Westminster Hall Sitting of 16 January 2001

Preamble
[SIR ALAN HASELHURST in the Chair]

Rural Policing
Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. Jamieson.]
9.30 am
Mr. David Prior: While researching this important debate, I was forcefully struck by a reminder that Sir Robert Peel first established a system of uniformed police patrols as long ago as 1829. The instructions given to the police force at that time stated:
It should be understood, at the outset, that the principal object to be attained is the Prevention of Crime. To this great end every effort of the Police is to be directed. The security of person and property, the preservation of the public tranquillity, and all the other objects of a Police Establishment, wil1 thus be better effected, than by the detection and punishment of the offender, after he has succeeded in committing the crime.
What a salutary reminder that is today, more than 150 years later. There is no better way of deterring and preventing crime than having local uniformed police officers living in the community—men and women who live and breathe the job and who are police officers because they believe in the concept of duty and public service, who have a true vocation to uphold the law and who have the respect and trust of the communities in which they serve. Charlie Brown and Sid Wright, retired police constables who live in my constituency, are two excellent examples of such officers. One may feel that such sentiments are old-fashioned, easily parodied and have little role in the professional modern police force of today. I disagree. To make one more old-fashioned statement, the likelihood of being caught is an important consideration in the mind of the would-be criminal. The overriding aim of the police is to stop crime before it happens and before it becomes a Home Office statistic.
The case for more uniformed police officers is, I believe, unanswerable. The fall in numbers over the past few years is well known and must be rectified. My constituents and I demand to see more police officers walking down our streets and about our market towns. We are constantly told that the statistics show how safe it is to live in rural areas. It sometimes seems that one will drown in statistics. The fact is that low level crime and antisocial behaviour are increasing. I can give the Minister umpteen examples of public toilets being wrecked, newly planted trees uprooted, street lights broken, shop windows smashed, obscenities shouted, playgrounds vandalized, boy racers speeding around car parks and town centres, and graffiti scrawled on churches. I doubt if many of those incidents end up in the crime statistics, but such behaviour causes great distress to ordinary, decent people.
The Minister should be in no doubt that ordinary, decent people have just about had enough. There is no more important freedom in a civilized society than the freedom to live without fear and intimidation. The rule of law and its acceptance by the people, even when they
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disagree with it, is the hallmark of a mature democracy. It is a paradox that freedom is both constrained and preserved by law and order policies. However, I am sure that all hon. Members believe that people should not feel or be threatened by crime.
Since the last election, the number of officers in Norfolk has declined by 45 to 1,387. In November 2000, Jim Wilson, the chairman of the Norfolk police authority, stated:
We have to cover a 2,000 square mile area with 1,400 officers. We only have 107 officers out on the beat at any one time and that equates to one officer per 19 sq. miles. The thin blue line is being spread very thinly indeed.
His predecessor, Brian Landale, earlier stated:
Crime in Norfolk is being fought on a shoestring.
Norfolk now has the second lowest number of police officers per 1,000 people in the whole of the United Kingdom. In north Norfolk, for much of the time, there are simply not enough police officers available to be on the beat. Last week, a senior officer said:
We want to put more police officers on the beat but we simply do not have the manpower resources to do so.
Another officer said:
We are always struggling with the bare minimum.
Police officers are frustrated that they do not have the resources to do the job, that too many rural police stations have closed and that the rent allowance, which enabled police officers to live more easily in their communities, has been abolished. The Conservatives in government were wrong to end the rent allowance. Equally, this Government have been wrong to allow police numbers to fall and police stations to continue to close. They have also been wrong not to allocate more resources to police forces that operate in rural areas.
I make the same point about specials, who are not a substitute for experienced, trained police officers, but can complement the force. Some are outstanding; all are volunteers. Their numbers, too, have been falling throughout the country, from just under 20,000 in 1997 to just over 14,000 today. That fall must be reversed— and quickly. Specials have an important role to play: more uniformed, visible police will go a long way towards reassuring the public.
I make two points about the culture of the modern police force. The first concerns the insidious growth of political correctness. Every time that I read of complaints about racism, sexism and homophobia in the police force, my heart goes out to the thousands of decent, normal police officers who have to put up with that liberal, woolly-minded, unfair criticism. How can the Norfolk constabulary, for example, justify a cultural audit on sexism, homophobia and racism? Are we really saying that they are important issues in Norfolk? Is it not time that we stood up for the integrity and decency of police officers, instead of seeing them harassed, wrongly, for lesbian bullying, institutional racism and the like?
Secondly, the Local Government Act 1999 introduced what is euphemistically called best value. It is a wholly bureaucratic system, which could almost have been designed to drive out what is best in the police service. It is all about models, corporate reviews, mission statements, research teams, statistics, key milestones, performance development reviews,

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corporate plans and best value performance indicators—and very little about effective community policing. That is a perfect recipe for paralysis through analysis.
There are now more than 700 civilians in the Norfolk police constabulary; 20 years ago, the number was minimal. It takes on average eight hours for a police officer to make an arrest and bring it to a conclusion. Police officers need to, and should, be on the beat, not in the office filling in forms.
Best value allows politicians, locally and nationally, to get into the minutiae of operational policing, which should be none of their business. It bogs the force down in a welter of unnecessary reports, overheads and administration. It distorts priorities and creates a culture of meeting published targets, rather than doing what is best. It creates political priorities, not policing ones. Most damaging of all, best value will move the emphasis even further away from the qualitative aspect of policing to the quantitative aspect. It will allow people to argue for more police in our cities—where more arrests can be made—and less in rural areas. It will measure crime detection but fail to measure crime prevention. It will divert the police away from the less visible aspects of policing into the political headlines. How can we measure the impact of a police constable walking the beat in a town or village that he knows or the informal words that he or she has with a parent or schoolteacher? How can we properly value the role of the traditional police constable who works within the community as part of the community? They are the unsung heroes who do not appear in Home Office statistics but whose contribution is, literally, immeasurable. Sir Robert Peel must be turning in his grave.
My message to the Minister is that he should get his and other politicians' hands out of operational policing. They should set the police free to run their own forces, rather than trying to do that for them. Equally important, they should not force chief constables and senior officers to become politicians and spin doctors.
Rural policing is about more than just the police. The police need the support of the public—parents, youth services, voluntary groups, statutory agencies, schools, district, town and parish councils and the Church—to do their job properly. Whether we like it or not, we are all involved: law and order touches us all. Without it, no one is free. With it, it will work—but only in a free society and with consent. To be fair, the Crime and Disorder Act 1998 encouraged partnerships between the police and parts of the community, but it provided no material resources or budgets. It has provided a forum for talking, which has some value, but little else.
Much antisocial behaviour originates from the young—but from only a tiny minority of them. The vast majority are well behaved, decent, and law-abiding. Of course, young people will sometimes behave badly: who did not when they were young? Do we do enough for young people; is there enough for them to do? If so, how do they get there without decent public transport? What has happened to our youth centres? Living in the countryside has many drawbacks for young people. Inner cities have different problems, but the Minister should be under no illusion about how difficult it is for
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young people living in the country to find things to do. I pay tribute to voluntary groups such as the Carpenter's Arms in North Walsham and the youth centre in Hickling, to youth workers and to all those who arrange after-school activities. The busier children are, the less likely they are to get into trouble.
What are my conclusions? We need more police officers on the beat; more police living in the communities in which they work; more respect for traditional police constables and sergeants who wish to serve their local communities and regard what they do as a vocation more than a job. We should recognise that the key function of the police is to deter crime and reassure the public. There should be less political correctness; less paperwork and bureaucracy; less political interference; greater support from all the community; and greater provision of activities for young people.
Rural policing is at a crossroads. There is no issue more important to those living and working in the country. The Minister may have no magic wand to wave, but I hope that he will give his unequivocal support to traditional community policing and pledge to give the Norfolk constabulary and other rural police forces the resources to do the job effectively.
9.42 am
Mr. David Drew: I am delighted to take part in today's debate. Debating with the hon. Member for North Norfolk (Mr. Prior) is like going over old terrain. I always thought PC was about getting police constables on the beat rather than political correctness. We must be approaching the election season because the hon. Gentleman's comments had a harder edge. I could, however, agree with much of what he said about the need to take rural policing forward.
The fact that we have debated the subject in the past does not make it any less important. If the "Today" programme is to be believed, policing is today's issue, so we must face up to our responsibilities, evaluate what is happening on the ground and ensure that policing is as effective as possible. There is no denying that rural policing is an issue; it certainly is in my constituency. I am not sure that it is the most important, but it is certainly a major issue. My constituents regularly talk to me about what should be happening and what they perceive—which are not necessarily the same.
I have regular contact with the police in my constituency. I go out on a Friday or Saturday night every three months to see what is happening on the street. It is the best way of understanding how the police operate, without telling them how to do their job.
Numbers are important and there can be no denying the dip since 1997. Gloucestershire is representative in seeking to recruit more officers, but budgets are an important factor. There can be no denying that the way in which we fund our police is under strain.
As the hon. Gentleman said, whether to close police stations or keep them open and move some police to areas with a larger population is a thorny issue. A police station was opened recently in my constituency because in the past 10 or 20 years the population has changed and the police must be where they are accessible and visible. Closing the police stations at Painswick, Rodborough and Minchinhampton caused difficulties

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in the community. People like the idea of the physical presence of a police officer and when they were told that they would have named officers in their community their fears were usually assuaged. However, the single police officer at a station was often unavailable because of the pressures of work; it was a myth that people could just knock on the door and talk to their friendly police officer.
Police have a role to play in the community and in education. If officers do not have the time to go into schools to talk to young people it is counter-productive, because giving information and advice to young people is active policing; it is the last thing that should be cut, but it is sometimes sacrificed to other operational work. That problem should be tackled, because such sacrifices should not be made.
As I said, apart from the number of police, the issue that causes the most tension in rural areas is how police time is allocated. There is no easy way to persuade the general public that a visible police officer is not the same thing as an effective police officer. That does not mean that we want all police officers to work in specialist teams; in Gloucestershire there has been a big drive towards specialism. The chief constable in Gloucestershire, Tony Butler—he is looking forward to his retirement, but knowing how well thought of he is, we will find other things for him to do—is adamant that specialist work should continue. My hon. Friend the Minister might want to respond to that, because specialism can be at the cost of police on patrol, which causes tension.
The first night that I went out with the Stroud police I got it in the ear that they felt things had gone too far and that their overall policing responsibility had been diluted by the setting up of specialist teams. If Gloucestershire is anything to go by, crime has been cut, but there are some sticking points in that success: if there are more police on patrol, the size of the specialist teams must be reduced. That is as much of a dilemma in rural areas as it is in urban areas because the criminals are more subtle and can hide more easily in the country.
The numbers issue is crucial; however many policies, strategies and initiatives there are, they cannot be carried through without sufficient police numbers. I tabled a parliamentary question on the matter, but I have not yet received an answer, perhaps because it is such a difficult issue. One problem is that there is an age skew in the police force: the number of officers retiring is greater than the number of recruits, although I was pleased to hear about the numbers going to police college at present. It is easy to blame the previous Government, but the problem is not of our making. Officers who are retiring now are not being replaced because of our predecessor's policies, and we have to tackle that problem. It relates to the lack of investment in both recruiting and retaining. The armed forces have the same problem. One can recruit as many people as one likes, but unless they are retained there is a problem.
Then there is the problem of the retirement time bomb. I make no excuse for always going on about this. We have a particular problem in policing and I blame the Government for failing to grasp the nettle. It is a painful nettle. Let us not beat about the bush: during the miners' strike the police were offered a retirement and pension package that could never the equalled. Yes, the police pay a high contribution but so do taxpayers, and
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local taxpayers in particular. In Gloucestershire an unacceptable 19 per cent. of the budget is now top-sliced for retirement and that comes out of operational funding. We cannot pretend that that is anything but damaging. Thankfully, the really unacceptable rate of increase of some of the figures has begun to slow. I suspect that that is because the budget is bigger and is perhaps being used in a slightly different way. We must accept that unless we grasp the retirement nettle, our budget will always be constrained. That has an enormous impact on what the police do.
Will my hon. Friend say something about what is being done about the retirement problem? One of the good news stories concerned asking police officers to serve longer. Fifty is a pretty arbitrary age, although I know that the police service is a 30-year service. Alan Cook, the community police officer in Stonehouse in my constituency, will be retiring this year. He is more than happy to carry on, not necessarily as a police officer, but in a civilian role. Everyone thinks that these officers must carry on in uniform, but that may not be the case. We could civilianise them and use them to good effect because of their knowledge and rapport with the local community. That would be much more cost effective than having police officers retire at 50 or in their early 50s to go on to other things. That problem is yet to be broached. It is the responsibility of this Government, but it arises from the actions of the previous Government. We must not misunderstand that.
Finally, I want to consider what is happening to policing. I agree with the hon. Member for North Norfolk that there are problems in rural areas as much as in urban areas. The market towns have a serious problem with alcohol abuse by young people on Friday and Saturday nights. It may be no different from when I was young, but it seems different. There seems to be more misbehaviour and more violence. I am the president of my local victim support group, and Sara Mason, who has been chairman during most of my time as president, has told me on more than one occasion how sad it is that when one counsels young people one finds that they are victims of crime as well as perpetrators of crime. In other words, they have been involved in a hell of a punch up and perhaps have been injured, but they also have to go to court because of offences that they have committed. The number of people who get involved in such fracas is a sad indictment of our society.
Mr. Prior: The hon. Gentleman touches on an important point. In the market towns of north Norfolk, which I know well, one finds groups of 20 to 30 young people, often as young as 11, 12 and 13. Most of them are entirely decent, but it takes only one or two troublemakers to lead the others astray. The fact that off-licences are often open in the street close by and the older boys can get alcohol to give to the younger children is a serious problem.
Mr. Drew: I totally agree. Anyone who has been a parish or town councillor—I am still a town councillor—will know that, trying to stop a licence being re-granted, or a new licence being granted, because of the allegations of what and to whom they sell, is the bane of our lives. The problem is that we have never had so much alcohol out on the streets and young

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people drink to excess. We need to examine that. The Government pledged to produce an alcohol strategy, but it is a long time coming, and that is not unconnected to the problems of policing and law and order.
There is of course a link to drugs. Much of the criminality in the market towns in my constituency is, sadly, drug-related. It is too early to judge the drug trialing and testing orders, but among those who know about them, they seem to be popular. Hopefully, they provide a way in which we can get a grip on criminality.
It is worth mentioning that in Gloucestershire we have been innovatory with police information points. Better communication may be one way to countermand negativity among people who feel that their police are not sufficiently present. We look forward to full implementation of the radio project, but it will not come without some teething problems, if planning permissions are anything to go by. People want more policing, but they do not seem to want the masts that allow the proper communication required for better policing. I do not say that they are wrong to question where those masts go, but it does hold up the ability to communicate.
Police information points are, in effect, holes in the wall, so that people can pass messages on, sometimes in confidence, which is very important. That links in to neighbourhood watch schemes, which are popular in my area and continue to grow, but need continual reinvestment, because they are so important. Those who run them deserve congratulation.
Another issue is how to bring more people into policing, not necessarily full-time police officers. It is sad that we have lost special constables, and we need to re-evaluate the importance of volunteering. Being a police officer is an important way in which people can use their time as volunteers, and we must always encourage them. It is a way in which they can test out whether they like the job. Specials sometimes serve for 20 years, sometimes for less. Any time is invaluable, but we need to recognise how important these people are and give them every opportunity to go on to what they want to do and to be a special part of the police force.
The idea of parish police officers is interesting. Devolving power in the benefice of the parish means that information, knowledge and the ability to pre-empt problems can be dealt with locally. As always, there are dangers in two-tier policing. Such officers might not be respected or might be abused by being required to do low level work. However, parish officers are an interesting idea, and no one should have a monopoly of ideas about what we should be doing with policing. I agree with the hon. Gentleman for North Norfolk that there are many interesting ideas.
However, none of that gets us away from the fundamental role of the police, which is to be out on the streets, talking to people and catching criminals. The fundamental dilemma is that those things do not always match. We have to persuade the public that not seeing the police does not necessarily mean that they are not active. Impossible though it is to ask for both, we should be striving to achieve that. If my hon. Friend the Minister were able to overcome such an impossible dilemma, it should serve as his epitaph.
9.59 am
Mr. Lembit Öpik: As the hon. Members for North Norfolk (Mr. Prior) and for Stroud (Mr. Drew) pointed out, we are lucky in the countryside in that, at this stage at least, crime in most parts of rural Britain is not all that bad.
A few years ago, I was talking to the police in my area of mid-Wales. There had been a spate of 64 crimes over a period of some months on one of the trading estates and they had arrested two lads who owned up to 62 of them. It is widely believed that they did not own up to the other two simply because they had forgotten that they had done them.
We have a good clear-up rate much of the time and we do not have some of the problems that one sees in some of the inner cities and the most deprived parts of urban Britain. Having said that, there is no excuse for complacency. Both hon. Members who have spoken highlighted the psychological importance of a rural presence, with bobbies on the beat and so forth. To some extent, the police presence—like that of the post office— defines the character of communities in rural Britain, particularly rural England and Wales. It provides an identity to a community and a confidence that there is a balancing element locally, to which people can turn if things go wrong.
First, therefore, I encourage the Minister to consider the nature of the partnership between the public and the police in rural communities. It is important because that very presence probably has a powerful preventive effect in such communities. As they are tightly knit villages and towns, people tend to know each other. There is a much bigger "bang for your bucks" in the policing of communities where individuals feel personally responsible about participating—passively—in the law enforcement process.
Secondly, I shall highlight the importance of recognising that some issues that have been mentioned are not new. Robert Owen was born in my constituency in 1771—he was, arguably, the inventor of socialism and, indeed, the inspiration for the co-operative movement. If hon. Members are interested in hearing more about him, they can purchase copies of a programme that I presented only last summer. One thing that I learned about the great Robert Owen is that he left Newtown, the largest town in my constituency, partly out of despondency about all the fighting in the pubs. That was in the 1780s, more than 200 years ago.
Things have improved a little since then, but let us be realistic, pub brawls are nothing new and are certainly not unique to the countryside. I suspect that, in some ways, we regard them more seriously in rural communities because we tend to hear of the individuals involved. It is a much more personally motivated fracas, with two groups of lads from different villages deciding to settle a feud with their fists. To put it in perspective, however, it is still easier to resolve these problems in the countryside than in towns where, I suspect, pub violence is rather more serious.
Having said that, the hon. Member for Stroud is correct to say that the advancing drugs problem is a new phenomenon—it was not around even 20 years ago, let alone 200. One of the pressures on the modern

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rural police force is to find ways to prevent that problem from getting worse. In most market towns and rural areas, there is not the same proportion of hard drug taking as there is in a comparable age group in an urban area, although I accept that there are variations.
Clearly, there is a relationship between the use of hard drugs and criminality, so I hope that the Minister will say how he intends to prevent the advance of such drugs in rural areas. Blessed as we are in those communities with a lower percentage of drug problems, there is a great and urgent challenge to try and keep it that way.
Thirdly, I agree with the hon. Members for North Norfolk and for Stroud that the rural police do a good job. They are very committed, not least because they identify with the communities they represent. It is that personal relationship that gives a good rural police officer his or her strength and authority. It provides additional pressure because, when officers are off duty, they are still known to the people in the area. More than urban police officers, rural police officers are on duty all the time.
Mr. Prior: Response times are one of the best value performance indicators in North Norfolk. When someone rings the police, he or she wants prompt service. For that reason, local senior officers feel that they cannot put people on the beat because they cannot make the response times. That is exactly the sort of issue that should be left to local police forces, rather than relying on a centralised overall performance indicator.
Mr. Öpik: I shall deal with performance indicators when I have concluded on this point. Most of all, we should consider how we might reward, not necessarily financially, most rural police officers, who have an almost pastoral role in those communities, where they still take a lead. One could almost say that police officers in the countryside do the job in a way that police officers in the whole country did 40 or 50 years ago.
Referring to the point made by the hon. Member for North Norfolk, we have to be careful how we measure the performance of rural police officers. Performance indicators are a rough and ready way of measuring success, as enormous distances are involved. Some of the performance indicators are more appropriate to a city or urban environment than to a rural environment. Can the hon. Gentleman comment on whether there may be a case for having slightly different indicators or altering the parameters to take into account the different environments in which the police operate throughout the UK?
I will conclude by raising three concerns. First, although policing in the countryside is different, it has comparable or even greater funding requirements because the distances are enormous—a small number of police officers are expected to perform an almost impossible task. For example, when organised gangs steal farm equipment, they have the advantage of stealth and the police have the disadvantage of sparsity of resources and distance. In that situation, the police would be grateful for additional resources to clear up a specific problem without compromising policing elsewhere.
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Secondly, strain in the probation service is a less recognised problem. Once the police are involved, their concern is often with sentencing rather than with curing the original cause. It is important that we recognise that the probation services in those areas need to be handled sensitively, and that their funding requirements will have a direct bearing on the degree of crime that the police have to clear up.
Thirdly, I hope that the Minister will recognise that his fellow Ministers in other Departments are considering where courts should be located in rural areas. In mid-Wales and Montgomeryshire we are particularly concerned that if the courts are closed, a siting injustice of distance will be imposed and the psychological presence of the courts will also disappear. That would be a serious problem and I hope that the Minister is sensitive to the relationship between his work and that of other Ministers.
I want to make a fourth point about fox hunting. I will not raise the issue but, if option 3 is passed on Wednesday, it will put an additional strain on the police forces, who will be expected to enforce it. I have asked the Minister to bear in mind that many of us think that that would require extra funding. If he wants to comment today, I should be glad to hear him, but I recognise that that is an issue for another day.
In conclusion, I congratulate the Dyfed-Powys police force on the work that it does, and other police forces throughout rural Britain that work so hard to enforce the law. I invite the Government to ensure that the police are given funding to maintain the sort of partnership that maintains the peace in their areas. I hope that the police can be involved in preventive activities rather than simply having to clear up the damage afterwards.
Finally, I hope that the Minister will confirm what I have always believed— that the ideal form of policing is self-discipline. Self-discipline comes from hope and gives young people and individuals a reason to be stakeholders in this peaceful society rather than to be disruptive. If we do that, I have little doubt that life in rural Britain will continue to be tremendously peaceful and rewarding.
10.10 am
The Minister of State, Home Office (Mr. Charles Clarke): I congratulate the hon. Member for North Norfolk (Mr. Prior) on a useful debate.
I begin on a slightly abrasive note. I respect and like the hon. Gentleman a lot, but his implicit criticisms of the chief constable of the Norfolk constabulary were wrong, and I want to say why. It is not right to criticise the chief constable for trying to address racism, homophobia and sexism in his police force. Ken Williams has been an outstanding chief constable, during times which, in many respects, have not been easy, with a number of cases given a great deal of local publicity. I support him, and I believe that the great majority of the citizens of Norfolk—I speak as a Member for a Norfolk constituency—would not associate themselves with some of the remarks that the hon. Gentleman made, and that some of his constituents have made in the press, suggesting that those are not appropriate issues with which a police force, or its chief constable, should deal. The chief constable has been

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right and courageous. It is important that the police force maintains high standards and values in the way that it approaches the citizenry that it seeks to police. I regret that the hon. Gentleman made those remarks in an otherwise interesting and informed speech.
I must take up two other aspects of what the hon. Gentleman said. The suggestion that there has been any encroachment by the Government on the operational independence of chief constables is wrong. Chief constables are rightly free to carry out policing in the way that they think fit. Of course, chief constables will talk to people—certainly the Association of Chief Police Officers, the Home Office and my right hon. Friend the Home Secretary and I—about policing issues. Neither I nor the Government intend in any way to inhibit, nor should we seek to inhibit, the operational independence of chief constables to take whatever policing decisions they think right in the circumstances that they face. That includes operational deployment, issues around particular crimes and so on.
The principle of partnership is important. I talk to police officers a great deal about that, and one of their greatest resentments is that all the problems of society, such as the matters to which my hon. Friend the Member for Stroud (Mr. Drew) referred, are laid at the police's door. In fact, it is up to the whole community to decide how such issues should be taken up.
The hon. Member for Montgomeryshire (Mr. Öpik) made some apposite and correct points about partnership, in riposte to the hon. Member for North Norfolk. Perhaps that prefigures the coming general election contest between the hon. Member for North Norfolk and a strong local Liberal Democrat contender. I share the view of the hon. Member for Montgomeryshire that partnership is at the core of the problem. Genuine partnership between the police and the public, community organisations and other statutory organisations is the way to build the self-reliance and self-discipline which, I again agree, lie at the core of our approach to many such matters.
A number of issues have been raised, and we should start with the reality of rural crime. The Government are today publishing figures—indeed, published them 14 minutes ago—on recorded crime in this country. In Norfolk, crime has gone down by 0.7 per cent. In Gloucestershire, which includes the constituency of my hon. Friend the Member for Stroud, crime has gone down by 2.7 per cent. In Dyfed-Powys, where the hon. Member for Montgomeryshire has his constituency, the figures are down by 4.9 per cent.
Fourteen police authorities, originally led by Lincolnshire, organised to make a case for rural policing, to which I have sought to respond. In 11 of those authorities, crime is down over the period from last year to this, according to the figures published today. Some of the falls are striking, and I shall give two or three examples. I have already mentioned Dyfed-Powys at 4.9 per cent., and I pay tribute to the force for achieving that. In North Yorkshire, the police authority of the Leader of the Opposition, crime is down by 6 per cent. In Devon and Cornwall, crime is down by 5.1 per cent., in Wiltshire by 9.5 per cent., in Northampton by
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9.5 per cent., in Cumbria by 13.4 per cent., and in Warwickshire by 7.2 per cent. Those are significant reductions by any stretch of the imagination.
I in no sense suggest that all in the garden is rosy—far from it. My hon. Friend the Member for Stroud and the hon. Member for North Norfolk rightly raised issues of violent crime and disorder in market towns—also discussed in today's newspapers—and I shall return to those issues shortly when I discuss partnership. But the record is stronger than some have suggested is the case. There is a great deal more to be done, but there are significant results and improvements. As I have said, crime is going down significantly—in some cases by large percentages—in 11 of the 14 police areas involved in the rural authorities group.
I am familiar with the Conservative politician's slogan of the 19th century—Benjamin Disraeli's
"lies, damned lies and statistics".
Statistics can confuse the public debate rather than enlighten it, and I understand that some people try to use statistics to that end. However, understanding what is really going on in society and trying to measure it is important. We need to inform the public debate on the various issues before us. I mean no disrespect to the hon. Member for North Norfolk, but to reminisce about how it used to be is not the way to focus public debate.
On police resources, I once again mention the 14 rural authorities that have been so successful in their roles. The police funding provisional settlement, announced last year, has yet to be completely finalised, but 11 of the 14 authorities have received settlements above the national average of 4.9 per cent., and three of them received lower settlements. Among the authorities of those hon. Members who have spoken today, Norfolk received 5.8 per cent, Gloucestershire 5.5 per cent. and Dyfed-Powys 6 per cent. Those figures are significant, and it is hard to argue—particularly given the very good performances on crime that many of the rural authorities achieved—that those authorities have not had a fair crack on resources.
Because we were concerned about sparsity, to which the hon. Member for Montgomeryshire referred, we were concerned about the costs involved for rural police forces. Members will be aware that last year we made an additional £15 million available to rural forces in the second half of this year. There will be £30 million for next year and the other years of the comprehensive spending review settlement, and that has been allocated to 31 police forces on the basis of a formula. The hon. Member for North Norfolk may be interested to know that Norfolk received just over £1 million this year, and will receive just over £2 million in a full year. That money will make a real difference to rural policing as we try precisely to address cost issues as raised by my hon. Friend the Member for Stroud and the hon. Member for Montgomeryshire.
I am the first to say that more resources would help and that dealing with things more effectively is important. However significant money has been provided, quite above and beyond the settlement on police funding.
Mr. Drew: The Minister was generous in seeing our deputation from Gloucestershire more than a year ago and we much appreciate the additional funding through

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the sparsity factor, but there is almost a need for a sparsity-plus factor because the budget for policing is not just about what the police authority gets but the impact on other parts of an area. We would strongly ask him to consider how we can build up the county council, and, indeed, funding through other services.
Mr. Clarke: I accept that that is a fair case, and, as my hon. Friend says, I greeted a delegation from the authority and the chief constable, Tony Butler, to whom I pay tribute. He is retiring shortly and has been an outstanding chief constable. He is the man who considers performance indicators and so on for ACPO. I have received delegations from police authorities throughout the country and, so far, although my ministerial experience has been brief, not one of them has asked for less money. I am confident that that will happen, but so far it has not. I live in hope. Certainly, I expect that from some Conservative parts of the country, as their overall spending plans make it clear that they cannot afford what we want to do. I am confident that Conservatives will come forward and ask for a little bit less. Perhaps one should not live in too much hope of that happening as one goes round the course.
The point about visibility is extremely important, and I shall come to police numbers in a moment, as it was a point raised at the outset by the hon. Member for North Norfolk. Visibility is critical. There are a number of ways of trying to increase visibility. One is police numbers, but there are other means. Parish specials, as mentioned earlier, have been used successfully in some parts of the country. I have spoken to the police officers concerned and, if a particular parish has a special constable who is committed to and living in that parish, that raises confidence and improves visibility, for exactly the reasons given by the hon. Gentleman. Other examples are the police working more closely with communities of which they are a part, or through churches or village halls. I met a group of vicars from Norfolk and discussed how the police could work more closely with the Church in exactly the way that the hon. Gentleman said. Establishing a local police presence in other areas—a local blue light in community halls—is another means of doing that.
In the north-west and north Wales, there are interesting things called pods—police vans regularly parked, like travelling libraries, in a central place, such as a city centre or housing estate. Police and people from the community can discuss problems and move forward. I have seen some interesting initiatives of that type.
Targeting patrolling raises important issues. I am sure the hon. Gentleman would acknowledge that that is not simply a matter of police walking around the streets in a rather unfocused way, but of looking at particular times and circumstances—in the middle of the night in a market town, for instance—to ensure a police presence where there are likely to be problems and targeting in a scientific and planned manner. I am currently discussing a variety of means with the police and I am confident that we will shortly agree that annual reports from chief constables will include local information on how they are improving visibility and accessibility in every ward or parish within their particular patch. That will create tensions and difficulties, of course, but it will be an important departure, so that people can see how visibility is being achieved in their particular locality.
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Police numbers are, of course, an important and critical element. We announced that during the six months to September last year, the number of police officers increased by 444 after a steady decline during the previous seven years. Ten of the 14 authorities to which I referred have seen an increase in numbers and the hon. Gentleman said that there has been an increase of six in Norfolk. There have also been increases of 28 in Gloucestershire and five in Dyfed-Powys. Some of those increases may be small, but the trend of the past seven years is beginning to turn. We have announced today that 10 of the 14 authorities have seen an increase in police officers. That is significant and a start in the right direction.
As a result of our crime fighting fund, there has been a major increase in police recruitment and training, and we announced the figures in a press release yesterday. During 1999-2000, 3,030 recruits started residential training nationally. In the current year, that number has increased to 5,268, which is a significant increase of 74 per cent. In Norfolk, for example, the number of people entering the police force increased from 30 in 1999-2000 to 64 in 2000-01. Again, that will not break the bank and will only provide some recovery from past problems, but it is a significant improvement and should be welcomed.
My hon. Friend the Member for Stroud asked about retirement. He rightly said that many police officers leave after 30 years' service. I know police officers in the Norfolk constabulary in the constituency of the hon. Member for North Norfolk who are distressed at having to leave because they believe that they have more to offer the service. We are discussing with the police how to deal with the pension and pay situation to make it financially sensible for police officers who want to continue in the service after 30 years to be able to do so. There are technical difficulties concerning pension rights and so on, but we are actively considering the matter because we agree that, as my hon. Friend the Member for Stroud said, many police officers can make a significant contribution at a time when it is better for them financially to retire. We want to ensure that they can make that contribution.
I was pleased that my hon. Friend referred to the numbers dilemma. His chief constable, Tony Butler, leads for ACPO in matters concerning paedophile crime, which is a major issue in which intelligence is the main means of tracking. Bobbies on the beat are not so involved, although they are important in some circumstances, because intelligence and resources are needed to discover where people are and to track them. Tony Butler leads for the police service nationally in what we are trying to do in that area. There is tension between that work and the number of bobbies on the beat, and we must deal with both. We cannot deal with one and not the other.
I was also pleased that my hon. Friend referred to my wife's good friend Sara Mason, who lives in his constituency. We had a Christmas card from her and I know that she is enjoying being a constituent of the hon. Gentleman. I do not know whether he knows her or whether he appreciates my reference, but it may feed discussion because she is very active and committed.
The hon. Member for Montgomeryshire referred to drugs, and rightly so. The problem of how drugs are distributed in rural areas has not been fully addressed, and we are trying to do deal with it through the

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partnership approach, and other measures. Drugs would have been unthinkable in many small communities in the countryside 15 years ago, but are now a normal part of life. We can deal with the problem only as part of our overall approach, and we are committed to that.
Court closure is a matter for my colleagues. On hunting, I look forward to the debate to see how the issues resolve themselves.
I heard what the hon. Member for North Norfolk said about performance indicators in rural areas. There is some variation—in terms of robbery, for example— between performance indicators for police in urban areas and rural areas. I assure the hon. Gentleman that we will give the matter positive consideration.
In conclusion, I thank the hon. Gentleman for initiating the debate. I have tried to respond to it in a rounded way. I believe that we can be proud of the Government's record, although there is a great deal still to be done if we are to achieve the secure rural communities about which hon. Members spoke and to which I am committed.

Air Passengers
10.30 am
Dr. Ian Gibson: It is a pleasure to be the third speaker from Norfolk, following the hon. Member for North Norfolk (Mr. Prior) and my hon. Friend the Member for Norwich, South (Mr. Clarke). That is surely a notable event in the history of this Palace.
Public health and safety are live issues in people's minds and in the media, and are high on the political agenda. Genetically modified crops, depleted uranium, the measles, mumps and rubella—MMR—vaccine, stem cells and bovine spongiform encephalopathy have all evoked a strong public response. The views of the public, which are often gained from the media and from personal experience, are much more important in policy decisions than they were five years ago. Many organisations, including government, have yet to get ahead of the game and see such issues coming so that they can react more proactively.
My subject is airlines and health, which has been the subject of an investigation and subsequent report by the House of Lords Select Committee on Science and Technology. The report, entitled "Air Travel and Health", was published in November 2000. The media have recently piled into the debate, providing useful— and less useful—data to enlighten the public. Over the past few days, serious accusations have been levelled against some of the airlines. Sadly, much of the available information is anecdotal. In the absence of a well-funded research programme carried out by independent researchers—for which the Committee asked—we have to rely on that level of data.
I am convinced that deep vein thrombosis is a problem on long-haul flights and that research into other modes of transport, such as cars and buses, is also necessary. My hon. Friend the Member for Norwich, South and I travelled down here with our knees together on the Anglia rail service. Although the journey takes only two hours, the effect on one's knee joints can be penetrating, and it is necessary to get up and walk around.
Eminent consultants at the Ashford hospital, which is the nearest hospital to Heathrow, have claimed that deep vein thrombosis causes about one death a month, although that figure is disputed. In the past few months, fit athletes on their way to the Olympic games have suffered from the problem. Speaking from personal experience, my wife developed a stabbing pain in her back five days after we had returned on a 12-hour flight from a cancer conference in New Orleans. Many people die on the aeroplane itself or just afterwards, but some suffer the effects five days to two weeks later. That means that the problem is not recorded as such in the data of the national health service; it appears as a pulmonary embolism.
Five days after the flight, my wife found that she could not breathe properly and was rushed into Norfolk and Norwich hospital's accident and emergency unit. The senior house officer's first question was, "Have you been on a long-haul flight?" It was clear that such symptoms are common knowledge among the hospital profession. Indeed, the house officer told me that she had seen at least 12 other cases over the past year. The blood has to

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be diluted with warfarin for six months—a strict regime involving procedures that can make life quite uncomfortable.
Happily, my wife survived the experience. She does not want to make it a big issue by going to court. She wants to get on with her life but remember the experience, so that she knows the tactics to prevent it from happening again. The problem is not confined solely to economy class, but in economy seats—most people have experienced them—one person's knees are in the back of the next person, so when the seat in front comes back, one has less room to move around.
Deep vein thrombosis is not age related. Sadly, young women have died, while people of all ages have experienced clotting. The clot does not always move to the lungs or brain; it may dissolve itself without effect. Nevertheless, it forms during the initial phase when the legs begin to swell.
What advice is received by Ministers, who travel frequently due to the nature of their jobs? Indeed, I inquired at the parliamentary travel office to discover what information it has received on that subject. One high-profile event could spark a major problem, perhaps even a panic, which we do not want. I suspect that the problem is common, but we must collect more data.
Dr. Ashok Kumar: My hon. Friend mentioned the report by the House of Lords, which states that if there is an increased risk of DVT from flying, it is small. We must do more research to link DVT conclusively with flying.
Dr. Gibson: Although it is true that the risk is small, it is incongruous to say that we need new data to prove that. We do not know how many people have contracted a thrombotic effect by flying, because we have anecdotal evidence only. Until we collect all the data from NHS hospitals, we shall not know the risk. It may be a small risk, but one death is one too many. There have been many anecdotal cases, and the report by the House of Lords includes 12 pages of such evidence, some of which was contributed by hon. Members.
The report by the Science and Technology Committee is a stunning document produced by some highly erudite people. It states:
Like other human activities, air travel can never be risk free. Most people readily accept substantially greater risks—to both health and physical safety—in respect of other forms of mass transport, and, indeed, many other aspects of their daily lives. So that people can make properly informed choices (even if others regard those as the "wrong" choices), risks need to be identified, managed and communicated.
My criticisms of the airlines relate to that point about communication. The health of the consumer on flights must become as important as safety issues such as exits.
The airlines have commented on the situation. However, because they do not want to create mass panic, there is a whiff of complacency in the air. On 28 May 2000, a spokesperson for British Airways commented on a possible reduction in cabin seats, to provide passengers with more space:
There is no evidence to suggest blood clots are linked to flying— the problem is prolonged immobility.
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In my view, that is flying. The spokesman continued:
Economy class syndrome is a misnomer, as this is a problem for the entire transport industry.
That seems to deflect the issue towards other forms of transport, which I acknowledge may share the problem. The spokesman said:
A lot depends on a passenger's lifestyle and previous medical history. Our in-flight managers give passengers important information about the need to exercise on long flights.
Yesterday, I met the official spokespersons for the airlines, and asked them what information passengers were given. The answer is that two thirds of the way through the in-flight document, which is stored in the backs of seats, there are three lines about possible health hazards.
When I asked the parliamentary travel office for the Government document on health advice for travellers, which was shown to me yesterday, all I got were astonished looks on the faces of the staff. The document is supposed to be available in post offices, but one cannot obtain it there, usually because it is out of print or cannot be found. The travel office had not heard of it. It contains a short paragraph on what airlines should regard as sufficient information. Other such documents may exist, but in 40 years of travelling across the Atlantic and elsewhere, I have never been given advance information on the hazards that may befall me. This debate must deal with how to present the risks, however small, associated with air travel. When I travel alone or with my family, I want to know what risks I am taking. Airlines have much to do in terms of health.
Yesterday, I received a letter from British Airways expressing concern about this issue, and stating that passengers should think about their health and take precautionary measures before they fly. However, the briefing note that accompanied the letter betrays a whiff of complacency, and I wonder whether British Airways will adopt that tone in the document that it has agreed to send with tickets. The briefing note states:
There is little evidence that sitting immobile in an aeroplane is any more likely to lead to thrombosis than sitting immobile in any other means of transport such as a bus, car or train.
That may be true, but at this stage we do not know. In my time, I have driven from London to Glasgow, and it is true that such journeys affect the body. One can imagine driving with one's legs wrapped around the steering wheel, but we should not try to compare one form of transport with another. One form of transport should not be allowed to hide behind other parts of the system.
I welcome the fact that British Airways' briefing note recommends participation in DVT research. It describes the economy class syndrome as a "misnomer", which is probably true. The House of Lords Science and Technology Committee agrees, and wants to call it "travel thrombosis" instead, because other forms of travel could also lead to development of a clot. However, I find the following passage from the briefing note particularly interesting:
British Airways are pro-active in providing passengers with information and practical health advice through our dedicated health website—
I bet that all hon. Members have accessed this one—
(http://britishairways.com/health), our 24-hour medical helpline, and the "Well Being" sections of our in-flight magazine, High Life and a video demonstrating the in-flight exercises.

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I am sorry that I missed that information. I hope that others have seen it and were happy with it. On sending out passenger tickets, British Airways will also include such information in a health leaflet.
As I said, the Science and Technology Committee has called for immediate epidemiological research. We do not know the extent of the problems, many of which, I should re-emphasise, develop days or in some cases weeks after a flight. Of course, it is difficult to say whether a problem was caused by a long-haul flight, given that the individual concerned might suffer from circulatory problems. We simply will not know the answers until proper research has been undertaken.
I understand why airlines are reluctant to accept that a cabin environment could lead to an overall increase in the risk of DVT, and I accept their argument that travel by other means could contribute to the development of thrombosis. However, they must take the issue seriously and do much more to inform the public. We need to indulge in preventive activities, and put an end to the patronising attitude that comes through in some of these documents. In terms of information, design and cabin services procedures, airlines and their associates must reappraise current air cabin practices, so that these problems can be dealt with. For example, when cabin staff explain emergency procedures, why do they not spend a few minutes pointing out that remaining immobile could lead to problems—whether sleeping on an overnight business class flight, or sitting with one's legs propped up trying to sleep in economy class? Why do they not make it fun? Why do they not get rows of five people at a time to get up at regular intervals to do exercises? Why do they not keep the aisles open so that people can move about and dodge the trolleys that are serving drinks?
As I am sure we all know, drinking is, in any case, bad for people when flying. Because one is worried about plunging out of the sky into the Atlantic, one tends to over-indulge. The airlines encourage that, while at the same time saying, "Don't drink alcohol—you'll get dehydrated. Drink lots of water." Although one can get plenty of water in the first or business class cabins, if one tries to get up to find water in economy, the cabin staff immediately say, " Go back to your seat, sir. We are in a pocket of air." It is difficult to deal with that sort of cabin procedure and some of the forceful staff. They are only doing their job, but practices need to be reconsidered if health problems are to be taken seriously.
I do not want to talk about the aspects of ventilation examined in the Select Committee report, because other hon. Members may want to talk about the fresh air problems and so on. The House of Lords Select Committee was not heavy on any of those issues and, while recognising that they needed to be looked at, it did not make a strong case.
Smoke odours and smells are also a problem in airliners. There are about 180 incidents a year when a puff of smoke comes through the cabin and passengers are told, "It is nothing, sir. We will sort it out in a minute." When that happens in the air, one tends to put one's head down because there is not much one can do about it, unless one has a parachute and has had the
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training to use it. There will be a question in the main Chamber about the matter this afternoon. There are problems, but I am sure that the Government are addressing them.
During flights, medical emergencies can occur. Hon. Members will remember the fantastic story about an operation being performed with a coat hanger. In that instance, the right consultant happened to be on the right plane to save the person's life. Although it is not possible to have a consultant or a doctor on the ever-increasing number of flights, there can be ground contact—a sort of NHS Direct to the friendly skies, as they are called, from the ground—so that information and medical advice can be relayed to those in the air.
What, then, should passengers be doing? I have already mentioned some actions that can be taken. Some people may be more at risk than others from the duration of a flight, immobility, limited leg room, seating procedures and low humidity. Personal factors such as smoking, obesity and height are involved and somebody somewhere will no doubt find a gene that makes one prone to risk. I do not care about genetics; I would rather tackle the environment to make it safe, so that such a gene does not express itself and cause a blood clot.
It is important that the public know about the risk, whatever its extent. We are told that we should drink water, get up and walk in the aisles. We are also told to take an aspirin before flying, although medical advice should be sought about that because there can be problems with stomach ulcers. If I fly, I shall take aspirin the previous day and again a few hours before to thin the blood—as will my wife. Some types of elastic stockings can also be used. I shall fight my way past those trolleys of drink, not imbibing as I go. I shall flex my legs, tiptoe around, duck and dive and weave to make sure that I get exercise every so often. I shall not smoke or drink too much coffee or tea and I pledge not to drink any more alcohol on flights—although I might take just a tipple for the bravery required for landing. Alcohol on flights is not there to help; it is a displacement activity to make one feel better and to counteract the fear of plunging from the sky.
Lady Wilcox, who chaired the House of Lords Select Committee, which conducted a stunning inquiry, said:
Intending passengers are not told enough to enable them to make informed choices about their air travel … we recommend urgent research and the development of user-friendly information for passengers to reduce risks any further.
The Select Committee took the matter seriously and we ask the Government to do the same and to enjoin every British airline flying out of this country to induce good standards across the world and keep the public informed about the risks and what they should do to lessen them.
10.49 am
Mr. John Smith: I congratulate my hon. Friend the Member for Norwich, North (Dr. Gibson) on securing this debate on a subject of exceptional importance. I congratulate him, too, on the way in which he delivered his speech. He is a scientist. He has a much-deserved reputation in the House for bringing matters, particularly public health matters, to its attention. He has done well to do so today.
I intend to keep my remarks brief because I know that other hon. Members wish to speak, but I want to draw the Chamber's attention to a particularly tragic incident

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of deep vein thrombosis that occurred in my constituency. I have taken a great interest in the matter. A few months ago, I did not even know that the issue existed. I did not even realise that there was the possibility of a connection between long-haul air travel and potentially fatal conditions.
Last June, a local policeman, 30-year-old John Anthony Thomas from Flemingston in my constituency, went on a dream honeymoon to Hawaii, a marvellous, once-in-a-lifetime opportunity. This chap was at the prime of his life. He had just had a rigorous police health check, which gave him a clean bill of health, he had no known history of cardiovascular or thrombotic conditions and, within about two weeks of returning from his honeymoon, he dropped dead. Clearly, that had a devastating effect on his wife, his family and everyone who knew him.
When I was asked by the family to intervene and to look at the case, I thought what a tragedy it was, but these things happened and a one-off tragedy such as that did not necessarily mean that there was a problem. Then I discovered a few defining characteristics of the case, some of which my hon. Friend has already alluded to.
Had the pathologist not mentioned that he thought that there might be a connection between pulmonary thrombosis and air travel, the family would not have had a clue. There would have seemed no need to look at the matter; they would not have made the connection automatically. However, the pathologist not only asked whether Mr. Thomas had been on a long-haul flight recently, but expressed the personal view that as many as 20 per cent. of DVTs treated by the national health service could be—I stress "could be"—associated with long-haul air travel.
That was when for me, as a lay person, the alarm bells started ringing. That is the difference between a one-off tragedy, no matter how horrendous and traumatic, and a public health problem. The gap between the flight and the tragic death suggests to me, as a lay man, that hundreds or thousands of undiagnosed deaths from pulmonary and other thromboses could be connected with long-haul flights. We simply do not know. That is the issue.
We have heard varying accounts of the numbers that might be involved. We have already heard about the number of deaths in Ashford, Middlesex, where it is estimated that one person a month dies. We have seen reports in the press suggesting that the number could run into thousands. We now discover that research has been carried out over the past 60 years. The first research into DVT connected with immobility was done in bomb shelters in the second world war, but who knew about that research? Did the airlines know about it? Has it been common knowledge that there is a direct correlation between immobility, especially in aircraft, and those potentially fatal conditions? I have concluded that there is a correlation.
Let me give a couple of small examples, although, sadly, they are anecdotal. I have not yet spoken to a doctor since we have been investigating the condition who does not take precautions before going on long-haul air flights, including taking an aspirin, wearing compression stockings, drinking large quantities of fluid and avoiding excess alcohol. It is not just one doctor, but every doctor to whom I have spoken. I recently took
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part in a debate that involved a number of cardiovascular consultants. Every one of them not only took precautions but had been doing so for many years. The question that went through my mind and that of lay people taking part in the debate was how the hell the rest of us did not know about the problem, when the information had been available for a number of years.
That situation concerns me greatly. It is why I gave Mrs. Ada Thomas, the mother of that young policeman, an undertaking that, as her Member of Parliament, I would do all in my power to prevent any other mother having to go through what she went through as a result of a problem associated with long-haul travel. Not that she can be compensated for her loss; I assure those who meet her or members of her family that that cannot be done. However, we can, and will, discover once and for all what is behind what I believe to be a major public health problem.
I agree with my hon. Friend that we do not definitely know what causes the problem and we must find out. We must take action now to find out. The track record on investigating public health problems connected with hidden hazards is not a good one. A number of examples are frankly scandalous—I need mention only the production of asbestos. It took 60 years to establish a link between the production and handling of asbestos and mesothelioma. That tells us that we need to do something about the problem.
I intend to use Standing Order No. 23 to introduce a Bill to require airlines that carry British passengers and use British airports to provide all the available information to passengers, so that they are aware of the potential problems. There should be a legal requirement regularly to update that information for passengers and, importantly, to facilitate the gathering of any research or additional information, particularly national data, to ensure that air passengers are fully aware of the potential problems. That is key and the only way in which to speed up the collection of data to carry out the research to discover the background to the condition. There must be a legal requirement to produce information and to facilitate research on the issue. I hope that we get the widest possible support for that in the House so that no one else has to go through the trauma and tragedy experienced by my constituents. We must carry out the research as quickly as possible.
We do not yet know the extent of the problem but there is every indication that Mr. John Thomas was not the only example in Wales. There have been many high-profile cases of deep vein thrombosis connected with long-haul flights. They involve people of all age groups, both genders and completely different backgrounds. What is the connection?
Why do more people die in Wales than in other regions of the United Kingdom? It has been suggested to me that the reason is that Wales has the highest incidence of strokes and cardiovascular disease. The House of Lords Select Committee report suggests a direct correlation between those conditions and deaths after long-haul flights. The problem is that people are not told about the risk; airlines do not bring it to their attention. We must do everything that we can to make that information available.
I again congratulate my hon. Friend on bringing the matter before the House. He has done an excellent job and a public service. I intend to try to introduce a Bill as

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soon as possible to place a legal responsibility on airlines in this country. I will not make allegations. Many allegations about cover-ups, the provision of misleading information and disjointed data and research, whether by accident or design, have recently appeared in the press. I intend to ensure that we fast track the finding-out process. The problem could be greater than asbestos. It could be an even greater public health problem than BSE, which has recently dominated the attention of people in this country and throughout Europe. Thousands of people could die, so let us act now before it is too late.
It is my understanding that the Civil Aviation Authority has responsibility for the safety and welfare of passengers, but may not have responsibility for their health. Will my hon. Friend the Minister deal with that matter when he winds up the debate? I am grateful for having been called and for the opportunity to speak on the issue.
11.1 am
Mr. Paul Tyler: I, too, am grateful for the opportunity to speak briefly. I sincerely congratulate the hon. Member for Norwich, North (Dr. Gibson) on raising this extremely important issue. If I may say so to him and to the hon. Member for Vale of Glamorgan (Mr. Smith), I very much support the idea that new measures must be taken, by legislative means if necessary, to make certain that the current complacency—it is complacency—in the industry is dispelled as quickly as possible.
I entirely agree with what both hon. Members said about deep vein thrombosis. The hon. Member for Norwich, North may recall that I raised the issue on the Floor of the House on 28 July. However, I want to spend a few minutes dealing with some other issues that affect the health of air passengers and, indeed, aircrews. I will contrast the apparent complacency from which the industry suffers, not only nationally but internationally, with the growing concern among the public.
I give credit to the Department of the Environment, Transport and the Regions, which seems to share the concerns of the public and of Members of Parliament. I am delighted to have had an increasingly responsive reception in the past few months when making representations to the Department. I pay particular tribute to the Minister for the Environment—I hope that the Minister present will convey this to him—for the positive way in which he has responded to my concerns, expressed in this and the main Chamber, on air quality in the aircraft cabin and cockpit.
Hon. Members present will acknowledge that, although the health and safety of passengers is extremely important, the health and safety of the whole aircraft may be in the hands of a small number of professional pilots and aircrew. I am therefore particularly concerned about the air quality that they may suffer during flight. I approach this issue as chairman of the all-party organophosphates group, of which the hon. Member for Norwich, North is a distinguished member. I was alerted to the problem of air quality by an incident in Sweden about 18 months ago. It was alleged—we still have no definitive report on
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the incident—that an organophosphate lubricant in an aircraft's engines had caused the pilot almost to black out.
I shall not go into the technical details, as I want to leave the Minister time to respond in full. Suffice it to say that organophosphates used as lubricants in jet engines, and oil seals used in the maintenance of those engines, can be crucial factors affecting air quality in the cabin. If the problem of oxygen supply in different parts of different aircraft is added, a potentially fatal cocktail emerges.
Organophosphates in toxic fume form are extremely dangerous—obviously in the short term, but also in the long term. It is still unproven whether the chronic effect of low-level exposure to OPs over a long period can be damaging to health, but it remains a matter of concern. The British Association of Air Line Pilots has done much to identify such problems among pilots and other aircrew and much valuable international work has also been done.
The Minister for the Environment responded to my inquiries. His letter to me stated:
The number of reported incidents per annum of smoke, odours, fumes etc. entering UK aircraft flight decks or passenger cabins over the past five years c r so has increased from 81 in 1996 to 156 in 1999, and 124 to date in the year 2000.
The letter was written on 30 November and there may have been further incidents subsequently. He properly went on to say:
Some increase with time is to be expected due to the combined effects of an increase in airline traffic and the growing profile of cabin air quality issues.
He referred specifically to incidents occurring in aircraft known as the BAe 146. That aircraft is used, incidentally, by the Queen's Flight, which explains the high-profile interest in its performance. As the manufacturers and operators of the BAe 146 have rightly emphasised, the problem is not exclusive to that particular aircraft: others share the same problem.
The right hon. Gentleman continued:
Of more concern are the reports that some incidents with the BAe 146 have not had strong cues to alert the pilots as to why they are feeling unwell. Seven such incidents are known to us, four in Australia, two in the UK and one in Sweden. These events are of great concern and, with the CAA we are closely monitoring the investigations being carried out in this area.
When the Minister replies, I hope that he will give us a progress report on the monitoring of these international incidents.
The House of Lords inquiry briefly examined air quality, but its attention was concentrated more on DVT. That is a high-profile issue, so I would not complain that little attention was paid to air quality and its effect on passengers and aircrew. However, at about the same time, a Senate inquiry in Australia investigated air quality in BAe 146 aircraft. During the summer, I had the privilege of meeting the chairman of that inquiry, Senator John Woodley. I also have the full report. Will the Minister give an assurance that the conclusions of that report—much more specific than the House of Lords report—will be taken fully into account in assessing any necessary changes in public policy in this country? Will he tell us what advice should be given to operators of the BAe and similar aircraft?
The work that has now been done by the OP Information Network—an excellent voluntary organisation—to analyse the studies being undertaken

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in different parts of the world should alert the Minister and the Department to the need for some speedy analysis of all this international work.
I shall make two points about the overall context in which the debate is taking place and its importance. I understand that of the 1,000 deaths in flight and on board worldwide, more are due to heart attacks than to accidents. I do not think that the general public recognises the significance of that. It is far more likely that one's health will be affected by the quality of the air, the conditions in the cabin and the way in which we are herded together than that one will be the victim of any form of accident. It is also important to recognise—this came out in the contributions from the hon. Members for Norwich, North and for Vale of Glamorgan—that certain people are more susceptible to ill health. For example, those who have any sort of respiratory problem are much more likely to be affected by air flight. The experience of the Lufthansa medical director, Dr. Luntz Bergkau is extremely relevant. He pointed out:
What passengers do not realise is that they fly in an artificial environment where there might be up to 20-25 per cent. less oxygen. This is equivalent to being on the top of a mountain and for people with heart or lung conditions, it can tip them into a crisis phrase.
This is an extremely important issue. I do not wish to detain the Chamber any longer. I hope that we shall receive a full response from the Minister. I hope that he will take it from those of us who have spoken that there is real concern about these issues across the House. We look to the Government to take a lead.
11.11 am
The Parliamentary Under-Secretary of State for the Environment, Transport and the Regions (Mr. Chris Mullin): I thank my hon. Friend the Member for Norwich, North (Dr. Gibson) for initiating the debate and for the responsible way in which he did so. I was sorry to hear of his wife's experience and I am glad to hear that she has now recovered. I was particularly sorry to hear of the tragic case described by my hon. Friend the Member for Vale of Glamorgan (Mr. Smith).
The health aspects of air travel are of considerable importance and the debate is timely. Not only is it a matter of substantial public concern, but the House of Lords Science and Technology Committee has recently published its report on air travel and health. We are giving detailed consideration to those recommendations that are addressed to Government and we hope to publish our response soon.
My hon. Friend the Member for Norwich, North is a scientist, and I am sure that he would agree that it is important to keep a sense of perspective on this issue. It might be helpful if I referred briefly to the wholly irresponsible article on the front page of the Daily Express this morning, which is based, as far as I can see, on the comments of a Mr. Farrol Khan. To our knowledge, Mr. Khan has never produced any firm evidence for his claims. He was one of those interviewed by the House of Lords Select Committee, which carried out a careful study, as hon. Members have noted. Other medical experts reported in the article dismiss Mr. Khan's proposals. The House of Lords Select Committee used words like "nonsense" and "carelessness with facts" when describing his evidence and added that
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we have been concerned at the confused thinking, lack of substance and erroneous statements in some of the other material presented to us and the public by Mr. Khan, the Institute's founder director—
indeed, he may be the only member of this so-called institute. The report goes on:
In spite of his evident enthusiasm for his cause, sadly we have not found him to be a reliable source of scientific and medical information.
I do not want to make too much of it, but front-page stories based on evidence from Mr. Khan should be accompanied by the health warning of the House of Lords Science and Technology Committee, not mine or that of any other Minister.
The Government welcomed the House of Lords inquiry and I pay tribute to their lordships for the in-depth consideration of the health risks that may be increased by air travel. Although there are undoubtedly some causes for concern, the topic has been the subject of much speculation and, in some cases that I mentioned, ill-informed comment. The Committee is to be congratulated on the sense of perspective that it brought to some complex issues.
My hon. Friend the Member for Norwich, North and others referred to several different types of health risk that might be posed by air travel, and I shall take each in turn. First, the possibility that travelling by plane increases the likelihood of deep vein thrombosis must be, and is, treated extremely seriously. Air travel, in common with some other means of transport, can involve long periods of immobility, which has long been known to increase susceptibility to DVT. However, it is important to establish whether factors specific to the aircraft cabin environment increase that risk. The hon. Member for North Cornwall (Mr. Tyler) referred to the smaller amount of oxygen available at height. At present, there is no definitive answer to the question; much research information is available but the findings often conflict. In practice, it is extremely difficult to identify how many cases of DVT are attributable, wholly or in part, to air travel. Given that lack of clarity, I support the House of Lords recommendation that research be carried out to establish with certainty whether the aircraft cabin environment increases the risk of DVT and, if so, to what degree.
The Government-funded study that I announced when giving evidence to the Committee last June will draw together and assess existing research on the subject and make recommendations on how further research can best be targeted. In the light of that preliminary work, the Government will initiate whatever research is necessary to obtain a clear picture of the relationship between air travel and DVT. The parameters and structures of that further research will depend on the outcome of the present study, but the aim will be to clarify the links between DVT and the cabin environment. When the research is complete, we should be able to take decisions backed by a genuine understanding of the risks and contributory factors, rather than on the basis of speculation. In the meantime, the industry and the Government are focusing on ensuring that information and advice are made available to passengers before and during flights and that that is as consistent and authoritative as possible, given the existing knowledge.

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I am aware that United Kingdom airlines are pursing strategies to inform their passengers. Last week, British Airways announced that it would issue a leaflet to all its customers. A welcome effect of the flurry of media attention and of debates such as this is the increased awareness that they produce in the travelling public. The Government are contributing to that process by expanding their information leaflets. The most recent pamphlet on health advice to travellers, which is being revised to take account of what we now know about air travel, had a print run of 12 million. If my hon. Friend the Member for Norwich, North had difficulty in finding a copy, it was not for want of trying. The document is being revised and a new version will be published shortly, which gives far more attention to the matters that we are discussing. We are anxious that all parties should have a consistent message on which to draw.
The hon. Member for North Cornwall mentioned air quality. First, I thank him for his generous tribute to my right hon. Friend the Minister for the Environment. The hon. Gentleman expressed concern that the air that circulates on board aircraft may be hazardous to health in several ways. Among the issues raised at different times are ventilation, filtration, humidity and the possibility of transmitted infection. I shall not go into each of those, although any added risks that are specifically attributable to flying clearly need to be isolated.
The House of Lords Committee made some helpful recommendations in that regard. A good deal of detailed work is going on throughout the world to test air quality on board aircraft and suggest improvements or better standards. We and the industry are following that work closely. The study to which I alluded should identify any gaps in existing knowledge about air quality and guide us on whether to promote further research, or whether any regulatory changes are needed.
On organophosphates, one aspect of air quality referred to by the hon. Member for North Cornwall as a particular concern is related to reports that fumes from aircraft engine lubricating oil leak into the air conditioning system, posing a risk to the health of passengers or crew. In this context, I note the comment in the House of Lords report:
The absence of confirmed cases of tri-ortho-cresyl phosphate poisoning … lead us to conclude that the concerns about significant risk to the health of airline passengers and crew are not substantiated.
I have also confirmed that, while a small number of incidents involving such fumes leaking into the cabins of UK-registered aircraft were reported to the Civil Aviation Authority during the year to June 2000, none was deemed to pose a threat to health or safety. However, as the hon. Gentleman said, we cannot be complacent. We have access to the report from the Australian Senate, to which he referred, and we are considering its recommendations carefully. The CAA is also monitoring closely the Swedish investigation. When the outcome is available, we shall consider it carefully.
As regards information for passengers, the House of Lords report is refreshingly comprehensive in dealing with such issues. I do not propose to go into detail, but
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if one message above all is coming out loud and clear from the Committee, it is that passengers should have access, as my hon. Friend the Member for Norwich, North said, to authoritative, precise information that allows them to make informed choices before travelling. That is a message that I fully endorse.
I have already referred to information on DVT. I have described the steps that we are taking to provide passengers—both before they book their ticket and during flights—with information and advice to help them make their own decisions and minimise the risks. If it emerges that regulation on health grounds is necessary, we will not hesitate to act, but a trade-off between price and comfort is not an appropriate area for regulation.
Many people are prepared to put up with some discomfort if it means that air fares are within their financial reach. For some passengers, air travel is a far more stressful and worrying activity than it is for others. The key aim is that people should have adequate information available to them so that they can make the choices that best suit them. However, I take on board what my hon. Friend the Member for Norwich, North said about, for example, exercises that can be performed at one's seat. We are subject to various other bits of information during flights. Why should that information not be given too?
The House of Lords report set in motion a valuable debate on a wide range of health issues. The Government have a role to play. We will endeavour to disseminate information, to help to close the gaps in our knowledge that currently hamper action in this area and to work with industry so that it provides passengers with the standards of safety and comfort that they are entitled to expect. Where necessary, we will regulate, although our preference is to avoid regulation where we can achieve the same effect by other means.
I accept that there is an issue of joined-up government. We need to create a suitable structure to deal with an issue that spans several parts of the Government. For that reason, we intend to establish a standing inter-departmental group, which will take forward the House of Lords recommendations on which the Government are to act, steer the current research project to which I referred earlier, monitor other developments on air travel and health and provide advice to Ministers on the way ahead. When I gave evidence before the Lords Committee, I did so accompanied by my hon. Friend the Minister for Public Health, so some joined-up government was present from the outset. The group to which I referred will consist of officials in my Department, the Department of Health, the Civil Aviation Authority and the Health and Safety Executive. It will work closely with the airlines and other parties with an interest in air travel and health.
I should say something about the role of the airline industry. It is important for the Government to play their part, but airlines must accept that they have the principal role, both in minimising risk and in providing effective information to their passengers before they fly.
In his speech late last year, when he launched the Government' s consultation document "The Future of Aviation", my right hon. and noble Friend the Minister for Transport set out a number of challenges for United

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Kingdom airlines to boost standards of service for passengers. One challenge calls on airlines to provide better information on health issues. My right hon. and noble Friend will shortly convene a meeting of airlines and other interested parties to provide an opportunity for the industry to explain how it will respond to that and other challenges. We are on the case.
This is an important issue and hon. Members are right to stress that there are no grounds for complacency. However, I hope that they will accept that we must keep the matter in perspective. No form of travel is risk free and, as my hon. Friend the Member for Vale of Glamorgan said, knowledge of the problem has existed since the second world war, before the days of mass air travel. The key problem is prolonged periods of immobility, and during the war that arose in bomb shelters underground.
Mr. John Smith: I accept that and I accept that more research is necessary into cabin atmosphere to discover whether it is a contributory factor. However, there is a qualitative difference between air travel and other forms of travel in which the opportunity to take exercise and to relieve discomfort is greater. We should not lose sight of that fact.
Mr. Mullin: I entirely accept that. All parties, including the Government, regulators, airlines and passengers, have a role in assessing and minimising the risks involved in air travel. I am a journalist by profession, and the media also have a responsibility to report the matter with accuracy and balance, which has not always been the case. There is a pressing need to obtain and disseminate accurate and comprehensive information, and my hon. Friends can rest assured that the Government will play their full part in the process.

Teacher Shortages (Essex)
11.28 am
Mr. John Whittingdale: I am most grateful for the opportunity to debate the crisis facing schools in Essex, which is causing considerable concern to heads, teachers and parents throughout the county. It is a measure of the gravity of the situation that a number of my colleagues in the county are here today, including my hon. Friends the Members for Southend, West (Mr. Amess) and for Brentwood and Ongar (Mr. Pickles) and the hon. Member for Basildon (Angela Smith).
The severe shortage of teachers does not affect Essex alone. It is a national problem about which my hon. Friends have warned the Government for a considerable time. In May last year, we chose to use an Opposition day to highlight the pressures on teachers, which were driving so many of them out of the profession. In October, we again used Opposition time to debate the growing crisis of teacher supply and recruitment. During that debate, the Secretary of State said that there was no crisis and, by sticking his head in the sand, he has allowed the situation to continue to deteriorate.
Two weeks ago, the director of learning services in Essex, Mr. Paul Lincoln, wrote to the Secretary of State. He did so expressly at the request of Essex head teachers, not of any Member of Parliament. In his letter, he expressed the increasing concern of heads about their severe difficulties in recruiting qualified teachers to fill posts at all levels. He pointed out that the problem has seriously worsened in the past year, with vacancy and turnover rates increasing in all sectors, and that consequently
headteachers are increasingly feeling demoralised and frustrated that, despite their best efforts, they cannot secure the teachers they need.
He concludes that

these problems have a significant impact on the quality of education provided by schools.
The letter received considerable coverage in the national press, accompanied by the warning that in some schools the teacher shortage had become so severe that they might have to consider the introduction of a four-day week. The reaction of the Labour group at county hall was to say that those warnings were unjustified and hysterical. Their response exactly matches that of the Prime Minister to the concerns that are expressed nationally—which was described by the general secretary of the National Association of Schoolmasters/Union of Women Teachers as "incredibly complacent".
Yesterday, I spoke to seven head teachers in my constituency, all of whom endorsed Paul Lincoln's letter and said that, if anything, it understated the seriousness of the position. Most of the schools in my constituency have managed to fill their vacancies. As one primary head said to me, they cannot have vacancies because that means classes with no teachers, so they have found ways to mask the problem.
Every head had similar stories—for example, of teachers having to teach classes in subjects in which they were utterly unqualified. A Colchester teacher told me at the weekend that she was teaching German to pupils although she does not speak German. She is now being

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offered a post as head of science at another school, despite being a history teacher with an O-level in biology. Other schools have relied on supply teachers to fill posts, with the result that even agencies are sometimes unable to meet demand and are giving out telephone numbers for teachers in South Africa and Canada, whom schools are expected to ring up. Poaching of teachers is now taking place among schools in Essex. No head teacher wants to do that, but they are being forced into it by the impossibility of recruiting suitably qualified staff.
The head of the Plume school in Maldon told me that, although she had managed to fill her vacant posts, she could do so only by inviting applications by fax or e-mail and filling the posts as soon as they were received— or, in the case of one maths teacher, by paying for a taxi to bring him straight from a job interview at another school. She told me that the lack of supply teachers meant that she could no longer release staff for training or allow teachers to take pupils on trips, and that the only advantage of the situation was that she no longer has to read 30 applications for a post, because she is lucky if she receives three.
At the County high school for girls in Chelmsford— which is one of the very best schools in the country— four applications were received for a post to teach English, but by the time of the interview three candidates had already found other jobs. At St. Peter's high school in Burnham, a vacant English post garnered no applications at all and had to be filled from a supply agency. The head told me that she could not remember a time when the situation was so bad.
The problems are even worse in the primary sector. At Beehive lane primary school in Chelmsford, the head teacher arranged sets of interviews on three occasions, only to find that every applicant already had a job by the day of the interview. Consequently, she is having to offer jobs as soon as applications are received. Even so, there was one day before Christmas when three classes had no teacher because no supply teachers were available.
At Heybridge county primary, a teacher left at Christmas with the result that the class faced the prospect of four different teachers in the space of one week. Although the school is managing, the head told me that if there were a staff illness—or, worse still, a flu outbreak—they would have real difficulty in coping.
At Great Totham primary, the head told me that five years ago he received 160 applications for every vacancy. Two years ago, the number had fallen to 80, and standards had also declined. There were about 20 applications last year, but on advertising a couple of vacancies last term, he received just six applications. He said that
the situation is getting desperate; the Government is living in cloud cuckoo land if it says that there is no crisis.
Perhaps most serious of all is the situation in the special schools. One school in Braintree has been unable to appoint a head teacher for a year. A school in Colchester had to close a primary class because it was unable to recruit a teacher. A school in Loughton has been relying on supply teachers, but that source has dried up, so it is obliged to consider moving to a four-day week.
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The situation is desperate. Experienced and highly qualified teachers are leaving the profession in droves. Those who are entering with one year's postgraduate training are neither sufficient, nor sufficiently experienced, to replace them. Every head I spoke to agreed, however, that money is not the problem. Time and again, they said that the problem is a collapse in morale resulting from the pressures of the job. One head told me that he has given up counting the number of times that he has lost teachers who say that they want their life back. Some have given up permanent positions to become supply teachers, for whom there are the same rewards, but without the pressures of planning, assessments and additional responsibilities associated with permanent members of staff. He summed up the problem when he said that there is not a teacher shortage, but an acute shortage of qualified teachers who are still willing to teach.
Therefore, it is all the more tragic when teachers who want to teach are prevented from doing so by bureaucracy. I shall mention two cases, about which I have written to the Minister, involving teachers at the Plume school, in Maldon. Richard Marshall, an electronics graduate, has been prevented from enrolling in the graduate training scheme because he is just a few months younger than the minimum age of 24. On writing to the Teacher Training Agency to ask whether he could join the scheme this year, he was told that he could not because he was not sufficiently mature, even though, as he pointed out, it is possible to be a fully qualified teacher at the age of 22.
The second case, involving Marita Ponting, has been publicised not only in local papers but in the national media. She has worked as a librarian and a learning support assistant at Plume school, but is now proving to be a very promising teacher of maths—for which, as the Minister will know, there is an extreme teacher shortage. However, because her degree is in psychology, rather than maths, her application to enrol on the graduate training scheme has been turned down.
Of course, I accept that it would be better if she had a maths degree. If lots of people were applying to be maths teachers, I could perhaps understand the TTA saying that she has not complied with its rules. However, the reality is that schools cannot afford the luxury of waiting for the right degree, particularly in respect of maths. As the head of Plume school pointed out, the suggestion that the head of the maths faculty should assess her mathematical ability would have proved problematic, given that his degree is in music. Surely what matters is that Marita Ponting is already proving to be a highly skilled maths teacher who wants to teach. Once again, because of bureaucracy, both she and Richard Marshall are being denied the opportunity to participate in graduate training schemes.
The crisis affecting Essex schools is real. Clearly, it is not restricted to Essex, but it is particularly acute throughout the county. That is borne out by every head and every teacher in Essex, and the problem is getting worse. Through superhuman effort, heads are just about managing to keep their schools going, but there is no doubt that standards are being affected, opportunities for pupils are being lost, and the strain on teaching staff is forcing more and more out of the profession. The sticking plaster will not stick for much longer. The Government must act and act now.
11.39 am
Mr. David Amess: I congratulate my hon. Friend the Member for Maldon and East Chelmsford (Mr. Whittingdale) on securing this debate and I wholeheartedly agree with every word that he uttered. It is a long time since I was a teacher and I would not relish returning to the vocation. Nevertheless, teachers do a magnificent job under difficult circumstances.
My belief that teaching is a vocation is at the heart of today's debate. This afternoon, I shall visit St. Thomas More high school, which, like Eastwood school, has made a successful capital bid. On a pleasant note, I wish to thank the Minister for that. However, I am disappointed that our grammar school, Southend high school for boys, was unsuccessful in its capital bid. I hope that it is successful next time
My hon. Friend was motivated to apply for the debate because he felt that Conservative-controlled Essex county council's position was being misrepresented. It is a travesty. Essex county council is Conservative only in that we hold the casting vote, so Liberal and Labour councillors have been able to foist their views on the council in setting its budget. The situation on the council has been distorted, especially at Prime Minister's questions.
Mr. Bernard Jenkin: It is worth pointing out that the Government think that Essex county council spends too much on education. It spends in excess of the standard spending assessment, but if it spent in line with that there would be further education cuts in Essex.
Mr. Amess: I thank my hon. Friend for pointing that out. It is a shame that one cannot intervene at Prime Minister's questions when a different light is put on the matter. I pay tribute to county councillor Mrs. Iris Pummell, who has done a magnificent job under difficult circumstances. She says that it is not the political debate that she is interested in, but the education of our children.
The Minister and I had a brief exchange at Education questions last week, when she referred to the situation in Southend. We have 23 vacant primary school posts and 38 vacant secondary school posts, so we have been forced to recruit in South Africa and Australia. There is nothing wrong with recruiting from those countries because they tend to produce good teachers, but we have been put in a situation where we have had to recruit without knowing the calibre of applicants.
When I questioned the Minister about the teacher shortage, I pointed out that Southend did not qualify for extra money because more than 25 per cent. of our children achieved passes at grades A to C. She replied that money had been allocated regardless of that and that it could be used for recruitment. I have checked that with our excellent chairman of education in Southend, Mrs. Sally Carr. As the Minister and her officials know, if we had not put the money that was allocated to Southend into particular projects, many schools would be in dire circumstances. She might say that that money could have been used to recruit teachers, but we were struggling with other problems.
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We do not qualify for other funds because less than 35 per cent. of our children are on free school meals. The Minister has the best interests of our children at heart, but it is quite wrong—I know that she said that we must help the parts of the country in most difficulty—that children in Southend do not receive help. It is good that our children are doing a little better than other parts of the country. Why are the Government unable to address our particular problems?
In Essex, last year, turnover of teachers in primary schools increased from 14.5 per cent. to 18.7 per cent., which is very large indeed. In our special schools, the increase is 30 per cent., and 43 per cent. of teachers who left permanent teaching posts left within the first 18 months. That is worrying for us all. The turnover for secondary schools in Essex increased by 38 per cent. in the academic year and the highest number of vacancies are in English, maths and craft, design and technology. That is not scaremongering—those are the facts.
Some of us will have read the article in the Sunday Telegraph this weekend about Mrs. Marian Williams, who is, I understand, a Labour activist and apparently an adviser to a Labour European Member of Parliament. She tells us in the article that she has always been opposed to private schools on principle, but that because of her circumstances she has had to put that to one side for her children. I am a fellow Catholic. Unfortunately the Catholic school to which she sends her children has difficulties and she has had to turn to private education. The head of a Catholic school in Essex has said that he blames the Government's failure to reward or to value teachers for the haemorrhage of staff from the profession.
Education, education, education—slogans, slogans, slogans. The Labour party manifesto in May 1997 did not say, "We want you to vote for us but, when you have a Labour Government, because of what has happened over the past 18 years, it will take us at least a decade to deliver the things we want." It gave the impression that, if the general public voted Labour, on health, education, transport and a range of other problems, everything would be put right, but that is not the case.
In every part of Essex, which is supposed to be a leafy, affluent county, there are vacancies. Why is that? Why did the Government not forecast that there would be problems? Why is it only now, just before an election, that there is such huge activity? People are right to be cynical. The Government made a great mistake in criticising so many of our hard-working teachers, in undervaluing them and in sending out endless directives and initiatives from central Government. I hope that the Minister will now do everything that she possibly can to support county councillor Mrs. Iris Pummell and to take action about the teacher shortage in Essex.
11.47 am
Angela Smith: I welcome the opportunity to contribute to the debate and congratulate the hon. Member for Maldon and East Chelmsford (Mr. Whittingdale) on securing it. I hope that I shall be able to spread some light rather than heat on the subject.
Following a meeting with my hon. Friends the Members for Harlow (Mr. Rammell) and for Harwich (Mr. Henderson), we went to a meeting at county hall with Mr. Paul Lincoln, director of learning services.

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Given the debate on the issue, we felt that our role as Members of Parliament was to contribute and to help to find a solution to the difficulties and problems. It was a productive and useful meeting and I shall report back to the Minister on how it went and what we can do to help.
It was interesting to hear from Mr. Paul Lincoln that he had not said that Essex schools were to go on to a four-day week. Indeed, he stressed that that was not the case. Those comments were made in the Evening Echo in Basildon by Mrs. Iris Pummell, about whom we have just heard. She also said in the Evening Echo that she felt so strongly about the issue—all credit to her for that; she should feel strongly about education—that she had contacted the Members of Parliament about it.
Representing a constituency with one of the highest turnovers of teaching staff in the county, I was disappointed that Mrs. Pummell had not contacted me. I thought that her letter to me might be lost in the post and checked with my Labour colleagues in the House, but they had not heard from Mrs. Pummell either. I then contacted the leader of the Labour group on the county council, who had not received a communication from her either. I regret that the debate entered the public arena and the press before the matter could be debated in the council first.
I am aware of the difficulties that are faced by head teachers. I pay tribute to the head teachers in my constituency, who have worked extremely hard to ensure good staff for their schools. Mr. Alan Roach of Chalvedon school in Pitsea, which is outside my constituency but is the school that I attended as a child, and Linda Kingston of Fairhouse school travelled to New Zealand and Australia during their summer holidays to recruit good staff and have been impressed with the standard of the staff who have come back with them. I shall touch on the difficulties that remain with regard to accommodation for those staff and ask the Minister to deal with them. It is worth noting that, last year, Chalvedon school recruited a teacher who won the new teacher of the year award. That shows the school's commitment to good-quality staff and high-quality teaching.
I pay tribute to the work by teachers in my constituency, but I am aware that, when there are shortages and teachers have to cover for other teachers, or when heads are trying to recruit in difficult circumstances, it places the teachers under additional pressure. We should pay tribute to those staff, not denigrate them.
With my colleagues, I visited many schools in our constituencies during the summer recess. September gives us the ideal opportunity to do that. No Member of Parliament can be unaware of the difficulties that schools face, but I take issue with the hon. Member for Maldon and East Chelmsford, who said that they were faced by every school and every head. I found a mixed picture: some schools were not experiencing such difficulties, but others were. Much of it had to do with the contacts that heads had built with training schools, past staff or staff who stay a long time, but in some schools there was a serious problem. Those schools need the help and support of every hon. Member and the county council. I am disappointed at the way in which
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the matter has been handled by the county council and indeed expressed that disappointment to Mr. Lincoln at my meeting on Friday.
I got the impression from Mrs. Pummell's original comments in the paper that there was an imminent crisis and that dozens of schools were about to go on to a four-day week.
Mr. Eric Pickles: The hon. Lady is doing Mrs. Pummell a disservice because she said that only two schools in Essex faced the possibility of a four-day week. To suggest, as she does, that Mrs. Pummell referred to dozens is wrong.
Angela Smith: I am grateful for that intervention. Had the hon. Gentleman been patient, he would have heard me come to that point. Had Mrs. Pummell said that in the article in the Evening Echo, I would agree. I understand that the comment about two schools came in a press release that was issued today, which has been faxed to me by the county council. It says that the three and four-day week was almost a reality in two schools, one of which was a church school, which has found it difficult to recruit, given its policy of recruiting staff of the same faith. I pay tribute to the county council for avoiding four-day weeks in those two schools.
The other thing that concerns me is the impression that has been given by the publicity that Essex has a more serious problem than anywhere else in the country—that Essex is a terrible place in which to work and a difficult place in which to teach. It is not. That must be put strongly on the record. I fear that the publicity and the way in which the matter has been handled by certain members of the county council have created future recruitment and retention difficulties, which I regret. I am sure that that was not the aim. We do not want the problem to be compounded by the actions of those in the county council who sought to make political capital out of it.
I was concerned—I should be grateful for the Minister's comments on the matter—that one of the comments in the Basildon Evening Echo article was that the budget for staff recruitment had already been spent. Essex county council had given £700,000 from the education budget to other departments to balance the books. It seems a bit rich to complain that the recruitment budget had been used up when money was transferred from the budget.
We must not dwell on what has happened, but must look to the future and at what can be done to ease the situation. We have established that it is not as serious as the fears of a four-day week in every school in Essex at first suggested, but certainly some teachers who make great efforts and do a sterling job in trying to recruit staff face serious problems.
Mr. Jenkin: What would the hon. Lady say to the head teacher of West Bergholt primary school, which also has infant classes, which recently advertised a post nationally? The one applicant was recruited to another job before the school had a chance to interview him. Does she consider that acceptable for Essex schools? Essex is a wonderful place to teach. Think how much worse the problems must be in other parts of the country such as central London.
Angela Smith: The hon. Gentleman has jumped the gun. Of course I am not suggesting that it is an

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acceptable situation—no one would say that. I said that there was a problem, but it is not as bad as stated in some of the reports that have been issued by members of the county council.
I am saddened that no hon. Members have looked to the future to consider what can be done. If there is a problem, the way forward is to try to find a solution to it. Mr. Lincoln, whom I met on Friday, sent a survey to head teachers to ask them what would be useful in easing their recruitment problems. He has started to receive responses, which we offered to present to the Minister on his behalf. I should like to put one issue to her: housing.
Housing in the south-east is extremely expensive. We often hear teachers who are interested in taking up posts say that they cannot afford to buy and find it difficult to find somewhere to rent. In the 1970s, many teachers were attracted to teach in Basildon by the offer of accommodation from the council and housing associations. A housing allowance for those taking up jobs in the south-east could improve the situation considerably. Teachers and head teachers in the west Basildon area have told me that it would make a great difference to them. I hope that the Minister will be prepared to meet the Members of Parliament who took part in Friday's meeting to take forward such proposals.
I welcome the news in today's newspapers about the rise in teaching recruitment. The primary problem is that of insufficient investment in the past—if that investment had been made, we would probably not be facing these problems. We must find a way forward to ensure that teachers have a choice of good-quality staff, which is what we want for all our schools.
11.57 am
Mr. Eric Pickles: It is a great pleasure to follow the hon. Member for Basildon (Angela Smith), especially as I disagree with so much of what she said. On her last point about teacher recruitment, it is a problem not of recruitment, but of retention—too many teachers are leaving the profession. There is no great problem in filling vacancies with newly qualified teachers, but no school can operate properly unless it has experienced teachers with many years of service under their belt to help and to guide newly qualified teachers.
I recently had the opportunity to meet all the head teachers and chairmen of governors of my local secondary schools. I had a similar meeting with primary schools just before Christmas. We met against the backdrop of the letter by the county councillor, Mrs. Iris Pummell, to whom my hon. Friend the Member for Maldon and East Chelmsford (Mr. Whittingdale) referred. I join him in congratulating Mrs. Pummell on the work that she has done to avert a crisis. It is wrong to criticise someone who has worked so hard. If she were treating the matter as a political football, as has been suggested, she would simply have let the problem get worse, but she has put a lot of effort into making the situation better and she deserves our credit.
When I spoke to the head teachers, they, like my hon. Friend the Member for Southend, West (Mr. Amess), repeated the Prime Minister's mantra about education, education and education, but pointed out that in their experience it actually meant teachers, teachers, teachers. They said that in that respect they were faced with an Elastoplast, Sellotape and make-do policy.
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Essex is an attractive place, although some pockets are less so than others. One of the more attractive, in terms of types of schools and children who are taught, is Brentwood. Brentwood is a prosperous area. If it faces recruitment problems, there must be a crisis in the county. It does indeed face such problems. Numbers are significantly down and quality is significantly down. People are being appointed to posts for which they are not qualified, whether academically or in terms of teaching experience. They may have a degree or teaching experience in a subject that is entirely different from that which they are appointed to teach.
We heard about telephone numbers being handed out. On Friday, I spoke to a head teacher in Brentwood who had just concluded a telephone interview with a teacher in Australia. That teacher may well be experienced and potentially a great asset, but I doubt whether we would be entirely happy if the same procedure were adopted for a teacher resident in the United Kingdom. We would rightly want to meet that teacher to examine references and to ask various questions. A telephone interview with a teacher in Australia is less than satisfactory.
I asked about the quality of teachers who have participated in the process. It is true that some are very good, but others are absolutely appalling. One head said that appointing a teacher in that way had probably been a mistake; the person concerned could not maintain discipline in class. The problem was made worse by the need permanently to keep a senior member of school management in the class to maintain discipline. That simply is not good enough.
I disagree with my hon. Friend the Member for Maldon and East Chelmsford on one small point. He said that money was not the issue, but to a degree it is. Staffing costs are being spread across school budgets, so that more money can be spent on staffing. The percentage varies considerably, but in the worst case staffing costs have jumped from 82 per cent. to 93 per cent. As a result, less money is available for the teaching of children.
Some people might reasonably say, "Hold on a minute. Surely it's a good thing that more money is being spent on teachers." However, the money is being spent not on teachers but agency fees, because the only way that heads can reasonably deal with the teaching crisis is to approach teaching agencies. Frankly, I find the figures surprising. A newly qualified teacher gets a salary of about £16,000, in addition to which— depending on how long the teacher stays—there is an agency fee of about £8,000. That £8,000 simply disappears from the education system. It could be spent on equipment, books or additional learning facilities, but instead it goes straight out of the window. According to head teachers, the current system is particularly vulnerable to those whom they describe as cowboys. People are getting involved in the process who should not even be there.
As my hon. Friend the Member for Maldon and East Chelmsford said, teachers are leaving the profession because an enormous burden is being placed on them. Not so long ago, the Secretary of State for Education and Employment said that, whenever he met teachers, he heard cries to cut bureaucracy so that they could do their jobs. Whenever I meet teachers, they say, "I've just had another piece of paper from the Department and I

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simply cannot cope." According to head teachers, the Department has made a genuine attempt to cut the number of papers that it issues to heads. One way to do that is to post them on the web alone, so that teachers must surf the web to obtain hard copy. However, the problem is not the paper; it is the burden.
All our secondary schools in Brentwood and Ongar were grant maintained and had greater flexibility, but the Government have stripped them of that. Essex county council is benign and devolves as much power as possible to schools, but they have less power than previously under the grant-maintained system. The Government must explain why, when there was a system in which devolved power provided greater flexibility in matters such as staffing and greater ability to use resources for pupils and parents, they replaced it with a system that provided less power. The present system is materially worse than the previous system. That places a heavy burden on the Government to explain. It is not acceptable for the Government and Labour Members in Essex to say, "Crisis? What crisis?"
12.6 pm
Mrs. Eleanor Laing: I join my colleagues in congratulating my hon. Friend the Member for Maldon and East Chelmsford (Mr. Whittingdale) on securing this debate on an important issue at an important time. Most of my hon. Friends have made the important points that needed to be made, especially my hon. Friend the Member for Brentwood and Ongar (Mr. Pickles), with whom I usually agree.
The hon. Member for Basildon (Angela Smith) said forcefully that the debate should not consist of political point scoring and I agree. Who said what in local newspapers is irrelevant. What matters to the people of Essex and the pupils who are being educated in our schools in Essex are the facts, not the political spin and soundbites on those facts. No hon. Members have disagreed and I am sure that the Minister will not disagree with the facts that have been put before us today.
One of the most important facts that we must face is that it is not only the shortage of teachers in Essex, as throughout the country, that is causing a problem, but that we are now facing the beginning of a crisis due to the turnover in teachers. As my hon. Friend the Member for Brentwood and Ongar said, the problem is not so much recruitment as retention. The enormous rise in turnover is the most worrying problem facing head teachers in my constituency.
One problem that arises from the huge increase in turnover is the vast increase in supply teachers. Head teachers in whom I have great faith and confidence and who work hard in my constituency and produce very good results have told me that, when a long-term supply teacher is in charge of a class of pupils, they do not make progress—they are taught, but they stand still and do not progress. The Minister knows a lot about education and I shall be interested to know what she has to say about that, because it is particularly worrying.
The other problem that concerns head teachers in my constituency is why young teachers are leaving the profession so soon after being recruited. Money is not
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the only reason, although it is important because the pay differential between Epping Forest and the London boroughs is bad, but house prices are the same. Since the travel-to-work difference between the London boroughs and my constituency is in some cases only two miles, it is not surprising that we suffer. The important question, to which the hon. Member for Basildon referred, is how to solve the problem and what is the way forward.
The answer is that teachers are leaving the profession not because of pay or conditions, but because of low morale, largely because they are asked to undertake so much form filling and bureaucracy. These young people decided to follow their vocation because they wanted to teach. Teaching is what they want to do; teaching is what they are willing to do, but they are not willing to spend hours and hours a week filling in forms and keeping up to date with the Government's extra red tape, which is continually being heaped on.
We all know that that is the problem, but the hon. Member for Basildon did not address it and I am not surprised since the Labour Government are the cause. Teachers in Epping Forest want to be allowed to teach. If, in their professional capacity, we allow them to do so and take away the red tape and bureaucracy, we will begin to solve the problem.
12.10 p.m.
The Minister for School Standards (Ms Estelle Morris): First, I congratulate the hon. Member for Maldon and East Chelmsford (Mr. Whittingdale) and his colleagues on securing this debate. I want to put on record to begin with that there is no one inside or outside the House who does not see this as a vital subject. It is dear to the hearts of parents and politicians because the future of the nation and our aspirations for it lie in the hands of its children. How they grow up and take over the mantle depends very much on schools. Nothing that I say diminishes the importance of the subject, nor takes away from the real and genuine concern of many hon. Members.
Against that context, I shall explore some of the issues, argue with a few points and indicate some promising signs that the measures we have taken so far may be having a good effect. As a former teacher, it gives me no pride or pleasure to say that there is an historic problem with teacher recruitment and retention. That does not excuse previous Labour Governments nor, certainly, Conservative ones. If we were to plot a map of the economic fortunes of the country, sadly, it would show that we only recruit well to teaching in times of decline. The truth is that for decades, when the country has done well and when graduates, young or not so young, have had a choice, they have not chosen teaching as a career. That is where the difficulty lies for many schools and local authorities.
We need a fundamental short, medium and long-term change in the way that we view, recruit and retain teachers and applaud the work that they do. This is not about quick fixes, nor about playing clever games with figures in any two-year or even 10-year period. We have to acknowledge that, as a nation, we have undervalued teachers for far too long and we have to invest in their development and everything that they need to be successful.
Against that background I shall put on record a point about the matters raised by the hon. Member for Epping Forest (Mrs. Laing) and her colleagues and my hon.

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Friend the Member for Basildon (Angela Smith). In Essex, despite the problems that teachers there may think that they have, there have been major achievements in the past three years. With the literacy and numeracy strategies in primary schools in Essex, we have seen results for English improve by 11 per cent., for maths by 15 per cent. and for science also by 15 per cent. Given that there is considerable affluence in some parts of Essex, as well as some poverty and difficulties, the fact that they have improved by at least or faster than the national average from a relatively high starting point is a real tribute.
I point that out, first, to pay tribute to the teachers, but secondly, to reassure people that whatever the problems are in Essex and elsewhere at the moment, the truth is that teachers in schools—whether they be supply teachers, teachers from overseas, or Essex born and bred—are delivering the goods for children. That must be acknowledged. Therefore, I give them my thanks. I know that it has meant more paper work, more training and more upheaval in how and what they teach, but it has increased the basic skills of literacy, numeracy and science that we all want for our children and our constituents' children.
I acknowledge that there is a problem. The hon. Members who spoke represent constituencies with particular problems because they are in areas of high housing cost. That presents a challenge for a profession that has a national pay scale and that has never had a pay structure that reflects different housing costs in different parts of the country. Therefore, although other parts of the country face difficulties, the south-east, London and schools that face especially challenging circumstances have the additional problem of housing costs.
Mr. Jenkin: The right hon. Lady has said two things that imply that teachers are under paid. She said, first, that teachers have been undervalued for decades and can be recruited only at times of economic decline and, secondly, that in many parts of the country they cannot afford the housing that is available to them. What is her reaction to the Scottish Executive's decision to pay substantial salary increases to teachers, funded by taxpayers' money from England because the money that Scotland spends is very much funded by English taxpayers? Does she think that that will exacerbate the problem?
Mr. Barry Jones (in the Chair): Order. Interventions should be brief.
Ms Morris: I notice a difference of opinion among Conservative Members as to whether the real issue is pay.
Mr. Jenkin: Answer the question.
Ms Morris: I am about to answer it. In view of the length of the hon. Gentleman's intervention, he should at least give me half a sentence to get to the reply.
Hon. Members were right to say that the problem is not just about pay, but about other things. It is about the quality of the working environment and, above all, whether we see our children learn. That is the real
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reward for a teacher: everything is worth while if, at the end of the day, the kids progress. In the survey published in the Times Educational Supplement on Friday, teachers say that there has been extra work and the job is more stressful, but it is still worth while.
If the hon. Gentleman wants to go into pay, I should remind him that the Conservative Government staged pay increases year after year, whereas the present Government have not staged a pay increase since we came to power. We have given above-inflation pay increases every year. The Government introduced threshold payments, so for the first time, teachers will be able to receive pay increases and access a new pay scale for staying in the classroom to teach, which they could not do before. Until we introduced the present performance-related pay, teachers had to leave the classroom and take on administrative responsibilities if they wanted further pay increases. That is the difference.
To return to some of the things that we have done, when I opened the debate, I was honest and did not say that there was not a problem. The question is, what have we been doing about it. That is what we must account for today. We are not taking a Johnny-come-lately approach: we are not reading a letter from Paul Lincoln or anyone else and then deciding to respond to it. In the past three years, the Government have systematically and carefully, with conviction, commitment and resources, invested in recruitment and retention and enhancement of the teaching profession, and the evidence shows that what we have done is beginning to work. Even that does not detract from the problems that I know exist.
Let me trace what we have done. Three years ago, in 1998, we introduced the golden hellos—real money to recruit people who would teach in shortage subjects— and the scheme worked. In the first year of golden hellos, we saw the first increase in teachers going into maths training for many a year. We can play with figures, but from 1992 onwards there had been a decline, year on year, in the number of people going into teacher training. Crucially, after the introduction of the golden hellos we stemmed that decline. It was not at a time of economic decline or by relying on the historic Tory way of waiting for the economy to go bad and then recruiting to teaching again—we stemmed the decline in recruitment to teacher training in a period of economic success.
Last year, we went further. Building on the golden hellos, we introduced the training salaries, which can be up to £15,000 for training to be a teacher—£6,000 for every postgraduate student, £4,000 extra for the shortage subjects and £5,000 extra for those on the fast track. The evidence shows that it works. Last year, when graduates could choose where to go, because every employer wants graduates, we saw the first increase in people going into teaching. There were 2,500, which was 9 per cent. more than there had been since 1992. Whatever problems there may be, the results of our investment in teaching are beginning to show.
Mr. Whittingdale rose—
Ms Morris: I want to put these figures on the record before I give way. They put our debate into context. Almost every Conservative Member who has spoken

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has said, "Ah yes, but the problem is not recruitment but retention." I doubt whether their spokesperson made that claim when the figures were mentioned last week. Never mind, it is a new week, so a new policy and a new focus. If one looks at retention too, there are almost 7,000 more teachers in service than there were two years ago. These are not our figures. We have not counted them. No one questions or challenges these figures. There are more teachers than there were last year. There are more teachers in service than there were when we came into government.
My hon. Friend the Member for Basildon was right. The debate is about how we move forward within that context and this highly competitive market. Make no mistake, more teachers are in service now because it is a better profession with better esteem, recognition, pay and chances for promotion. More people are coming into teacher training than at any time in the past decade because there is more incentive to do so.
I am proud of teaching. It is one of the best professions in the world. I admire teachers. Do not knock the young men and women who are deciding to change careers. Do not pretend that there are fewer teachers now than there were. Do not pretend that more are leaving than coming in, and do not pretend that there has not been a shift in those going into training. Let us discuss the problem, but those figures are real. That is the good news during what has been a difficult period for those who care passionately about the future of schools and children, which is everyone in the Chamber.
Mr. Whittingdale: I would be the first person to welcome good news about teacher recruitment, but can the right hon. Lady confirm that the figures released this month by the Graduate Teacher Training Registry show that the number of applicants for teacher training has fallen from 14,224 last year to 11,935 this year?
Ms Morris: I am delighted to respond to that question as it offers me a wonderful chance to read out a press notice released today that updates the figures from that organisation. It states:
Figures showing 17,700 people applying for postgraduate teacher training—a 10 per cent rise—were today welcomed by School Standards Minister Estelle Morris.
I am thrilled to pieces that the number of inquiries about teaching has doubled compared with the same period last year. On 2 and 3 January this year, the largest number of people rang for information about teaching than at any time in the past decade. We said that those inquiries would be converted into applications. We knew we had to wait until they had been processed. That is why I am delighted to be able to announce today a 10 per cent. increase compared with this time last year. Primary teaching applications are up by 13 per cent., which I know will be welcomed by the hon. Member for Epping Forest, who has a primary school problem, and applications for secondary schools have increased by 4 per cent.
I am particularly thrilled with the 33 per cent. increase in applications for chemistry teachers because that has been a problem. Having said that, and thanking the hon.
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Member for Maldon and East Chelmsford for giving me the opportunity, I must point out that even that is not enough. We need to do better. Even today's figures show that we need more maths and physics teachers.
The message that I want to get across is that I do not underestimate the difficulties. Having worked as a teacher for 18 years, I know how tough it is for teachers to lose their non-contact time because they have to take other teachers' lessons. The job is tough and that problem adds to its difficulty, but accountability is important. Do we know that there is a problem? We do. Are the measures that we are taking having results? They are. Are we ignoring problems today, while those measures take effect? We are not.
Mr. John Hayes: Will the Minister give way?
Ms Morris: I will in a moment.
At 10 am yesterday, we were told about the school that was threatened with a four-day week. By the end of the day, we were able to offer it the names of four teachers, including a maths specialist. I hope that the head will be able to conduct interviews today and prevent the school working a four-day week next week. That illustrates the action that we are taking now for today, next week, the medium and the long term. We are not complacent and do not underestimate the difficulties, but we will not spend our time arguing about the figures for this year or that. Our re-election will bring about real results. I shall now give way to the hon. Member for South Holland and The Deepings (Mr. Hayes), who arrived late in the debate.
Mr. Hayes: I am extremely grateful to the right hon. Lady for giving way. I share her enthusiasm and support for the profession. She has updated the figures from the Graduate Teacher Training Registry in overall terms, but will she be absolutely frank and tell us what the figures are for maths? She will know that the figures from 3 January showed a 29 per cent. decline in the number of maths applicants. Is the current number a decline, an increase or about the same as last year?
Ms Morris: I am now working from memory and if I am wrong, I apologise for an honest error. I think that the figure is 3 per cent. down on last year. The hon. Gentleman tells me that the figure was 29 per cent. so that is good progress. If I am wrong, I will write to the hon. Gentleman, but I think that my memory serves me well.
My hon. Friend the Member for Basildon was right. I welcome the conversation that she has had with Paul Lincoln and the desire to move on. The politics of this issue involve teachers and parents' ability to decide which party has the best policies for turning education around. I have said what this Government have done. I am proud of our record on training salaries and investment in education.
I do not think for one minute that a policy that relies merely on sending fewer pieces of paper to schools will tackle the difficulties that face us in teacher recruitment. People should make no mistake. The Tories would abolish training salaries and golden hellos. They would cut the graduate recruitment programme that we have

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expanded to 1,000 places. There is no commitment— [HON. MEMBERS: "Rubbish."] I would be delighted to sit down if any hon. Gentleman wanted to make a commitment to training salaries, but they are not part of the schools budget that the Tories have promised to protect; they are part of another budget, which the Tories have promised to cut. Whenever they have been challenged on the issue, they have not made that commitment. They rely on being able to say, "If paper doesn't work, let's do what we've always done—hang around and wait for the next recession."
That is not good enough for this Government, for schools in Essex, parents, teachers or kids. We have taken action. The problem is challenging, but our action will bear results in the medium and long term. We are ready today, tomorrow and next week to work in the schools in my hon. Friends' constituencies and elsewhere to ensure that we help teachers to meet the challenges that they face.
Mr. Jenkin: The right hon. Lady has rather marred the past few minutes of an otherwise admirable speech by going in for political point scoring, which had previously been avoided. We have had a taste of the scaremongering that we will see in the forthcoming general election campaign. Would the right hon. Lady like to point to a single example of a reduction in spending that has been announced by the Conservative party in the education budget and that is relevant to teacher education?
Ms Morris: With permission, Mr. Jones, I will finish my speech. The Tories have promised to protect the schools budget, not the education budget. Training salaries are not paid for from the schools budget.
Mr. Jenkin: We have not announced a single reduction. We will be able to deliver our reduction in spending—
Mr. Barry Jones (in the Chair): Order. I am advised that the Minister has concluded her remarks. I cannot allow the hon. Gentleman to intervene on a speech that has concluded.
Mr. Jenkin: With permission. Mr. Jones, I was hoping to take the opportunity to speak. The right hon. Lady cannot point to a single announcement that we have made that implies that we are going to cut the education budget, and we will be able to deliver our reductions in the Government spending plans without touching important items such as teacher recruitment. The right hon. Lady knows it and should apologise.
Mr. Barry Jones (in the Chair): Order. It is time to move on to the next debate.

Royal Shrewsbury Hospital
12.30 pm
Mr. Paul Marsden: This is a welcome opportunity to place on the record some pertinent questions about the condition of certain hospital buildings known as Copthorne south at the Royal Shrewsbury hospital. There are two acute hospitals in Shropshire—the Princess Royal hospital in the east, in Telford, and the Royal Shrewsbury hospital on the outskirts of Shrewsbury, in the centre and towards the west of the county. The latter services not just the whole county but mid-Wales, which makes it an extremely important hospital.
The Royal Shrewsbury hospital is on a split site. A main road—Mytton Oak road—runs straight through it, from east to west. On the north side is a modern hospital with modern facilities that are brand new or built within the last 20 years or so. On the south side is a ramshackle collection of buildings, some dating back to 1930. Rough macadam roads run around wooden huts, and it is pretty much a disgrace.
In 1997, I had an opportunity to put forward a private finance initiative case to my right hon. Friend the Secretary of State for Health, who was then the Minister of State. I showed him a set of photographs of the Copthorne south buildings. He said that they were some of the "worst hospital buildings" that he had ever seen. Some three and a half years later, we are still using those buildings.
Before I go into detail on those buildings, I want to make it clear that the Royal Shrewsbury hospital has an excellent reputation for care. Under the Government, it has developed and improved a new accident and emergency unit with some £600,000 of investment. It has been given the green light for £1 million of cancer care equipment and a new linear accelerator. Since 1997, it has had more doctors, more nurses and more acute beds. Waiting lists are down for both in-patient and outpatient treatment, and Shropshire health authority has had a massive increase this year and for the next few years of around 6 per cent., which is starting to make a real difference in terms of investment.
Hand in hand with investment goes modernisation. When we put money in, we must get the best possible value out for the national health service. The blame for failing to do so lies fairly and squarely with the Tories, for two reasons. First, they were in power for 18 years, so could have done something about those buildings. Secondly, I was told that a child development centre on the south side was supposed to run for only 15 years until about 1990. However, nothing was ever done about it, and children still have to go there 10 or 11 years after it should have been closed down.
We also inherited in 1997 an incredible amount of red tape and argument between the east and the west of the county. Week after week, there were arguments between the executives of the two hospitals—the Princess Royal and the Royal Shrewsbury—which became very familiar to readers of The Shropshire Star, The Shrewsbury Chronicle and The Telford Journal. Those arguments came about because the Tories had set up competition so that the executives had to fight to the very last bone over investment, planning, resources, staff and so on. The ethos of the Tories was to make sure

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that those hospitals were at each other's throats. Since 1997, that has changed. We are now working towards one hospital on two sites. We already have a joint chief executive and other joint working relationships. Clinicians have also come together. We also have a much better understanding between the public on both sides of the county and within mid-Wales. So it is within that context that I plead the case for the new investment on the understanding that it has to be on the modernisation agenda of the national health service.
Some buildings on the south side date from 1930, but most date from 1945, when, I understand, Canadian solders were enlisted to build a hospital on the Copthorne south site to provide medical facilities for Canadian wounded at the end of the second world war. Those buildings are still being used 56 years later. Forty-four in-patient beds at the Copthorne site are in flat-roofed wooden huts in some of the most appalling conditions that I have ever seen. I have been around the site many times and can provide examples. I record my thanks to Neil Taylor, the joint chief executive at the Princess Royal and the Royal Shrewsbury hospitals for his support. I would also like to thank Tom Caulcott, the chairman, and Graham Seager, the estates manager who is asked to cope with this mess of a building.
For instance, I noticed on one of my tours round that a main electricity switch has to be held up with string, so that it does not turn off all the electricity to a set of administration offices. Most wards containing patients have draughty single-pane windows. There is little ability to control the temperature, so in winter the hospital is extremely cold and in summer it can be very hot. There is no in-between temperature because the heating has to stay on all the time. Water and electricity cables run across the buildings and some of their protective coating is starting to come off. The wood on the outside of the buildings is rotten and paint is peeling off.
There is the phenomenon of rutted floors. In certain wards, ruts run up and down the middle of the ward with beds on either side of them. Those ruts are the width of a trolley, because over the decades the trolleys have been wheeled in and out of the wards and the linoleum, which has been replaced many times, keeps warping. People risk tripping over the flooring, and the lighting is poor. It is obviously a danger in every sense. There are real health and safety problems as well as fire hazards. On one of my tours I asked Mr. Graham Seager, the estates manager, what he would do in the event of a fire alarm, as there is no fire protection for the patients or staff. He told me that there was nothing that anyone could do except evacuate people as quickly as possible and see what happened.
All that is, of course, very inefficient. The heating bills are high, there are problems with mechanical equipment because of the damp, and so on. At the Copthorne south site, some of the facilities are in modern buildings and some in buildings that are 20 or 30 years old. There are 68 medical and rehabilitation in-patient beds, of which, as I mentioned before, 44 are in buildings of the poorest state. There is a day surgery with two theatres, and endoscopy in two rooms. I was shown round a child development centre—I am grateful that I am not a parent who has to take a child with learning difficulties
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around such a single-storey building and out to a back yard that has paving stones lying at all sorts of angles for children to trip over.
A canopy comes from the side of the building, and there is a wooden column, which so rotted that only a metal bracket holds it up, in an area where children have to play. There is a day hospital, a physiotherapy department— which I must thank for getting me back up and running when my knees gave way—a locomotor assessment unit, a dietetic and social works unit and the medical institute, which can be seen from the road. The wooden facade is completely rotten and falling down. Anybody seeing that as an advert for the Royal Shrewsbury hospital would be appalled, until they looked to the oppositte side of the road and saw modern buildings and facilities—including administrative offices—to be proud of.
I have some questions for my hon. Friend the Minister. First, will she tell the people of Shrewsbury, Shropshire and mid-Wales that the Copthorne south site, where the most dilapidated buildings are, will be closed for good? Some buildings can be re-used and others are relatively new but, please, can we get rid of those wooden huts still housing patients? Secondly, when can we see some new buildings on the north side to let us transfer patients into modern facilities as part of a modern NHS, with well-motivated staff in the best possible working environment? Thirdly, will the Minister come to Shropshire to see the appalling conditions at the Copthorne south site?
I do not want politics to affect decisions, as happened in the time of the Tories, when there was an east-versus-west divide in the county and people could not agree that Copthorne south had to go. There has been too much talk and now it is time for action. There is universal agreement across mid-Wales, across the county, and further afield, because we take in patients from other counties, that we need investment and a new build now.
Finally, change is urgent for the patients and particularly the staff, who have to go into those buildings day in, day out. The buildings can be too cold or too hot or draughty. How can staff convince patients that they can be cured even though the roof might be falling in or leaking and the window panes are rattling? It is hard work for all the staff—auxiliaries, nurses, doctors, consultants and administrators. Now is the time to get the new building and deliver the modern NHS that the people of Shropshire deserve.
12.43 pm
Mr. Lembit Öpik: I pay tribute the hon. Member for Shrewsbury and Atcham (Mr. Marsden), who happens to be my neighbour, for the work that he has done to protect our hospital in a non-party political way. That hospital saved my life in 1998 when I had a serious accident and broke my back. Aside from that great contribution to society, it has also done great work for my constituents, my friends and some of my family. The hospital is a vital resource for Shrewsbury, for the whole of mid-Wales, including Montgomeryshire, Brecon and Radnor, and even further afield.
First, I hope that the Minister will confirm her support in principle for the continued operation and updating of the Royal Shrewsbury hospital, along the

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lines that the hon. Gentleman has suggested. Secondly, I hope that the Minister will take up the hon. Gentleman's invitation to visit that very important facility. The Minister would see staff committed to doing the best that they can, as well as the dilapidated buildings. More than anything, she would meet staff in touch with the needs of the region. I hope that she will take up the hon. Gentleman's offer and visit a success story in medicine that, with a little investment and planning, can continue to serve Montgomeryshire, mid-Wales and Shropshire for many years to come.
12.45 pm
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I congratulate my hon. Friend the Member for Shrewsbury and Atcham (Mr. Marsden) on securing a debate about a subject that is of such importance to his constituents. I pay tribute to his consistent efforts and commitment to health provisions in his constituency—clearly demonstrated by the number of parliamentary questions that he has tabled on the subject over the years. None can doubt his dogged determination to improve his constituency's health facilities.
I welcome the opportunity to respond and outline the Government's progress in improving the quality of NHS facilities both across the country and in Shrewsbury. I am also grateful for the intervention of the hon. Member for Montgomeryshire (Mr. Öpik): approximately 20 per cent. of the Royal Shrewsbury hospital's facilities are used for his constituency.
The NHS plan promised major investment in new NHS buildings, and we are delivering on that promise. We now have the biggest ever hospital building programme in the history of the NHS. The development of the hospital building programme is largely attributable to our success with the private finance initiative and the increase in public capital expenditure, which will rise by almost 50 per cent. in real terms to £2.4 billion by 2001–02. The NHS plan also identified a further round of major hospital developments with a capital value of over £2 billion, details of which my right hon. Friend the Secretary of State will announce in due course.
Our aim is to eradicate old and inappropriate buildings, bringing NHS facilities up to the standard appropriate for modern clinical services—the standard that patients have a right to expect from a modern health service. Our hospital development programme will deliver 38 major new hospitals, 31 under the private finance initiative. Of the 38, 19 will be opened by 2003–04 and the other half will be well under construction. By 2010, 40 per cent. of the total value of the NHS estate will be less than 15 years old. Our buildings will be better designed and the procurement process more efficient.
In committing such major investment to new facilities, we must ensure that the basics are in place. That is why the NHS plan also includes our commitment to investing in cleaner hospitals, better hospital food and better access to facilities for patients. We are providing that in Shrewsbury. For example, we have invested about £1.5 million to provide extra critical care beds, with an additional nine beds at the Royal Shrewsbury and eight at the Princess Royal hospital. We have invested £100,000 at the Royal Shrewsbury
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hospital as part of our clean hospitals initiative, and we are providing extra resources to the local health authority. Indeed, in the next financial year, the health authority will receive an 8.7 per cent. cash increase of more than £23 million, which builds on the 9 per cent. cash increase that it received this financial year.
Collectively, those and many other elements that I could mention if time permitted will ensure that, in the future, patients locally will have the benefit of receiving hospital care with up-to-date equipment in facilities that are fit for the 21st century.
What about the problems at the Royal Shrewsbury hospital, which my hon. Friend so graphically illustrated? I was delighted that both hon. Members who spoke could do so from personal experience of the first-class medical treatment that the hospital provided.
Mr. Öpik: I assure the Minister that I was indeed delighted to have had that experience and I probably speak for the hon. Member for Shrewsbury and Atcham too.
Ms Stuart: Both hon. Members would have preferred not to make an appearance at the hospital, but they are living examples of the excellent clinical care that they received.
The Royal Shrewsbury hospital, which is located near the centre of the town, provides services from two sites—Copthorne north and Copthorne south. The sites are adjacent, but divided by Mytton Oak road, the arterial road from the town centre. I am more than aware, from personal experience, of what it is like when hospitals have to operate from two sites. Copthorne north, regarded as the main acute site for the Royal Shrewsbury hospital, houses a majority of acute services, including accident and emergency, and has 488 beds; Copthorne south has 68 beds. The north site is the newer, and much larger of the two, being a greenfield development that began in the late 1960s. The south site is older and based on single-storey, hutted accommodation. Of the 68 beds on the south site, 44 are situated within older accommodation, with the remaining 24 beds in a more modern, purpose-built unit. As they constitute only 9 per cent. of the total number of beds at the Royal Shrewsbury hospital, and only 5 per cent. of the total acute hospital beds in Shropshire, after taking account of the nearby Princess Royal hospital in Telford, I agree that the facilities provided are poor and must be replaced.
It is important to see the development as part of a strategic context for services across the region. Shropshire health authority is committed to ensuring that services re-provision maximises clinical advantages without compromising clinical safety and viability. To progress that aim, the west midlands regional office of the NHS executive asked the local health economy to produce a joint strategic plan. The plan not only considered the delivery of those objectives directly linked to hospital facilities, but addressed the known services issues related to clinical sub-specialisation across the county. The strategic plan also took account of the need to achieve financial stability to enable the delivery of both national and local priorities.

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Now that the strategic direction has been established, a key objective of the local health economy has been to develop robust plans to facilitate the movement of facilities on the Copthorne south site. The strategic outline to vacate Copthorne south was approved by the regional office in December 2000. An action plan and timetable for those, and the long-term changes that I shall outline shortly, were agreed at a meeting between key stakeholders at the beginning of January.
I assure my hon. Friend that relocation of services from Copthorne south and its subsequent closure, for which he asked, is a recognised priority both locally and regionally, with capital funding of £8 million already earmarked within the regional capital programme to take it forward. The plans are to provide a new emergency admissions unit on the north site, and an expansion of the accident and emergency department, an additional theatre and radiology capacity at Princess Royal hospital to accommodate service changes, the re-provision of physiotherapy services and new child development and locomotor assessment facilities in a community setting, the last of which I hope will delight the hon. Member for Montgomeryshire, in view of his earlier comments.
Public moneys will also fund the replacement of the training facilities, and the Royal Shrewsbury Hospital NHS trust is proceeding with arrangements to develop a new medical institute and postgraduate centre on its north side.
I recognise that my hon. Friend is keen that the planned developments progress as quickly as possible and the approved strategic outline case provides the framework for detailed service plans to be worked up by the end of February. The main priority to develop a new medical assessment unit on the Copthorne north site is scheduled for completion by the end of December 2002.
What about the longer-term provision of facilities on the site? I understand that the clinicians and hospital managers at the Royal Shrewsbury hospital have concluded, after looking at all the evidence, that a new ambulatory care centre would be the best solution to meet the health needs of people in west Shropshire. There are also proposals to build an acute rehabilitation unit on the north site encompassing a day hospital and physiotherapy services.
The trust believes that the scheme should be taken forward through a PFI arrangement as the capital cost is in excess of £10 million, and there is land to accommodate the new unit on the north site.
The strategic outline case will be taken forward through the development of two concurrent business cases, one for public capital and the other for private finance. I appreciate that there are concerns about the state of the buildings during the interim period. My hon. Friend has asked many parliamentary questions about health and safety and fire safety issues, of which he gave graphic examples. The inability to control temperature is not limited to old buildings; it happens in many a new building, including this one. My hon. Friend is right to raise the matter; we are providing new facilities but in the interim we must ensure that the facilities still used by staff and patients are safe.
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A survey carried out in 1985 on the buildings on the south site indicates that bringing all of the buildings up to modern standards or, where that is not practical, replacing them, would cost around £8.12 million. The trust working with the health authority has decided that such expenditure is not appropriate and that closure of the outdated facilities is the most appropriate solution. In the short term, steps have been taken to reduce the use of the site by patients and to ensure that a safe environment is maintained for those patients and staff that remain. The trust will ensure that that course of action will not have a detrimental effect on waiting lists or inconvenience patients.
Under the NHS plan, trusts are required to improve the standard of the environment for patients, and independent inspections are being carried out. I am pleased to report that the most recent inspection of the Royal Shrewsbury hospital in December 2000 recorded an overall score that indicated a good and improving position. I am also delighted at what the hospital had been doing, not just in terms of health and safety but in terms of investing money in cleaner hospitals. The £100,000 that it was given has been used to good effect, with money put into ward and common area decorations, upgraded toilets, furniture replacement and entrance refurbishment, staff uniforms, corridor lighting and improvement of signage. The trust is aware that it needs to provide both a safe and genuinely more pleasing environment.
I should address, briefly, my hon. Friend's concerns about fire safety. The plans for the vacation of Copthorne south will achieve compliance with fire safety regulations within the 31 March 2003 time scale, laid out in the health service circular 1999/191. Furthermore, risk management arrangements have been put in place by the trust to ensure that the appropriate level of safety is maintained in the interim period.
I pay tribute to the way in which key players in Shropshire have played their part in the development and progression of plans to address the current unsatisfactory position. My hon. Friend was absolutely right to say that there had, before 1997, been a culture of hospital trust being set against hospital trust. That has been overcome: we now have a degree of co-operation that we had not seen before. I know that local Members of Parliament play an important role in that process of working together, and that the plans are supported by all the key stakeholders, including, as I understand it, the community health council in the constituency of the hon. Member for Montgomeryshire, which shows that support goes across party lines.
The fulfilment of the plans will achieve a shared vision of the improvement of services for patients. Old, outdated buildings will be disposed of and instead, patients will benefit from a new, diagnostic treatment centre. This will enable the delivery of new services in new settings, consistent with the vision of services that we have outlined in the NHS plan. My hon. Friend asked me three questions, I hope that I have satisfactorily answered one and two.

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The third question was a repeated request for my right hon. Friend the Secretary of State for Health to visit my hon. Friend's constituency, and I am delighted to accept it in the knowledge that he would welcome me just as warmly. It is simply a question of arranging diaries. My visit would enable me to see for myself not only the conditions that he so graphically described but the good work being done on the new site, sometimes in spite of less than satisfactory environmental conditions. I understand that patient care there is excellent, but we need to improve, invest and build on that already existing success. From what I and hon. Members have said today, we are well on the way to doing that.

Transport (Tiverton and Honiton)
12.59 pm
Mrs. Angela Browning: At the conclusion of the Christmas Adjournment debate, I raised matters concerning road and rail transport in my constituency. So important are those matters to my constituents that I felt it appropriate to do so again today so that a Minister could respond to them. Within the Department of the Environment, Transport and the Regions, Lord Whitty takes primary responsibility for the matters concerned, but I am grateful to the Under-secretary of State for the Environment, Transport and the Regions, the hon. Member for Streatham (Mr. Hill), for being here today. I have given his office notice of the key matters that I shall address.
The first is the A30 road between Honiton and the M5 in my constituency—a design, build, finance and operate scheme which was opened by the Deputy Prime Minister in August 1999. From its inception, I raised with the Department of the Environment, Transport and the Regions and the Highways Agency the concerns of my constituents about the noise that would be created if the top surface of that road were concrete rather than asphalt. I took a delegation from my constituency to see Lord Whitty and passed correspondence that I had received on the matter on to him. I had been assured in writing that the noise level of what was described as whisper concrete—a misnomer if ever there was one— would be virtually no different from that of a tarmacked finish.
Many road schemes are not popular in their locality, but this one was much wanted in my constituency. I have lived adjacent to it for nearly 25 years and I know how dangerous the old road was, and how high its death toll. However, the noise suffered by residents quite some way away, not just those living immediately alongside the road, has become intolerable. A local action group, the RT30 team, has done a lot of work, as has our local daily newspaper the Exeter Express and Echo, in assisting local residents to get to the bottom of why the road is so noisy. Lord Whitty kindly agreed that the Highways Agency could undertake road noise tests, as did the RT30 campaign, assisted by the Express and Echo and Exeter university. It is clear from both sets of tests that the residents are experiencing from between 8 to 13 decibels higher than the permitted level. Many properties adjacent to the road are subject to noise levels that exceed the recommendations of the World Health Organisation or at which planning permission for residential development would not normally be permitted under Government planning policy.
People in the affected areas have invested huge sums in double glazing, but many are still precluded by the noise of the road from enjoying their back gardens in summer and have to keep the windows closed day and night in summer. When the Prime Minister visited Exeter to attend a Labour party conference last July he told us, to our delight, that the Government agreed that the noise levels were too high and that the road would be resurfaced. In addition to their delight, residents wanted to know when we would see some action. I continued to provide Lord Whitty with letters from my constituents and wrote to him myself on 23 August.

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He replied:
I regret that I am unable to give a firm promise on timing for the A30 until this programme has been drawn up and agreed. I will ask the Agency to write to you again in the autumn when we should have further news on when resurfacing work on this length of A30 will commence.
Clearly, the autumn has come and gone, so I hope that the Minister will fix a date for the work to start, because this is not just another concrete road.
I was misled by the Highways Agency and I was misled by Connect, the contractors, which both verbally and in writing assured me that the surface would not cause noise aggravation, which it clearly does. Even worse, at the public inquiry the inspector at the inquiry that preceded these events was misled as to the anticipated decibel level. When the Prime Minister made his promise, we felt that because he was personally involved in such a local matter, we could expect to benefit from his clout. I re-emphasise that this is not just another concrete road. This is a road over which promises have been made and broken.
I have another point to make to the Minister, because it was not appropriate to put it to the deputy Leader of the House at Christmas. Clear written evidence was sent to me, and to the inspector at the public inquiry, that we could have expected a quieter road. Can the Government enforce the contract, into which they must have entered, to ensure that the whisper concrete complies with its terms? The Minister will be under pressure to resurface many of Britain's concrete roads, but I plead that this is a special case because we were misled. Perhaps the department responsible for transport was misled. Perhaps the Highways Agency should look to the contract for this scheme.
Throughout the road's construction, I informed my constituents about it in good faith. We were led to understand that whisper concrete does not cause noise problems; it clearly does. It causes insufferable distress to my constituents, and I have received dozens of complaints from people along the length of the road, many of which I have passed to Lord Whitty, the Under-secretary. For example, I have received letters from Feniton amenities association, Ottery St. Mary and Clift Honiton, which make it clear that this road has a negative impact on the quality of everyday life. That is why I have placed this urgent matter first on my list; this is not just another road. Given the background and the promises that have been made, I hope that the Minister will understand. We look to the Prime Minister, who has kindly involved himself, to keep his promise and give the scheme priority, so that my constituents can enjoy quiet in their homes.
I shall briefly touch on other roads related matters before I turn to serious rail transport issues. I am delighted that the Government have recently decided to reverse their policy of antipathy towards bypasses. Crediton, a small Devon market town in my constituency, needs a bypass. When I attended the public examination of the Devon county structure plan at county hall in September 1997, the county environmental director stated that he anticipated a scheduled start for the Crediton bypass in 2003–04.
There are two elements to the Crediton bypass: the first concerns Government funding, the second relates to the county council maintaining the pecking order and
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priority lists that they have put forward for bypasses. I regularly correspond with Devon county council and other interested parties about the Crediton bypass. I shall keep up the pressure, so that Crediton does not slip down the list.
Although these are long-term plans, I hope that the Government will give some hope in terms of time scale. I do not expect the Minister to say today that we will have our Crediton bypass next year—I doubt whether the county council would be ready to do that. However, in planning these welcome road schemes, I hope that the Government can provide a time framework. The bottleneck at the Exeter road end of Crediton is causing huge environmental problems. The streets are narrow, and big lorries sit there with their engines labouring. I am concerned about the health of the people who live close to that road.
The good news is the Government's recognition of the need to dual the A30 at the opposite end of the Honiton bypass, which links with the A303 further up the road, and, ultimately, the M3. I welcome that development, for which I have long argued, although it is a difficult step for a constituency Member of Parliament to take. This stretch of road passes through some beautiful countryside, particularly in my patch. However, there has been a public inquiry, which was in fact completed before the general election.
As a peninsula, the south-west depends on the movement of people and goods to access other parts of the country. Of course, there is the important M5–M4 corridor, but it essential that we have a second arterial route, so that people can use the M3 link and travel to Exeter and the far south-west. That is vital not just to my constituents, but to the overall economy of the south-west. The Minister will recognise that it is rather unusual for a constituency MP to want a decision to allow a trunk route through her constituency to be implemented. However, the south-west's larger economy, particularly tourism and the movement of goods, depends on it.
I come to railways. The Minister will understand that we in the south-west feel that the two-way process of good transport access to the rest of the country is vital. However, there are huge problems with bridges on the main line—the line from Paddington to Exeter, Plymouth and Cornwall, which has a spur to Torbay— that connects London with the far south-west. I am sorry to say that those problems seem to affect my constituency. All I need is a proposed prison development and a few other problems and I would have the full set. The bridges are causing great disruption not just to my constituents but to all commuters in the south-west.
Mr. Colin Breed: I want to emphasise that, in addition to the hon. Lady's concerns, any rail dislocation or road disruption in Devon has an immediate impact on the entire economy of Cornwall.
Mrs. Browning: The hon. Gentleman gave me notice that he wanted to make that point, and he is absolutely right. That shows the importance of this railway line.
There are on-going problems with Stafford bridge, which is a rail bridge over the River Exe at Stoke Canon. There has been considerable investment to try to resolve

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the problem, but when there is heavy rainfall and the river is in full flow or flooding, the bridge's foundations can be undermined. In the past, divers have had to check the foundations, which has resulted in delays. Not for one minute am I suggesting that anyone wants to compromise rail safety, and I recognise there has been investment. However, real problems remain, of which the Stafford bridge is one.
There is a more recent, and perhaps long-term, problem. The Cowley bridge, which is on the edge of my constituency, is a road bridge over the railway line on the approach to Exeter St. David's station. Huge problems have been experienced there. In the two months before Christmas, the main line was out of action for 22 days. That means that passengers wishing to access the main line have to be bussed between Exeter St. Davids and Tiverton Parkway—a huge disruption to what is often a long railway journey.
Railtrack told me that it has taken measures to try to resolve the problem at Cowley bridge. Initially, it thought that it was a once-in-a-lifetime problem that, having been dealt with once, would not have to be revisited. However, within five weeks the problem was as bad as ever, and Railtrack's preliminary investigation showed that the problem will not go away.
Provisions have been made to deal with the immediate problems involving drainage pipes and culverts, but local engineers say that a full feasibility study is required. I emphasise to the Minister that a large engineering project may be necessary, because the problem involves not only the railway line, but a road bridge at a major connection across the railway. I hope that he can use his influence to persuade and to help Railtrack to carry out the feasibility study and to bring in all the attendant agencies and departments that will inevitably be involved in such a big engineering project.
We in the south-west cannot afford to have our main railway line cut off for 22 days out of two months. We all know that there are changes in the weather pattern, for which I do not pretend to understand the full reasons. Local engineers clearly believe that the problem could recur, and we must therefore look to the long term. I urge the Minister to do all that he can to ensure that the overall feasibility study takes place as soon as possible.
1.16 pm
The Parliamentary Under-Secretary of State for the Environment, Transport and the Regions (Mr. Keith Hill): I congratulate the hon. Member for Tiverton and Honiton (Mrs. Browning) on securing the debate, which gives hon. Members an opportunity to discuss road and rail transport in the Tiverton and Honiton area. I am grateful to her for her courtesy in providing me with advance notice of the matters that she intended to raise. I also recognise the concerns that were expressed by the hon. Member for South-East Cornwall (Mr. Breed).
Let me turn immediately to the issue of noise on the A30, which I know well from my journeys to the southwest. The feelings of local residents about noise are obvious from the placards which appear along the road. It is a matter for regret that the road—one of the flagship design, build, finance and operate private sector roads initiated by the previous Government—should have proved to be a source of disturbance to local people. It
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was a concrete-built road, designed to minimise maintenance requirements and to keep costs down, while fully complying with the standards for the traffic volumes that were anticipated—and are currently experienced—on the road.
I am assured that no promise was ever given by the Highways Agency—for which I have direct responsibility—regarding the use of so-called whisper concrete in the construction of the road. However, the agency acknowledges that noise levels are higher than was predicted at the public inquiry. That is why the Government have confirmed, more than once, that that stretch of the A30 will be resurfaced with a lower-noise surface.
As the hon. Lady will be aware, no precise date has been given for that resurfacing work. However, contrary to her assertion, no promises have been broken. In the words of the Prime Minister, as quoted in the 3 July 2000 edition of Exeter's excellent Express and Echo:
This stretch of the A30 will be resurfaced with a lower noise surface. I can't give you a firm promise on timing because it's only fair that those roads with the worst noise problems are dealt with first. But I can promise this problem will be tackled.
Mr. Ben Bradshaw: Is the Minister saying that nothing misleading was said during the public inquiry to which the hon. Member for Tiverton and Honiton (Mrs. Browning) referred to give people the impression that the road would not break noise levels? The road has broken noise levels. Does he accept that people were misled? Will he address her question about whether he has the power to force the Highways Agency to enforce any contractual agreement that was made at the time about noise?
Mr. Hill: I repeat that the agency acknowledges that the noise levels are higher than those forecast at the public inquiry. As regards the enforcement of the contract, I assure hon. Members that I shall look at that matter personally to see what opportunities exist to enforce the contract. I shall certainly write to the hon. Lady and to other hon. Members with the conclusions of that inquiry.
The date of resurfacing will depend on a number of considerations, not least the conclusions of the present consultation between the Highways Agency and the local authorities, of which Devon is one, on the criteria for prioritising such work. I shall refer to that in a little more detail shortly.
The Government recognise that traffic noise is a major concern for many communities living close to roads, including the A30. Tackling traffic noise is a high priority for the Government and for the Highways Agency and we are taking action on a number of fronts. The Government's 10-year transport plan "Transport 2010", published in July 2000, gave a commitment that
quieter surfaces will be installed on over 60 per cent. of the network including all concrete stretches.
The Highways Agency is committed to using quieter surfacing as a matter of course, whenever a road needs to be resurfaced as part of its on-going maintenance programme. It is expected that at least 55 per cent. of black-top roads will have been resurfaced by March

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2011. Some 70 locations on the trunk road network that have a concrete surface will be resurfaced by March 2011.
Mrs. Browning: Following the Prime Minister's verbal promise, Lord Whitty wrote to me on 23 August saying:
I will ask the Agency to write to you again in the autumn when we should have further news on when resurfacing work on this length of the A30 will commence.
My constituents believed that, in anyone's language, that would mean that we would be given a date—not that it would start straightaway, but that we would not be left, as we now are, hanging in limbo, with dates such as 2011 being bandied about.
Mr. Hill: I do not think that 2011 should necessarily be bandied about, but I recognise the force of the hon. Lady's point that an assurance was given that information would be provided to her in due course about the timing of the resurfacing work. Again, I give hon. Members the undertaking that I will ensure that the promised correspondence is dispatched at the earliest opportunity.
I was explaining the various measures that the Government have taken to expedite the resurfacing work. In March last year, they established a ring-fenced budget of £5 million to provide noise mitigation measures to deal with some of the most serious and pressing cases of traffic noise on existing trunk roads, as promised in "A New Deal for Trunk Roads in England".
We are committed to open government and to improving decision making by ensuring that decisions take account of both the people affected by them and their interests. The Highways Agency has developed criteria to fulfil the Government's commitments in our 10-year plan. It has embarked on a consultation exercise with local authorities on the criteria to be used for prioritisation of resurfacing of concrete roads. The consultation document has also been published on the agency's website to allow other interested parties to comment, and copies can be obtained from the agency.
Mr. Adrian Sanders: I endorse everything that the hon. Member for Tiverton and Honiton (Mrs. Browning) said about rail transport, but although a noisy bypass is a nuisance, no bypass at all is an even greater nuisance. In considering Devon's highway network, will the Minister give some thought to the Kingskerswell bypass and Torbay's link with the country's road traffic network?
Mr. Hill: I am pleased yet again, if I may say so in a public forum, to receive the hon. Gentleman's representations on behalf of his constituency. He has been most assiduous in the margins of the House in pressing that case.
For the interest of hon. Members, let me explain the criteria on which the Highways Agency will develop its programme for resurfacing roads. The first criterion is to deal with the noisiest sites that affect the most people. That means that the agency will endeavour to improve
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the situation for the maximum number of people who are closest to trunk roads in the earlier part of the programme.
Secondly, the programme aims to minimise disruption to general public and users of the network. That means that the agency will try to combine the work with other planned works on the network and use construction, procurement and traffic management methods that speed up the works. Thirdly, the programme aims to minimise whole-life cost. That means providing the right treatment at the right time with minimum disruption to traffic and achieving value for money.
The agency is planning to complete the consultation exercise by the end of April 2001 and publish the criteria in due course. I am sure that hon. Members will appreciate that I cannot anticipate the outcome of the agency's consultation, or the programme that will develop, based on the adopted criteria.
The hon. Member for Tiverton and Honiton raised many points and I have taken many interventions. Following the priority that she set in her own speech, I now say a word about the Crediton bypass. As hon. Members will be aware, the A377 road is not a trunk road, so Devon County Council, as the local highway authority, is responsible for the road and for any improvements to it.
In its local transport plan for 2001–2006, Devon county council explained that over the plan period it would work with partners to identify the most appropriate sustainable solutions to traffic congestion in and around Crediton. Devon county council accepts that the need for a bypass has yet to be proven. Over the next five years, it will carry out an appraisal of present and future traffic trends in the Crediton area. Any proposal to construct a bypass will have to be tested against a range of options, so that it can be demonstrated to be an appropriate solution to the town's traffic problems. It will, of course, need to demonstrate how it fits with and meets the Government's five overarching objectives for transport—safety, environment, economy, integration and accessibility.
It will be for Devon county council to decide if such a scheme can be included in its local transport plan for 2006-2011 and the priority that it should enjoy in relation to any other schemes that it wishes to seek funding for in that period. The hon. Lady will clearly be making her voice heard by the local authority in establishing priority for that bypass. If the case for a bypass is accepted, the funding will be provided through the local transport plan from the £180 billion that we will deliver in the 10-year transport plan.
The hon. Lady mentioned other road schemes. A number of road schemes along the A30–A303 corridor are being considered under the London to the south-west and south Wales multimodal study. Those include the March Honiton and A35 Honiton eastern bypass. A decision on the scheme will follow the study outcome.
In the meantime, over the past six months, the consultants have been building a comprehensive picture of the problems and issues in the study area. They have done that through workshops, exhibitions, briefing sessions and one-to-one meetings as well as through data collection and other sources. The next step is to

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work towards an emerging preferred strategy, on which there will be formal consultation—probably in May. Following the establishment of a preferred strategy, more detailed solutions to the problems identified will be developed that are consistent with the preferred strategy.
My officials who are managing the study will continue to keep hon. Members in the study area up to date with progress. I understand that very shortly a further letter will be sent to the hon. Lady and to other hon. Members in the study area setting out more details on progress and outlining the remaining study programme to the end of the year.
Exceptionally rapidly, let me turn to at least one other issue raised by the hon. Lady. I am aware that the Tiverton and Honiton constituency has been particularly affected by recent floods that have damaged railway track and bridges in the area, causing widespread disruption. I understand that the Yeovil to Exeter line reopened on 4 January, albeit with a 20 mph speed restriction. I have also been informed that Railtrack is to install additional relief pipes at Cowley bridge, to which the hon. Lady referred, to divert excess water from the River Exe when it floods, so that it does not interfere with the railway. In addition, as the hon. Lady will be aware, Staffords bridge has been subjected to improvements in the past five years to make it more robust. Railtrack is continuing to look at ways of either preventing future flooding or reducing the duration of the impact of the floods and consequent line closures. In more general terms, we are aware that more regular users of the railways—
Mr. Barry Jones (in the Chair): Order. We must now move on to the next debate.

Cystic Fibrosis
1.30 pm
Ms Tess Kingham: I am grateful to have the opportunity of raising the important issue of the screening of babies in the first few weeks of life to detect cystic fibrosis. As cystic fibrosis is a bit of tongue-twister, I will refer to it as CF for the rest of this debate.
I first became aware of CF through my mother-in-law Delia Luetchford who worked as a physiotherapist, specialising in the treatment of CF patients for more than 20 years. Delia's experience of working with families affected by CF convinced her that screening for the disease at birth would mean early diagnosis and therefore early treatment for children. Early intervention is crucial to prevent unnecessary damage to patients' lungs in the long term, which helps to lengthen life span. Early diagnosis of CF also reduces emotional strains on families who otherwise suffer months or even years of uncertainty as they watch their children suffer.
Delia's view that early screening is essential is shared almost unanimously by professionals working with CF patients, and the Cystic Fibrosis Trust has over the past five years run a campaign to achieve a national CF screening programme. For the benefit of the House, I should first like to explain a little about CF and its effects, as it is important to have a basic understanding of the disease to appreciate why early screening is so crucial.
CF is the UK's most common inherited life-threatening disease. It affects the internal organs— especially the lungs and the pancreas. At present there is no cure, and average life-expectancy for sufferers is around 30. Approximately 7,500 people have CF in the UK today, and every week five babies are born with the disease. Three young people die from CF each week, usually as a result of lung damage.
In simplistic, layman's terms, CF causes thick mucus to clog the lungs. Healthy lungs have small hairs called villae, which throw up any mucus that collects, acting as a daily self-cleaning process. In CF sufferers the mucus is abnormally thick and sticks to the villae, so that the cleaning process does not work. The mucus is also salty and kills off the good anti-bacteriological agent present in lungs, which prevents infections, so that CF patients are more prone to serious chest infections.
CF patients need daily physiotherapy to help clear this mucus and they require speedy antibiotic treatment to fight off infections. An added problem for sufferers is pancreatic insufficiency, which most babies born with CF suffer, and which means that their bodies do not produce the correct enzymes to digest food properly. Often CF babies will eat and eat and not thrive because the food passes straight through them. They become malnourished and, unless treated, will not have the strength to fight off the inevitable chest infections that they will suffer. That layman's version of the disease is important to our understanding of the debate.
Early CF diagnosis through screening means that treatment can begin immediately, and that has a major impact on the long-term prognosis for the patient. If a baby is diagnosed early, physiotherapy can begin straightaway and antibiotics can be swiftly administered, helping to prevent lung damage in the

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long term. Babies can also be fed artificial enzymes and given other appropriate nutritional treatments to ensure that they can digest their food and thrive. That helps to provide babies with the energy to fight off chest infections. If there is no screening programme for CF and if babies are not diagnosed until months or years later, there could be serious consequences.
Families often know—as parents and mothers do— there is something wrong with their child but feel frustrated by continual GP and hospital visits with no clear diagnosis. I know of cases in which children were ill with CF for six years before it was diagnosed. The child may suffer continual chest infections, stomach aches and be unable to put on weight. Continual worry and anxiety without knowing the cause can put terrible pressures on family relationships. Late diagnosis can mean that repeat chest infections are not dealt with appropriately, leading to eventual lung-damage and reduced life expectancy.
Dr. Jim Littlewood, retired consultant paediatrician at St. James hospital, Liverpool and now chairman of the research and medical advisory committee of the cystic fibrosis trust, has had over 30 years experience of working with patients with CF from the UK and overseas. He is a passionate advocate of neo-natal screening for CF. In his personal submission to the cystic fibrosis workshop held at the institute for child health at University college, London last year, he explained why early appropriate treatment is vital for CF patients, as it enabled them to avoid reaching the point of no return. That point comes when a person moves from having CF to lung disease.
After the onset of lung disease there is chronic infection, inflammation and progressive deterioration. If the point of no return can be avoided or delayed, the patient can live longer and therefore have the benefit of any new treatments that are coming onto the market. That can make the difference between a person living from, say, 16 to 17 or 30 years, and in future, hopefully, life expectancy will become 40 or 50 or more as treatment for cystic fibrosis improves—as it is doing all the time.
Dr. Littlewood is convinced that early diagnosis, if it is followed by effective treatment, will avoid or delay the point of no return, and the role that neo-natal screening plays in this is obvious. I have no medical background but I have spoken to many professionals involved with CF care, and their argument has seemed like common sense to me. Why do we not screen babies at birth? Why do we not get an early diagnosis and ensure that their treatment starts immediately, rather than risking delays that can lead to lung damage and reduce life span? Is it because the screening process is very complex? Is it incredibly expensive? Would it require setting up major new facilities and investment in costly new technology? The answer, on all counts, is no.
It is very simple to screen babies at birth for CF. If parental permission is given, all babies currently take the Guthrie test—a simple heel prick to take blood that is tested for a range of diseases. Cystic fibrosis could be tested using the same blood, and we believe that that would cost around £2 for each baby. The experts—I mean the paediatricians, doctors, physiotherapists and people with years of practical experience of working
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with people with cystic fibrosis—are overwhelmingly convinced and determined that the screening should happen nationally.
The NHS health technology assessment programme issued a report on screening for cystic fibrosis in June 1999. It reviewed the results of 20 neo-natal screening studies, and concluded that
in view of the low false positive rate and the low cost of the test, we conclude that each purchasing authority could consider providing neo-natal cystic fibrosis screening, either in combination with neo-natal screening or alone.
Professionals around Britain have seen and treated children, whom they know have sustained avoidable lung damage while awaiting diagnosis—damage that will shorten their lives. Some paediatricians were so appalled that they persuaded their health authorities to set up neo-natal cystic fibrosis screening programmes, and those operate in East Anglia, Trent, Wales, Leeds, Wolverhampton and Northern Ireland. Currently, the screening programmes cover only 23 per cent. of babies. Some 77 per cent., including my own twins who were born last year, are not covered. That is an example of the postcode lottery that our Labour Government have pledged to end.
We should bring other health authorities around Britain up to this standard by implementing a national screening programme. In fact, I know of one dreadful case that illustrates that point well. A pregnant woman lived equidistant from two maternity hospitals, one of which provided screening and one of which did not. She went to the one that did not. Her baby was born with CF, did not thrive and died seven months later, undiagnosed. She discovered her baby had CF only from the autopsy report. If the baby had gone to the other hospital, been screened and had the early nutritional and antibiotic treatment, the outcome might have been very different. Understandably, she is rather bitter.
Health authorities, however, were instructed not to set up any new neo-natal cystic fibrosis screening programmes until the UK national screening committee had produced its report on the issue. The child health screening sub-group, however, recommended, much to the dismay of those in the cystic fibrosis world, that neo-natal screening for cystic fibrosis should not be recommended. Those arguments, I believe, are not sufficient to prevent a national screening programme from taking place, and I should like to look at them briefly, in turn.
First, the group argued that there was a lack of evidence showing that early diagnosis by screening makes an important difference to the long-term outlook for a patient. Let us be clear about what is meant by that. That argument makes it appear that there is no evidence that screening babies gives any advantage over not screening. Many studies show, in fact, that screened infants have a better medical condition and better nutritional state, and that there is reduced cost from fewer diagnostic tests and less expensive treatment. There is also a benefit, clearly, to the families involved, by cutting out months, even years, of uncertainty before diagnosis. That gives those families the information that they need to make informed choices about whether to risk having any more children who may be born with cystic fibrosis.

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It is almost impossible to come up with the pinpoint scientific proof that the committee appears to demand. It wants conclusive data from randomised control trials. Given long-term survival rates and improved treatment over the past decade, any new studies of that nature in the UK could wait around 20 years until selected screened and non-screened children had reached early adulthood. That would be a long delay in setting up a national screening programme. I am sure that the Minister would not see that as appropriate.
There is, however, as a counterbalance, a wealth of other medical evidence and studies. I do not have time to go into them all in detail, but some examples are a recent 10-year CF screening data from the New South Wales group, and a recent 13-year study from Wisconsin. There is also a 10-year screening study from Brittany. The French Government have introduced screening generally in France. Yesterday, I learned that the Government of the Republic of Ireland have decided to introduce a national neo-natal CF screening programme, much to the delight of that country's paediatricians.
I also have information of new evidence from the Cystic Fibrosis Research Trust, which I believe is highly significant. The trust runs the UK database, where consultants send anonymised information about CF cases that they have treated. It currently covers, I believe, around 6,000 cases. Research on that database has shown that if a child is not diagnosed and treated with the appropriate antibiotics early on, it is much more likely to develop chronic pseudomonas, which is a mark of possible early death. However, having antibiotics administered at the right doses early after diagnosis will prevent colonisation by pseudomonas. I believe that that is highly significant new evidence of which the Minister should be aware. The Cystic Fibrosis Research Trust will submit its evidence to the national screening committee imminently.
The national screening committee sub-group currently recommends more research. However, as there is now vast clinical experience of CF to draw on, we surely do not need yet another controlled trial to show that it is better to diagnose a life-threatening disease early, given that so much rests on effective treatment commencing as soon as possible.
Clearly, evidence-based science has brought us great benefits, but there are cases where common sense must be paramount. Sometimes the evidence of experience is as important as statistical data, and I feel that that may well be the case here. Perhaps we should hear what is being said by the people who know this disease best. For a start, Dr. Little wood says:
While conceding the lack of absolute proof of a favourable effect on long-term prognosis, if one considers all the available comparative studies, all tend to show some advantage for the screened infants … From a clinician's point of view, the following complete the now unassailable case for neo-natal CF screening: the clinical facts, the present-day improved treatment which must be introduced early before chronic damage, the imminent prospect of more specific, even curative treatments, unlikely to help patients with advanced disease, and last but not least, simple common sense, and what we would wish for our children and their children.
If we insist on evidence, we must consider what happens when a child is not diagnosed early. What is the impact on families and the baby if there is no screening, no early diagnosis, and no early treatment? Surely that
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should carry equal weight. Who better to tell us than the parents involved? The Cystic Fibrosis Research Trust carried out a survey last year, and I would like to quote five parents who were interviewed. The first parent said:
Having two children with CF at a similar age, and on the same medication, X's health is far better than Y's. Y has had more infections, more hospital visits, her weight still isn't good and she gets more breathless. More importantly, Y has damaged her left lung which is from the first 10 months of her life being undiagnosed. But X's lungs have no damage so far, because her medication started at birth.
The second parent said:
I am very angry that my son was not diagnosed earlier. If he was he could have avoided all the pain he went through. X was born and I was told I had a lovely healthy baby boy. Myself and my husband were overjoyed. However, this soon turned to misery as day after day we watched a chubby 81b baby turn into a tiny skeleton; his skin had lost so much muscle that only skin and bone remained. When you picked him up he would cry in pain… Eventually at 12 weeks old they admitted him to hospital weighing just 91bs; he was suffering from malnutrition. He had various tests done and a week later he was diagnosed with CF. We were devastated. A week later he went for a routine check and they found that part of his lung had collapsed due to the mucus.
The third parent said:
We feel extremely lucky that he had the screening. He is now a very healthy little boy, putting on plenty of weight with thanks to Creon and so far no chest infections due to regularly having his physio. My heart goes out to those families whose babies are not screened.
The fourth parent said:
I now look back and regret her late diagnosis and feel that as parents maybe we have let her down in not recognising a more serious problem earlier on. But maybe it was not us really but the system that let us down.
The fifth:
We were very disappointed, hurt and angry that Jamie was not diagnosed at birth because he was born in the wrong part of the country. No child should have to suffer like our child did.
That says it all.
We should also know the opinion of medical experts in the field. When asked by the Cystic Fibrosis Research Trust about neo-natal CF screening, 96 per cent. of paediatricians who responded and 78 per cent. of physicians favoured it. Let us ask an important question: what should carry ultimate weight—clinical trials or the experience and opinions of parents, patients, paediatricians and health professionals involved in the day-to-day care of people with cystic fibrosis?
The second argument adduced against screening was that there is no laboratory or clinical treatment protocol, but that hardly seems a major hurdle. Professionals have made it clear that although the various laboratories that carry out the screening have developed their own variations on the IRT/DNA method, it would not be a major problem to unify them, if necessary. In terms of clinical treatment protocol, I am informed that the committee is misguided and that clinicians have a clear treatment protocol for very young infants diagnosed by screening. On balance, the case for a national neo-natal cystic fibrosis screening programme is overwhelming.
The national screening committee has said that the door is not closed and the child health screening subcommittee will continue to work with the Cystic Fibrosis Research Trust on a way forward. That is

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positive. There is also considerable support in the House for a screening programme. More than 100 Members signed the early-day motion tabled by the hon. Member for Hazel Grove (Mr. Stunell). I am sure that a campaign run by the trust will attract considerable media and public attention. I invite the Minister to meet me, members of the trust and Dr. Littlewood, to listen to views and examine important new evidence.
Finally, there is the moral issue. Can it be right to prevent screening when common sense shows that it benefits children's medical condition, helps to prolong their lives and is of minimal cost and effort to the NHS? In the long term, it could even save the NHS considerable sums of money. It cannot be right to prevent that, and I believe that the Minister will decide to proceed with a cystic fibrosis screening programme in the near future.
1.47 pm
The Minister for Public Health (Yvette Cooper): I congratulate my hon. Friend the Member for Gloucester (Ms Kingham) on securing the debate and raising such important issues. As she knows, cystic fibrosis is the most common genetic disease to be found in Caucasian children and affects about one in 2,500 children. It is a disorder of the mucus-secreting glands of the lungs, pancreas, mouth, gastro-intestinal tract and sweat glands of the skin. Symptoms include failure to gain weight despite a good appetite and repeated attacks of respiratory infections. Treatment is possible and consists of regular physiotherapy, drainage antibiotics and the taking of pancreatic supplements and vitamins.
There have been significant improvements in care and services for people with cystic fibrosis in the past 25 years, so that 75 per cent. of sufferers survive into adult life today. Two decades ago, only 12 per cent. of affected children survived into adolescence. Current life expectancy can be about 30 years, but it is rising as more effective treatment becomes available. Experts predict that those born in the 1990s may live for about 40 years.
As a result of our success in increasing the life expectancy of people with cystic fibrosis, we are developing a broader range of adult services. The Department of Health has charged regional offices with ensuring that effective and systematic arrangements are in place for commissioning specialised services and identifying local priority specialised services for a major review of service provision and commissioning arrangements. Five of the eight regions have prioritised cystic fibrosis in the regional specialised commissioning groups in their 2000–01 annual work programme.
My hon. Friend focused on neo-natal screening. We take cystic fibrosis seriously. We are extremely interested in developing ways to improve diagnosis and treatment. We are also continually assessing ways to improve antenatal and childhood screening to improve child health. I am keen to look further at possible improvements in children's health and health services.
The House will be aware that we recently announced new child screening programmes as part of the modernisation agenda in the national health service plan. We announced plans in the past few months to introduce a national screening programme for children
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with sickle cell and blood disorders and the piloting of universal neo-natal hearing screening so that we can implement nationally an early test for hearing problems. Both are significant advances. Both policy announcements were informed by the work of the United Kingdom National Screening Committee to review the research evidence and test the effectiveness of the screening programme.
We also turned to the NSC for advice on cystic fibrosis screening. It is chaired by the chief medical officer for Northern Ireland and advises Ministers in England, the devolved national Assemblies and the Scottish Parliament on all aspects of screening policy. In forming its advice, it draws on the latest research evidence and the skills of specially convened multi-disciplinary expert groups, which always include patient and service user representatives. A child health subgroup was established to look at the range of screening programmes for children and offer advice about stopping, starting and changing programmes and improving their quality. It assesses proposed new screening programmes against a set of internationally recognised criteria covering the condition, the test, the treatment options, and the effectiveness and acceptability of the screening programme.
Assessing programmes in that way is intended to ensure that they do more good than harm at a reasonable cost. We need to be sensitive to the fact that screening programmes can cause anxiety and distress, especially if they lead to large numbers of false positives. If many parents are likely to be told that their child has a serious health problem, when in fact they do not, the anxiety and distress that that could cause to those families needs to be taken into account when assessing the case for the screening programme.
The NSC is considering two forms of testing for cystic fibrosis: neo-natal and antenatal screening. I will return to the latter if I have time. I wanted to concentrate first on neo-natal screening, as that is the issue that my hon. Friend made the subject of her powerful speech. Screening newborns for cystic fibrosis can be done via the blood spot collected on the Guthrie card. Screening can lead to positive tests, which, after further tests, lead to a diagnosis being confirmed at a few weeks of age before any symptoms are apparent. Therapy can then start. Without the screening test, some cases are identified by presentation in the newborn period, such as bowel blockage. With increasing awareness of the disorder, many cases can be diagnosed at six to 12 months due to respiratory symptoms or failure to thrive. This often picks up most of the severe cases, which would benefit from early therapy.
About 18 per cent. of the population are covered by a neo-natal screening service for cystic fibrosis. The NSC has invested considerable energies in reviewing the case for introducing a national neo-natal screening programme for cystic fibrosis through reviews of evidence and workshops. Its assessment is that screening for cystic fibrosis is not as straightforward as some other screening programmes. There are different professional viewpoints. I am aware that some of those who are involved in screening are enthusiastic advocates for a national programme. I am also aware that others in the paediatric world are not convinced that the case is yet sufficiently proven.

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The President of the Royal College of Paediatricians and Child Health, for example, believes that there is not yet sufficient evidence for the benefits of the screening programme. The NSC's advice to the Govt is that we should not yet move towards a national programme until we have more evidence of effectiveness. First, the committee argues that there is no direct evidence that the outcome is different for children in those parts of the country that have a screening programme and those that do not. It argues that, given that screening programmes can have harmful effects, usually psychological but also physical, clear evidence of benefit is essential before a new programme is established.
The health technology assessment, "Screening for Cystic Fibrosis" published in 1999, to which my hon. Friend referred, systematically reviewed the available evidence and was authored by some of the country's leading experts in the field. It stated:
The ability of screening to alter long-term prognosis has not been conclusively proven.
The NSC concluded that it is not yet clear whether there is a benefit in finding newborn babies with cystic fibrosis through screening compared with identifying them through traditional diagnostic routes. It also points out that there is evidence to suggest that false positive cases can cause parents significant psychological harm. In addition, in some positive cases, over-dependence on drugs at an early stage may also have a negative impact. The NSC also concluded that there was no current consensus on which screening test was the best or agreement on its interpretation, that early treatment in milder cases may have limited benefit and possibly adverse effects, and that there are no quality management systems for a programme. It has kept the evidence base under constant review, including examining the international evidence.
I have considerable sympathy with the arguments of my hon. Friend and of parents and doctors, who are keen to have the earliest possible diagnosis of cystic fibrosis. I also have a responsibility to consider the evidence and, in particular, the advice of the NSC—the expert committee that we have set up to review the evidence. In the light of its central conclusion that there is insufficient evidence at this stage to justify rolling out a neo-natal screening programme, I have asked it to consider how those gaps in the evidence, could be filled as rapidly as possible. I have also asked it to review its advice, on the basis of that evidence, in the next 12 months. The NSC is, therefore, working to extend the knowledge base on the issue to inform that review.
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First, the NSC will be funding a study of the existing screened population to help clarify and quantify differences in the outcomes for screened babies and later presenting symptomatic babies, to ensure that we examine the fact that some areas have cystic fibrosis screening and others do not and to compare the outcomes for those areas. Secondly, it is undertaking a further review of emerging international evidence from Canada and the USA, in particular, the large-scale trial in Wisconsin, which is expected to offer new and robust material in the next 12 months. I understand that the Wisconsin trial is examining outcomes for those with cystic fibrosis identified through screening, and those identified through other diagnostic routes.
Finally, the NSC is working with the Cystic Fibrosis Trust and the key professional bodies to develop a strategy to improve awareness in primary care about cystic fibrosis and respiratory disease. The NSC will, therefore, be exploring methods of analysing routinely available data from the existing NHS service in more detail, but also collecting new data.
I appreciate my hon. Friend's argument that we should not set inappropriate evidence tests, but I also feel that we could gather considerable evidence in the next 12 months better to inform a decision on cystic fibrosis screening in babies. It is not acceptable for us to identify gaps in the evidence but not to attempt to fill them as rapidly as possible to ensure that we can make a fully-informed decision about cystic fibrosis screening in babies as quickly as possible. As part of that work, I will happily meet my hon. Friend and any delegation that she wishes to bring. She will appreciate that the Government have to make assessments on the basis of the evidence and that we have to ensure that we are providing evidence-based care, both for screening programmes and for treatment across the board. The Government are also happy to continue working closely with interest groups, such as the Cystic Fibrosis Trust, to raise awareness throughout the NHS.
I have set out the considerable work that has been undertaken, but also the work that we have set in train in the next year to improve our knowledge and progress this matter. Our aim is to ensure that all children with cystic fibrosis have the best opportunity to lead fulfilling lives, that their families receive support and that we remain committed to providing effective and appropriate screening programmes for children. I thank my hon. Friend for raising such an important issue and contributing to a stimulating debate, and I look forward to meeting her to discuss this subject shortly.
Question put and agreed to.
Adjourned accordingly at Two o'clock.