District Health Authorities (Capital Allocations)
To ask the Secretary pf state for Wales if he will make it his policy for the capital allocations to district health authorities to be assessed separately from the regional requirements of the total capital allocation.
It is already my policy to do so.
As my hon. Friend is aware, under the regional review of December 1986 the capital resource assumptions for Clwyd health authority were reduced by approximately £10 million over 10 years. Does he agree that investment in the capital programmes of health authorities such as Clwyd — particularly increased investment—would enable them greatly to increase the efficiency and effectiveness of their hospitals, thus enabling them to provide a better service at less cost? Will he therefore make more money, not less, available to Clwyd so that schemes such as that for a Hollywell community hospital can be brought forward?
To some extent, my hon. Friend makes an obvious point. The other point is that health authorities should try to use their allocations as effectively as possible. I notice that in the current year Clwyd's capital allocation rose by 14 per cent. That is the sort of funding that enables the authority to give good service to its people.
Does the hon. Gentleman accept that hospital closures are scheduled in Gwynedd such as those in Porthmedog and Llangefni—where new capital programmes had been promised but are not going ahead, yet the closures that were to make way for the capital programme are taking place? Is not that ridiculous, and cannot more capital be found to ensure that new hospitals are built instead of others being closed?
As the hon. Gentleman knows, I cannot comment on the proposals that will be coming forward from the health authority, because of the quasi-judicial position of my right hon. Friend. Over recent years Gwynedd health authority has been the best funded, both in capital and current terms.
Is my hon. Friend aware that adequate capital allocation will enable money-saving schemes, such as the concentration of services at Glan Clwyd hospital, to take place, whereas under Labour there were savage cuts in the capital allocations, which probably resulted in increased expenditure on current account?
Indeed, that is what the right hon. Member for Swansea, West (Mr. Williams) said. He is one of the few who remember that. I certainly remember the fall in expenditure. In one year alone, real expenditure on capital on the Health Service in Wales fell by 33 per cent.
Does the hon. Gentleman recognise, too, that there are individual black spots, such as the Royal Gwent hospital at Newport, which has a massive waiting list that includes one of my constituents, Mr. Mark Williams of Rogiet? He is 77 years of age and has been waiting for the past 12 months for an operation on both his knees. Now he has been told that he must wait for a further 21 months. Yet at the same time the Minister goes around the country saying that by next April people will not have to wait longer than 12 months to get into hospital. Why does he go around making those false claims?
It is worth pointing out that the Gwent health authority has been funded since 1984–85 for capital by an increase of 145 per cent. It is up to the authority how it operates its finances. For instance, I hope the hon. Gentleman will agree that there are many ways in which it could raise funds, but it has so far obdurately refused to to so.
Hospitals And Health Services
To ask the Secretary of State for Wales whether he will make it his policy that no final decision will be made on future hospital and health service provision in South Glamorgan and other Welsh health authority areas, pending the outcome of the consultative processes currently in progress; and if he will make a statement.
It is already the policy of my right hon. Friend not to make a final decision on proposals for future Health Service provision that are referred to him until the relevant consultation process is complete.
The Minister will be aware of the excellence of the Royal Hamadryad hospital in my constituency, and of the fact that it appears on the consultative document very close to the beginning of the 10-year period, as does the children's ENT hospital in the constituency of my hon. Friend the Member for Cardiff, West (Mr. Morgan). Will the hon. Gentleman confirm that the position of those hospitals will not be prejudiced and that no decisions in line with the policy that he has outlined will be taken until the consultative process is over? Will he reassure people who are worried that it comes so close to the beginning of the consultative process that that is the case?Will the hon. Gentleman also confirm that no decision has been taken about the district hospital in the docks area which at the moment is blighting the only area of factory land available in the city?
I can certainly confirm that no decision will be taken until the conclusion of the consultative process. That is what I have said before. I note what the hon. Gentleman said about hospitals in his constituency and in other constituencies.
Will my hon. Friend take account of the fact that the Sully hospital building is among the best hospital buildings in the South Glamorgan area? Apparently the health authority has no further use for that hospital in the National Health Service. Will he look closely at this matter, because this is a splendid building which is admirably sited and has plenty of land? Surely it is highly desirable.
I can only repeat to my hon. Friend exactly what I have said up to this point, but I can add that his support over many years for Sully hospital has been widely noted.
With regard to Health Service provision, will the Minister seek to ease the financial situation facing low-paid ancillary workers in the National Health Service? Will he also look at the financial position of medical laboratory scientific officers, who are making a substantial contribution to the well-being of the National Health Service? In my constituency some Health Service ancillary workers are paid £60 a week. That is less than half the £135 per week that is the European Community poverty level wage.
I note what the hon. Gentleman has said. These matters are generally decided at national level. Some people might wish that it were otherwise, but that is the position and all that I can do is to take note of what the hon. Gentleman says has said.
Can my hon. Friend confirm that as part of the consultation procedures he will discuss with the health authorities in Wales the present poor record of putting services out to tender, compared with the position in the English regions?
I certainly agree with my hon. Friend. We are looking for a greatly improved procedure in the coming year and we have been promised that by health authority chairmen.
Has the Minister seen the representations made today to the Government by the three royal colleges of medicine that acute hospital services have almost reached breaking point? Is he also aware of an article in the British Medical Journal of 21 November by Russell Hopkin, the unit general manager at University hospital, Cardiff, saying that we face a similar crisis in Wales? In this context of an impending breakdown crisis, is it not incredible that there is a standing Welsh Office instruction to Welsh health authorities to try to save an extra 0·5 per cent. every year on spending in this very area of acute services?
It takes the biscuit to have the right hon. Gentleman lecture us. He was a Minister in the Government who saw spending on hospitals fall.
Answer the question.
The right hon. Gentleman saw pay cut by over 20 per cent., and saw the pay of consultants cut. When he left government he left the Health Service in uproar, and that is why we have been in government for the last nine years.
To ask the Secretary of State for Wales how many redundancies have been notified to his Department, to take place in (a) Neath, (b) west Glamorgan and (c) Wales during the last four weeks.
The numbers of confirmed redundancies in Neath, west Glamorgan, and Wales during the calendar month of October — the latest available — were 32, 74 and 239 respectively.
Does that answer not show that the euphoria of Conservative Members is somewhat premature? Are not the redundancies that are taking place full-time jobs, whereas any gains that we hear about are part-time jobs? Can the right hon. Gentleman tell us whether the redundancies that are taking place will appear in the unemployment statistics or will they disappear as a result of the Government's sleight of hand in these matters?
I know of the hon. Gentleman's interest in these matters and I am delighted to inform him that redundancies in Wales for the first nine months of this year were the lowest for many years. They were two thirds down on last year, and massively down on 1977, 1978 and 1979.
To ask the Secretary of State for Wales when he expects the two European Economic Community directives on water quality to be complied with in full in Wales, including the ending of all derogations currently granted by the Commission.
In respect of directive 80/778/EEC on water for human consumption, the Welsh water authority has in hand a programme of remedial works. As a result, the need for the 17 derogations and 22 delays, advised to the Commission under articles 9 and 20 respectively, should be removed by 1992 at the latest. In respect of directive 76/160/EEC on quality of bathing waters, the Welsh water authority programme of remedial works is scheduled for completion in the next 15 years, as I indicated in my answer to the hon. Gentleman on 26 October.
Will the Minister comment on the article that appeared in The Observer yesterday saying that there was to be a crash programme on the quality of drinking water, and will he say how that will affect the current programme of the Welsh water authority? Secondly, will he comment on the answer given to an oral question that I asked in the European Parliament last month, a copy of which I gave him today, which said that the Commission was concerned about the poor quality of bathing water in the United Kingdom, that it was pursuing a number of cases in the European Court of Justice against the British Government, and that it would not be satisfied with a 15-year delay? That being so, it is likely that the investment programme will have to be speeded up considerably.
I note what the hon. Gentleman said about the answer that he was given in Europe, which he very kindly gave me at the start of Question Time. I cannot comment on it, except to say that the Welsh water authority is aware of the position. The programme on drinking water is, as I said, very well advanced.
Is the Minister aware that we are all concerned about the quality of water? Did he listen to Radio One today to hear about the pollution of the Llynfi and Ogmore rivers in my constituency, where many salmon, sewin and trout have been washed up on to the banks of the river and children are picking up the fish and taking them home? What will the Minister do to ensure that everyone in my constituency and in other areas such as Bridgend and Porthcawl are informed that there is pollution in the Rivers Llynfi and Ogmore, going down to the sea at Porthcawl? What action will he take to ensure that this does not happen again?
This is an extremely serious matter, and I am not surprised that the hon. Gentleman has raised it. My officials are in contact with the Welsh water authority, which is responsible for doing exactly what the hon. Gentleman requires. The message about the pollution was flashed up on television stations last night immediately the position was known.
When my hon. Friend looks at the matter, will he consider the fact that, whereas the European Commission appeared rightly to have given a good deal of emphasis to the effects of sewage deposits in the sea, possibly not enough emphasis was put on the massive pollution caused by great rivers such as the Rhine, which deposits much refuse in the North sea?
My hon. Friend may be right, but that does not come within the remit of the Welsh Office.
Does the Minister accept that if the Government take tourism seriously they must do more to clean up beaches in Wales? The present position is absolutely disgraceful. How does the hon. Gentleman see privatisation having any beneficial effect?
The hon. Gentleman should be aware that it is proposed to spend £200 million within 15 years, and some £70 million will be spent on the 47 original waters listed; so a great deal of money will be expended on the cause he espouses.
Has my hon. Friend the Minister made any estimate, or told the water-consuming public, of the potential cost of these measures? Is he satisfied that the measures are realistic and reasonable? Has he satisfied himself, following the question by my hon. Friend the Member for Vale of Glamorgan (Sir R. Gower), about how far other members of the Community will take equal or more rapid steps towards meeting the same standards?
I am not in a position to answer that rather wide-ranging supplementary question. We endeavour to make people aware of the costs of works done on their behalf, not least through Question Time.
To ask the Secretary of State for Wales when he last met the chairman of British Coal; and what matters he discussed.
I have spoken recently to the deputy chairman of British Coal and the director of the south Wales coalfield on a range of matters affecting the coal industry in Wales.
What measures does the Secretary of State intend to take to protect south Wales pits and the supplies from them to the Central Electricity Generating Board and British Steel markets in the event of both organisations being privatised?
The announcement of the privatisation of British Steel is good news for the coal industry in Wales. There is no doubt that the two steelworks in question in south Wales are the strongest and most modern in the region, and with all the advantages of commercial freedom in future they are the most likely to be the beneficiaries of substantial investment. I think that this is good news for the coal industry. It will be good news if the negotiations on six-day production succeed and there is investment at Margam.
Is the Secretary of State aware of the proposals by the Opencast Executive in my constituency that are creating disquiet and unease among residents, especially those at Cheapside, Liverpool road? Will the right hon. Gentleman or another Welsh Office Minister visit the area to meet the residents and hear their worries? Does the right hon. Gentleman know that good agricultural land is at risk and that residents fear for nearby amenities?
In former capacities I have become well aware that there is anxiety wherever opencast mining takes place. It must be recognised that opencast mining is an important part of the Welsh coal industry as a whole and makes an exceedingly important contribution to its success.
Will my right hon. Friend take this opportunity to congratulate British Coal on the new £50 million surface drift mine at Point of Ayr in my constituency, which will enable output to increase by 30 per cent. to 600,000 tonnes a year? In only five weeks the new mine has resulted in an increase in output per man shift from 2·8 tonnes to 3·8 tonnes.
Yes. There are many other examples of substantially increased productivity. Hon. Members on both sides of the House should reflect that since March 1985, £100 million has been invested in the Welsh coal industry.
To ask the Secretary of State for Wales if he has carried out any research into the effects of unemployment upon the health of the people of the Principality.
Is the Minister aware that many in the Principality believe that he and his Government bear a direct and heavy responsibility for increased ill health as a result of unemployment and the increased number of suicides during the years that the Conservative Administration have been in power? Does the Minister recall that Mr. Mark Robinson, who occupied his position prior to the 1987 general election, said on 20 January 1986 that he did not believe that there was any link between unemployment and ill health? Does the Minister agree with that?
There is no known causal connection between the two. Figures show quite clearly, however, that in the area of our society that is most prone to unemployment—socio-economic group five—there is the heaviest toll of ill health. That applies, however, whether individuals are employed or not. There is a serious problem in making the connection that the hon. Gentleman seeks to make. The aim and drift of our policies—for example, the valleys initiative, the reform of primary health care and the community nursing review—are directed at trying to correct the imbalance which we inherited, and which has existed for a long time in health services in some of the more deprived areas of Wales.
Has life expectancy increased since 1979 in Wales?
We certainly have many more old people. I must admit that my hon. Friend has taken me by surprise statistically.
The relationship may be difficult to assess, but will the Minister consider the position at Merthyr Tydfil, for example, where one in five of the population have been in hospital during the past three months? There have been 7,000 admissions over the past year and 10,000 people have been treated as out-patients. Only 10 days ago Hoover advertised 16 temporary vacancies and 150 queued overnight in the street for application forms. Does that not illustrate a catalogue of neglect on the part of the Government?
The very fact that Hoover has survived and prospered shows quite the reverse. The quality of the health services available to the people of Merthyr, including the Prince Charles hospital and all its facilities — the hon. Member for Merthyr Tydfil and Rhymney (Mr. Rowlands) knows that I visited it the other day and saw for myself that it is a marvellous hospital—shows how much we care for Merthyr and other parts of south Wales.
Common Agricultural Policy
To ask the Secretary of State for Wales what representations he has received concerning the effects of proposed changes in the European Community common agricultural policy on Welsh farmers; and if he will make a statement.
I have received numerous representations from all parts of the industry in Wales about the proposed reforms of the common agricultural policy. These have centred on the milk and sheep sectors. Negotiations are continuing.
Will the Secretary of State now take advantage of my question to tell the House that he will defend the level of income for the sheep sector in Wales? Can he assure us that, as a result of sheep stabilisers or long-term changes in the variable or basic premium, there will be no drop in the income of sheep farmers?
I agree that in some low-income forms of agriculture—hill sheep farming and beef are examples—incomes must be maintained by one method or another.
Will the Secretary of State confirm that, now that the guide prices have been announced for 1988, the sheepmeat regime will continue during that year? Will he also recognise that if the stabilisers which may or may not come out of the European Community put pressure on the lowland arable farmers and encourage them to move into sheep farming, that may have disastrous economic and social consequences for the Welsh uplands? What action will the right hon. Gentleman take to protect our upland communities?
My right hon. Friend the Minister of Agriculture, Fisheries and Food is in negotiations at present, in which he has made it very clear that he is interested, not in maintaining the sheepmeat regime just for next year, but in maintaining the principles of the regime continuously. It would be crazy for the Government to start contemplating what would be done if we were not successful in the negotiations. Our object is to be successful.
Japan (Ministerial Visit)
To ask the Secretary of State for Wales if he will make a statement on the anticipated outcome of his visit to Japan.
I met leading industrialists, bankers and politicians in order to establish with them the attractiveness of Wales as the location for Japanese outward investment into western Europe.I am pleased that in the last month three further Japanese companies have decided to locate their industries in the Principality.
May I suggest to my right hon. Friend that the new factories and jobs that were decided on during his visit were a very worthwhile, positive contribution to the future of Wales, as was all the effort put into securing further investment, which I am sure will come? Was that not infinitely superior to the sterile arguments that my right hon. Friend would have had to listen to from the Opposition Benches if he had cancelled his visit?
Yes. I am almost tempted to ask you, Mr. Speaker, to extend our Question Time a little.The total figures for Japanese interests in Wales are very impressive. I am delighted to say that among the people whom I met there were some who had originally invested heavily in Wales, and that most of them are deciding to increase their investments massively over the years ahead. I also managed to speak to some 200 or 250 leading Japanese industrialists who have an interest in the longer term in considering Wales as their location in western Europe. As I have always said, I believe that our success is due to the combination of the trade unions, local authorities and the Welsh Office having done everything possible to encourage Japanese firms.
The Secretary of State will know that it has been quite difficult to attract Japanese firms to locate further west than Bridgend. Has he given any thought to the problem?
We are trying to attract Japanese firms to all parts of the Principality by the way in which we pursue our policies—through the Welsh Development Agency, with factory allocations, and by pointing out the various services that are available.
Does the Secretary of State agree that it is extremely difficult to establish a causal link between his visits to Japan and the arrival of factories? One of the three Japanese investments was announced before he went to Japan.
As the hon. Gentleman knows, I was delighted to point out that that investment had been announced just before my visit. I joined others on the Friday before the visit in saying how pleased I was that it was happening. I hope that the hon. Gentleman will rejoice equally strongly over all the investment that will come from firms in the future, and that he will congratulate the Government on pursuing policies that will encourage them.
To ask the Secretary of State for Wales what plans he has to avoid a deterioration in health care in Wales arising from the financial difficulties faced by many Welsh health authorities.
District health authorities have management responsibility for ensuring the effectiveness of health care within the resources available to them. They have been funded well in excess of inflation. Between 1978–79 and 1987–88 their recurrent revenue provision grew by 32 per cent. in real terms.
The Minister is again missing out the fact that, in order to stand still, health authorities need to be funded way above the rate of inflation to cope with the demands of our aging population and the more expensive needs of the medical services. The announcement that was made last week in a parliamentary answer shows that the funding is below that level. It copes with inflation, but it does not cope with the other needs. It is not the helping hand that health authorities need. It is another slap in the face and a certain prescription for a deepening crisis within the National Health Service. Will the Minister now admit that his Government's policy is to allow the NHS to decay and to allow services to become debased in order to force people into the private sector.
I do not think that the hon. Gentleman can have listened to the answer to the question, which showed that funding is well ahead of inflation. That is very different from the position before the hon. Gentleman came to this House. Under his party this country had to suffer. The hon. Gentleman referred to a reduction in Health Service funding. How can that service have been reduced when there are 13 per cent. more nursing staff, 13·3 per cent. more medical and dental staff, over 17 per cent. more consultants and over 10 per cent. more registrars? We are treating 84,000 more in-patients a year than were treated when the hon. Gentleman's party was in office. I cannot believe that that represents a failure in any service.
The hon. Gentleman's answers are based on largely phoney figures, going back over the whole period. Do they mean that he and his right hon. Friend will take no notice of the representations of the presidents of the royal colleges, whose most important representations were referred to by my right hon. Friend the Member for Swansea, West (Mr. Williams)? Surely the proper answer by anybody who represents, or is responsible for, the Welsh Health Service should be to say today, "We will enter into immediate consultations with our British opposite numbers and ensure that something is done to meet the representations that are now coming not only from the Labour party but from the heads of the royal colleges and the great hospitals of our country."
When the right hon. Gentleman was a senior member of the Labour Government, the Health Service stumbled to its knees. Does he really call it a fake figure, when nurses' pay fell by over 21 per cent. when he was a Minister? Is that the way to run the National Health Service?
My hon. Friend has tried to give the real facts about the increase in staff in the National Health Service, but the Opposition do not want to listen. Will he repeat those facts? Will he also tell me how many additional patients have been treated by the Health Service under this Government who would not have been treated had we returned to the funding levels that existed under the last Labour Government?
I shall repeat, because of the uproar last time, that the number of in-patients has increased by up to 84,000—an increase of 24 per cent. The number of out-patients has increased by 76,000. That is not a declining service; that is an improved service, as the people of Wales are well aware.
To ask the Secretary of State for Wales what proportion of health services in Wales are provided by (a) private medicine and (b) the National Health Service.
The information is not available in the precise form requested. However, there are in Wales 54 authorised pay beds in NHS hospitals and 212 beds in private hospitals; jointly these are equivalent to 1·23 per cent. of the NHS provision of 21,613 beds.
Will the Minister comment on Health Service developments in Carmarthen? It was announced in October that there was to be a private 50-bed hospital, costing £15 million—the first private hospital in Dyfed. The very next week the East Dyfed health authority announced that, because of financial constraints, it would have to shed 3 per cent. of its staff during the current financial year. Does that not reflect what is happening in our Health Service: that the Government are giving every encouragement and every incentive to private medicine but that the National Health Service is declining, by natural wastage?
The fact that somebody wants to open a private hospital in a particular area of the country does not say anything about National Health Service provision of health care. East Dyfed is receiving over £20 million for building the Llanelli hospital. There has been no lack of funds from central Government for the building of that hospital.
When Welsh health authorities are facing a serious financial crisis, when our hospitals fear a breakdown in services, when the Minister has already had to renege on his July commitment about hospital waiting lists, and when, on Friday, the Secretary of State issued a spending announcement showing that there are no plans even to meet fully the basic standstill needs of the Health Service, which the Minister knows full well include not only 4½ per cent. for inflation but the 2 per cent. extra that is needed to meet the cost of the aging population and technological change, how on earth can the Welsh Office issue a press release such as that entitled "Additional Resources for Health and Personal Social Services", which is utterly smug, misleading, indifferent and inept?
That was a long, prepared supplementary question. I should like to give just one alternative figure. The right hon. Gentleman was a Minister in the previous Labour Government. When he left office, expenditure per family on the Health Service was £15·84 per week. It is now £21·14 per week. That shows the growth. The right hon. Gentleman was a senior Minister in a Government who cut spending and the pay of nurses and practitioners. That is a disgraceful record, but he has the cheek to come here and declaim against us.
To ask the Secretary of State for Wales what assessment his Department has made of the average cost of the poll tax per family, as compared with rates bills, in local authorities in the valley areas of Mid Glamorgan.
The average rate bill per household in Mid Glamorgan in the current year is £220. Future payments under the community charge will depend upon decisions to be made about grant and needs assessment levels, as well as the expenditure of the local authorities at the time.
Is it not a fact that, even by the most conservative estimates, the average tenant and homeowner in a community such as I represent will face a significant increase in the poll tax as compared with the rates bill? By what possible justification can there be equity or fairness in increasing the cost of services, rates or the poll tax to the people who are the poorer home-owners in the community?
In Wales less than 20 per cent. of all local Government expenditure will be met by the poll tax. Added to which, if the hon. Gentleman had listened to my answer to his question, the poll tax will depend on what happens about needs assessment levels.
To ask the Secretary of State for Wales what representations he has received concerning staff shortages in Welsh health authorities; and if he will make a statement.
My right hon. Friend has received a number of representations about staff shortages in Welsh health authorities. This is an issue which is currently being addressed at both departmental and health authority levels.
When my hon. Friend discusses this matter with the health authorities, will he bear in mind the problems of Pembrokeshire health authority and the fact that we are short of staff because of the wages that are paid? Does he agree that there may well be a case for bringing the market into the wages of staff in the Health Service and paying more in areas where it is difficult to recruit staff?
My hon. Friend may indeed have something in what he says. My right hon. Friend and I discussed the issue with the district health authority chairman on 23 November. My hon. Friend may be interested to know that last year the Department established a manpower steering group to develop a comprehensive manpower strategy for the National Health Service in Wales. The group is giving attention to recruitment difficulties and my Department has requested the district health authorities to prepare a 10-year manpower resources plan to forestall future difficulties.
To ask the Secretary of State for Wales if he is satisfied with the standards of transport links between north and south Wales; and if he will make a statement.
Recent years have seen a steady improvement in standards and more is being and will be done. A substantial number of schemes for improving the A470, A487 and A483 road links are either in progress or planned.
Does the Minister agree that one of the most important criteria in economic performance and development is good transport links? Does he also agree that there is an urgent need for a good, modern and efficient road linking north and south Wales? In view of the importance of roads in Wales to facilitate links with the Irish Republic and mainland Europe, will the Minister consider making an approach to the EEC for joint funding with the Irish Republic for road improvements in Wales?
Naturally, we understand the importance of road links, which is why we have improved 128 miles of motorway trunk roads at a cost of £700 million since 1979. With regard to the north-south link, the hon. Gentleman must remember that certain improvements have been carried out. There is the Brecon bypass and the Dolgellau bypass, and the Abercynon-Pentrebach section has also been dualled. However, we must examine carefully the economic and traffic justification for any further work.
To ask the Secretary of State for Wales how much was spent per pupil in secondary schools in Wales in the most recent year for which figures are available; and what was the comparable figure for 1978–79, at constant prices.
Provisional figures for 1986–87 show a unit cost figure of £1,320 for each secondary school pupil in Wales, compared with £1,033 in 1978–79 at constant prices.
Can my hon. Friend say whether capital allocations to schools in Wales have increased over the same period?
I am happy to tell my hon. Friend that there has indeed been a substantial increase in capital allocations. The system was introduced in 1981–82 and from then to the current year there has been an increase of 50 per cent. The capital allocation for this year amounts to £43 million, and for next year a capital allocation of £47·5 million has been announced by my right hon. Friend, which is a further increase of 9·1 per cent.