—
Mr. Bill Olner (in the Chair): Order. So that the Minister has time to reply to this important debate, I ask the hon. Lady to keep her comments brief.
Mrs. Michie: Thank you, Mr. Olner. I will be as swift as I can.
I congratulate the hon. Member for Islington, North (Mr. Corbyn) on having secured the debate. I welcome the opportunity to raise briefly a matter which, given the tenor of the debate, may surprise the Minister and hon. Members. I hope that, although the issue that I raise is entirely different, the hon. Member for Islington, North will understand that that does not mean that I do not acknowledge and appreciate the remarks he made with knowledge and sincerity about human rights in Chile. However, I believe that it is necessary to draw attention to our trading relations with that country, and I am trying to do that under the heading of UK relations with Chile.
One matter in particular could cause a deterioration in our relations and the loss of significant exports, worth many hundreds of thousands of pounds. When talking about our history of trade and investment in Chile, the hon. Member for Ruislip-Northwood (Mr. Wilkinson) mentioned salmon farming and, in so doing, foreshadowed the matters that I wish to discuss.
I have in my constituency a company, Land Catch Salmon Hatchery, which has been exporting high-quality, disease-free salmon eggs to Chile since 1988. The company has established an enviable reputation and track record in many years of trading with Chile. I had the pleasure of opening the salmon breeding and research unit in 1988. The problem is the regulations introduced in December by the Chilean department of fisheries, apparently because of infectious salmon anaemia, commonly known as ISA. No ISA has been diagnosed in Scotland for two years. By banning the imports of salmon eggs originating from Scotland because of concerns about ISA, Chile is unilaterally treating the whole of Scotland as a controlled zone for ISA. It is not. Ormsary in my constituency has never had any ISA. It is in an ISA-free zone. The Scottish Executive Rural Affairs Department has established ISA-free zones to standards exceeding those recommended by international organisations and has made that clear, as has the company on numerous occasions to the Chilean authorities.
The hon. Member for Ruislip-Northwood also talked about our investment in Chile. There are customers in Chile who want to invest and who have built the required facilities. They need to know immediately that they can import land-catch eggs as normal but the new quarantine regulations make that difficult.
Mr. Bill Olner (in the Chair): Order. Will the hon. Lady draw her comments to a conclusion so that the Minister may reply?
Mrs. Michie: The company is a highly regarded breeding stock catchery with stringent health and environmental regulations. The impasse has existed since the end of August. We are likely to lose another

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£500,000. I do not expect the Minister to be able to answer me in detail today but I should like advice about what I should do because the situation is critical.
12.16 pm
The Minister of State, Foreign and Commonwealth Office (Mr. John Battle): I congratulate my hon. Friend the Member for Islington, North (Mr. Corbyn) on winning the debate in the ballot and I thank him for raising the topic. He has conducted a sustained campaign for human rights internationally, and has stood up for human rights in Chile for many years—certainly for as long as I have known him.
My hon. Friend declared an interest and said that he had visited Chile. I hope that he did not declare that with any chagrin because I welcome the fact that he visits Chile. I would encourage other hon. Members and Ministers to do so as often as they can. We are building good relations with President Lagos's Government. Maybe I too should declare an interest retrospectively. I vividly remember the accounts of what happened in the Santiago football stadium in the early 1970s and I was involved in supporting the Chile Solidarity Campaign. Chileans came to my home city of Leeds where we made them warmly welcome and campaigned with them. Some of them remain good friends to this day, including some who, thankfully, have been able to return to Chile—some to high office in the Chilean Government, which is encouraging.
Those who commit atrocities should be brought to justice internationally and locally and we should campaign for that. I visited Chile just a few days after Pinochet's return—I went with some fear and trepidation, although I did not quite go out on the same plane as he did—to attend the inauguration of President Lagos. When I got there, I expected and received two reactions. One was from Chileans who felt that they wanted to "sort him out" themselves and bring him to justice, and the other was from those who felt that we should not even have challenged him because he had done such a great job.
Our relations with the new Government are now on an excellent footing and will be developed on that basis. We can work together on those matters and on trade relations. The episode of General Pinochet staying in Britain is not a barrier between us and is not holding back our relations politically, socially, culturally or commercially.
I welcome the comments of the hon. Member for Ruislip-Northwood (Mr. Wilkinson) about trade. We have good trade relations. The Minister for Housing and Planning visited Chile in November, the Minister for Trade did so in December, and there have been meetings with the Secretary of State for Trade and Industry. My right hon. Friend the Prime Minister also had a positive meeting with President Lagos in New York in September last year. Our trade relations are going well. We are encouraging and strengthening our ties commercially, politically and economically.
The arguments of the hon. Member for Ruislip-Northwood were surprising. Would he have justified a coup in Britain against Mrs. Thatcher at the time of the poll tax? That would make an interesting debate, but I shall not go down that road.
I can tell the hon. Member for Argyll and Bute (Mrs. Michie) that we are concerned that Chile is imposing controls on the import of salmon eggs from
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Scotland. All countries have the right to regulate imports on health grounds, but the production of salmon eggs in Scotland is subject to one of the strictest health regimes in the world. We are urging, and will continue to urge, the Chilean authorities to remove their import controls. I am grateful to the hon. Lady for raising the issue on behalf of her constituents. The Government intend to help.
My hon. Friend the Member for Islington, North raised human rights issues. Dealing with the legacy of the Pinochet Government remains an immense challenge for the present Chilean Government and for the Chilean people. The National Commission on Truth and Reconciliation, set up under President Aylwin, examined the human rights record of the military and its report identified more than 3,000 deaths and disappearances between 1973 and 1990.
Since 1990, more than 300 prosecutions for human rights abuses committed under the Pinochet regime have taken place in Chile—including the prosecution of the former head of the Chilean intelligence service under Pinochet. Some progress has been made since 1990—and since the restoration of democracy under Presidents Aylwin, Frei and Lagos. The fates of most of the 1,009 disappeared remain unknown, but information and the truth will come out eventually.
On January 5 this year, the armed forces handed over to President Lagos a report containing information gathered over the previous six months about the fate of some 200 of the disappeared. That information is now in the hands of investigating judges, who must try to establish what happened. The difference between the Executive and the judiciary is important: it is the judiciary who must process the allegations and bring those responsible to book.
As a direct result of the information provided by the armed forces in their round table report, established in August 1999, human remains have now been discovered in a disused copper mine on the Santiago hillside of Cuesta Barriga. The outcome of the round table leaves many cases yet unresolved, but it is a breakthrough. I gain the clear impression, on the basis of our relations with President Lagos and his Administration, that the Chilean Government intend to call people to account and ensure that justice is done.
Mr. Corbyn: Is my hon. Friend the Minister able to discuss with the Chilean Government, the Department of Health and human rights groups in Chile whether we could provide any forensic DNA-type support to help to identify the remains?
Mr. Battle: That is a practical and positive suggestion. I am prepared to make that offer: there is no reason why Chile cannot use the best of our scientific techniques.
The commander of the army's division in the northern region of Antofagasta where the caravan of death took place gave a surprise TV interview on 25 January, firmly blaming Pinochet for the military regime's human rights violations. General Lagos's comments were prompted by Pinochet's statement to Judge Guzman that the regional commanders, not he, were to blame for failing to investigate human rights abuses in those zones. General Lagos's graphic descriptions of the victims who had been tortured before being murdered unsurprisingly

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shocked the nation and the international community. A Government spokesperson described the interview as shattering and General Lagos's accusations prompted the usual reactions. They will be followed through.
On 31 January, Judge Guzman formally charged Pinochet as the co-author of 57 deaths and 18 kidnappings on that caravan of death case. His written decision details how the medical tests concluded that Pinochet had some mental impairment and was physically frail but was not incapable of facing trial. He rejected the defence's arguments that he should not face house arrest or trial for health reasons, but left open the possibility of Pinochet's poor health being a mitigating factor if and when sentence was passed. I simply draw my hon. Friend's attention to that because the UK medical decision is in the Library. It is important to emphasise that we let due process take place in all these matters. There was no collusion or collaboration and we were not leaned on by the Chilean authorities when Pinochet was here. I underline that.
Official reactions in Chile have been cautious. President Lagos was on holiday when the formal charges were placed, but Vice-President Insulza reiterated the Government's line of not commenting on judicial decisions. He recognised the significance of the ruling and welcomed the demonstration of the free and fair working of Chile's institutions, but he also noted that this was not the end of the line. The legal process has some way to run and there are several other processes to go through before there is a prospect of a trial. If appeals go badly for Pinochet, there could be movements towards that trial. The due processes of law are taking place in Chile.
I turn now to the other cases to which my hon. Friend referred. We have raised the case of William Beausire with the Chilean Government on a number of occasions and it was raised by previous Administrations in 1976 and 1979. The case was formally submitted to an ad hoc working group of the UN High Commissioner for Human Rights and our embassy in Santiago has also made numerous representations. As my hon. Friend acknowledged, I met Michael Woodward's sister, Pat Bennetts, on 10 February last year. Following that meeting I asked our embassy in Santiago to raise Father Woodward's case with the Chilean Ministry of Foreign Affairs. The embassy called on the ministry in March
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last year and it accepted that, although the case was detailed in the Rettig report, it did not establish who had been responsible for the torture and death of Father Woodward. It maintained that the Government had investigated the case as far as they could, but Mrs. Bennetts could take the matter forward only through the Chilean courts.
When I visited Santiago for the inauguration I raised the case again with our ambassador and asked the embassy to proceed through the diplomatic channels to make sure that the case was kept in the forefront of the Chilean authorities' minds. Mr. and Mrs. Bennetts had a meeting at our embassy in Santiago on 12 January. Mrs. Bennetts informed the embassy of her intention to present a law suit on her brother's case. Mr. Bennetts also expressed concern about the comments made by the commander in chief of the Chilean navy and the Chilean ambassador to Canada to the effect that torture had never taken place on the Esmeralda. The embassy had raised that with the Chilean Ministry of Foreign Affairs on 19 January and it has acknowledged that those remarks caused concern in the Chilean Government and that that ambassador has been admonished. I give my hon. Friend my personal assurance that I will continue to press this case. We will draw to the attention of the Chilean authorities any information and evidence that comes our way.
My hon. Friend referred at length to the release of documents. The release of documents is governed by the Public Records Acts of 1958 and 1967. There are provisions for the release of documents earlier than 30 years after their creation, although the Foreign Office does not usually release records unless there is a compelling case for so doing. As my hon. Friend acknowledged, there are implications for bilateral relations with Argentina, Uruguay and Paraguay if records relating to most of the 1970s and 1980s are released. Nevertheless, it would be a massive task to review all those files before they could be released, and it is a statutory obligation on all Departments to screen them for sensitivity.
My hon. Friend makes a serious and fair point about evidence that might help the Chilean authorities to bring people to account for their crimes. In this debate, however, I can only give him a commitment to look again at those records and see if there is anyway we can assist in bringing people to account. The International Criminal Court may be of help in that matter.

Policing (East Anglia)
12.30 pm.
Mr. Richard Spring: I am grateful for the opportunity to introduce this debate. I am also grateful to the Minister of State, Home Office, the hon. Member for Norwich, South (Mr. Clarke), for being here to respond.
Two weeks ago in Risby, near where I live in Suffolk, there was a raid on the small post office, which is part of an antiques centre. The raiders wore balaclavas and carried coshes. They screamed and shouted at the sub-postmistress, saying that they were going to kill her. They smashed the glass to ensure that the robbery was speeded up. It was a deeply shocking and traumatising experience for all involved. Just last week, across the border in Cambridgeshire in the village of Bassingbourne, a similar robbery took place. Masked robbers with baseball bats went into the post office and held it up. I have here an article from the Cambridge Evening News that proves the extent of the anxiety in the local community. The article points out that the robbery rapidly followed similar raids in Grantchester and Great Abington. Late last year, again in my constituency, the post office at Kedington was held up, on that occasion at gun point. That occurred shortly after a raid on the small post office at Stoke-by-Clare.
Let me make clear to the Minister something of which he will already be aware as a Member who represents an East Anglian constituency: such events are deeply traumatising to small communities. They have a ripple effect that sends out fear and anxiety in the locality. When a small shop or village post office is held up, the community's sense of well-being is greatly disturbed. The truth is that in the past two years in my constituency, in addition to the places I have already mentioned, hold-ups have taken place in Lakenheath, Dalham, Worlington, Horringer, Barton Mills, West Row and Newmarket. Even that is not a complete list. I have had hundreds of letters from people who are sick to death of the huge rise in violent crime in our region.
I focused on the problem in a newsletter that I put out just before Christmas. I pointed out that it was a source of considerable anxiety to people in my constituency and asked whether the concern was justified. The truth is that, since the general election, there have been 40 fewer police officers in the Suffolk constabulary and crime has risen by 20 per cent. Since April 1998, when the measurement of violent crime changed, crimes of violence in Suffolk have risen by 59 per cent.—twice the rate of other English counties. Given that, in the 12 months preceding April 1998, crimes of violence increased by 21.2 per cent, the figure of 59 per cent. over the four-year period of which I am speaking is certainly an underestimate. That is a shocking statistic. Such violence profoundly undermines the fabric of rural life.
To be frank, the problem arises from chronically inadequate police numbers. The pressures on Suffolk constabulary and surrounding constabularies are greater than ever and the effect on police officers' morale is devastating. A letter to me from Mrs. Butcher of Brandon reveals the problem. She states:
"In my young days, there were always two policemen on foot every night patrolling the town, even though we had a population of 2,000. Those were the days."
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I refer to the results published in my "West Suffolk Westminster Report" after I invited people to put their views on crime and policing in my constituency. I asked 10 questions, of which the following are three with the responses. When asked, "Do you think that there are enough policemen and women on the streets?" only 1 per cent. replied yes and 98 per cent. no. The question "Do you feel that crime is on the increase in our local area?" elicited a yes from 84.1 per cent. and a no from 5.6 per cent. At the risk of straying into party politics, I also asked "Do you feel that the Government have met their pledge to be tough on crime and tough on the causes of crime?" to which 2 per cent. replied yes and 97 per cent. no.
The impact on local communities is reflected in the way in which the local media deal with the issue. They respond to the anxieties of people who live in the local community and who are extremely worried about the lack of police coverage. No one could describe the local newspapers in East Anglia as being remotely sensational. For example, on 17 January, the front-page headline of the Thetford & Watton Times, the local paper in the constituency of my right hon. Friend the Member for South-West Norfolk (Mrs. Shephard), stated: "Stand up to yobs on estate call". The article stated:
"A Thetford housing estate is being held to ransom by a group of marauding youths because residents are too scared to report incidents to the police."
The article refers not to a sink estate in an inner-city area in which alienation and despair might be rife, but to Norfolk, in East Anglia. Only a few days ago, a headline in the Cambridge Evening News read "Time to halt violent tide". The Newmarket Weekly News headline on 1 February was "Stern warning for criminals", and the following article stated that although the detection rate in Newmarket had gone up, which is welcome, crimes of violence in the preceding nine months had increased from 110 to 150. Thus the pattern continues.
I shall read the Minister an extract from a letter that truly disturbed me, from four 12-year-old girls who live in Newmarket—Catherine Snell, Elizabeth Lennie, Charlotte Telford and Corrine Marston. They said:
"We are concerned because there is a lot of vandalism, young smokers, alcoholism and drug abuse. We are also concerned because sometimes it is worrying to walk through the town where there are a lot of gangs of teenagers hanging around because they don't have anything to do."
That was reported in the Newmarket Journal and in the Soham and Newmarket Standard, which also carried two stories on—guess what—a baseball-bat thug in Mildenhall and an armed raider who was twice thwarted in the high street in Newmarket. Such things are deeply disturbing to the balance of communities, and the media are fully entitled to report them.
In Brandon—a police catchment area of about 20,000 people including those living in surrounding villages—there is sometimes only one police officer on duty. In Haverhill, with a catchment area of 33,000, there are sometimes only two police officers on duty, although I pay tribute to the success of Haverhill's police in reducing crime in the town. In Newmarket, too, the number of police officers has fallen in the past few years, in spite of Newmarket having become the nightclub capital of East Anglia. The pressures on the police are enormous. We have had staggeringly huge increases in

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crime, yet the number of police officers has fallen. The chief constable of Suffolk spelled out the problem when he talked of his his constabulary being stretched to the limit and of the absolute need for 100 additional police officers. His views are summed up in a comment made to me by Mr. C A Bailey of Mildenhall, another constituent of mine, who said:
"My wife and I recently retired and we no longer feel able to walk safely in our local area in the evenings. Where are the police these days?"
I hear that cry every weekend when I am down in my constituency. I was given another letter from a constituent of my hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley), a gentleman called David Barker, who is a distinguished former chairman of the National Farmers Union in Suffolk and who is very plugged in to his community. Mr. Barker writes:
"Although we have 1,100 in the Suffolk Police force many do not actually patrol. The Elmswell area has 35 villages and normally three police officers by day. At night there is virtually no cover because Elmswell and Eye, an area of 90 villages, has just one car on patrol. To travel from say Hoxne to West Suffolk to say Chadacre takes almost an hour. This is totally inadequate. We also have the problem of Life Science at Occold drawing away precious resources. This combined area, I am told, has 40 officers for one sixth of Suffolk."
Mr. Barker makes a further point:
"Rural people are being ignored and under protected in favour of the urban areas. Standard New Labour policy. I think the police force needs a good objective assessment to target police in the areas of real need."
There is widespread anxiety throughout my constituency, Suffolk and the rest of East Anglia. I would like to make two specific suggestions to the Minister, the first of which rests on the fact that much crime, particularly violent crime, has to do with youth crime. I have some pride in my involvement in setting up a drugs taskforce in Newmarket which has been replicated elsewhere, but I shall refer to a project that I saw while on a parliamentary visit to north America, one that dealt specifically with drugs and young people. I applaud many constabularies in different parts of the UK who have tried to connect to young people through specific projects—perhaps during the summer or school holidays—but the project I have in mind was a permanent one. It was in Ottawa in a truly run-down housing estate with every possible social problem—high crime, drug-taking, alienation, a very large immigrant community and many people who traditionally disliked each other. It was an almost impossible area for the police to deal with. What the police did was to identify something very simple about young people, which is that they have natural aggression. The police took over a building and turned into a sports centre run by police officers who had a good sporting track record and liked dealing with young people. Those officers started to build up a relationship with the young people and, crucially, acted as role models.
I allude to that idea having seen its success and because we need the Home Office to encourage and sponsor such projects, not only as the one-off schemes that exist now—although I repeat that I applaud them—but as projects to reach young people through sport and physical education.The Secretary of State for Culture, Media and Sport, who must hold the world
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parliamentary record for taskforces and reviews, announced the other day—though I think it curious that
it took nearly four years of Labour Government—that there would be a review of sport and physical education in schools. Physical education in this country is in rapid decline, and the level of fitness and sports participation among young people is not good. I hope that the Home Office will link up with the Department for Culture Media and Sport and have some input into the review. It is very important that we reach out to young people and that we make the police role models in their local communities. We have an opportunity to resolve a problem that exists in our schools; through the co-operation of the two Departments, the situation could be improved significantly. I applaud what is happening in Newmarket, where PC Greenwood is setting up a drop-in centre, which will be opening up to young people to encourage them to meet the police in a positive atmosphere. Not only are young people who participate in sport, less prone to criminal activity, they also perform better at school.
I would also like to make a very specific suggestion. The management of the Post Office have been down to my constituency, visiting the post offices that have been held-up and raided with the terrible consequences I already described. Running a small rural post office is expensive: it is difficult to build up the business, it is hard work, and the business is not very profitable. As a result, record numbers of rural post offices have been closing— there are 450 post offices for sale at this moment. I urge the Minister to talk to the Post Office about security in a proactive and positive way. I have repeatedly had meetings with the managers and they must be made to understand, that if there is inadequate security provision in rural post offices and if the police are not there to help when a problem arises, the ripple effect started by closure is exacerbated, encompassing all the problems that that brings for local communities. I urge the Minister to engage in high-level discussions with the Post Office on specific measures to address the issue.
It is a characteristic of the present Government that they like to target things—they have challenge funds and other sums that can be accessed for different purposes. I fully accept and acknowledge that there has been an increase in funding to the Suffolk constabulary, but the Minister should bear in mind—because it is a culture prevalent throughout Government Departments—that to secure those funds requires a very high level of bureaucratic activity on the part of the constabulary, and we know that the bureaucratic pressures on the police are already high. I hope that the ability of chief constables to organise policing in their areas is not being further impaired by the amount of bureaucratic activity that such funding requires.
At the heart of the issue is the absolute necessity to redress the reduction in police numbers that has happened in areas such as Suffolk. Indeed, we must add to those numbers. We must be tough on crime and on the causes of crime: in an area like East Anglia—where the causes of crime do not bear comparison with those in many other urban parts of England—there is no excuse. To be tough on crime requires transparency in sentencing and it requires that local criminal justice systems be supported so that magistrates understand about problem families in their local communities.

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There is a crisis of violent criminality in East Anglia, in Suffolk in particular, and in my constituency. Enough is enough.
12.47 pm
The Minister of State, Home Office (Mr. Charles Clarke): I congratulate the hon. Member for West Suffolk (Mr. Spring) on securing this debate, although I found some of his language a little extravagant. The debate provides a useful opportunity to air some of the concerns that have been raised about policing in East Anglia and it allows me accurately to set out the overall situation and put it into context.
East Anglia is relatively a very safe place to live. In all major categories of crime, offences per 1,000 of the population are well below the national average. In fact, the Audit Commission report on police performance for 1999–2000 published in January—the sort of good objective assessment to which the hon. Gentleman referred—shows that his local area of Suffolk, has the fourth lowest crime rate in England and one of the highest detection rates. I understand from the chief constable of Suffolk that house burglary in the force area is the lowest in the country in terms of number of offences and of repeat victims. The below-average trends for crime per 1,000 of the population are repeated in the other East Anglian counties of Cambridgeshire and Norfolk, to which I shall refer during the course of this debate. I shall leave north Essex out for the time being and stick to the three county areas that make up what might be called "real" East Anglia.
Overall crime in East Anglia increased by 6 per cent. between April 1996 and September 2000, and in the 12 months to September 2000, offences in Suffolk increased by 10.8 per cent., according to recently published figures. In Cambridgeshire, however, crime fell by 2.9 per cent. and in Norfolk by nearly 1 per cent. There was an overall decrease in crime over the population as a whole, but crime is still too high and all our policies and strategies are directed to bringing crime levels down.
In respect of funding, in recent years East Anglian forces have consistently set budgets that are above the national average: in the past two years, budgets have been increased by between 4.5 per cent. and 5.8 per cent., whereas the national average increase was 3.1 per cent. in 1999–2000 and 3.6 per cent in 2000–01. For 2001–02, forces in East Anglia will receive Government-supported funding increases of 5.6 per cent. across the range; Suffolk will receive 5.8 per cent., Norfolk 5.8 per cent. and Cambridgeshire 5.4 per cent. Those figures compare with the national average of 4.9 per cent., so each force and East Anglia as a whole will receive significantly more than the average overall increase. In addition, East Anglian forces will receive £4.626 million from the rural policing fund, which was specifically established by the Government to deal with some of the problems of crime in rural areas to which the hon. Gentleman referred. The settlement has been a good one for forces in East Anglia and I am sure that chief constables and their police authorities will use it to best effect.
It is common ground across the House that police numbers are important, but only as part of a comprehensive package of measures to ensure a modern
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and efficient police service. The public, rightly, feel reassured by the visible presence of police officers on the streets; that helps to reduce the fear of crime and increases the possibility of gathering intelligence in order to address crime issues as they arise. That is why we established the crimefighting fund. At the end of September 2000, East Anglia had 3,768 police officers; I am glad to say that that reflected an increase on 31 March 2000. For the first time since 1993, police numbers are beginning to increase. It is also important to note that the number of civilian staff increased in the same period by 54 to 1,786 as of 30 September 2000. The hon. Gentleman will acknowledge that many of the extra civilian support staff will have been used to free police officers from paperwork and other jobs that can be as effectively undertaken by civilians. Thus, police officers will have been freed to spend more time on operational work. In Suffolk constabulary, that meant that the operational presence of police officers increased from 66 per cent. in 1988–89 to 70 per cent.—well above the national average of 53 per cent. In my own force area, the figure was 43 per cent, which is below average, but in Suffolk there was above average operational capacity.
There is further good news in the hon. Gentleman's local force area. Although his force had 31 fewer police officers on 30 September 2000 than on 31 March 2000, the force has projected that there will be 1,152 officers by 31 March this year, which is six more than there were 12 months before. Police forces in East Anglia have genuinely reversed the trend under which wastage exceeded recruitment. Our published police manpower statistics for 1999–2000 show that 83 officers were recruited and 167 left forces in East Anglia in that year. However, in the first six months of 2000–01 alone, 121 new officers were recruited and 89 left, meaning that 32 more officers joined the three forces than left them. Overall, the numbers are improving and we are determined that they will continue to improve by means of the crimefighting fund that the Government have established. I pay tribute to the three chief constables of Suffolk, Cambridgeshire and Norfolk for their committed efforts to improve the situation. They lead strong and committed forces in areas of relatively low crime nationally and they seek to make a major difference to the communities that they serve. The position on police numbers is a strong one. There were 78,000 responses to our national recruitment campaign and a large number of expressions of interest, many of which have been passed on to forces in East Anglia.
I mentioned rural policing issues, which I will not go through in detail, except to say that £4.6 million—15 per cent. of the total available—has gone to East Anglia: Suffolk got £1.4 million, Norfolk £2.08 million and Cambridgeshire £1.1 million. The forces are spending money to support a wide variety of imaginative initiatives, including the development of intelligence-led patrols, the use of mobile police stations, additional police officers and overtime in rural areas, improving rural police stations, accelerating civilianisation of some police work to increase police officers' operational presence as I have described, the installation of new communications technology and the development of community safety partnerships in rural areas. The situation has improved significantly and will continue to do so in future.

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On performance, I pay tribute to the East Anglian forces, which are doing well at maintaining a high standard of service, as shown in the Audit Commission report to which I referred. Their primary detection rates exceed the national average of 12.22 per officer. The figure was 13.3 in Suffolk, 13.1 in Norfolk and 13.8 in Cambridgeshire, which is a tribute to the way in which those forces are managed. I am sure that the hon. Gentleman would associate himself with that comment. Responses to calls requiring an immediate response exceeded local targets. The figure was more than 88 per cent. in Suffolk and more than 79 per cent in Cambridgeshire and Norfolk. Overall, more than 89 per cent. of 999 calls were answered within the target; the figure was 89.9 per cent. in Cambridgeshire, 93 per cent. in Norfolk and an impressive 95 per cent. in Suffolk. Our partnership schemes have received large resources—£4.2 million in total—from the crime reduction programme, focused on targeted policing, reducing burglary and a range of other initiatives. Bids for neighbourhood wardens and closed circuit television are under consideration by the Government. There is a substantial range of achievements.
The hon. Gentleman made two particular points. On the first, I commend the work that he described on youth crime in Ottowa. I am sure that many police forces in this country, including Suffolk and my own, have had specific schemes and approaches based on involvement in sport. In Norfolk, we have a motorbike club for young people precisely to address those issues, especially as they involve aggressive young men. It is simply not true to say that we are not making sport a priority. He will be glad to know that my Department is in touch with the Youth Sport Trust, which is a highly effective organisation, to develop and roll out the sports initiative that he described under our crime reduction programme and to put resources into those areas. From my time as an Education Minister dealing with youth sport, I know that there is simply no correlation between the picture that the hon. Gentleman painted and reality. Sports education is increasing and will continue to do so. On his second point, I confirm that through our retail crime reduction group we are discussing with the Post Office what steps we can take to address such issues more effectively.
I am delighted to have had a chance to respond to the debate, although I rather regret the pre-election atmosphere. In a more relaxed and open environment, and in his heart of hearts, the hon. Member for West Suffolk might concede that real progress is being made in policing in Suffolk and elsewhere in East Anglia. The Government certainly intend to continue making the kinds of changes necessary for us to be able to do that.

Economic Regeneration (Plymouth)
1 pm
Mrs. Linda Gilroy: Plymouth is the largest city on the south coast, and the second largest in the south-west. The city's population is 250,000, but its influence spreads further. Some 330,000 people live in Plymouth's travel-to-work area. Plymouth's shopping catchment area includes more than 400,000 people. Its economic health and well-being are therefore important to a substantial number of people.
Economic regeneration is being led by the 2020 partnership. Founded in 1993 as the Plymouth 2000 partnership, the Plymouth 2020 partnership promotes regeneration, social inclusion and economic development across the city. It is made up of representatives from the public, private, voluntary and community sectors, and is jointly chaired by a senior elected council member and a nominee from Plymouth chamber of commerce and industry. It provides the overall lead and direction for the pathfinder initiative, and co-ordinates other partnership work in the city, including employment, education and health action zones, the single regeneration budget programme, and links to environmental and community safety partnerships.
Historically, Plymouth has been greatly dependent on employment in defence-related industries, particularly the dockyard. Some 15,000 people worked in the dockyard in 1981, but that figure had dropped to 3,500 by 1997. Despite growth in some sectors over the 10 years to 1996, a net 4,000 jobs were lost to the city. As a consequence, Plymouth saw a sharp rise in unemployment and poverty, and a fall in incomes. The response of the city was to diversify while seeking successfully to consolidate naval and other Ministry of Defence activities.
Plymouth has been fairly successful with inward investment. Some 25 major foreign-owned manufacturing companies in Plymouth employ more than 12,000 people. Tourism employs a similar number, and call centres are a recent, fast-developing sector, which now employs over 4,000. The city has important health and higher education sectors, with some key centres of excellence. High-tech firms, such as JDS—manufacturers of fibre optic cable who moved to the city last year—and existing employment, such as BAE Systems, need access to skilled and well-trained people, which our university, with its traditions of science and engineering, is well placed to develop.
The recent go-ahead given by my right hon. Friend the Secretary of State for Trade and Industry for the development of the Langage energy park on the outskirts of Plymouth by Wainstones is hugely important. The investment of more £600 million—twice the value of objective 1 to Cornwall—has the potential to increase the Devon population's GDP by nearly £180 per person each year. I am sure that my hon. Friend will be surprised to learn that some leading local Conservatives have been lukewarm in their encouragement of that investment, and in some cases downright hostile. The extension of the high-pressure gas pipeline, which is part of the project, will bring opportunities for combined heat and power generation in other parts of the far south-west peninsula. All four

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Labour Members of Parliament in Devon and Cornwall, including my hon. Friend the Member for Falmouth and Camborne (Ms Atherton), were enthusiastic and active in their support for that important investment.
A significant dimension to Plymouth's regeneration is the release of MOD property. Work on the site of the Seaton barracks in the constituency of my neighbour, and hon. Friend the Member for Plymouth, Devonport (Mr. Jamieson) is well under way. We hope that other major developments will follow the announcement last summer that the Phoenix trust, headed by the Prince of Wales, is to develop an important part of the Royal William yard site. I am currently making representations to the MOD that large parts of the dockyard wall, which run along the south yard of Devonport dockyard, should be knocked down.
Access to some land and buildings, especially some of the historic parts such as the old market and the ropery, are needed for community economic regeneration.That is important for the new deal for communities project, "Devonport people's dreams". There was a time when someone from every house in every street of a 4,000-strong community was employed in the dockyard. Few are now so employed, so it is important that they should have the best chance of using the £30 million investment from the new deal for communities to build new opportunities on their doorstep, where the unemployment rate is one of the highest in the city.
Unemployment in Plymouth has fallen, which is one of the key success stories for partnership working. Led by the Employment Service, Plymouth has made the most of various new deal programmes. Long-term adult unemployment has plummeted by more than 60 per cent. since May 1997, and youth employment by a staggering 90 per cent. Unemployment is below the national average for the first time in 20 years. The quality of our partnership approach to regeneration has ensured that Plymouth has seen some of the most significant improvements in employment in the country.
We are fortunate that our local Evening Herald supports the new deal programmes. Under the leadership of editor Rachel Campey, the paper has featured success stories of what young people, lone parents, and, more recently, older people have achieved through the new deal. The paper has played a key part in helping Plymouth people to see their city as a can-do place, in which the success stories of individuals add up to something better for everyone. Such positive reporting has not done the paper's circulation any harm—perhaps because a more prosperous city buys more newspapers.
Plymouth, however, still tells a tale of two cities. In May 1997, unemployment in the poorest inner-city wards was six times greater than in the affluent suburbs of Plympton. In seven wards, 25 per cent. of the community lives in poverty. There is a 700 per cent. variation in coronary heart disease across the city. The legacy left by my Tory predecessor included the poorest ward in England.
Many of Plymouth's housing issues are linked with wider problems of deprivation: the sale of council housing has left the authority with a stock of which half are flats, although most people would prefer a house. In the more deprived areas, the choice of housing type is
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severely restricted and the turnover high. More than 20 per cent. of the privately rented stock is unfit, as are 10 per cent. of owner-occupied homes—twice the national average. Tackling fuel poverty is important to how we improve housing stock.
The range of issues that need tackling in the city has attracted six rounds of single regeneration budget support, largely focused on 90,000 residents living in the most deprived waterfront communities. At long last, in SRB round six, Prince Rock and Cattedown are getting attention. Alongside employment, leisure and healthy living projects, improvements to housing stock will be an important part of the east end renewal project that residents are working hard to develop.
The new commitment to regeneration is a Local Government Association initiative, developed with other public, private and voluntary sector partners, which has the full backing of the Government. In July 1998, the Department of the Environment, Transport and the Regions announced that Plymouth unitary authority was to be one of 20 pathfinder local authorities that would lead the initiative.
Some £1 billion of public money is spent in Plymouth. Of course, we would like more money, but we welcome what comes our way. Health service expenditure at Plymouth Derriford hospital trust is set to increase by 30 per cent. in real terms during the next three years. Expenditure at the trust has already increased by one third since Labour took office. The new Peninsula medical school will train more than 100 new doctors as part of the Government's nationwide investment in 1,000 extra doctors, and we are campaigning vigorously for a new £50 million planned health care centre.
Those developments will have wider significance in Plymouth's regeneration, as will investment in 41 extra police officers in Plymouth, made possible by additions to the Devon and Cornwall police authority budget. Health, education and employment action zones have brought several million pounds in extra income to the city's coffers each year. An above-inflation standard spending assessment has been boosted by £2 million more than the Tory-invented formula would have given the city. Little thanks has been forthcoming from the Tories, but I hope that the Minister will convey my thanks and those of my hon. Friend the Member for Plymouth, Devonport to the Secretary of State for responding to our representations and those from other parts of the country. The floor that he introduced protects Plymouth from the full impact of growing prosperity, as reflected in the new earnings survey which affects how the local government finance cake is divided. The city has had an inflation-busting 14 per cent. increase in funds for education and social services, a doubling of the proposed neighbourhood renewal allocation for the coming year, and the biggest local transport settlement in recent memory with the go-ahead for an £8 million investment in the northern corridor, which will allow for the all-important protection and development of the city airport.
My hon. Friend the Minister may be surprised to learn that the Conservative leader of Plymouth city council repeatedly says that Plymouth is always at the bottom of the pile. This year, the council claims that there is a £20 million shortfall in its budget. That, of course, is a fantasy figure that can quickly be reduced to a more manageable proportion of the city's £250 million

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budget; my hon. Friend will be familiar with such claims. In Plymouth's case the Minister may find those claims surprising, considering the special attention given to the city.
Granting zones status to Plymouth and giving it special pots of money was intended to ensure that public money was spent to achieve value and effectiveness across the normal public service boundaries. Those involved in the partnership working, including the city council, can claim considerable success in respect of the employment outcomes to which I referred, and in matters such as the recent reported success of the health action zones in stopping people smoking. If sustained, that will help to tackle the terrible coronary heart disease figures that I mentioned earlier. The added value is evident from the first year's activity of the education action zone on standards in schools, and in the joint tackling by health and social services of pressures on bed blocking in hospitals by ensuring that adequate support is available for people coming out of hospital.
With her experience in local government finance, the Minister will recognise the challenges and choices that councils throughout the land have to make. She may also share my view that it is a bit rich of a Tory council to say that it cannot manage on Labour's above-inflation settlement after year-on-year cuts in expenditure by Tory Governments. She may consider, as I do, that axing car parking charges at a full-year cost to the council's budget of £800,000 might not be the right priority for a council so challenged. She may consider, as I do, that cutting £1 million from the housing budget in the SRB east end renewal project to finance swimming pools, which may be expensive to build and to run in future years, is not the right priority. She may consider, as I do, that precipitate proposals to cut money from the highly successful welfare rights unit are inappropriate, when that unit has brought more than £500,000 to some of the most vulnerable people in the city.
The Minister may share my anger and fear that such priorities place question marks over the council's understanding of and support for our successful partnership work. Alarm bells ring; I hope that such foolish proposals are born of inexperience. Perhaps the council will realise that wrongful penny-pinching can mean thousands of pounds down the drain and misery for people at Granby and Torybrook when the homes in which they thought they would end their days are threatened with closure without proper examination of whether and how that could be avoided. When one resident is approaching 100, one might think that someone, somewhere, should have asked those questions first, but no one did, so callow inexperience becomes callous indifference to people who deserve better.
It is not the Minister's place to determine the detail and priorities of local council budgets—if it were, there would be no point in having local councils. There are, however, challenges in sustaining Plymouth's partnership work that fall within the remit of the Minister's Department and which I want to flag up for her attention. The 2020 partnership is preparing plans to be among the first communities to have approval as a local strategic partnership. Sustaining partnership is an instant challenge for the public, private and voluntary
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sectors. To support and participate in initiatives such as "Devonport people's dreams" and the east end renewal project, means that, city-wide, the community-based partnership work needs constant motivation, refreshment and resourcing. I hope that the Minister will share her observations on how to maintain the momentum. What scope is there for bringing some focus to the plethora of area-based and city-wide initiatives, particularly on funding?
My hon. Friend the Minister will be aware that some good projects continually lose out in the competitive bidding process. I recognise the merits of bidding—the most project-ready groups secure what will always be scarce resources—but some groups miss the boat time and again, sometimes right in the heart of the most deprived areas. Will local strategic partnerships have the tools to take important decisions about resourcing and identifying gaps? Can some separate funding streams be joined up to complement the joined-up thinking and action exemplified by the partnership projects?
Finally, what links will there be between local strategic projects and regional development agencies regarding such important matters as transport? I refer not just to air but rail links, which have been in the news so often in recent weeks. My hon. Friend the Minister will know that outrage has been expressed the length and breadth of the peninsula in response to the proposal to use 40-year-old rolling stock on intercity links to benefit services in Wales. Keeping the air link to Gatwick is vital, and it would be good to restore some links to Heathrow, if only one or two per week. That would be important to businesses such as Gleason's, Kawasaki and Toshiba, which have far-eastern links.
I pay tribute to the Minister and her colleagues for the Department's work on regeneration. In our short debate, I have left out many initiatives—the urban and rural White Papers, the 10-year transport plan, the regional development agency, the housing Green Paper and much else. My hon. Friend will forgive me and know that I did that because I wanted to highlight local hopes and fears and celebrate some important successes. I thank her for recognising our needs, our challenges and our ability to respond positively to the opportunities that come our way.
1.16 pm
The Parliamentary Under-Secretary of State for the Environment, Transport and the Regions (Ms Beverley Hughes): I congratulate my hon. Friend the Member for Plymouth, Sutton (Mrs. Gilroy) on securing the debate and on her comprehensive and informed speech about the importance of partnership in her area. I hope that my short reply can do justice to it. My hon. Friend's speech demonstrated her commitment to her area, and I acknowledge her important role as a local Member of Parliament. She has been an assiduous campaigner, working with Ministers to secure the best for Plymouth. The catalogue of benefits gained since 1997 is as much a testimony to my hon. Friend's highlighting of Plymouth's needs as it is to the Government's commitment to such areas.
My hon. Friend outlined Plymouth's strengths and weaknesses. She spoke about the city's ability to respond to economic change and to diversify. She spoke, too, of the skills and experience of Plymouth's people,

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and the city's resource strengths, including its industrial and economic base, excellent training facilities and transport. Those factors help to position Plymouth now and in the future. My hon. Friend also rightly identified key problems and highlighted areas of Plymouth that suffered more than most from long years of neglect under the previous Government. She drew attention to pockets of significant disadvantage, which must be tackled.
I was pleased that my hon. Friend referred to the Government's various commitments to Plymouth—partly through the RDA, but also more directly as the city has benefited from a number of Government initiatives. Certainly the RDA is working closely with local partners and the community in Plymouth, and RDA investment commitments are approximately £18 million currently. These include expansion of the hugely successful Tamar science park, which the Prime Minister opened last year, and several other important initiatives for economic development.
My hon. Friend touched on Government support in several areas. Time does not allow us to go through them individually, but some important direct assistance from Government is provided through the single regeneration budget. Plymouth won nearly £24 million in SRB funding in recent rounds, helping some of the most deprived communities in the area. It was also successful in securing continued objective 2 status within the south-west programme, which is worth a total of £108 million in European grant over the period.
However, my hon. Friend also identified area-based initiatives that have been a hallmark of what the Government have tried to do on regeneration. Plymouth is one of a small number of areas across the country that has secured a "full house" in terms of employment, education and health action zones. There are sure start and new start programmes too, and I am delighted to be able to tell my hon. Friend—she probably already knows—that Plymouth is one of the 66 areas recently invited by my right hon. Friend the Secretary of State for the Environment, Transport and the Regions to bid in round 4 of sure start 2, something for which she has campaigned for some time.
We look forward to receiving, next month, a full delivery plan for the local new deal for communities, which the partnership has been putting together. That could bring up to £50 million of funding to the area for regeneration, again tackling some of the areas that most need help. My hon. Friend mentioned the new deal, and I think that it has had tremendous success in Plymouth. It has helped more than 2,150 people aged between 18 and 24 into work, and has, very importantly, a retention rate of approximately 70 per cent. That has made an important contribution to the fall in unemployment, particularly among young people.
Last October, we announced the neighbourhood renewal fund. Among areas with a multiplicity of difficult issues to tackle, Plymouth became one of four areas in the south-west that will benefit from neighbourhood renewal funding. That will help to improve housing, raise school standards, reduce crime and improve health in some of the most deprived communities. My right hon. Friend the Secretary of State announced in January an increase in Plymouth's funding under the neighbourhood renewal fund to £4.8 million over three years. Clearly the NRF will play a key
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role in the Government's wider strategy to improve prosperity, tackle poverty and create opportunities for all.
As my hon. Friend has said, a great deal has already gone into Plymouth, and rightly so. Further regeneration opportunities will continue to come from the Government, but it is gratifying to see that we are already able to demonstrate—and my hon. Friend is able to talk about—the effects of what we have done so far. The Employment Service in Plymouth has placed more than 6,800 people in work since April, of whom 2,500 were long-term unemployed.
That incredible achievement will make a lasting difference to the vitality of the economy of Plymouth, not just helping individual families, though that is important, but maintaining stimulation of the local economy, which will benefit everyone. I am delighted that unemployment in Plymouth has fallen to 3.2 per cent., a reduction of nearly 30 per cent. over the past 12 months. The rate is now below the national average for the first time in many years in Plymouth. Real measurable improvements in performance are having an impact on people's lives and on the local economy.
My hon. Friend touched on the importance of partnership in stimulating and sustaining that kind of progress, and I agree with her on the importance of partnership between central and local government and the strengths of local partnerships. I welcome my hon. Friend's eagerness for Plymouth to be at the forefront of developments in partnership. On the neighbourhood renewal fund, the requirement to have a local strategic partnership to administer the fund is an important step. Local strategic partnerships should build on existing good practice to rationalise existing partnerships, to improve on working practices and to cut down on bureaucracy.
We expect local strategic partnerships to rationalise some current processes and to create savings in the work involved in sustaining a number of partnerships. They will have scope to join up funding in creative ways and to decide priorities, so long as they meet targets on four big issues: crime, housing, health and jobs. It will be up to the local strategic partnership to decide the priorities for how that money is spent. It is implicit in what my hon. Friend says, and I agree that we need mature local authorities to fulfil the strategic roles that we have given them in leading and nurturing effective partnerships, both locally and between the local area and central government.
I want to refer to funding, which my hon. Friend raised. Plymouth has received funding through the local government settlement, and I am disappointed by erroneous accounts that have appeared in the local press. Plymouth will receive more than £5.5 million more in general grant this year than it did last year. That position has been protected by the introduction of the floor. In addition, there will be a 12 per cent. increase for education and nearly 21 per cent. more for social services, giving a total increase in ring-fenced grants of 4.5 per cent., which is twice the rate of inflation. That should give substantial assistance to the council.

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I cannot comment on the council's priorities; I do not have the total picture. I think that my hon. Friend was right to question some of those priorities. There may be a case for doing so, in certain circumstances.
Mrs. Gilroy: Does my hon. Friend agree that, in addition to the substantial above-inflation increase that she has mentioned, the other pots of money for the health action zone, the education action zone, the employment action zone and winter pressures in the NHS are also relevant?
Ms Hughes: Of course, all those things provide additional funding, which Plymouth would not have received if the present Government were not in control. Those funds are additional to what was already a generous local government settlement. My hon. Friend is quite right to point that out.
In terms of priorities, my hon. Friend was right to question whether it is a good idea to forego £800,000 of income to cut parking charges. There may be an economic case for that; I do not know. In another of the examples she pointed out, however, it is rarely economic to cut welfare benefits advice services. We know that, across the UK, money invested in that advice increases the amount that people receive in benefits. Many people are unaware of what they can claim, and welfare benefits advice can help them to receive what they are entitled to. Again, there is an economic case for welfare benefits advice, and I suspect that it is short-sighted to cut the service.
I repeat that we need mature local authorities that are willing to put aside political issues, about which they may feel strongly, to work with the Government and local partners to benefit the community. I hope that the ruling group on Plymouth council will not use these issues as a political football but will, as my hon. Friend suggests, work with others to benefit her constituency.
In conclusion, the Government are committed to working in partnership with the council and communities in Plymouth. The debate demonstrates the enormous progress that the partnership and the additional resources have already achieved in my hon. Friend's constituency. I look forward to that continuing with the support of my hon. Friend and the local partners.

Miners' Compensation Scheme
1.30 pm
Mr. Elfyn Llwyd: I welcome the Minister for Energy and Competitiveness in Europe to the debate and to his new post. I believe that he will do his utmost to put right the shambles and the great injustice done to the miners of the United Kingdom, especially those for whom I speak today—the miners of Wales. I remember arguing with a Minister during an Adjournment debate about a set of temporary traffic lights. Those temporary traffic lights had been in place for 23 years; it took 10 months to have them replaced. I hope that the same success will follow today's important debate.
The Minister is on record as saying that the Government's handling of the claims is a chaotic shambles. I do not disagree. Today's Western Mail carries a long article by the Minister, which I welcome, although it includes one or two misconceptions that need to be corrected. First, non-smokers have always been discriminated against; they received less money than others because that fact was built into the settlement. Secondly, he said that widows are to be given top priority. With respect—I do not aim this at him personally—that is hypocrisy. The Department of Trade and Industry has just issued a new legal challenge to reduce widows' compensation. I feel sure that the Minister was not aware of that. We need to stop such legal challenges, not to mount fresh ones and thus deny people what is rightfully theirs.
In 1988, the National Association of Colliery Overmen, Deputies and Shotfirers—NACODS—began to investigate the links between dust and bronchitis, emphysema and so on. Shortly afterwards, it appointed solicitors and an epic legal battle followed between one of the smallest trade unions in the country and the Government. The case commenced in the High Court registry in Cardiff in October 1996 and culminated in September 1997 in the High Court in London. It was the longest injury trial in British legal history.
The complaints that the miners suffered were, as the Minister will know from knowledge of his own constituency, absolutely awful. I was in the Rhondda three weeks ago speaking with a gentleman who is unable to leave the house or speak to anyone. He uses four bottles of oxygen a day and can hardly move. He is relatively young, getting on for 60, but is absolutely crippled. The Minister will be familiar with the comment he made: with half a smile, that man said that he believed that the Government were waiting for him to die so that they would not have to pay out.
The Minister for Energy and Competitiveness in Europe (Mr. Peter Hain)indicated dissent.
Mr. Llwyd: I quote the man's remark. It is not what I said, but what he said to me. I do not know what that man's politics are, nor was it of any interest to me in my investigation.
Mr. Richard Livsey: In my constituency, a Mr. Stripp is suffering from vibration

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white finger. His claim started four years ago and still is not resolved. It is time that such bureaucratic nonsense was tackled head on.
Mr. Llwyd: The hon. Gentleman is absolutely right. In the union case, judgment was not handed down until 23 January 1998.
Several serious problems need to be addressed today. The first is about medical staff. At the beginning of 1999, the Department of Trade and Industry stated that it would be completing full medical assessments at the rate of 2,500 a month by March 1999, and 4,000 per month by the summer of 2000. However, by the end of 2000, not even 2,000 per month were being carried out. Almost 133,000 claims are waiting to be completed, more than 27,000 of which are in Wales. In the week commencing January 2001, only 455 full medical assessments were completed; in the same week, nearly 2,000 new claims were made. The Government must ensure that more medical staff are employed so that the targets that they set so long ago can be reached. It is no use opening more testing centres if there are no more staff to do the work. The doctors will simply be playing musical chairs between one centre and another.
I pay tribute to all those who stood up for what was clearly right, and pursued their claims with tenacity and spirit. Those men were sick with a disease that was crippling and killing many of them. It was distasteful in the extreme that such an obviously worthy and excellent cause had to be fully litigated in the High Court. I pay tribute to the solicitors concerned, Hugh James Jenkins of Merthyr Tydfil, who took on the mammoth task with enthusiasm. Many tens of thousands of people will want to express their deep gratitude to the person who above everyone else made everything possible: Bleddyn Hancock, the general secretary of NACODS. He played a vital part in making legal history. He has been tireless in his pursuit of justice for miners and he will carry on until the fight has been won. Despite several knocks, he has never fallen down, but has carried on, driven by the aim of ensuring fair play for the mining community.
Mr. Michael Clapham: May I point out that the unions in the mining industry have been pursuing the matter for a long time? They want the disease prescribed and to be able to proceed with a scheme at the same time. The issue is of long standing.
Mr. Llwyd: The hon. Gentleman is right. More than one union was involved, but only one took the matter to court. Let us remember that the Government had to be dragged into court kicking and screaming before any compensation could be paid.
Mr. Hain indicated dissent.
Mr. Llwyd: No compensation was considered until the High Court judgment was delivered. I shall come to the question of agreeing liability in a moment, as it is a separate issue.
The Minister has been busy in the press saying that Plaid Cymru Members do not have constituency interests in this subject. I do not represent a mining area, but that does not prevent me from raising my voice on
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behalf of people in mining communities. If we are to play that silly game, I remind the Minister that my party has constituency interests through National Assembly Members in the Rhondda, Carmarthen, Llanelli, Islwyn and in the north-east and south-east of Wales. Our two Members of the European Parliament represent the whole of Wales. I hope that that issue will not come up today. The main point is to ensure that we fight for and achieve justice for the miners.
I respectfully remind the Minister that even the previous Government saw fit to exempt people suffering from pneumoconiosis from the clawback now being enforced so unfairly against the miners. I sincerely believe that we must bring the matter to a head. It is insulting, adds insult to injury and only strengthens our resolve to put matters right. Perhaps the Minister will reply on that point in due course. To deflect blame, the Government claimed that the High Court settlement was cumbersome.
Mr. Hain indicated assent.
Mr. Llwyd: I see that the Minister agrees. The Government also alleged that the judgment was difficult to put into practice. In these days of the culture of BSE—blame someone else—it was inevitable that the Government would attempt to put some blame on the solicitors negotiating individual settlements for claimants; it has been suggested to me several times that a large proportion of the blame for the delay rests with solicitors. However, in an unprecedented move, Mr. Justice Turner, the High Court judge who decided the case recently, sent out a public memorandum in which he specified:
"That there is no evidence to suggest…that solicitors are in general dragging their feet in processing claims".
He also said:
"The fund out of which compensation is to be paid is not diminished by the costs of the legal advisers".
That is from the horse's mouth, as it were. Another attempt at BSE was to say that there were insufficient doctors of a senior grade to do the work. That is also wrong. If the Government have the will to sort the problem out—I believe that the Minister is sincere and has the will to do so—registrars will be brought in and paid properly for their work, and taken off elective surgery if necessary. The problem is huge and urgent. Waiting for it to sort itself out will clearly not do, as that will not happen. As the Minister mentions in his article, the Government are speaking about a priority system. I hope that more of the sick and elderly will be brought in far quicker than they have been hitherto. The Minister has given that assurance, and I have no reason to doubt that he will do his utmost to ensure that it happens.
I referred to people kicking and screaming through the courts. I accept that there was an acceptance of liability at the very last moment, but that brings me to a thorny issue. In 1989, the previous Government brought in a recovery of benefits provision that allowed the state to recover moneys paid in benefit to those who were eventually compensated for their injuries. However, it did not apply to those for whom the onset of disease started before 1989. In practice, therefore, nearly all miners with chest disease were exempted. Against that

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Backcloth—that Government were hardly the workers' friends—in September 1997 and within weeks of an
indication by the High Court that it would find for the claimants, the Government tabled the Social Security (Recovery of Benefits) Regulations 1997. They did so while the House was in recess, thereby bringing in the regulations surreptitiously, before the full judgment was given at the end of January 1998. Never before has there been such underhandedness and sleight of hand. The Conservatives had exempted pneumoconiosis sufferers from the clawback, but new Labour effectively acted against the miners.
I shall highlight some cases that prove how ridiculous the clawback is. The Government demanded £21,707 from a man in Treorci in the Rhondda. That was reduced to £8,540 on appeal; the appeal was then reviewed by solicitors, and in the end only £6.38 was payable. In another case, a man from Pontypridd received a demand for £19,924. That man died before receiving compensation; on appeal, the sum was reduced to £4,170, and a further appeal by the widow reduced it to £22.02. Those are stunning errors. They are disgraceful and immoral, and they represent a waste of the Government's time and money. Even bearing in mind the stance of the previous Government, whatever the situation and regardless of whether a substantial sum might be recovered it is immoral to expend so much money and time to recover only £6.38.
The miners are a special case. Theirs was a huge class action and a legal landmark. When I met the Under-Secretary of State for Social Security, the hon. Member for City of York (Mr. Bayley), a few weeks ago, he said that the miners were not a special case, adding that some of his constituents suffer from asbestosis contracted when they were working for British Rail. I said to the hon. Gentleman that I was not there to plead for his constituents, but for the miners; I told him that pleading for his constituents was his job and that if he did it properly, they, too, might be a special case. That sort of attitude is becoming more common. At a meeting in Betws near Ammanford, a Labour, councillor said how pleased he was that I had kept the matter non-political. He went on to ask why the miners should be treated as a special case and then gave examples of why that should not be so. I could not believe that a Labour councillor in a Labour ward could decry the miners' cause and make them out not to be a special case. To add insult to injury, the Government line is that the miners are not a special case and that the benefits will have to be clawed back, despite the decades of suffering, hard work, loss of health—and, in many cases, life—that were endured on
our behalf.
The miners are now being told that they are not a special case and they should get to the back of the queue because they are just like everyone else. That is abhorrent and disgraceful. I do not care what the Minister says, such a claim cannot be substantiated. Does the Minister agree with the Under-Secretary of State for Social Security who said that the miners' injuries are no different from a nurse putting her back out in a hospital? There is a great difference, because the nurse, thank God, will not die and will not be incapable of working again. To add insult to injury, the Treasury is clawing back money from the pension fund.
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We are in a terrible situation—a chaotic one, as the Minister acknowledges. It is now up to him and others to sort it out. Over the past few months I have met many miners and miners' widows. We owe them our respect and gratitude for what they have gone through, but most of all, we owe them justice. We in Plaid Cymru, the party of Wales, will continue to fight for justice, as will Labour Back Benchers. The Government are blind to all this. There will be consequences for them politically, but there will be more consequences for them socially, if they ignore those people.
1.45 pm
The Minister for Energy and Competitiveness in Europe (Mr. Peter Hain): This is the first debate that I have answered as Minister for Energy. I enjoy the job enormously and am relishing the opportunity to get stuck in and sort out the problems that have bedevilled this scheme over recent years. I do not question the integrity with which the hon. Member for Meirionnydd Nant Conwy (Mr. Llwyd) has pursued the matter, but I feel that it is important to bear in mind that the Labour Government is delivering for miners while Plaid Cymru is screaming from the sidelines. The hon. Gentleman should be working with us to deliver a better system and ensure that the improvements are put in place.
Mr. Llwyd: Will the Minister give way on that point?
Mr. Hain: No.
Like many hon. Members, I represent a mining constituency and, in taking up my new responsibilities, I am grateful to the hon. Gentleman for giving me a chance to set out the Government's position on the vital issue of compensation for retired miners and their widows. In doing so I worked very closely with my hon. Friend the Member for Delyn (Mr. Hanson), my right hon. Friend the Secretary of State for Wales and others across Britain.
I agree with the hon. Gentleman that miners are a special case. That is why we have introduced the biggest compensation scheme of its kind in the history of Britain and probably the world. I want to immediately correct one of the many falsities that he presented by way of argument. The scheme is not designed to penny-pinch and save money; it is the biggest scheme of its kind. Some £2 billion and more is already available and there is no capping of that figure. As the claims are settled, they will be paid according to the rules agreed on both sides and in keeping with the court's judgment. There is no attempt to deny miners or their widows the justice that we as a Government are delivering. The matter is a top priority for my Department and me and I welcome the opportunity to tackle it. Bringing justice to both miners and their widows is my mission. I shall do everything I can and I shall work with all those who share the same objective.
As hon. Members will know, there are two major schemes on coal health claims resulting from successful 1996 litigation against the British Coal Corporation and the last Conservative Government. The hon. Gentleman made it seem as though the Labour Government caused the case to come to court. It began under the Conservatives: they were dragged kicking and screaming into court and we have had to cope with the

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consequences of that. We were elected on a pledge to bring justice to miners and their widows and we have never at any point questioned the court's decision. The hon. Gentleman should be more even-handed and objective.
In addition to 131,000 claims for respiratory diseases, 28,000 of which are in Wales, the Department has received over 116,000 claims for vibration white finger—VWF—nearly 16,000 of which are in Wales. Progress has been good on VWF: to date the Department has settled nearly 20,000 claims, 3,700 of which are in Wales, and has made a further 22,650 interim payments, 2,480 of which are in Wales. In total, we have paid nearly £215 million in compensation, of which £28.4 million has been paid in Wales to 6,204 people. In the village of Seven Sisters in my constituency, £410,644 has already been paid to 64 people. Many such examples could be cited from right across south and north-east Wales. In Neath the total paid is £781,729 to 167 people, and in Gwent £9.1 million to 1,330 people.
Mr. Livsey: I acknowledge that that constitutes progress, but does the Minister acknowledge that even after two years solicitors are still dealing with questions from the Department to which the answers are already known? For example, an ex-miner obtained a correct diagnosis from a doctor; two years later he had received no compensation and was asked how many operations he had had. Such nonsense must stop.
Mr. Hain: I agree. Progress on lung disease has been much slower. It has been much more difficult to deal with the claims as speedily as we would want, as the legal and medical issues that flow not from Government policy but from the High Court judgment to which NACODS among others was a party are far more complex than those relating to vibration-related diseases.
Mr. Clapham: I welcome my hon. Friend to his new position. I am sure that with his background in a mining constituency he will bring great energy to sorting out the issue that we are considering.
The Minister's predecessor, our right hon. Friend the Member for Airdrie and Shotts (Mrs. Liddell), set up a monitoring group of which I am a member. One of our tasks was to begin turning the legal formula, of which my hon. Friend is aware, into a practicable formula that could be applied to bring compensation into miners' pockets. As of this month, £1 million a day is being paid to miners for chronic bronchitis and emphysema and for vibration white finger.
Mr. Hain: I welcome my hon. Friend's point of information, which contributes to the balanced outlook that I am trying to develop. It is far from the sneering view that Plaid Cymru continually adopts. Incidentally, a Welsh monitoring group is meeting on Monday and I shall attend.
The number of claimants continues to rise at the rate of 1,000 a week, making this the biggest compensation claim in Britain's history. Payments are now beginning to flow. In total, £108 million has been paid in respiratory compensation, with £27.1 million being paid
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in Wales. Including compensation for vibration-related diseases, in recent weeks we have been paying about £1 million a day. For chest diseases, for example, more than £1 million has been paid in my constituency of Neath. In the former pit village of Seven Sisters, £400,000 has been paid to 80 people and in my own village, the former pit village of Resolven—I am wearing the local rugby club tie today—£98,258 has been paid to 24 people. It is not true that no money is being distributed; in Wales alone last week a total £1 million was paid out.
However, that is not good enough. More needs to be done. The mechanism must be better and speedier and the Government are working urgently on that. In the past 10 days I have been considering ways to accelerate the process. As part of that undertaking I want to satisfy myself that we have done all that we can. I want to hear the first-hand experience of hon. Members who represent mining constituencies. I know that many changes have been made in the past six months, but I have identified several categories in which I believe that fast-track offers can be made to bring quick relief to thousands more ex-miners and miners' widows—perhaps as many as 18,000. I am taking legal and medical advice to ensure that the new initiatives can be carried out quickly.
In addition, I want solicitors, Healthcall and the claims handlers IRISC to ensure that three groups are given priority: the oldest, those who are most ill and widows. That will probably mean that younger and fitter men's appointments will be rescheduled, but I am sure that they will agree that men in their 70s and 80s who can hardly breathe or move should go ahead to take the earliest opportunities. At the end of September, my predecessor announced new fast-track proposals to generate thousands of new and revised expedited offers by Christmas to those whose initial screening tests suggested likely disability. I am pleased that we have now made more than 15,200 offers, totalling £74 million, of which 2,200, totalling £10.5 million, were in Wales. Of those, 1,200 have been accepted, leading to payments totalling £4.3 million.
I remain troubled by delays in medical assessment procedures. We are presently completing around 500 medical assessments a week, and last week the figure was 570. We need to increase that figure significantly. The lack of sufficient numbers of respiratory consultants to perform the medical assessment process, as mentioned by the hon.Member for Meirionnydd Nant Conwy, is the key bottleneck. We are working hard to try to solve that problem. First, we are urgently trying to recruit more respiratory consultants and we are considering how doctors are used and paid to ensure that we attract as many of them as possible. We must also ensure that we use the doctors we have flexibly and efficiently and use our resources more efficiently; therefore, secondly, we seek to streamline the medical assessment process: for example, we are thinking about using nurses to flag entries relevant to lung diseases in the extensive medical records currently examined by the consultant, which will help to free up additional time for the consultants to examine claimants. In addition, Healthcall, the contractor carrying out the medical assessments, is opening two new test centres in south Wales, in Ystrad Mynach and Ammanford.

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In every way that we can, we continue to try to reduce delays for widows. That requires the co-operation of all involved, to ensure that claimants are kept in touch and provided with the necessary information.
Mr. Llwyd: Will the Minister give way?
Mr. Hain: I am afraid that I do not have time.
We are also prioritising widows claiming on behalf of their late husbands. The Department has made more than 4,650 bereavement awards, totalling nearly £39 million, of which 1,030 have been in Wales, totalling nearly £8.5 million. Those are big figures. The largest such payment in south Wales was £140,000. The next largest was £94,000.
Mr. Llwyd: Will the Minister give way?
Mr. Hain: No. I have taken several interventions.
Mr. Llwyd: None from me.
Mr. Hain: I have been as generous as I can. The hon. Gentleman had a lot of time to make his point.
On compensation, my motto is maximum compensation, minimum benefits reduction. The hon. Gentleman's points were simply inaccurate. The pneumoconiosis scheme was a no-fault scheme negotiated between the solicitors and British Coal. The levels of compensation took into account benefit received, so the exemption applied.
On the matter of smoking and damages, plenty of personal injury case law in other industries shows that courts consider smoking when fixing damages for lung injury. For example, awards have been reduced in cases of byssinosis in cotton workers and lung injury caused by exposure to toxic chemicals in marine workers. I am passionate about resolving the problems that have bedevilled the compensation scheme, whether caused by legal wrangling, Healthcall or the claim handlers, IRISC. Labour came into office in 1997 determined to
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bring justice to former miners and their widows, who had been so shabbily treated by the Tories for many years. Instead of being able to get moving, we faced a year-long delay in the court process triggered under the Tories. Then, there were 18 months of wrangling over a handling agreement, with the result that, according to a court judgment, every major improvement that we wanted to introduce required agreement between solicitors. In addition, records are often hard to trace: the archives at Cannock contain 30 miles of files of old records, many not indexed.
Those are not excuses, merely a plea for understanding. Members of the House who have worked hard on the matter include the Parliamentary Secretary, Privy Council Office. Everyone has been at fault, including the Government, for not driving through a better system quicker. I give a warning, however, and it may be directed at the hon. Member for Meirionnydd Nant Conwy: I shall be tough in exposing any individual, whether claiming to be a miners' leader or not, and any Opposition party that plays politics with people's suffering. There has been far too much of that already. Equally, I welcome constructive criticism—the hon. Gentleman offered some—and practical suggestions for improvements from all quarters. It is important that we all work together, as has been said by the main north Wales paper, the Daily Post, and in the south of Wales by the South Wales Argus. The complaints and wrangling must stop, and everyone must pull together. We have a debt to pay to the men who have worked in this country's coal mining industry, as the Government have freely acknowledged. After years of obstruction by British Coal and the previous Tory Government, I will ensure that that debt is paid as speedily and fairly as possible. With the full co-operation of all parties involved, we will succeed.
I emphasise that payments are going out week by week. I can list all the payments made in south Wales, the north-east and Yorkshire during the past few weeks. Huge sums are paid to many, but I fully acknowledge that more needs to be done. I urge everyone to work with us.
It being Two o'clock, the motion for the Adjournment of the sitting lapsed, without Question put.