To ask the Secretary of State for Health which organisations concerned with community care he has met since the publication of the National Health Service and Community Care Bill.

To ask the Secretary of State for Health which organisations concerned with community care he has met since the publication of the National Health Service and Community Care Bill.

We regularly meet local authorities, health authorities and voluntary organisations. They all have vital roles to play in the provision of community care.

The Government, in their proposals, and in the answer that the Minister has just given, have rightly emphasised the part that the voluntary organisations can play in this sector. If that is the case, why do not the Government give adequate time to consult those organisations on the proposals contained in the Bill? Can we have an assurance today that the Government will provide enough funds for voluntary organisations fully and properly to carry out their functions?

The whole spirit of the proposals, leading on from the original Griffiths report, "Community Care: Agenda for Action", has been on the basis of consultation with voluntary organisations and local authority associations. About 280 representations were made on the original report. Since my right hon. and learned Friend's statement last July, about 100 further representations have been made. Since the publication of the Bill I have been involved with local authority associations and voluntary organisations in carrying forward these important plans. We have made it clear that adequate resources will be available.

Had the Minister held discussions with voluntary organisations, perhaps the future role of hospices in community care would have been raised. Will she explain why hospices in Scotland are funded pound-for-pound by the Scottish Office, yet, despite repeated requests from my hon. Friends and me, the Minister steadfastly refuses to do the same for those in England and Wales? Will she explain to those involved with the Carlisle hospice appeal why they are working so hard to build a hospice in my constituency when nine miles up the road in Scotland the Government provide money? Is it not time that the Government stopped discriminating against the terminally ill in England and Wales?

The hon. Gentleman may have been drawing attention to the way in which matters have developed in Scotland. One way in which we manage matters is to have some variation between different parts of the country. I thank the hon. Gentleman for giving me the opportunity publicly to pay tribute to the voluntary hospice movement which has been a major force for good. I draw his attention to the announcement that I made shortly before Christmas of a further £8 million for the voluntary hospice movement to be distributed by the regional health authorities. That will greatly add to the financial assistance that they already receive.

Does my hon. Friend agree that all organisations, with the exception of the Labour party, welcome the Government's proposals for community care, which are largely in line with the Griffiths recommendations? What discussions has my hon. Friend had with the Association of Directors of Social Services, particularly in respect of funding and the timetable for implementation?

The proposals offer a major opportunity to improve care in the community, and many people have long looked forward to them. The key is now to make a reality of them. We have held discussions with local authority associations on the ways in which we can work together on projects and in giving guidance and training. I reiterate that we made it clear that adequate resources will be available, taking account of demographic factors. At present, many resources are misspent, without any proper assessment of the necessity, for example, for residential care. The proposals provide an opportunity to ensure that the frail and vulnerable are well cared for in the community.

Has my hon. Friend had any contact with the National Schizophrenia Fellowship. SANE Concern or allied organisations about the over-rapid closure of pyschiatric hospitals and the placing of their former patients into the community when there are inadequate facilities, and an inadequate number of qualified persons, for looking after them? Sadly, those people are going off medication, sleeping under arches, and in some cases ending up in prison.

My hon. Friend draws attention, rightly and properly, to a particularly vulnerable group. There is general recognition that the great swing to remove people from psychiatric hospitals—in which many of them were quite improperly incarcerated a generation ago—needs tempering. My hon. Friend the Under-Secretary of State for Health has presented proposals for dealing specifically with that needy group.

Is the Minister aware that local authority social services departments are examining local plans for delivering community care? The hon. Lady will be aware of the concern expressed by many voluntary organisations that, in view of their increased responsibilities, local authorities are taking insufficient account of their views in the consultation process leading to publication of community care plans. What guidance are local authorities being given to consult voluntary organisations before publishing such plans?

Clearly, we want community care plans to be discussed with voluntary organisations and the users of services, and, above all, with carers—who have so often been overlooked and neglected in the past. We are giving local authorities precise guidance on the importance of preparing their plans properly, and I assure the hon. Gentleman that the role of voluntary bodies in community care is perceived to be enormously important. We want a mixed economy of voluntary organisation, local authority, and private and independent provision. We want choice and dignity for the vulnerable.

To ask the Secretary of State for Health what steps his Department is taking to provide psychiatric care for homeless people who need such care.

The responsibility for providing psychiatric services for people who need them rests with district health authorities and local social services authorities. However, the Department is presently exploring what practical steps might be taken to assist such people who are homeless.

My hon. Friend will be aware of the concern expressed in the House and outside. Will he confirm that Ministers will not approve the closure of any hospital for the mentally ill without first demonstrating that adequate alternative facilities exist? I cite as an example the £3 million project for a mental illness unit at Manchester royal infirmary, which is to start this year.

I confirm my hon. Friend's remarks about the facilities at Manchester royal infirmary, which I visited recently, and which has excellent plans to meet the needs of patients from Cheadle hospital. I confirm that no hospital for long-stay psychiatric patients will be allowed to close until the National Health Service is satisfied that proper facilities exist in the community.

Although the House welcomes the Minister's last statement, does he accept that over the past 10 years, more than 40,000 long-stay patients have been dumped in the community with nowhere to go? Is he aware that many of them are homeless and are wandering the streets? While we are grateful for the Government's concern, at least as expressed in words, how much new money is being put up front?

There is no question but that some discharge policies by some hospitals were ill-advised by present standards. The hon. Gentleman is right in saying that it is of concern to the House, and to the Government, that some people are now homeless or roofless. We have outlined specific policies so that no one should be discharged from any psychiatric hospital unless a care programme is agreed for the individual. We have also made provision for the year 1991–92 for a specific mental illness grant, to be distributed through the regional health authorities, to help local authorities to improve the quality of social care in the community.

The House will be pleased to learn of the sums of money that have been allocated to deal with this problem, and to know that specific instructions are being sent to local authorities to deal with the issue. How long will it take before those plans reach the point where they are helping people who have been released from hospital?

My hon. Friend refers to district and regional health authorities' responsibilities, and those are separate from the responsibility of the consultant and the authority in charge of the hospital. I have stressed that no patient should now be discharged without a proper care programme. By April 1991, every district health authority should have a proper care programme for all patients who have been discharged or will be discharged. We will provide additional funds for local authorities to enable them to improve the quality of social care.

Has the Minister seen the report in The Lancet on homelessness over Christmas, which says that mentally ill people are now living:

"like feral children…scavenging for food"?

Is not that a bitter criticism of the Government's community care policy at a time when The Sunday Times has shown—I speak as a trustee of Crisis at Christmas—that there is massive public backing for more humane provision? Is there not now an urgent and compelling case for full implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986?

I read the article in The Lancet, but I think that, unfortunately, it was written too early to take account of the Government's new proposals on care for the mentally ill. As for roofless people in our cities who have a history of mental illness, the Government recognise that that is a problem and hope to bring forward proposals to deal with it in due course.

Is my hon. Friend aware that mentally ill people in my constituency have been discharged from Cane Hill hospital and put in bed and breakfast accommodation by the local authorities? They are walking the streets. It is all very well for my hon. Friend to say that that will be fixed in 1991, but what will happen to them between now and then?

We must be careful to distinguish patients who are discharged from hospital properly, because they are psychiatrically and medically cured and have the same rights as other people. I share my hon. Friend's concern about the past discharge policies. We have given all district health authorities due notice that they must make progress within 12 months. It is not possible to reform procedures overnight. We have made substantial progress, and I shall study the example that my hon. Friend has cited and write to him.

To ask the Secretary of State for Health if he will make a statement about funding for Stockport district health authority.

Stockport district health authority will benefit from the increased cash resources announced by my right hon. and learned Friend the Secretry of State for Health on 14 December last year for the North Western region amounting to £77·8 million, representing a cash increase in resources amounting to 7·21 per cent.

Exactly how much will be received by Stockport, as opposed to North Western region? Is the Minister aware that since 1984 Stockport has lost £1·6 million in real terms, and is now being asked by the region to make cuts of £1·1 million? It has also lost out in capital terms, and the people of Stockport want to know why their health service is doing so badly under the present Government.

I do not agree that Stockport health authority is doing badly under the present Government. North Western regional health authority will shortly make allocations to all the districts, including Stockport, although they have not been announced yet. My right hon. and learned Friend the Secretary of State for Health has enabled the region to experience a real growth in resouces this year, especially when we take account of cost-improvement programmes and income generation, and I am sure that that welcome increase will be reflected in the allocation to Stockport.

Is my hon. Friend aware of Stockport's application to have its general hospital on one site? Am I right in thinking that what should have been a first-class application has been bungled, and that Stockport should have had a share of the £300 million that is to be used for capital projects over the next three years? Will my hon. Friend come and see the position in Stockport for himself, and will he take it from me that, having done so, he will agree that the hospital should be on one site, not only to prevent inconvenience but to save money and lives?

Owing to sustained pressure from my hon. Friend for me to visit Stockport, I can now tell him that I shall be going there on 30 March. As for the specific project that he mentions, all is not lost. I understand that discussions are continuing between the district and the region, and that the region will have a chance to reconsider later in the year further construction at Stepping Hill hospital for 1993–94.

To ask the Secretary of State for Health what representations he has received concerning the closure of Park hospital, Liverpool.

There are no firm proposals at present to close Park hospital, which is a mental illness hospital. The Liverpool health authority is considering how some of the patients at the hospital may be better cared for at the new acute unit at Broadgreen and other hospitals, and, of course, in the community.

Is the Minister aware that Liverpool health authority is currently being lobbied by a committee consisting of women and relatives of patients and all the NHS trade unions? Is he aware that Park hospital has been declared a centre of excellence by the Mental Health Act Commission, and that £2·5 million has recently been spent on it? Selling off such a priceless asset would be a crime against humanity.

I have already said that there are no plans to close Park hospital. As the hon. Gentleman and many of his hon. Friends will know, a formal procedure takes place before the closure of any hospital, or indeed any significant change in the service. In the event of sustained opposition from the community health council, the proposal ultimately comes to Ministers, but in this instance, that has not happened.

Surely the Minister must come up to Liverpool, visit Park hospital and see the reality for himself. Staff have been told that four of the seven wards are to close. Some patients will be shunted to Rathbone hospital; others will be dealt with in the private sector and by charities. The least able members of society will be left to fend for themselves, and psychiatric patients will be forced to wander the streets of Liverpool. Despite the nonsense talked by the Minister about there being no diminution of care in the community, old people will clearly be treated despicably by the Government.

I have been to Liverpool six times in the past 12 months, but I have not been to Park hospital, and next time I go there I shall certainly consider doing so.

No patients, elderly or otherwise, will be wandering the streets. I am sure that the hon. Gentleman will agree that those patients—and that does not mean all—who can be cared for better in the community, which may mean hostels or their own homes, should be cared for in that way; it is correct and the humanitarian way.

To ask the Secretary of State for Health when he last met the British Medical Association; and what subjects were discussed.

I last met representatives of the British Medical Association formally on 18 October 1989 when we had a friendly and constructive discussion about the implementation of our proposals in the White Paper "Working for Patients".

Will the Secretary of State draw to the attention of the BMA the fact that in anticipation of changes in GP contracts and changes to the Bill some GPs are already beginning to strike off their lists patients whom they regard as potentially uneconomic so that far from choice for patients being increased, some patients are losing the choice even to remain with their existing GPs? I know that the Secretary of State does not keep such information, but will he now undertake to do so in order that he can monitor any such changes in GPs' lists and the fate of those patients affected?

I personally have seen no evidence whatever that any such practice is taking place. If any GPs were striking off their lists elderly or chronically sick patients, they would be doing so on a mistaken interpretation of the contract. If they study the new contract for GPs and the proposals in the White Paper, they will see that there is no financial or other incentive to any GP to refuse to accept an elderly or chronically sick patient.

Does my right hon. and learned Friend agree that many patients, especially elderly people, have been frightened by comments made by some doctors which have fallen short of the level of objectivity and accuracy that one would expect from the profession? Can my right hon. and learned Friend confirm that no patients will be deprived of the medicines they need and that in particular, the indicative drug budgets are likely to be very helpful in encouraging doctors to prescribe well?

I am sure that my hon. Friend agrees that we welcome the end to such campaigning over recent months. There was certainly no such suggestion at my last meeting with the BMA. It is extremely unfortunate that last summer a great deal of effort was put into concocting inventions about our proposals and then publicising them to patients. I hope that now we can put behind us some of the damage that did to doctor-patient relationships.

Will the Secretary of State look into the case of Mrs. Jackson who arrived home from hospital to find on her doormat a letter from the Hillingdon FPC saying that she had been struck off her GP's list because she would require too many expensive night visits? Will the Secretary of State together with the BMA now monitor the growing number of so-called uneconomic patients who, because of the GP contract and the changes in the forthcoming National Health Service and Community Care Bill, are losing the right to stay with their own GPs?

I shall certainly look into that case. I should be extremely grateful if the hon. Lady would pass on to me the evidence that she has to support it. I would strongly disapprove of anybody being struck off on that ground or any other. The only change that the new GPs' contract is making is that doctors who carry out their own night visits, or send a doctor from their own practice, or one who is likely to be known to the patient, will be paid three times as much for those visits as one who uses a deputising service. That encourages a welcome improvement in patient services. If the hon. Lady's allegation turns out to be true, I shall certainly investigate it most closely.

To ask the Secretary of State for Health what was the increase in spending on family planning services over the last three years; and if he will make a statement.

Over the past three years for which figures are available, spending for family planning purposes in England has increased from £76·7 million in 1985–86 to £84·2 million in 1987–88. Family planning is an important preventive service which contributes to better maternal and child health and to the stability of family life.

I am grateful to my hon. Friend for that reply. I am sure we all welcome the increased expenditure on that most important service. Does she agree that family planning plays a vital role in health care? Do the Government intend to continue their financial support for the outstanding Margaret Pyke family planning centre in London?

I assure my hon. Friend that we continue to give priority to family planning services and that funding for the Margaret Pyke family planning centre will continue. It is a national centre of training in family planning, training something like 850 doctors and 60 nurses a year. It also does very important work in the prevention of AIDS.

Will the Minister come clean and tell British women that family planning will suffer under the Bill as health authorities will have an incentive to close clinics, and women will be left with no choice other than their GPs and a much reduced service?

The key point about family planning services is that women and men should have a choice of services. Whether they are provided through the family health service, the family practitioner or the district health authority is a decision to be made locally. In recent years, many women have demonstrated that they would rather receive family planning advice from their practitioner than from family planning clinics. That must be a matter for them rather than a diktat from on high.

To ask the Secretary of State for Health what steps are being taken to allow general practitioners more control over their own budgets.

The National Health Service and Community Care Bill currently before the House provides for GP practices which volunteer to do so, and which meet the eligibility criteria, to run their own practice funds. This will give them additional freedom to decide how funds are best used in the interests of their patients and, in particular, to influence the way in which hospital treatment is provided. In December I issued a programme to all GPs in England for the scheme, inviting expressions of interest to regional health authorities. I am pleased that there has already been a very encouraging response.

I thank my right hon. and learned Friend for that reply. Can he confirm that GP practices that decide to set up their own budgets will have access to up to £32,000 of the management charge? Does not this make nonsense of all the stories that we have heard about GPs having to spend more time on paperwork than with patients?

There will be £32,000 available to reimburse GPs for expenditure that they incur on the management of the practice budgets. They will use that money to obtain information technology, including software, as well as the staff that they need to make sure that the budget can be run effectively without intrusion on their clinical duties.

Will the Secretary of State recognise doctors' genuine worries and patients' concerns about the changes in the Health Service? Today I received from a Mr. Bramald a letter enclosing a letter from his doctor, Dr. Durkin, stating that the change in payment for doctors means that they can no longer afford to keep on their lists people who require more active night calls and weekend calls, and saying that Mr. Bramald and his family were being given 10 days in which to find another doctor. Does this not show the problem, and will the Secretary of State take action to rectify it?

I understand that there are uncertainties among doctors at a time of change, but it is my experience, and that of everybody in the National Health Service, that those uncertainties are diminishing rapidly. GP practice budgets are entirely voluntary, and only GPs who want to take advantage of them will apply to do so. I think that the vast majority of eligible practices will apply.

I will have a look at the letter from Dr. Durkin to which the hon. Gentleman referred, but on the basis of the hon. Gentleman's account I can only say that, under the contract that the doctor has been given, he has no justification for making such statements. I suspect that he is yet another doctor who has been misled by some of the rather over-the-top campaigning that went on last summer about the contract, and that if he looks more closely at the contract he will see that it gives him no encouragement to take such steps against his patients.

As all GPs have tight budgets, and inevitably always will do, will my right hon. and learned Friend consider GP practice leaflets? GPs are not allowed to use ordnance survey maps unless, as I understand it, they negotiate directly with the Ordnance Survey. Is not this a case in which my right hon. and learned Friend should knock a few heads together and encourage direct negotiations between the Department of Health and the Ordnance Survey so that GPs may use those maps?

GPs must have reasonably tight budgets for their premises and practice expenses, but, as my hon. Friend will know, the amount that has been spent, under this Government, on the improvement of premises and on practices has increased enormously with the huge expansion in the practice staff that GPs employ. I am grateful to my hon. Friend for drawing attention to this problem. I understand the desire of the Ordnance Survey to protect its copyright, but I will look into the possibility of my Department's being able to help to sort out the problem.

Has the Secretary of State recognised the genuine and legitimate anxiety of patients and general practitioners arising from the changes to the GP service that, in the shape of legislation and contracts, he has forced through this House?

Can he not see that there continues to be legitimate anxiety arising from the peer audit to which GPs are subject, particularly on spending? It makes sense, from the point of view of the Department of Health, only if punitive action is likely to follow supposed or alleged overspending. The injection of that cash element between the family doctor and the patient at the coal face of the Health Service is utter poison for what are supposed to be the principles of the National Health Service.

The hon. Gentleman is muddling a variety of aspects of general practitioners' work. The general practitioners' contract, for which a majority was obtained in the House, will reward general practitioners better than in the past for heavy workload and good performance. That is the point of the contract. The hon. Gentleman is referring to indicative budgets for drugs and prescribing costs, and we have repeatedly made it clear that every patient will be entitled to the drugs which, in the general practitioner's opinion, the patient requires. General practitioners will be subject to penalties under the contract only if they deliberately continue to overprescribe in the face of professional advice that points out their wasteful practices. That is not a serious intrusion into the care of patients.

Has it occurred to my right hon. and learned Friend that the minimum size for practice lists is approximately four or five times the size of the sample drawn by opinion pollsters to represent the population as a whole, so it is highly likely that practice lists will be representative? Will he assure the House that in the event of there being an unusual patient profile, the system will be sufficiently flexible to ensure that general practitioners do not lose out as a result of their introduction?

I can certainly give my hon. Friend that assurance. The funds placed at the disposal of each practice will reflect the make up of its patient list. If general practitioners are not satisfied with the sum provided by the regional health authority, they can refuse to proceed with their application for a practice budget.

To ask the Secretary of State for Health if he will make a statement on the implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986.

To ask the Secretary of State for Health if he will make a statement on the implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986.

We have always made it clear that implementation of the Act depended on identifying and making available the necessary resources without damage to other priority social services. We have already implemented six sections, which include imposing duties on local authorities to assess on request the needs of disabled people, while taking into account the abilities of their carers.

Does the Minister accept that if the consumer control provisions are to have any meaning at all, sections 1, 2 and 3 of the Act should be implemented at the same time as the National Health Service and Community Care Bill?

It would be irresponsible to consider only the administrative costs of implementing sections 1, 2 and 3. We must also look at the underlying resource assumptions for providing the services. We shall be commencing formal consultations with local authorities on the implications of implementing sections 1, 2 and 3, and other sections not yet implemented, within the next few weeks.

The Minister's answer falls short of giving satisfaction. Is he aware that 40 per cent. of local authorities are not making provision for wheelchair access into rooms and buildings from which disabled people can obtain information, including council agendas, so that they can be treated as citizens equal to non-disabled people? Is it not a disgrace that so long after the Act was passed, disabled people are still being treated by local authorities, encouraged by the Government, as second-class citizens?

The sections of the Act already implemented are clear on the obligations placed on local authorities. They have to provide services within their resources. In the coming financial year, 1990–91, we will provide £31 million through the rate support grant to help local authorities to provide services under the sections of the Act that we have already implemented.

I thank my hon. Friend for the £24 million already allocated this year for the implementation of the Act, but does he accept that if disabled people are to have a reasonable standard of care in the community they should have access to the assessment procedures and the right of appeal? Therefore, will he expedite the implementation of sections 1, 2 and 3?

I assure my hon. Friend that we shall proceed as quickly as possible in our review of sections 1, 2 and 3. The social services inspectorate will be reporting shortly on the success so far in the implementation of the Act.

I welcome my hon. Friend's commitment to early implementation of the sections of the Act that have not yet been implemented, and I am delighted that he is already consulting local government. Does he agree that it is important to rest on a consistent national framework so that all individuals who depend on community care have the same treatment?

I agree with that. The report of the social services inspectorate, which I hope will be published next month, will make that point and comment on the differences in the standards of treatment and, ultimately, their elimination.

If the Government are genuinely committed to community care, is it not odd that they do not see this important Act as a framework for involving—[Interruption.]—disabled people, their carers and advocates in contributing to the formulation of policy which is important to them? Despite the Government's rhetoric, they have not lifted a finger to implement the remaining sections of the Act since April 1987.

Is the Minister aware that that is being seen not simply as a scandal, but as one of the Government's greatest failures and most mean-minded acts of lethargy, if that is possible, in this Parliament?

It is not mean minded. We have implemented six sections of the Act, as the hon. Gentleman knows, and I have given a commitment about the consultation procedure on the remaining three sections. I share his view that they are important. It would be irresponsible to consider only the administrative costs of implementation and not to make sure that the underlying service provision increases. That requires real resources—[Interruption.]

Order. I appeal to the House to listen to both questions and answers.

My hon. Friend will know that Dorset local authorities are keen to pick up their responsibilities under the Act. Is he aware that local government councillors are unhappy about the grant given to local councils to fulfil those responsibilities? They believe that it will not be possible properly to fund implementation of the Act or the community care provisions when they come into force in 1991. Can he comment on whether funds will be transferred to the local authorities?

As my hon. Friend the Minister for Health said, community care provision in 1991ߝ92 will be properly funded.

To ask the Secretary of State for Health if he will make a statement on the progress being made with the implementation of the Children Act 1989.

The target date for implementation of the Children Act 1989 is October 1991. We are preparing the regulations, rules of court and guidance documents needed. Plans are also being made for a training and dissemination programme for local social services departments, the courts and other agencies.

Why, when the Association of Directors of Social Services warned six months ago that record numbers of children are registered as at risk from abuse or neglect, have the Government chosen to delay implementation of the Act by another six months? Does the Minister realise the difficulties that social services departments have with inadequate staff, training and resources? Why do the Government preach the value of the family when they cannot find the money or the time to do something about the matter?

In identifying the serious problems of children at risk, the hon. Gentleman is naive about the implications of the Children Act 1989. It is a complex and important Act which co-ordinates the legislation dealing with the protection of children. It is extremely important to ensure that the necessary training is in place in local authorities and in the courts so that a comprehensive, integrated programme can make headway. In conjunction with other agencies we have embarked on plans to ensure that that programme is put in place as swiftly as possible and in time for implementation in 1991.

To ask the Secretary of State for Health what provision has been made by his Department to encourage the training of consultants in general management aspects of hospital activities.

In December last year I announced in the House the allocation of £1 million for this purpose. Programmes of training are due to commence in April of this year for 100 consultants from seven National Health Service regions.

I am grateful to my hon. Friend for that answer. Does he agree that, aside from the Government committing huge resources to patient services, consultants are playing an increasing part in the management of hospital activities and that training is essential? Does he agree that it would be wise to give general management training to nurses, whose clinical skills are often ahead of their managerial skills?

I shall certainly look at the question of management training for senior nurses. The Government believe that clinical freedom for doctors, which is vital, is perfectly compatible with doctors sharing more responsibility for helping to manage National Health Service resources.

While training consultants in management, will the Minister pay some attention to what the consultants are trying to tell him about the future management of their hospitals? Is the Minister aware that there have been a dozen ballots of staff on whether their hospitals should form trusts and that in ever single one the staff have voted to stay in health authority management? Is he further aware that consultants from Plymouth to Aberdeen have recorded votes of 75 per cent. against forming NHS trusts? If the Minister believes in letting local people take local decisions, why does he not try to listen to them and allow them to decide whether their hospitals should opt out?

The Government listen to the medical professions. There is substantial support among consultants for National Health Service trusts. On the point about consultants in management, I hope that the hon. Gentleman will join me in welcoming the resource management initiative, which is about getting doctors involved in the management of the Health Service.

To ask the Prime Minister if she will list her official engagements for Tuesday 23 January.

This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall be having further meetings later today.

Does the Prime Minister accept that the rebel cricket tour of South Africa is most certainly a breach of the Gleneagles agreement in spirit and in letter? Does she accept the words of Sebastian Coe, who described the players involved as nothing less than mercenaries? Will the right hon. Lady make contact with those players and tell them to pack their bags and come on home?

My hon. Friend the Minister for Sport put the Government's views to those cricketers before they went on that tour. We had a duty to seek to persuade them not to go and we tried to persuade them not to go. However, their going is not contrary to the Gleneagles agreement because it is a voluntary agreement. People were free to choose and to make their own decisions, and that is what they did.

To ask the Prime Minister if she will list her official engagements for Tuesday 23 January.

I refer my hon. Friend to the reply that I gave some moments ago.

Is my right hon. Friend aware of how encouraged those who have been organising Expo 90 in Japan have been by the positive help that the Government have recently given to that project? Is my right hon. Friend further aware that Royal Horticultural Society, the horticultural industry and the industrialists who have helped with the project will redouble their efforts to make sure that this important environmental Expo, which will be attended by 40 Asian countries, will be a great success from the British point of view?

My hon. Friend has been assiduous in trying to persuade the Government to take part in the Osaka garden festival as part of Expo 90. Both Expo 90 and the garden festival are mainly for the private sector, but the Japanese have been keen that we should take part. In response to my hon. Friend, we have now agreed that there should be official British participation in the garden show. I understand from our Japanese friends that a commissioner-general is required to be in charge of the British participation in the garden show, and my right hon. Friend the Foreign Secretary will shortly be writing to my hon. Friend to offer him the post of commissioner-general.

With business bankruptcies increasing and industrial output falling, would the Prime Minister say that her high interest rate policies are having the effect that she intended?

Of course, there are always some businesses that go out of business and close down, but we have many new ones starting up. May I point out that in 1978, the last year under Labour, there were 6,000—[Interruption.]—

Order. The Prime Minister must be given a chance to answer.

In the last year of the Labour Government, 6,000 more businesses closed than opened. In 1988, after some eight or nine years of Conservative Government, 64,000 more businesses opened than closed.

The right hon. Lady appears to be interested in references to the past. Does she recall that under her Government there were a record number cif business failures—some 22,000—in 1984? Does she further recall that last year there were in excess of 18,000? Is she trying to break her own record?

The right hon. Gentleman heard what I said. The critical test is how many more businesses open and flourish than go out of business. In Labour's last year in office—its most experienced year—some 6,000 more businesses closed than opened. In 1988, 64,000 more businesses opened than closed. In 1989 over 80,000 more businesses opened than closed. That is a good Tory record, and it shows that the Tories are creating more jobs than ever before.

Will my right hon. Friend confirm that the hallmark of a free and civilised society is the rule of law? Will she further confirm that the people who have power and authority are subject to that law and that all are equal before the law, no matter how high or how humble? Will she consult her Cabinet colleagues about the apparent assertion by the former Chief Constable of Northern Ireland that a man no longer remains innocent until proven guilty, and the apparent introduction by the chief constable of Greater Manchester of the concept of guilt by association?

Will my right hon. Friend reaffirm that no matter what happens in the rest of the world, in these isles justice and freedom from fear prevail?

Of course, I confirm that the rule of law and equality before the law are the hallmarks of a civilised society. They form the cornerstone of our society. My hon. Friend feels especially strongly about this matter. My right hon. and learned Friend the Home Secretary has already made it clear that he does not consider there to be a case for an inquiry. If Mr. Stalker has information that he thinks affects his case, he should make it available to the appropriate authorities as soon as possible. I do not understand why he has delayed doing that.

To ask the Prime Minister if she will list her official engagements for Tuesday 23 January.

I refer the hon. Gentleman to the reply that I gave some moments ago.

I warn the Prime Minister that my question has nothing to do with the Labour Government. We all appreciate her sentiments about democracy, which she preaches throughout the world. Is it not time that she considered democracy within her own party? Is it not amazing that within seven or eight weeks of the beginning of this Session of Parliament she was challenged for the leadership of her party? Is it not strange that within a matter of weeks that challenger was deselected in the constituency of Clwyd, North-West?

Order. The hon. Gentleman must ask about matters relating to the Prime Minister's ministerial responsibility—[HoN. MEMBERS: "Answer!"] Order. I repeat, the hon. Gentleman must ask a question about the Prime Minister's ministerial responsibility.

To ask the Prime Minister if she will list her official engagements for Tuesday 23 January.

I refer my hon. Friend to the reply that I gave some moments ago.

Although many small businesses support the new business rate in principle, many in Norfolk would like to see a longer phasing-in period. Does the Prime Minister agree that it would be a complete disaster if we adopted for small firms Labour's proposal to give back to local authorities the power to levy punitive business rates?

I agree with my hon. Friend that it would be disastrous for many businesses in the north if we gave back to Labour the power to levy punitive business rates, which frightened many good businesses away from precisely the towns and cities which needed them. I understand that the north wants the transition period to be as fast as possible because it will gain some £900 million, while the south and midlands wish it to be much slower. We have to consider both. The present transition period is five years, but that is not an absolute figure and it could be extended if need be.

Has the Prime Minister had the opportunity to read in detail the speech in the House last week by the hon. Member for Southend, East (Mr. Taylor) in which he pointed out that the Government had a clear obligation to treat each constituent part of the United Kingdom with parity? If she endorses that view, will she be encouraging the 35 rebels of last Thursday to do the same this Thursday when similar legislation for Scotland is debated, or will she continue to railroad through legislation which has the support of only 16 per cent. of the Scots?

If there were parity for each region of the United Kingdom, Scotland would not do anything like as well as it does. It is treated most generously both in regional issues and in general public expenditure per head.

To ask the Prime Minister is she will list her official engagements for Tuesday 23 January.

I refer my hon. Friend to the reply that I gave some moments ago.

Has my right hon. Friend noted from the "Newsnight" poll last week that only 15 per cent. of people want more power shifted from Westminster to Brussels? Furthermore, did she note that in his speech to the European Parliament last week Mr. Delors placed a new and positive emphasis on national parliaments? Does she agree that this is a very welcome move not only in the light of our well-tried parliamentary system in Westminster but for the other countries in eastern and western Europe?

I welcome each and every recognition of the part that national parliaments play in democratic accountability in the Community. I noted that in the speech, and it was very welcome. Ministers meeting in the Council of Ministers reach decisions, and they are and must remain accountable to their national parliaments. That is how proper democratic control is exercised in the Community and it must continue that way.

To ask the Prime Minister if she will list her official engagements for Tuesday 23 January.

I refer the hon. Gentleman to the reply that I gave some moments ago.

Is the Prime Minister aware that an ordinary family with a £20,000 mortgage is paying £50 a month more than it was only 18 months ago? Why is she so surprised that her policy of high interest rates leads to claims for higher wage rates?

When it comes to wage rates the important thing is to keep an industry competitive. There is no point in taking wage costs way above those of our competitors. The hon. Member will have seen that the average increase in earnings in industry over this time last year is 9·25 per cent. He will also be aware that our unit wage costs are going up much faster than those of our competitors. If people are concerned to keep their jobs, as I am sure they are, they must have regard to the future competitiveness of industries.

Is my right hon. Friend aware that I am in favour of the role of women in public and private life? Is she further aware that there is a growing demand for more women in the workplace? Does she agree that, admirable though that is, we must safeguard the institution of marriage and the bringing up of children?

Yes. As usual, my hon. Friend puts his finger on the right point. It is vital that we safeguard the institution of family life, and undoubtedly the mother has the most important role in bringing up the children. But we also believe that she, too, must have the chance to work, possibly part time outside the home, or full time in a career, if she wishes, and we try to do our best to accommodate those wishes.

To ask the Prime Minister if she will list her official engagements for Tuesday 23 January.

I refer the hon. Gentleman to the reply that I gave some moments ago.

The Prime Minister will be aware that in his last days in office, President Reagan approved legislation to compensate veterans of nuclear tests in the United States who were suffering as a result of being too close to such tests. Does the Prime Minister now agree that British veterans who suffered as a result of being present at Christmas island and elsewhere during the early tests should receive similar compensation? Will she look favourably at the private Bill initiated by my hon. Friend the Member for Sunderland, North (Mr. Clay) and give Government support to that measure?

The Government are ready to pay appropriate compensation wherever the Crown's legal liability is established and where there is firm evidence to show, on the balance of probabilities, that ex-service men have suffered ill-health as a result of exposure to radiation in the course of their duties as members of the armed forces. In the absence of any such evidence, special compensation arrangements for test veterans could not be justified.

The hon. Gentleman will be aware that current legislation allows for the consideration of the award of a war pension if there is reliable evidence of reasonable doubt that harm may be regarded as attributable to service factors.