asked the Secretary of State for Social Services what is the total number of cervical cancer screening machines in each of the English and Welsh district health authorities.

Cervical cancer screening requires only the simplest of equipment, which is readily available in all district health authorities.

Despite that comment by the junior Minister, is it not the case that, in most authorities, there is not an adequate system of call and recall for cervical cancer screening? The reality is that only one authority in five in England and Wales has that service. Is it not time for the Minister, instead of giving glib answers, to reassure men and women throughout the country that she is prepared to invest in a real service and to make the money available for a call and recall scheme for all women at risk?

The call and recall system is not in itself a screening system, as I am sure the hon. Gentleman realises. I am also aware that in his own city, Leeds, progress is being made to introduce a full computerised call and recall system. The family practitioner committee is currently computerising its register as the first stage. Until then, a manual system is in operation for recall, which is achieving a commendable 80 per cent. response.

Has my hon. Friend any knowledge of when it may be possible to offer regular cancer cervical tests for all women who are calculated by the medical profession now to be at risk?

It is possible now to offer regular testing, and we recommend that women between 20 and 65 should come in and be tested on a regular basis. The dispute is not about the screening system that is available now. It is about the computerised call and recall systems, and we expect that all health authorities will meet their target of next spring.

Does the Minister realise that several hundred women in Liverpool have had to be recalled, either for hospital treatment or for further tests, because of errors in analysis? What assurances can she give women throughout the country that tests of this kind are accurate? Does she have faith in the present system, or does she believe that these errors can be eliminated in some way or other?

Yes. I, like many millions of women, have complete faith in the present system. The problems in Liverpool, as the hon. Lady knows, are the subject of an inquiry.

I congratulate my hon. Friend on the substantial progress that the Government have made in this area, but may I draw her attention to the length of time it has taken, particularly in the county of Shropshire, for people who undergo the examination to get the results of the tests? I have a letter from a constituent in the Bayston Hill area of Shrewsbury who has been waiting since January, and we are now in the last day of June. That is quite long enough to wait.

It gives me no pleasure whatever to confirm that the waiting time in Shropshire is the worst in the country. I hope that my hon. Friend will add these remarks to those made during last night's Adjournment debate in his further discussions with the local health authority.

Will the Minister tell us when the 56 health authorities that promised to bring in call and recall schemes by 30 March, but failed to do so, will do so?

The advice that we have received, which we have confirmed once again this week, is that all health authorities expect to have their computerised call and recall systems up and running by next spring. I reiterate that if the hon. Gentleman wants to assist women who might at some stage suffer from cervical cancer he should encourage those who have never been tested to come in for a test. They do not have to wait until they get a computerised piece of paper. The test is available now.

asked the Secretary of State for Social Services when free needles and syringes will be available to diabetics.

Re-usable syringes and needles are already available on prescription. As I announced on 14 May, disposable syringes and needles will be available on prescription from 1 September. Since diabetics who need insulin are exempt from all prescription charges, they will be free for adults as well as for children.

I congratulate my hon. Friend on making available the resources to bring about an improvement which will be of considerable benefit to many diabetics. Is he satisfied that by September sufficient supplies of the disposable equivalent will be available and that satisfactory arrangements will be made for the safe disposal of used needles?

Yes. It is because I wished to be sure on those two points that the system is being introduced a little later than I had originally hoped, but we have made arrangements which I am confident will be satisfactory.

Doubtless the Minister is aware that many thousands of carers now have to pay for syringes for those loved ones for whom they care. The carers tend to be poor women who cannot afford to pay. Was it not a mean act by the Government to announce at one and the same time the increase in prescription charges and the availability, albeit later, of free syringes? Was not the availability of the free syringes put in as a sweetener, as it were, to disguise the increase in prescription charges?

I am a bit puzzled by what the hon. Lady says. Syringes and needles are already free on prescription, but they are re-usable syringes and needles. We are substituting free provision of the more convenient and comfortable disposable syringes and needles. The hon. Lady's approach is typical of the mean-minded, nitpicking that we have heard from the Opposition recently.

asked the Secretary of State for Social Services what is the value in real terms of the basic retirement pension to (a) a single person and (b) a married couple, as a proportion of average earnings, compared with their value after the November 1977 upratings.

The basic retirement pension was 33·8 per cent. of average net male manual earnings in November 1977 and 29·8 per cent. on estimated April 1987 figures. The corresponding figures for a married couple were 50·8 and 45·3 per cent., respectively.

Is it not disgraceful that, at a time when, for instance, managing directors throughout the country are increasing their own salaries at a colossal and almost unprecedented rate and are telling people who want a slight increase not to be greedy, pensioners should be hard put to it to pay standing charges and television licences? Surely the so-called boom that is going on should not allow that to happen. Was not the last increase of 40p a direct, pitiful insult to the pensioners, and is it not time that the Government did something for them?

If we are talking about pitiful points, the hon. Gentleman secures first prize. What the Government have done since they were elected is to see that the total income of pensioners as a whole—and that is what matters—has risen twice as fast as the income of the population as a whole. We have given pensioners a share in Britain's rising living standards.

Will my hon. Friend concede that we want no lectures from the Labour party on caring for pensioners? Was it not the Tories who first introduced pensions for the over-80s and who twice restored the Christmas bonus that was snatched away by the Labour Government?

Although I am very tolerant, accepting lectures from those who behaved in the way described by my hon. Friend, those who pledged themselves to link pensions to earnings and then failed to fulfil their promises in government, is a bit thick.

Will the Minister concede that one of the biggest losses to pensioners during the period of this Government has, of course, been the conscious break with uprating in relation to earnings and that that has led to a severe loss of pensioners' puchasing power? Will he at least look at the principle of entering into discussions with the major utilities with a view to trying to abolish standing charges for pensioners?

With regard to those utilities, gas and electricity prices have fallen in real terms over the period of this Government. That fall and the general fall in inflation have helped pensioners. A mistake that is often made in these matters is to refer simply to the basic pension rather than to the total income of pensioners as a whole. Our plans and aims for the future mean that we will widen choice and improve opportunities so that people may receive extra help beyond the basic pension.

I recognise that the Government have done a great job for pensioners, but does my hon. Friend none the less agree that while he was out on the election trail most hon. Members on both sides of the House must have been struck by and concerned about the level and quality of life of people living on nothing but the state pension? When he considers the uprating of pensions, will he see whether the Government can do something for people with no income other than the one pension? Those people cannot maintain dignity of life simply on the current level of pension.

The vast majority of people who receive the basic pension would also be entitled to supplementary benefit and full housing cost benefit. They would also receive help with heating additions, insulation grants and a passport to a free Health Service. It is the duty of all hon. Members to encourage those people receiving the basic pension to ensure that they receive all the benefits to which they are entitled.

I welcome the Minister to this particular bed of nails. I sympathise with him, because he obviously has not been with the Department long enough to know just how dubious are some of the facts that he has been fed. The total income of pensioners has risen only as a reflection of the scheme introduced by the previous Labour Government, which the present Government have just emasculated. The figures that the Minister has given show that under this Government the standard of living of a pensioner couple has fallen by 5 per cent., and that rather more reflects reality. How many pensioners do the Government predict will he on income support by the end of the century?

This will depend on the levels of income support and how they move. Incidentally, I am grateful to the hon. Lady for her generous welcome. I note that she is fresh from the hustings. I regard this, not as a bed of nails, but as an opportunity to ensure that the vast sums of money that the Government spend and are continuing to spend on social security are targeted increasingly on those most in need.

Does my hon. Friend recall that at the hustings the majority of pensioners rejected Labour's fake fiver? Does he accept that pensioners understand better than any other group in society the hyper-inflation that would follow from any kind of proposed linkage?

The electorate saw through the blank cheque offered by Labour Members, not least noting the divisions between the hon. Member for Oldham, West (Mr. Meacher) and his hon. Friend the Member for Dagenham (Mr. Gould).

asked the Secretary of State for Social Services what extra resources his Department is making available to local authorities to deal with the problems of child abuse.

The1987–88 provision for personal social services was a 12·8 per cent. increase on 1986–87, representing a significant increase in real terms. This included additional provision for children's services and for training. Central funds have also been made available for a number of specific projects to improve the training of social workers and others who may be concerned with child abuse.

While in no way wishing to comment on any of the matters that were raised yesterday in a very heated atmosphere, may I point out to the Minister that physical or sexual abuse of children, which is now reported in far greater numbers, is about the biggest theft of childhood that any child can experience and that local authorities, despite what the Minister has said, are hard pushed to meet the demands on them for training in detection and how to deal with children who have been damaged'? Is he aware that we further betray those children if, having encouraged people to come forward and give evidence about these matters, we fail to meet the needs of the children?

I would not entirely agree with the implication of the hon. Lady's remarks. I agree that the problem is not only one of resources, but of skills and expertise, and that is precisely why we have been putting so much additional effort—including, for example, cooperation with Great Ormond street, the National Children's Bureau and the National Society of Prevention of Cruelty to Children—into improving training in those areas. That is important.

Quite apart from resources, does the Minister not feel that when doctors, social workers, magistrates and local authorities appear to be approaching this extremely important matter in divergent ways it is urgent for the Secretary of State, together, perhaps, with the Home Secretary, to call together representatives of all the strands of care in this vital area of activity to see whether a more cohesive approach can be created, including updated legislation if that proves necessary?

If I agreed entirely with my hon. Friend my answer would he yes, but the arrangements for proper inter-agency co-operation are working well in most parts of the country. It is clear that in at least one part of the country they do not appear to be working well, and our problem is to make sure that they work well everywhere.

Will the Minister condemn the outrageous statement made in the House yesterday by the hon. Member for Stockton, South (Mr. Devlin) when he equated the Cleveland social services with the SS?

My hon. Friend referred to a particular case which he said had been brought to his attention and on which I am not in a position to comment—[Interruption.] I am not prepared to comment on the hon. Lady's question this afternoon any more than I was prepared to comment on my hon. Friend's question yesterday afternoon.

Are not such cases always extremely difficul to assess, and does not intervention and help require great skill? Does my hon. Friend agree that social workers require proper training and co-ordination and that procedures between agencies must be properly implemented? Can my hon. Friend offer any encouragement that we shall update the law on child care, making more explicit the rights and responsibilities of local authorities and parents?

My hon. Friend will know that we have published proposals in those respects and that within the next few months we are hoping to put out in a final form the draft guidance that we have had out for some time to make quite sure that inter-agency co-operation, which we all agree is needed, takes place effectively throughout the country.

Does the Minister accept that often the increase in cases of child abuse occurs most when families are under pressure in areas of deprivation; that, as the hon. Member for Eccles (Miss Lestor) said, some places need an increase in resources; that others, particularly the inner cities, need better co-ordination between the health and social services; and that in all regions the Minister should take a lead in implementing a system of second checks so that the rights of all can be protected at the first stage, because after that it can never be done adequately and suspicion will never be got rid of?

The hon. Gentleman will have noted what was said yesterday by the Northern regional health authority in setting up a pilot scheme. We shall obviously want to look at and learn from the experience of that scheme.

Will the Minister accept from one who has just left the administration of social work training that those directly involved accept that there is a desperate need for additional resourcing in that vital area? All members of the social work profession accept that professionally trained social workers are the best way to avoid problems in society. Therefore, will he give an early indication of when we can expect a statement on the diploma of qualification in social work, to enable schemes on the certificate in social service and the certificate of qualification in social work to progress in preparation for 1991?

With her expertise, the hon. Lady will know that I had discussions with the Central Council for Education and Training in Social Work a few months ago. It is doing some more work on its proposals in order to refine them, and we shall look at those carefully when we have them later in the year.

Does my hon. Friend recall the case of Maria Caldwell, who was brutally killed by her stepfather in my constituency? Surely he will remember that, as a result, a new Act came on to the statute book which altered the balance of the rights between parents and children. In view of the tragic situation that has now arisen in Cleveland, and the new figures produced by the NSPCC, will he ensure that any future legislation continues to keep that balance right, that we do not overreact, and always remember that children's rights must come first?

Having held these responsibilities at an earlier stage, and in a different capacity as well, I am very conscious of the fact that the most difficult single problem is getting that balance right. Indeed, that has been illustrated within the past few weeks—by the Kimberley Carlisle case not long ago, on which we shall soon receive a report, and by what is now alleged to have happened in Cleveland. It is an acutely difficult problem, and I am very conscious of it.

Given that most perpetrators of this kind of abuse are men and that the overwhelming majority of victims are young girls, should not the Government, among other things, encourage the recruitment of many more women doctors into the ranks of police surgeons? Police surgeons have an important role to play, and they, too, must be given the right kind of training.

I believe I am right in saying that the number of women doctors generally is increasing. I look to my hon. Friend the Parliamentary Under-Secretary to confirm that. However, I shall certainly undertake to draw the hon. Gentleman's point to the attention of my right hon. Friend the Home Secretary.

Does the Minister accept that, while women doctors may be becoming more numerous, women police surgeons are not? Even in the House today there is a tendency, which is reflected nationally, for people to bury their heads in the sand and miss the tragedy that is taking place in the nation. More resources are needed to deal with it. Can a social worker do a case conference, enter into multi-disciplinary conferments, and at the same time be on his or her patch dealing with the problems? Does the Minister accept that more resources are needed? Can such resources also be made available to Northern Ireland, or will that have to go to the Anglo-Irish Intergovernmental Conference?

I said in my reply to the original question from the hon. Member for Eccles (Miss Lestor) that there had been a substantial increase in the provision for social services for the current year and that that took account of children's services. Of course, we shall continue to take those matters into account, not least the recent experience, when considering allocations for future years.

Is the Minister aware that, in view of the stream of horrific child abuse cases in recent years and the current hysteria that does not make for good policy-making, it is a serious failure that the Government have still not formalised guidance for dealing with such cases? As Cleveland is now referring children at a rate more than 10 times greater than the national average, does that not suggest that there are enormous and unacceptable variations in the handling of problems and that there are no agreed medical rules for diagnosing child abuse? Will the Minister therefore convene a national panel of all the relevant professional interests to try to achieve a national consensus on the identification, handling and treatment of a very serious problem that has been underestimated for years?

We already have in hand arrangements to prepare practice guidance for social workers, for health visitors and, in the sense that the hon. Gentleman suggested it, for doctors. As I said yesterday on a different angle of the problem, I frankly think that it would be better for us to get on with that work than to convene a national conference along the lines that he suggests.

rose——

Order. The House will understand why I allowed a fairly long run on that question, but I feel that we must now move on rather more rapidly.

asked the Secretary of State for Social Services whether he will make a statement on the national breast cancer screening programme.

The first nationwide breast cancer screening service in the world is to be established in this country within three years. Regional health authorities are making good progress in planning for their first centres, which will be set up by 31 March 1988. The remainder will follow within the next two years. The four training centres for staff involved in screening throughout the country have already been selected and are now being set up. They will be at Guildford, Nottingham, Manchester and Camberwell.

May I be the first on the Conservative Benches to congratulate my right hon. Friend on his appointment and express the hope that in future he will find it possible to spend more of the nation's resources more effectively on those most in need? May I also ask him to confirm to the House that the Government intend to implement in full the recommendations of the Forrest report?

Yes, my right hon. Friend the Secretary of State for Employment made that absolutely clear on 25 February when he announced the publication of the Forrest report and the acceptance of its proposals and decisions. While thanking my hon. Friend for his remarks, may I also confirm that what all of us on both sides of the Chamber ought to be concerned about is the effective use of national resources for caring.

Will the Secretary of State confirm that in taking on the full recommendations of the Forrest report the Government will make available all the necessary financial resources to achieve immediate implementation?

Comments on resources were made quite clear on 25 February : £6 million in the first year, £13 million in the second year and £22 million in the third year. That will allow, as was also made clear in the statement, not simply for screening but for assessment of the diagnoses and for treatment.

Is the Secretary of State really satisfied with a breast cancer screening system that will not screen any women under the age of 50 or over the age of 65?

I am satisfied that, unlike some Opposition Members, the Government took precisely the advice that was given in the Forrest report. When it was published in 1986 the Forrest report concluded that

the effectiveness of screening by mammography has not so far been demonstrated in women under 50 years of age. Out of some 15,000 deaths from breast cancer in the United Kingdom, over 13,000 are among women over 50.

Therefore, it is quite clear that the Government sought to implement precisely the Forrest recommendations. As for women under the age of 50, the Government have made it clear that research will continue to be pursued not only through Professor Vessey but through the Medical Research Council. As for women over the age of 65, they may avail themselves of the service, but it is not specifically geared to them in the first instance.

asked the Secretary of State for Social Services when his Department last conducted a survey of the safety standards of National Health Service X-ray equipment.

The safety standards of National Health Service equipment are covered by the Health and Safety at Work etc. Act 1974 and more recently by the Ionising Radiations Regulations 1985. It is the health authorities and other National Health Service users of X-ray equipment who are individually responsible for ensuring that these regulations are observed, and it is the duty of the Health and Safety Executive, which is the responsibility of my right hon. Friend the Secretary of State for Employment, to enforce compliance.

I thank the Minister for telling me what I already knew. I know where the responsibilities lie. Having avoided the question on the Order Paper, will the Minister tell me whether she is aware that medical opinion—and I guess that we must listen to medical opinion, even if there is conflict among it—says that 1,400 serious cancers per year are caused in the United Kingdom by the over-prescription of radiography and by the use of outdated and antiquated radiographic equipment? What does the Minister or her Department intend to do about that parlous state of affairs?

I am sure that there are many medical opinions that would challenge vigorously the extraordinary statement that the hon. Gentleman has just made. Radiotherapy is one of the most long-established and best treatments for cancer that we have. May I also remind him, in case he had not noticed, that we are in the middle of the biggest hospital building programme in the history of the National Health Service. As part of that programme, in the past five years more than 120 new X-ray rooms have been provided. More than 50 of them were provided last year.

asked the Secretary of State for Social Services when he intends to abolish the time limits on board and lodging payments to young people on supplementary benefit.

April 1989, Sir.

Is the Minister aware that the Opposition greatly condemn these pernicous, punitive and unpopular board and lodging payments and the fact that young people will have to wait as long as 1989 for them to be abolished? Why cannot he for once act in a humanitarian way by announcing an immediate end to this lousy and rotten system that was introduced by the Government?

From April 1989 unemployed boarders will look to housing benefit to meet their housing costs. The reason for its postponement to April 1989 is precisely because the local authority associations wished it to be that date.

I congratulate my hon. Friend on his elevation to the Front Bench. His appointment will give much pleasure to many of his colleagues. Does he accept that there are links between homelessness and joblessness, and that a consequence of the present system is that a considerable number of younger people are required to move every few weeks?

I am most grateful to my hon. Friend for his kind personal remarks. The evidence from the surveys that we have conducted is not that young people are being forced to move from area to area. Many are remaining in the same area and claiming the benefit at the non-householder rate.

Is the Minister aware that during the summer months——

Look at the hon. Member's jacket.

Order.

Is the Minister aware——

Look at the jacket.

Order. It is often worn in tropical countries.

Speaking on behalf of those in the hills, is the Minister aware that during the summer months many young people, especially in London, face a particular danger in that their board and lodging accommodation is taken away from them to make way for tourists, who are prepared to pay more money for it, and that consequently those young people are thrown on to the streets? What action does the Minister intend to take to protect those young homeless people in the cities from the ravages of the tourist industry?

One of the reasons why we have imposed time limits is that we did not want to induce young people into this sort of accommodation. We believe that the levels that have been set for paying these boarding charges are appropriate to the areas in which those levels have been set.

Will my hon. Friend assure the House that no changes to the current DHSS regulations will be made until the changes to the use classes order 1986 have been clarified, to ensure that no further seaside hotels are turned into DHSS hostels by "dole-on-sea" racketeers?

I can certainly reassure my hon. Friend that we are not going back to the bad old days. Under the new system boarders will no longer get special benefit rates over and above those that are paid to other claimants. They will have to meet the enhanced availability for work tests that are being introduced at present. Local authorities will have greater powers to refuse to meet unreasonable charges, rather than greater incentives to do so.

Does the Minister not realise that if people are staying in the same place it is probably because of the number of times on which the Government's regulations have been ruled to be illegal and, therefore, not operative? Does he not recognise that the exemption system is working very badly, that there is tremendous resentment among those who are forced to move round and that it is particularly stupid that by doing so they cannot even get on to a housing list? Will he reconsider the answer that he has given?

No. I am not aware of those problems. It appears to me that the system is working well. Twenty five per cent. of youngsters between 16 and 25 are exempt and there is the possibility of applying to the Secretary of State for further exemption. Some 280 cases for exemption have been considered.

asked the Secretary of State for Social Services when he expects nurses to receive the pay increase which the Government awarded them in April.

All nurses should have received the new rates of pay in their June pay packets and arrears by the end of July. This means that under this Government the pay of nurses in the National Health Service has risen since 1979 in real terms by 30 per cent.

Will my right hon. Friend acknowledge that in inner London there are acute shortages of nurses in many departments in many hospitals? Can ways be explored to find the means not only of recruiting but of retaining those nurses in London hospitals?

My hon. Friend is quite right to draw our attention to the problems of London, which do affect the employment not only of nurses, but of many other employers in the capital city as well. There are clear problems in relation to accommodation, the environment in which the hospitals are situated, and transport. These are being looked at, because I recognise that there is a particular difficulty with regard to the recruitment and retention of nurses.

Why should a highly trained operating department assistant working in theatre earn less than a nurse? Is his or her contribution to the NHS any less, or the same?

If I were to start what I hope will be a lengthy career in this job by trying to decide on the relative differentials of those who are employed in the good, caring National Health Service I would be starting on the wrong track. The Government have sought to ensure that nurses and the Health Service as a whole have received real increases, which was their due, and I was delighted to be able to confirm that in the original answer.

Is my right hon. Friend aware that in places outside London, such as Stoke Mandeville hospital in my constituency, there are peculiar difficulties in recruiting nurses due to the high cost of housing and the abundance of other jobs? Will he give careful consideration to the possibility of extending some sort of pay weighting to help offset this?

I do not want to go into the technical details to which my right hon. Friend has referred, but I am aware of the problems of Stoke Mandeville hospital. All of us are concerned to ensure that nurses, who serve us so well, are properly rewarded. We are aware of particular parts of the country where there are problems that are specifically related to accommodation. I will concern myself particularly with the point that my right hon. Friend has made.

asked the Secretary of State for Social Services whether, in his review of benefit rates in the tax year 1987–88, he will take account of the increase in average earnings since 1979.

Several factors, including any increase in earnings, may be considered when benefits are uprated, but the statutory obligation is to take account of whether benefits have retained their value in relation to the general movement of prices. We have honoured that obligation.

Will the Minister acknowledge the fact that had average earnings been linked to pensions a single pensioner would be £7·40 a week better off and a married couple £11·20 a week better off than in 1979? Is it any wonder that pensioners feel abandoned and ignored by this Government? Does the Minister understand that if pensions rose, not only would that give greater dignity in retirement to pensioners, but it would have a good effect on the British economy and on employment, as the spending of pensioners tends to relate to British jobs and services?

Characteristically, the hon. Gentleman is entirely wrong. He is concentrating entirely on basic pensions. The income of pensioners in this country has risen by no less than 18 per cent. in real terms since we took office. By pursuing a pensions policy for the future that is based on choice and flexibility we intend to ensure that pensioners share in the increased prosperity of the country.

Is the Minister aware that it is a shameful indictment of the Government's pensions policy that the single pension today in France and Germany is more than 50 per cent. of average earnings, yet in this country under this Government it is only 18 per cent., and falling? Within 20 years, under current policy, it will he less than 10 per cent. Is it not symbolic of this Thatcher Government that the only people in this country who are denied a rise in living standards are the pensioners and the unemployed?

I suspect that the hon. Gentleman is still too hooked on the arguments of the hustings to recognise the reality of the matter. We have heard the arguments that are being put forward and of this so-called league of shame. In Europe this country is second only to Denmark on spending per capita on the elderly. That is the essence of our commitment to the elderly in this country in real terms. We make that commitment clear and we are second only on spending on the elderly per capita in the league in Europe.

asked the Secretary of State for Social Services what representations he has received concerning the proposal to close four hospitals in the Liverpool inner city area.

None, Sir.

May I inform the Minister that any proposals to close the world-famous St. Paul's eye hospital, two specialised maternity hospitals and the women's hospital and to locate them in a Victorian-style royal infirmary will be fiercely opposed by the Health Service trade unions, community health councils, doctors and patients? Is that what the Prime Minister meant when she was talking about Victorian values?

I assume that the hon. Gentleman is referring to the district strategic plan, which was published on 8 June and on which comments are required by 31 August. My cursory first glance at the plan—we received it only a few days ago—revealed that there will be a new development at Broad Green hospital, with new build accommodation for ophthalmology upgraded accomodation at the Liverpool royal infirmary site and a new combined unit for obstetrics and gynaecology. The hon. Gentleman is right to draw attention to Victorian values. Liverpool, like many other cities, is suffering from a surfeit of small, old Victorian hospitals from the last century. The health authority is trying to build a Health Service for the next century.

asked the Secretary of State for Social Services by how many the waiting lists in the north-west region have been reduced since June 1979.

asked the Secretary of State for Social Services what action he is taking to reduce hospital waiting lists.

In the north-west region between 31 March 1979 and 30 September 1986 waiting lists fell by over 16,000, or 21 per cent. The need to make significant improvements in waiting times is a high priority for the Health Service, supported by the £50 million waiting list fund. I am determined that this drive will continue.

Can my right hon. Friend say what effect the waiting list initiative announced by his predecessor will have on the north-west region?

At this stage the north-west regional allocation will be £2·3 million, which we expect to produce results that will look after an extra 11,240 in-patients and day cases and 7,280 extra out-patients. That is in the first instance.

Does my right hon. Friend think that the waiting list fund constitutes a useful precedent for the official allocation of funds in the Health Service? If he does, will he ensure that it is extended to other areas, so that the most efficient use is made of taxpayers' money?

I am answering a question only about the Health Service and the special fund. My hon. Friend is right. The National Health Service is to be commended for the way in which, in the first year, it has made more effective use of beds and theatres and has enabled 100,000 additional waiting list cases to be treated by the use of the fund. I expect it to do equally well in the second year of the fund with the second £25 million.