asked the Secretary of State for Social Services if he will seek powers to discontinue the payment of unemployment relief to any person who, after being unemployed for three months, refuses to accept any offer of employment made by an employment exchange.

No, Sir. Under existing provisions, a person who at any time and without good cause refuses suitable employment can be disqualified for unemployment benefit for up to six weeks, and any entitlement to supplementary benefit that he may have would normally be reduced by up to 40 per cent, of his personal requirements.

Will my hon. Friend bear in mind that when the ruling that I have suggested was tried in Australia the number of unfilled job vacancies fell quite dramatically, to the benefit of industry and of the taxpayer who hitherto had been paying out large sums of unemployment benefit to many people who had not been genuinely seeking work?

We believe that the rules here are fairly powerful if they are fully applied. They have not been adequately enforced in recent years. They are still not being adequately enforced. For that reason we are employing extra officers on the work. We shall be employing some 450 additional officers on various ways of checking on abuse of the system this year. They will include unemployment review officers. We shall employ a further 600 next year.

Will the Minister tell his benighted hon. Friend that, when he loses his seat at the next general election, he can always apply for a job down the pit? Is he aware that the only probable result would be a decline in the productivity of the coal industry?

I think that that is a problem that will face Labour Members rather than my right hon. and hon. Friends.

Does my right hon. Friend recognise that one of the great problems in this respect exists in areas such as Thanet? A considerable number of people go to live there when they cannot possibly get a job there using the skills that they have used all through their lives. They therefore remain permanently unemployed. I am referring to people such as civil servants and welders. Is it not necessary for the Minister to be able to issue a direction that they shall not continue to receive unemployment pay when they remain in an area where they know they cannot get employment?

That presents a difficult aspect of the problem. The legislation that I summarised earlier refers to the acceptance of reasonable offers of employment. It is because that can be adapted to particular geographical areas and levels of skills or experience that we consider it the best way to operate while enforcing the law more strictly.

rose—

Order. I remind the House that yesterday we were able to make much better progress with questions because hon. Members tried to ask only one supplementary question and because both questions and answers were brief.

Does the Minister realise that the tone of the two supplementary questions from Conservative Members illustrates what they think of the workers of this country? Does he appreciate that the great majority of the 1,400,000 employed are genuinely seeking work? Is it not the duty of the Government to find them jobs and not to be so despicable in their actions?

The majority of people who are registered as unemployed are genuinely seeking work. It is in their interest and that of the whole country that the minority who try to cheat the system should not be allowed to do so. That is why we intend to enforce the law more strictly.

asked the Secretary of State for Social Services if he intends to meet members of the Merton, Sutton and Wandsworth area health authority.

I have no plans to do so.

Is the Minister aware of the great concern felt in the Merton, Sutton and Wandsworth area about the harsh cuts in Health Service expenditure imposed upon it by his Department? Will the right hon. Gentleman take another look at the consequences of those cuts and the many hospital closures that are about to take place to see whether he can do anything to relieve the situation?

I have already commended the action of health authorities which are taking the necessary steps to remain within the budgets established by our predecessors and to which we have adhered. I recognise that for many of the London health authorities this has meant most painful decisions, but I have once again to make it clear that the Government cannot provide extra funds. Next year's spending plans provide for a small measure of growth in health authority spending.

asked the Secretary of State for Social Services whether he has any proposals for changes in the consultation procedure laid down for the closure of hospital wards.

Not at present, but we are looking at the guidance which is given by the Department on the procedure for the temporary closure of all or part of a hospital.

Does my hon. Friend agree that the decision to close the children's ward at Victoria hospital, Romford, in February of last year, without consultation and notice and on the pretext that the closure was temporary, was an abuse of the present procedure? Is he aware that that ward is still closed 21 months later and that it was an attempt to undermine the viability of the hospital as a whole?

If there is disagreement locally and any question of a permanent closure, the matter would come to my right hon. Friend for decision. I am well aware of my hon. Friend's anxieties about the Victoria hospital. There are consultations taking place at present and we should wait and see how they develop.

Is it not true, however, that a number of area health authorities are seeking to use temporary closures to evade completely the responsibility of consultation? Is he aware that in this way they avoid the need to consult the community health council and to refer the decision to the Minister if the CHC disagrees with the closure?

I am not aware that any health authority is abusing the temporary closure procedure in that way. However, the guidelines may need clarification and we are looking into that. The temporary closure has no fixed time limit. Providing the authority genuinely intends to reopen a hospital, the closure is regarded as temporary.

Is my hon. Friend aware that, without any public consultation, the Kingston and Richmond area health authority announced the temporary closure of St. Mary's hospital, Hampton? Will he do all in his power to encourage the authority to keep that hospital open in the long term?

The essence of temporary closure is that urgent action is taken because of an immediate need. A health authority cannot, therefore, go through the whole process of consultation.

Is the hon. Gentleman aware that his right hon. Friend's letter to the chairman of the North-West Thames regional health authority of 28 August last has been interpreted by many community health councils throughout the country as an attempt to exclude them from a large part of their consultative role in hospital and health service changes? Will he give the House an undertaking that that letter is meant to apply only to temporary closures and small units?

I should be glad to discuss that letter with my right hon. Friend, but I am interested that the right hon. Friend should ask such a question. He is clearly ignoring the fact that the Labour Government closed 280 hospitals in England, and that on 31 March this year there were a further 31 in the pipeline for closure, making 311 in all.

The community health councils were consulted about all those hospitals, and only 18 closures were raised with the Minister by the councils concerned. They agreed to the remainder of the closures.

That is a curious argument in view of the complaints about the lack of consultation under the previous Government.

asked the Secretary of State for Social Services what was the value per week of family allowance or child benefit for a family with three children of school age in October 1977, October 1978 and October 1979 at constant 1977 prices.

The value is: October 1977, £4, October 1978, £6·40, September 1979, which is the latest date for which the retail price index is available, £9·60.

Is the Minister aware that this financial year will be the first time since the war that the majority of children have derived no financial benefit from increased tax allowances and direct payment in the form of child benefit? In the light of the 17½ per cent. rate of inflation, which is still rising rapidly, that is disgraceful.

Perhaps the hon. Gentleman has forgotten that from April this year child benefit increased by £1. Yesterday child benefit was increased by a further 50p for the first child in one-parent families and the supplementary benefit child dependency allowance was also substantially raised.

Am I correct in thinking that, had my hon. Friend answered that question in regard to children of one-parent families, the figures would have proved still better for 1979? Is not that a pointer to the fact that the Government have to be more selective in the distribution of child benefit, particularly where overall resources remain restricted?

My hon. Friend is right. Efforts to help one-parent families over the past years have been given prominence, and that is particularly so this year. There are other problems for one-parent families which are not purely financial and there is still much to be done in those areas.

Does the hon. Lady agree that her Government cancelled a 50p increase which the Labour Government intended to pay this November? Further, will she acknowledge that the £4 child benefit in April next year will be worth only £3·20? When will her right hon. Friend announce an increase to back up the Conservative Government's alleged commitment to child benefit?

The right hon. Gentleman has totally missed the point. There was no provision in the previous Government's estimates for an overall 50p increase in child benefit. We shall review the uprating of child benefit as required to do and my right hon. Friend will make an announcement when he is ready.

Does my hon. Friend recognise the importance of increasing child benefit as a substitution for the tax allowances that would have been increased had child benefit not been introduced?

Yes, we certainly recognise that.

asked the Secretary of State for Social Services whether he will intervene to prevent the threatened closure of the Bull Hill maternity hospital in Darwen.

The Lancashire area health authority sees the hospital's closure as part of the long-term reorganisation of maternity services in the Blackburn district, but that will not take place for a number of years. Formal consultations on its proposal have yet to be undertaken and my right hon. Friend would not wish to become involved at this stage.

Does my hon. Friend realise that that small and excellent hospital is exactly the type which he must have had in mind when he spoke recently about the need to preserve small hospitals? Will he keep a watchful eye on the bureaucratic and remote actions of the Lancashire area health authority?

Let no one doubt this Government's commitment to small hospitals and their expanding role in the community. I am not surprised that my hon. and learned Friend speaks so highly of that hospital. If any proposals are brought forward I shall certainly keep his views in mind.

Is the Minister aware of threatened hospital closures throughout the country—

Order. The question is about a specific hospital, and supplementary questions should be related to that hospital.

asked the Secretary of State for Social Services what representation he has received on the effect of public expenditure cuts on services for the elderly.

We have received representations from many organisations, including local authorities, health authorities, trade unions, voluntary organisations, professional bodies and others about the level of resources available for health and personal social services. Each authority has to decide how to match its spending programme to the resources at its disposal. We have made it clear that direct patient services and personal social services for the old and frail should be protected as far as possible.

Does the Minister accept that the reductions in public expenditure, particularly in such services as home helps and meals on wheels, and the discontinuation of the electricity discount, are likely to place an increasing number of elderly people at risk in the coming winter?

We have asked local authorities to do their utmost to make the necessary savings in ways that will protect services to patients and vulnerable groups. Some local authorities have achieved the targets that we have set without cutting social services.

Is my hon. Friend aware that some area health authorities are closing geriatric wards or geriatric hospitals because they regard them as a "soft touch", and that there is no compensating provision of facilities through county social services?

We have protected health authorities as far as possible from the economic difficulties which we have inherited. We have asked them to adopt the same criterion as the local social services when they make decisions about services for patients.

What advice will the Minister give to the old, sick and disabled in Cheshire, where the county council has cut not only transport for the blind and disabled to clubs and meals but has cut down on the numbers of home helps?

We have defended the amount of money available for joint funding in an effort to overcome some of the problems about the division of responsibilities between the health authorities and the personal social services.

What epithet would my hon. Friend apply to local authorities such as Haringey, which has apparently decided—

and Cheshire.

Perhaps the hon. Lady will just listen. What does my hon. Friend think of Haringey, which has decided to cut down on personal social services so as to sustain the propaganda broadsheet it put out to ratepayers last month?

I hope that the local electors in Haringey will come to the correct decision when they next go to the polls.

Following representations that have been made to the hon. Gentleman, is it not a fact that the elderly will suffer from the cuts this winter?

The right hon. Gentleman should take note of what the director of social services in Newcastle has said. He asked people not to over-react and he said that there were extravagances, waste and some incorrect priorities in our services. He said that the:

"social services can save money without making vast inroads into existing services."

Is the Minister satisfied that there are no examples of local authorities which will not be able to meet their statutory obligations in social services, particularly in relation to the elderly, without increasing the rates, because of the implications of the rate support grant?

We know of no such instances.

asked the Secretary of State for Social Services what has been the aggregate cost to public funds of benefits paid to those involved in industrial disputes, and to their dependants, respectively, in the current year so far.

Up to 2 October, supplementary benefit payments amounted to £4,700 and £1·9 million respectively.

Those are formidable figures. Does my right hon. Friend agree that at a time when the trade unions appear to have enormous funds for expenditure on fringe benefits for their own union apparatchiks it is urgent that we should take the action to which, as Conservative Members, we are committed, to ensure that the unions bear a fair share of the cost of industrial disputes?

My hon. Friend refers to the manifesto obligation on which he and I both fought the last election. We promised a review of this matter and I assure my hon. Friend that it is being carried out. We shall announce our conclusions as soon as the review is completed.

Is the right hon. Gentleman aware that in a recent television dispute in my area the members of the local branch of NATKE voted by ballot to remain at work, yet they were locked out the next day by the employers? Does he realise that they have had great difficulty in obtaining unemployment and other benefits?

I cannot become involved in the detail of individual disputes. It is clear that local social security offices are examining—rightly and carefully—the question of entitlement to benefit in circumstances involving industrial disputes.

Is my right hon. Friend aware of the intense public feeling against the payment of strikers' benefit? Does he agree that, in many cases, the strike works against the community which becomes less and less willing to bear the financial strain.

My hon. Friend is absolutely right. We are in no doubt where public opinion lies on the issue. The Government are determined to get the matter right and therefore we are taking some time over our studies.

Will the Secretary of State confirm that in the last full year for which figures are available the amount paid out in supplementary benefit to the dependants of strikers amounted to 1 per cent. of the total amount of unclaimed supplementary benefit? Only 4 per cent. of all strikers' families received benefit. On behalf of the Opposition, I give due warning, along with the Engineering Employers Federation, that if the right hon. Gentleman changes the present system he will be heading for a major row and major problems in the country.

Like last winter, is it?

I am sure the hon. Gentleman does not challenge the view that a democratically elected Government may carry forward the commitments which they put firmly before the country at the last election. The hon. Gentleman is quoting from an answer that he received from my Department earlier this month. Last year, the average payment for the benefit of a striker's family was about £74. The total amount of money involved was £3·3 million. These matters are regarded as being of considerable provocation by many members of the British public.

asked the Secretary of State for Social Services what representations he has received about the Government's decision to end the statutory requirement to increase pensions according to the average increase in wages or prices, whichever is the higher; and if he will make a statement.

Representations have been received from pensioners' organisations, the TUC and members of the public. In reply, we have made it clear that we can no longer accept the present statutory provisions which, over a period, would result in pensions increasing by more than prices and earnings, regardless of the country's ability to provide the necessary resources. We shall shortly introduce a Bill to provide that pensions, like other benefits, shall be increased at least in line with the movement of prices. But this will be a minimum requirement. We are determined that, once the economy has improved, pensioners will share in that improvement.

Is the right hon. Gentleman aware that some 159 Members, both Labour and Tory, have signed early-day motion No. 89, demanding that the Government reconsider the matter? Will not the Minister scrap this mean proposal? Otherwise not only will he face opposition from us, he may face a revolt from some of his Back Benchers who do not share his desire to launch a vicious Right-wing attack on the living standards of pensioners.

There has been no vicious Right-wing attack on the living standards of pensioners. Pensions increase this week by almost 20 pence in the pound. That is a rise which is more than the statutory requirement. However, we regard the rise as a minimum requirement on which we can build, as circumstances allow. If Opposition Members want to help pensioners they should persuade some of their trade union friends to modify the wage demands that are now in progress.

The right hon. Gentleman is a traitor.

If those demands are acceded to, they will have a devastating effect on the living standards of pensioners during the coming winter.

Will my right hon. Friend give some thought to the early-day motion which encourages him to consider raising pensions every six months rather than annually? That would not greatly increase public expenditure but it would be of great advantage to pensioners, particularly in times of inflation.

We would all wish to do that. However, my hon. Friend is mistaken when he says that it would not greatly increase public expenditure—it would. The greatest service that we can perform for pensioners now and in the future is to hold inflation in check. That means pensioners, wage earners and others facing the necessity of receiving increases at intervals of not less than 12 months.

Is the right hon. Gentleman aware that by attacking the workers and the pensioners he is doing a disservice to the House? Is it not a fact that the increase that was given to pensioners by the previous Government between 1974 and 1979 meant an increase in real terms of over £5 a week for a married couple? That is to be removed by this Government.

No, Sir, it is not, because that would be to assume that the increase would have been only in cost of living terms. If the right hon. Gentleman will look at the earlier years of Conservative Government, between 1970 and 1974, he will find that increases kept pace with earnings, without any statutory requirement. Surely it is constitutionally correct that the Government of the day and Parliament should be able to decide this matter year by year in the light of the economic position and in the light of other priorities.

asked the Secretary of State for Social Services what representations he has received following the announcement of the fuel costs (assistance) scheme.

asked the Secretary of State for Social Services what representations he has received following his announcement on the fuel costs (assistance) scheme.

At 7 November, the latest convenient date, 15.

Is the Minister aware that, notwithstanding the paltry increase in the heating allowance, which does not even keep up with the cost of living, the chairman of the Supplementary Benefits Commission, speaking in Glasgow yesterday, said that it was inevitable that many thousands of pensioners would suffer great hardship this winter because of an inability to pay their heating bills? In the light of this, will not the Minister reconsider the heartless decision to end the fuel cost assistance scheme?

I do not think that Government expenditure of £120 million this year on helping with heating costs should be described as paltry. I draw the hon. Member's attention to the comments of the chairman of the Supplementary Benefits Commission about first ensuring that the poorest people are adequately protected. That is what we intend to do with the scheme this year.

Is the Minister aware that the Government's decision to discontinue the electricity discount scheme, plus the apparent confusion already existing at local level about the mechanics of implementing the 95p mandatory award, will create great hardship for many thousands of people, including pensioners, who are in the trap of having all-electric homes? Will not she and her hon. Friends reconsider what appears to be an extremely callous approach to a serious human problem?

The House was very much aware last year that the electricity discount scheme was extremely wasteful to administer. The hon. Gentleman mentioned misunderstandings at local level. All local offices have been instructed exactly what to do. The 95p addition to supplementary beneficiaries of age 75, or those in supplementary benefit households with someone over the age of 75, commenced from this week. If there are individual difficulties, I shall be grateful if the hon. Gentleman will bring them to my attention.

May I congratulate my hon. Friend in that 110,000 elderly pensioners who did not previously get help will now receive help? Will she, with her right hon. Friend, consider whether in some way those over 75 who are in receipt of rent and rate rebates could be included? Is she aware that many hon. Members will have advised pensioners in their constituencies to take rent and rate rebates because they would be better off than if they were getting supplementary benefit? The opposite may now be the case.

I believe that many people may now, as my hon. Friend says, be better off on supplementary benefit. We have been told that by this announcement we have clarified the question whether people should be on rent and rate rebates or on supplementary benefit.

My hon. Friend asked whether we would look at the position of those who gained on average £7·50 last year through the rent and rate rebates being entitled to the electricity discount scheme. I repeat what my right hon. Friend said on 22 October. We shall keep under review the range of help available for fuel costs as the months go by.

That is not good enough. The hon. Lady knows it and so do her colleagues. Are they not prepared to state in this House and elsewhere that there are millions of people who were benefiting previously, however inadequate the discount scheme may have been, but who will now no longer benefit? Will the Government accept, as I would expect anyone on either side of the House to accept, that there is a growing problem for fuel poverty in this country which will not go away?

Will the hon. Lady or her right hon. Friend take the lead, with colleagues in other Departments, to establish a clear policy on fuel poverty, involving the operation of the Homes Insulation Act, involving changes in the tariff structure, involving changes in the—[Interruption.] This is a serious matter concerning millions of people in the country. Does the Minister agree that there should be increased financial help, in line with rent and rate rebate allowance schemes? There should also be a major review. Will the hon. Lady accept that?

The House is already well aware that the last Government left absolutely no money in their forward estimates for the heating scheme this winter. The right hon. Gentleman is very well aware that we are concentrating the available help on the most needy people. We are spending £120 million this year, in comparison with £125 million spent last year. The right hon. Gentleman also mentioned growing problems. Discussions will, of course, continue with other Government Departments which are already involved in other aspects of fuel costs.

asked the Secretary of State for Social Services what discussions he has had with the trade unions in the Health Service whose members are affected by cuts in public expenditure; and if he will make a statement.

I have regular meetings with the TUC health services committee and with other staff organisations. As regards the constraints on health spending this year, I refer the hon. Member to what I said in the Supply day debate on 24 October.

Is the Secretary of State aware that many trade union leaders and other people are protesting about the hospital closure programme, including Lang-with Lodge, a renowned diabetic hospital near my constituency? Will he reverse the decisions that seem to have been made and keep this and other hospitals open? Or will he, and the squalid bunch on the Conservative Benches, headed by Britain's No. 1 lady terrorist, carry on with this closure programme, inflicting death and injury on those on the nation's hospital waiting list this winter?

I wonder whether I might respond to the hon. Gentleman by inviting him to use his considerable energies in trying to point out to his friends in the trade union movement that there is, at first sight, some apparent inconsistency between, on the one hand, their demonstrating in the streets against what they claim to be cuts against patients, and, on the other hand, picketing hospitals.

Will my right hon. Friend tell the hon. Member for Bolsover (Mr. Skinner) that the hospital closure programme was instituted by the last Government.

I might also point out to the hon. Member for Bolsover that if he studies table 2 in the public expenditure White Paper, published a few days ago, he will find that in the health and personal social services column and in the social security column the expenditure next year provides for an increase on the expenditure this year.

Does not the Minister realise that the cuts in the National Health Service fall most hardly—

What cuts?

Massive cuts, of course. The hon. Member does not even know about them. Does the Minister realise that the terrible cuts in the National Health Service have the greatest effect on the patients and on the lower-paid people who work in the Health Service? Does he not realise that the way to avoid any unnecessary strikes is to give more money to these people, just as his Government have given more money to the police and to so-called defence? Does he realise that, if more money were given to the National Health Service, it would avoid anything going wrong in the coming winter?

The hon. Gentleman cannot have understood the arguments on this issue. The Government have funded the National Health Service to the tune of an additional £250 million to pay the wage increases that we inherited. That is twice as much as the amount by which we have had to ask health authorities to trim their expenditure in order to contribute to the cost of those pay increases. That is not a cut in the National Health Service by any normal standards.

Following up what my right hon. Friend said when he slapped down the hon. Member for Bolsover (Mr. Skinner), can he tell us what discussions he has had with the TUC about the patients in the National Health Service, and the people who would like to be patients in the NHS, who are being denied treatment because of the squalid activities of trade unions?

My predecessor, the right hon. Member for Norwich, North (Mr. Ennals), discussed with representatives of staff organisations in the NHS proposals for trying to establish a disputes procedure—for instance, to solve problems such as the present problem at Charing Cross hospital. That matter was referred to the Whitley Councils. The Government are entitled to ask the councils soon to come to a conclusion on a way in which we can make these damaging local disputes a thing of the past.

Will the right hon. Gentleman stop misleading the House on the question of public expenditure, when he knows that, for example, his plans take no account of the doubling of VAT, of the increased pressure which the cuts in the social services have thrown on to the NHS, or of the roll-on of the budget additions for 1978 and 1979 for next year? Will he dissociate himself from the statement of one of his hon. Friends that the NHS has enough money and does not need any more?

The right hon. Gentleman is quite wrong. The figures quoted in table 2 of the public expenditure White Paper fully recognise the impact of VAT. They fully recognise the squeeze that he, as the former Health Minister, imposed on the NHS before he left office. The fact is that spending on the NHS next year will be about 3 per cent. above the likely outturn of spending this year. By no stretch of the imagination could that be called a cut.

asked the Secretary of State for Social Services if he will make a further statement concerning the phasing-out of area health authorities and their replacement.

I hope to issue a consultation paper in a few weeks setting out our proposals for simplifying the structure of the National Health Service, including proposals about area health authorities.

When that paper is published, will the Secretary of State give consideration to the desire of local authorities to undertake an exercise by which they believe that they can much better integrate the health services that they now provide with those provided by the NHS'? Will he look at the time scale involved and see that the local authorities can now get down to the job of studying the implications for them following the abolition of the area health authorities?

I know that local authorities will want to read very carefully the proposals that we shall be putting forward in our consultation document. I think that there is now widespread recognition that making the boundaries of local health authorities and local authorities coterminous was achieved at much too high a price in terms of the remoteness of the management of the Health Service.

Does my right hon. Friend agree that in reforming the system we need not only greater efficiency and greater economy but greater democratic participation in the administration of the hospital services? Is it not the case that many of the recent problems with regard to temporary or partial closure of hospitals and lack of consultation might not have arisen had there been proper local participation?

Of course, one wants to try to make health authorities more responsive to the popular feelings in the areas that they administer. One of our main objectives in trying to decentralise, simplify and localise the administration of the Health Service is that people shall feel a closer involvement with their own local health services. This will be very much part of our strategy.

Will the proposals need legislation? When the right hon. Gentleman lays them, may we have a parliamentary debate?

The question of a debate is for my right hon. Friend the Leader of the House, but I think that he has indicated that he recognises the widespread desire in the House for a debate, perhaps not merely on the consultation document but on the Royal Commission report as a whole. The answer to the first part of the right hon. Gentleman's question is "Yes". We may well be taking powers in a health services Bill that we shall shortly be introducing.

asked the Secretary of State for Social Services if he will make a statement on nurses' pay.

Nurses' pay is at present being considered by the Standing Commission on pay comparability. The Commission intends to report by 1 January, and the Government have accepted a commitment to implement its award by two equal stages, from August 1979 and April 1980. We have indicated that we shall honour the commitment on cash limits made by our predecessors to health authorities, although the previous Administration had not provided any funds for this purpose.

Does the Minister recall the statement made by the hon. Member for Reading, South (Dr. Vaughan), now the Minister in charge of the Health Service, in a debate before the election, when he said that the nurses should be treated as generously as the policemen and the firemen? When will the Government translate that promise into practice?

I recognise that nurses' pay should not again be allowed to fall behind, as it has done in the past. The Government are considering what arrangement should apply in the future for settling the pay of various public service groups, such as nurses. We shall be bringing forward our proposals in due course.