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Commons Chamber

Volume 173: debated on Wednesday 6 June 1990

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House Of Commons

Wednesday 6 June 1990

The House met at half-past Two o'clock


[MR. SPEAKER in the Chair]

Private Business

Medway Tunnel Bill Lords

Order for consideration read.

To be considered tomorrow.

Port Of Tyne Bill Lords

Order for Second Reading read.

To be read a Second time tomorrow.

Oral Answers To Questions


Health Boards


To ask the Secretary of State for Scotland what are his criteria for appointments to health boards in Scotland.

Individuals are appointed on the basis of the contribution that they can make to the duties and responsibilities of the health boards.

Does not the Secretary of State realise that the cuts and panic closures affecting hospitals in Lothian region made by the right hon. and learned Gentleman's Tory-appointed health board are an indictment of his system of appointment? Will he come with me to Longmore hospital in Edinburgh, where an excellent breast screening clinic and facilities for geriatric patients are threatened by a panic closure in eight weeks rather than in eight years? Will the Secretary of State give an assurance that Lothian health board will receive proper funding—or will he go?

I share the hon. Gentleman's anxiety to ensure that the health board's recommendations are considered on the basis of their implications for health care in the region. The hon. Gentleman should not suggest that the problem has been caused by underfunding. As he knows perfectly well, all Scottish health boards are funded in exactly the same way. The fact that Lothian finds itself to be seriously overspending is clearly a result of its own internal financial management—as the report now published by Peat, Marwick Mitchell clearly demonstrates.

Will the Secretary of State guarantee that if health board appointments become more business oriented, as is presaged in the White Paper, he will pay particular attention to the successor bodies to the health councils, to ensure that they are properly funded and properly accountable, so that effective patient and consumer consultation boards can be established within the Health Service?

The hon. Gentleman makes a reasonable point. We shall certainly want to ensure that the boards offer the widest breadth of experience, consistent only with the important criterion of avoiding any conflict of interest between those who serve on health boards and those who have financial associations with the provision of health care.

If Scottish health boards were to be financed and paid for by a Scottish Parliament or Assembly that raised taxes in Scotland, as opposed to being funded by the general Exchequer, what would be the increase in the taxes due from Scottish people?

If there were to be a Scottish Assembly and it had to fund Scottish health provision entirely from Scottish resources, there is no doubt that that would lead to a substantial increase in the amount of income tax paid by people in Scotland. Health expenditure in Scotland is about 25 per cent. higher per capita than that south of the border.

Surely ultimate responsibility for the current shambles in Lothian health board rests directly with the Secretary of State for Scotland. Is not the crisis due to the sheer and utter incompetence of the board members—all of whom were directly appointed by the Secretary of State, and half of whom have either direct or indirect connections with the Conservative party? Is not it the case that unless increased funding is made available to Lothian health board, the crisis will be resolved only by the Secretary of State reneging on his promises, closing hospitals and introducing measures that will directly affect patient care?

The Government have already been helpful with regard to the problems of Lothian health board by saying that it will not be required to pay for last year's overspend in the current year, but it is crucial that the health board, like all other health boards in Scotland, should gain control over its expenditure and resources. The hon. Gentleman knows perfectly well that if he were speaking from this Dispatch Box, he would be the first to insist that all health boards in Scotland commit themselves to no more expenditure than the resources provided to them. If Lothian is the only health board in Scotland to have found itself in this difficulty, clearly that is a result of financial mismanagement within the health board.

Scottish Homes


To ask the Secretary of State for Scotland when he last met the chairman of Scottish Homes; and if he discussed the current levels of capital spending on housing by the agency in Scotland.

The Parliamentary Under-Secretary of State for Scotland
(Lord James Douglas-Hamilton)

My right hon. and learned Friend and I regularly meet Sir James Mellon, chairman of Scottish Homes. Our discussions cover all aspects of Scottish Homes' functions and responsibilities.

The Minister promised the tenants of Scottish Homes that there would be no element of compulsion in moving them into other types of tenure. Does he now accept that the latest investment priorities declared by Scottish Homes, stating that it is its intention to invest in every other type of tenure before investing in its own stock and tenants, are tantamount to blackmail—trying to force them into other types of tenure? Does not that mean that effectively the Minister has reneged on his promise to tenants of Scottish Homes; is not he ashamed of himself; and should not he reverse those investment priorities or tender his own resignation?

The hon. Gentleman is incorrect on that subject. Funding for Scottish Homes' budget this year is some £356·5 million. I understand that the hon. Gentleman is primarily concerned with the project in, Fintry, which was delayed because of apprehensions expressed by some of his constituents. I believe that the estate-based strategy is being worked out and is likely to go ahead. Specific projects have begun or will begin shortly and other projects are under consideration as part of the continuing process of developing plans for the area. I shall draw the point that the hon. Gentleman has made to the attention of the chairman of Scottish Homes, but I stress to him that our commitment to upgrading Scottish Homes' stock remains as strong as ever.

When my hon. Friend next meets the chairman of Scottish Homes, will he discuss with him the importance of its work in the regeneration of Barrhead in my constituency? Is he aware that following the welcome announcement on industrial improvement areas by my hon. Friend the Minister of State, Renfrew district council, in co-operation with other public sector agencies and the private sector, is preparing imaginative but realistic plans for the future of Barrhead? In encouraging Scottish Homes to clear the path and to implement plans, will my hon. Friend also take the opportunity to point out to Opposition Members that the greatest threat to the improvement of the quality of housing in Scotland would be a roof tax?

I agree with what my hon. Friend says about a roof tax, because it would swallow up a large part of the income of people who have bought their council house. Scottish Homes is now studying a consultancy report that considers the future of Barrhead. Housing is one aspect of the regeneration proposals. Scottish Homes will need to judge how best its involvement in this important project can complement other economic objectives of the Scottish Development Agency, the region and the district.

Is not it a disgrace that the Government have conned people into buying so-called homes when the Minister and Scottish Homes know that in my area those properties were largely slums? A court case is being heard at the moment, and probably the Minister will argue that he cannot comment on that. Nevertheless, we still have tenants who want repairs to their homes, which they are not getting because Scottish Homes is hiding behind the law, the capitalist system and this Government. What has the Minister got to say to people in Leith who deserve support, repairs and justice? Will he give them that, because they need it?

The hon. Gentleman has raised that matter with me before, on behalf of his constituents. Tenants have applied for improvement grants to the district council, but they are some way down the queue of priorities. The pre-1984 backlog of improvement grants is being worked off quickly. The matter is a responsibility of the district council, but it does not have sufficient priority at present.

What is the Minister doing about the plight of tenants, as well as people who foolishly bought their slum houses?

If the hon. Gentleman is referring to tenants of Scottish Homes, I shall of course draw the matter to the attention of the chairman. I should be grateful if the hon. Gentleman made it perfectly clear which streets he is talking about.

Order. Brief questions lead to briefer answers and more hon. Members are then called.

Higher Education


To ask the Secretary of State for Scotland if he will make a statement on measures to protect freedom of speech in institutions of Scottish higher education.

Following our earlier undertaking to consider the position in Scotland, we have decided to consult interested parties on arrangements for safeguarding freedom of speech in universities and colleges in Scotland, in the light of which we shall consider whether any action is necessary.

Does my hon. Friend recall the promise that was made on 20 June 1989 at column 268 in answer to a debate that I initiated on freedom of speech in Scottish universities and polytechnics—that the review would take place in six to nine months? As a year has now gone by, when can we expect the results of that review?

I recall the debate and the undertaking that was given, which was to consider the position in Scotland in the light of the review of the legislation, in particular section 43 of the Education (No. 2) Act 1986 as it affects England and Wales. That review is still under way. We shall obviously wish to take account of the outcome of that review when considering the position in Scotland. However, I hope that my hon. Friend welcomes the commitment that I have just given.

What advice does the Minister expect to give to regional councils that have been led to understand, although they have not yet been informed, that the technical and vocational education initiative is to be slashed by 50 per cent. in the coming year? What involvement did the Scottish Office have in the discussions and what advice does the Minister of State intend to give to regional councils whose preparations are well advanced for the training of young people in the coming academic year?

Some rephasing of the forward extension of TVEI is taking place. I welcome the £1·8 million that my right hon. and learned Friend the Secretary of State for Employment has announced for the extension of TVEI. However, that has nothing whatever to do with freedom of speech, which is the subject of this question. I wish that the Opposition would spend more time on upholding freedom of speech rather than abusing it.

Does the Minister accept that this is a serious matter and that I regret the fact that there appears to have been a shift in the Government's position? He will remember that the Under-Secretary, the hon. Member for Stirling (Mr. Forsyth), made it clear on 7 June 1989 that

"there was little evidence in Scotland of the problems that prompted the legislation south of the border."—[Official Report, 7 June 1989; Vol. 154, c. 210.]
and led to the imposition of section 43 in England. I recognise that recently there was one deplorable incident at Glasgow university, but that was very much a case of rent-a-crowd. Does the Minister accept that if the law were to be changed on the basis of such a demonstration, it would delight those who are responsible for trouble, but it would be a sad day indeed for university freedoms in Scotland?

It is because the situation in Scotland was different that we did not follow our English colleagues down the road of section 43. However, I am sure that the hon. Gentleman would wish us to fulfil our commitment to reconsider the matter and therefore to hold consultations. I hope that he will also support Conservative Members when we say that freedom of speech is vital. If, as Disraeli said, a university should be a place of light, liberty and learning, it can be none of those things unless freedom of speech is upheld.

Does my hon. Friend agree that those who seek to silence those with whom they disagree demonstrate their own unsuitability for higher education? Does he further agree that university authorities ought to adopt a more robust attitude toward those who behave in such a disruptive way?

I agree entirely with my hon. Friend. I am glad that a number of universities are looking at their codes of practice and their codes of discipline to ensure that freedom of speech is upheld in our universities.

Local Government Finance


To ask the Secretary of State for Scotland what recent representations he has received seeking changes in the poll tax legislation; and if he will make a statement.

I regularly receive representations about different aspects of the community charge.

Is not the Secretary of State ashamed of the fact that he offered the people of Scotland as poll tax guinea pigs, that there was not a whimper of protest from Tory Members of Parliament during the first year of the Scottish poll tax, but that when the poll tax hit England and Wales it met with a storm of protest and the Prime Minister was forced to think again? If the Secretary of State is to avoid the accusation of being a silent stooge in the Cabinet, will he speak up and tell the Prime Minister that a few pussy-footed amendments will not satisfy the people of Scotland who are demanding the abolition of this evil tax?

I remind the hon. Gentleman that the poll tax applies throughout the United Kingdom——

The right hon. Gentleman is quite right to correct me with regard to Northern Ireland. The poll tax applies throughout Great Britain, unlike Labour's roof tax. We have yet to see whether the hon. Member for Falkirk, West (Mr. Canavan), who feels so strongly about these matters, wishes to impose on Scotland alone a roof tax, which the hon. Member for Glasgow, Hillhead (M r. Galloway) has attacked and which has been attacked by the Scottish Labour party. The Leader of the Opposition has said that he certainly would not wish to impose it south of the border. The Labour party needs to address itself to that.

Will my right hon. and learned Friend acknowledge that it is better to address particular anomalies that emerge in relation to the tax rather than necessarily the tax itself? Does he recognise that there are several anomalies affecting merchant seamen, those who spend a considerable part of the year overseas and some holiday homes, and that individual community charge payers have had to take matters to the courts for a decision? That course of action is not open to every individual. Will my right hon. and learned Friend therefore make sure that the legislation is amended appropriately to deal with those specific anomalies?

We shall naturally look sympathetically at any constructive suggestions. There have already been important changes to the standard charge, which meet some of the points raised by my right hon. Friend'. However, most of the examples to which he referred involve classification, when the community charge registration officer in one part of the country may have acted in a different way from the community charge registration officer in another area. In precisely those circumstances an appeal to the courts is a way of ensuring uniformity and fairness of treatment throughout the country.

Jobs, Glasgow


To ask the Secretary of State for Scotland what special measures he intends taking to create jobs in the east end of Glasgow.

Jobs are created by market forces, not by Governments. However, the Government continue to support a number of initiatives in the east end of Glasgow, including the provision of business advice and training, with the aim of stimulating and protecting employment in the area.

Is the Minister totally ignorant—[HON. MEMBERS: "Yes."]—of the fact that four of the seven constituencies with the highest unemployment in Scotland cover the east end of Glasgow? Does not he realise that the problem cannot be solved without special Government assistance? Just when will he do something about it? His reply is disgracefully inadequate. We are sick and tired of promises, press releases and cosmetic exercises. Just when will the Minister and his colleagues in Government realise that the people of Scotland and of Glasgow want the same job opportunities as people in London and the south of England? Can he tell the House when that day will come?

It seems to me that the hon. Gentleman, if not ignorant, is at least blind to the success of Government policies in Glasgow as elsewhere. In the past three years unemployment in Glasgow has fallen by no less than 29,000. In the hon. Gentleman's own constituency, unemployment stood at 7,000 in January 1987, but is now down to 4,500. He also should know that the Government are giving considerable support through the SDA to the East End Executive and that through the SDA there have been a number of projects to the value of £6 million in Shettleston. In those and other ways the Government are helping to assist the development of enterprise and employment in the east end of Glasgow.

Will my hon. Friend give a warm welcome to the statement made by the chief Opposition spokesman, the hon. Member for Glasgow, Garscadden (Mr. Dewar), when he said on Radio 4 on 28 May that Scotland does very well out of central Government funding and remains substantially funded from England? While it may be a little premature for the hon. Member for Garscadden to start talking as if he were a Minister, is not his change of heart very welcome?

My hon. Friend is probably right. It is true that certain parts of Scotland get special help from the Government, as do certain parts of England, including the north-east and the north-west. That help is given because it is needed to generate employment and enterprise in areas of severe dereliction and difficulty. It is evidence of the success of Government policies in Glasgow that unemployment there has fallen by 29,000 over the past three years.

The Minister will know that in my constituency, in the Dennistoun area of the east end of Glasgow, more than 550 jobs in the tobacco industry have to go. Does he agree that it is a sad day when any industry that has increased its productivity and has good industrial relations and whose workers have worked there for generations finds that when Lord Hanson takes over a company, he strips the assets and closes factories? Surely the Minister and his colleagues in the Department of Trade and industry should do something about those asset-stripping companies.

I sympathise with the hon. Gentleman on the loss of some 530 jobs in his constituency because of the closure. However, that loss will take place over the next two years and Hanson has given undertakings on assistance with counselling, job searches and training activities. I am sure that the hon. Gentleman agrees that those decisions must be taken on commercial grounds and that industry must remain competitive, or more jobs will be lost. I am sure that he will welcome the fact that, by taking a commercial and competitive approach to the economy, the Government's efforts have resulted in a fall in unemployment in his constituency of about 3,000 over the past three years.

Helicopter Ambulance Service


To ask the Secretary of State for Scotland on what criteria the decision was taken that a helicopter ambulance service is to be fully funded by the National Health Service in Scotland.

A commercially sponsored trial in the highlands shows that a helicopter ambulance service represented value for money and improved the service greatly. The service is continuing on the basis that it will not add to the costs to the National Health Service overall.

Is my hon. Friend aware that, although the decision to fund the helicopter service in Scotland in full from Government sources is not begrudged in Cornwall, it caused dismay, consternation and puzzlement? The NHS has refused to make any contribution to the first helicopter ambulance service, which was provided in Cornwall. Did any special circumstances apply to the decision to fund in full the operating costs of the service in Scotland? Does my hon. Friend accept that the experience in Cornwall with that first helicopter ambulance service shows that the service is viable and valuable? Should not the same criteria therefore apply?

The helicopter ambulance service in Cornwall does a splendid job and has been commercially sponsored and supported by the community. Following the pilot scheme in Scotland, which was commercially sponsored, it became clear that the service represented value for money and that it would improve the quality of patient care. For those reasons, and within the existing resources available to the ambulance service, it was decided to take on the helicopter ambulance service for the highlands. The decision was based on the interests of patient care. Any expansion of that service may well involve sponsorship as it applied in Cornwall, but because that is not my responsibility, I cannot give my hon. Friend any detail on aspects relating to the project in Cornwall.

Is the Minister aware that the proposal to cut hospital services in East Lothian by a crippling 22 per cent., including the closure of the casualty unit at Roodlands hospital in Haddington——

My question will be about that. That proposal will give rise to serious difficulties in transporting about 600 casualty patients a month from East Lothian to the accident emergency unit at Edinburgh royal infirmary. Does the Minister believe that the existing ambulance service can cope with that, or is he thinking of helicopters?

The hon. Gentleman will be aware that at Scottish Question Time he has cheered when the Government's policy on competitive tendering has been attacked. He will be aware also that the revenues that have been saved in the Scottish ambulance service as a result of the pilot scheme on competitive tendering in my constituency are almost sufficient, over the three-year period, to meet the costs of the helicopter ambulance service.

The hon. Gentleman will know that Lothian health board's proposals, which involve hospitals in his constituency, are out at consultation at present, and they will come to my right hon. and learned Friend the Secretary of State for consideration in due course.



To ask the Secretary of State for Scotland how many bypasses in Scotland are currently under construction; and how many further ones are planned.

The Scottish Development Department has nine trunk road bypasses currently under construction, with a further 23 currently programmed. Bypasses on non-trunk roads in Scotland are of course a matter for the regional councils as roads authorities.

Does my hon. Friend agree that the £1·6 billion of potential and actual spending on Scottish roads and bypasses has benefited the motoring public and has cut my regular journey to Aberdeen by about an hour and a half as a result of the improvements to the A94? Does he also agree that that spending has improved the competitiveness of Scottish companies and, if that is not enough, has contributed towards the attraction of £2·6 billion of inward investment into Scotland since 1981?

Spending on roads is 15 per cent. in Scotland higher than in England, where there has also been a substantial increase in resources. This year we are spending £205 million of capital and current expenditure which we believe is extremely important for jobs. My hon. Friend referred to Aberdeen; the upgrading of the road between Inverness and Aberdeen is the joint priority in Scotland along with the M74. We published recently a progress report about the bypasses that we hope will be brought to fruition before long in many parts of Scotland which will be important for jobs and will benefit the environment.

Although the Minister may give us a roll-call of expenditure on bypasses, does he recall that in my constituency there is a serious problem in Dalkeith with the A68? Will the Minister consider that problem? Traffic in Dalkeith is a disgrace, and we badly need the A68 bypass.

The Dalkeith bypass will go ahead as quickly as possible and we hope that it will greatly benefit the hon. Gentleman's constituents. As the hon. Gentleman is aware, the A7 will be upgraded to dual carriageway status later in the 1990s and we hope that that will also be of substantial benefit. If the hon. Gentleman is aware of particular problems on the A68 with accident blackspots, I should be grateful if he would let me know so that we can set in hand accident remedial schemes straight away.

May I congratulate my hon. Friend the Minister on the expenditure on the A75 between Gretna and Stranraer, including the bypasses at Annan, Castle Douglas, Gatehouse and Glenluce? There are many more to come including one for Dumfries. Is not that exceptionally wise expenditure which will benefit industry, agriculture and tourism and is not it something that the Government should continue with all possible haste?

I assure my hon. Friend that the progress on the M74 is such that it may be the fastest motorway to be built in Britain to date. We certainly intend to go ahead as quickly as possible.

The Minister will already know of the concern in my constituency about the delays to the Ardrossan-Saltcoats-Stevenston bypass and perhaps he can say something about its prospects. Does he agree that there is a danger of defeating the purpose of bypasses if they act as magnets for developments round them, particularly in green belts?

On a subject that is closely related, does the Minister agree that the fate of football clubs should not be decided by property developers behind closed doors without regard to the interests and wishes of the people who support those clubs and attach a great deal of importance to them?

The hon. Gentleman was bypassing the question. However, he made a serious point about the Ardrossan-Saltcoats bypass. About 23 bypasses are planned to start in Scotland and we will take the hon. Gentleman's point into account. Nine bypasses are under construction now and considerably more are likely to go ahead by 1991, including one at Bennane Hill on the A77. I must leave the Hearts bypass to my hon. Friend the Minister for Sport to answer another day.

Does the Minister recognise that the people of Northern Ireland, living just 20 miles or so from the coast of Scotland, regard the bypasses and roads in the west of Scotland as their lifeline into the rest of the United Kingdom and to Europe? In future, will he take that into account, consult the Northern Ireland Office and seek its support and co-operation for the improvement of the road system in any applications made to Brussels for European Economic Community support?

I shall certainly contact my colleagues in the Northern Ireland Office to make them aware of the right hon. Gentleman's point. The commitment to upgrade the A75, which is a Eurolink with Northern Ireland, is moving steadily forwards fulfilment.

In contradiction to the Opposition, will my hon. Friend the Minister tell the House how grateful Perth is for its southern bypass so that St. Johnstone football club can have the most modern football ground in Scotland with the best facilities in a greenpeace site—[interruption.]—where people can enjoy the football?

We believe that all road projects should be environmentally friendly, and we shall do everything within our power to ensure that that happens.

Steel Industry


To ask the Secretary of State for Scotland if he intends to meet trade union representatives from the Scottish steel industry to discuss investment in the Scottish steel industry.

My hon. Friend the Minister of State and I met representatives of the steel trade unions in Scotland recently.

I am glad that the Secretary of State met representatives of the work force at Dalzell and Ravenscraig because their jobs are on the line and they know better than any hon. Member the problems of the steel industry. Is the Secretary of State aware of growing suspicion among workers' representatives and others that the closure of the hot strip mill at Ravenscraig is a result of the manipulation of the monopoly position of British Steel? What will he do to investigate that? I am aware that he welcomed the study of the market by Motherwell district council, but that will not be sufficient. What independent investigation has the Scottish Office initiated, or does it intend to initiate, into the competitive—or otherwise—practices of British Steel now and in the future?

We have said that the first priority is to try to obtain greater information—indeed, some information—from British Steel on the reasoning and thinking behind its announcement. I endorse what the hon. Gentleman said about the attitude of the work force. When I wrote to Sir Robert Scholey last week seeking further information of the kind that I have indicated, I also suggested to him that he might find it helpful to meet representatives of the work force at Ravenscraig not only to explain to them the thinking behind his proposals but to hear their constructive suggestions on how they can continue to make a viable contribution to the well-being of British Steel as a whole through the Ravenscraig works.

Is the Secretary of State aware that one of the most important meetings this year on investment in the future of the Scottish steel industry will be the annual general meeting of British Steel in July? Will he confirm that one of the privileges of the golden share held by the Government is that a Crown Minister has the right to attend and address the shareholders' meeting? Will the Secretary of State take the opportunity in July to exercise that right and address the board and the shareholders on the unfairness of the investment by British Steel since 1983 and try to elicit from the meeting the information that has so far been denied to us?

However sincere the hon. Gentleman's intention might be in making that proposition, it is a rather foolish suggestion. He knows as well as I do that the golden share is relevant only to any proposal by an outside interest to acquire more than 15 per cent. in the shareholding of British Steel. That is made quite clear by the prospectus, and the hon. Gentleman knows it as well as I do.

May I remind my right hon. and learned Friend that we are talking about the British steel industry and that there will be considerable resentment among my constituents and others on Teesside if he seeks in any way unduly to influence British Steel in making its commercial decisions simply because of the volume of voices from the parliamentary Labour party?

Although I understand my hon. Friend's views, I remind him that the Government amendment, which the House approved, called upon British Steel to explain and defend its decision with regard to its proposals for the hot strip mill, and that is exactly what we intend to do.

Does the Secretary of State accept that it is not encouraging to hear a Minister of the Crown say that he is hoping to get some information from British Steel? Is the Secretary of State receiving information from the company about the arguments, the facts and the figures? Has Sir Robert Scholey stated that he will discuss his case openly and frankly with the work force and with the Government? What steps does the Secretary of State propose to take if that co-operation is not forthcoming? If the information does come forward, will the right hon. and learned Gentleman look seriously at the need to challenge and test the assumptions behind that disastrous decision, perhaps with the help of independent advice?

Naturally, I understand the hon. Gentleman's need to make those remarks. However, I remind him that the Labour party's policy on this matter is, in practically all respects, exactly the same as the Government's. The Labour party has clearly ruled out the renationalisation of British Steel. It therefore follows that Labour is saying exactly the same as everyone else—that this is ultimately a decision for British Steel. If my assumption about Labour's policy towards the renationalisation of the steel industry is incorrect, I have no doubt that the hon. Gentleman will wish to make that clear.

Water Charges


To ask the Secretary of State for Scotland what information he has on the percentage increases in Scotland on the community water charge between 1989–90 and 1990–91.

The average personal community water charge has risen by less than 9 per cent.

The Minister must know that as the community water charge is not rebatable, the figure that he has announced amounts to quite an additional burden, especially on people with low incomes. As it is estimated that £1·25 billion will be required to improve water quality to meet the regulations, the community water charge looks set to become a crippling burden on families unless the Government do more to help local authorities. What proposals do the Government have to match the capital debt write-off for and the dowry given to the water companies in England and Wales before privatisation? Will the Government give the same help to Scottish local authorities? If they do not, Scottish families, businesses and communities look set to be crippled by high water charges throughout the 1990s.

The cash injections into eight of the 10 water authorities in England and Wales were part of the capital restructuring before privatisation which the hon. Gentleman knows is not happening in Scotland. The Scottish Office is considering the implications for Scotland. However, I stress that water charges are very much lower in Scotland than they are south of the border. The average household in Scotland pays just over £41 per year for water, whereas in England the figure is £64. Similarly, much more is paid per head south of the border for sewerage than is paid in Scotland. The hon. Gentleman knows that there are special circumstances in Shetland because of the negotiations over the Sullom Voe terminal, but, as Shetland has the lowest community charge in Scotland and Orkney the second lowest, the whole picture must be taken into account.

Will my hon. Friend bear in mind not only the domestic water charge payer, but the business water charge payer in areas such as Grampian, which last year had a dramatic increase in its water charges? When we see debts being written off for the English water boards, there is obviously anxiety among high water users, such as the food-processing and paper-making industries, that they cannot compete on level terms with similar industries south of the border because of the water charges that they must pay.

There is a general desire for harmonisation. However, I stress that the non-domestic water rate for premises that are not connected to a metered water supply is levied in Scotland according to a proportion of the net annual value. That proportion is determined by the water authority and ranges from 100 per cent. to 12·5 per cent., depending on the type of premises. In general, we are seeking harmonisation.

Does the Minister accept that there is a feeling that the charges have been held low in anticipation of the regional elections? Does he further accept that one of the anomalies of this matter, as with the poll tax, is that the charges are not income related? If the Secretary of State is looking to remove anomalies, what proposals is he putting before the Cabinet to make the poll tax and the water charge tax income related?

I must stress to the hon. Gentleman again that water charges in Scotland are much lower than those south of the border. I consider that that is a satisfactory position. There are many more difficulties with business rate payers who have to pay more in Scotland. We are trying to harmonise as quickly as practicable.

Income is taken into account in the rebate system, and a considerable number of people are exempt from water charges. Full-time students are entitled to an 80 per cent. rebate. People are exempt from personal community water charges if their premises do not receive a public water supply. Any person listed in the schedule to the Abolition of Domestic Rates Etc. (Scotland) Act 1987 who is exempt from the personal community charge is also exempt from the community water charge. That includes the severely mentally impaired and long-term and residential care home patients.

Will my hon. Friend confirm that the water charge is use related and that if we could relate any form of local authority expenditure to use, we would not need a standard licence fee for the use of local authority services, which is the equity that the community charge represents?

I thank that I can explain to my hon. and learned Friend that water charges depend on a variety of factors such as the cost of treating and supplying the water, the amount of pumping facilities, the level of capital debt and the method of apportionment between classes of consumer. All those matters can vary among local authorities in Scotland and in fact do.

Glasgow-East Kilbride Railway


To ask the Secretary of State for Scotland if he has received the submission from the East Kilbride development corporation and ScotRail to build a new railway station in East Kilbride and to extend the Glasgow-East Kilbride railway; and if he will make a statement.

The submission from East Kilbride development corporation and ScotRail on the building of a new railway station in East Kilbride has been received and is being considered. I expect to announce a decision soon.

Is the Minister aware that the long delay in reaching a decision on this matter is causing serious anxiety and uncertainty to householders who will lose their homes if the development goes ahead? Will he explain why it has taken so long to reach a decision on what is, after all, a relatively straightforward matter of extending a railway line a few hundred yards and building a modern up-to-date railway station to service the needs of commuters to and from East Kilbride? Will he give me an assurance that the answer that he has just given means that we shall receive a decision from the Minister in a matter of weeks, not of long, weary months?

I assure the hon. Gentleman that "soon" means soon. It is important that such decisions are carefully considered in the normal way. That includes an economic appraisal. That matter is in hand and I hope to set the hon. Gentleman's mind at rest in early course.

Will my hon. Friend confirm the importance of the Glasgow-East Kilbride line to the people of Eastwood? Will he congratulate Strathclyde region on putting new rolling stock on the Glasgow-East Kilbride line and the Glasgow-Barrhead line? On the point about reopening stations raised by the hon. Member for East Kilbride (Mr. Ingram), is not it encouraging that several new railway stations are being opened in the Greater Glasgow area—one example being Dumbreck, which is only five minutes from where I live?

I agree with my hon. Friend. As a result of a grant from my right hon. and learned Friend the Secretary of State of about £30 million two years ago, there has been a substantial expansion and improvement in the rolling stock in Strathclyde. Last year about five stations were opened or reopened. This year 10 stations are scheduled to be reopened in the Strathclyde area, including Dumbreck, to which my hon. Friend referred.



To ask the Secretary of State for Scotland what initiatives he intends to take with respect to solving Scotland's housing problem.


To ask the Secretary of State for Scotland what initiatives he intends to take with respect to solving Scotland's housing problem.

My right hon. and learned Friend and I are developing a rural housing strategy for Scotland through Scottish Homes and we have asked Scottish Homes to give priority to the problem of homelessness.

As 100,000 Scots are now on council house waiting lists and homelessness is even higher in Scotland than it is in England and Wales, when will an emergency programme for Scottish housing be set up to match the necessary programme for homelessness in London and the south-east of England? The south of England has 30 per cent. of the population of the United Kingdom and obtains 50 per cent. of mortgage tax relief —an additional subsidy to the subsidy junkies of the south-east of £1,000 million. When will that spending be matched by investment in public sector housing in Scotland and elsewhere?

We have increased the net capital allocations at the final stage by about £40 million above the previous year. A huge number of houses—more than 205,000—has been built in the past 10 years. The public sector built almost 60,000. We believe that the housing associations have an important role in catering for people with special needs and that the district councils are taking their statutory responsibilities seriously. Although each year there may be 25,000 or more applications from homeless people, the district councils are finding them places to stay.

The district councils are operating extremely effectively. We believe that Scottish Homes should give priority to assisting them in that purpose.

How can the Minister reconcile his answers at parliamentary questions in October last year, when he made it clear that the Scottish Development Department did not keep estimates of homelessness or overcrowding in Scotland, with a letter circulated in May this year to all Scottish Members in which he attacked Shelter, an organisation which does an effective job combating homelessness, for keeping such records? Will he stop talking about net capital allocations and instead talk about gross capital allocations? Last year the budget in Scotland was slashed by £51 million and in areas such as Moray that meant a reduction of 15 per cent. When will he take action to reduce and eradicate this social injustice?

As for gross capital allocations, if district councils, especially in cities, processed right-to-buy applications more speedily, there would be millions of pounds extra to spend on Government housing this year. A few days ago I visited the hon. Lady's district council and saw the housing there. It is making good progress with the projects before it. The rural housing strategy, on which we hope to reach a decision on the way forward certainly by the autumn, will be of considerable assistance in helping to bring back into use many of the 130,000 empty houses in Scotland. I hope that that will have relevance in many rural areas, including that of the hon. Lady.

How many council houses in Scotland are unfit to live in because of dampness and other problems? When does the Minister expect every family in Scotland to have a house fit to live in at the current rate of financial contributions from the Government?

We think that it is a serious problem that about 48,000 houses have rising damp and condensation, but it is for the district councils concerned, which know their stock best, to choose the priorities for dealing with these matters. Many are completing local house condition surveys, which we welcome.

Does my hon. Friend agree that the problem in Scotland is that too much housing is in the public sector? Is he aware that Scotland has a lower percentage of owner-occupation than Czechoslovakia? What are the Government doing to speed the privatisation of the housing stock in Scotland?

Approaching 200,000 public sector tenants have purchased their homes in Scotland and we have a rents-to-mortgages trial scheme. As the Prime Minister said, if that scheme proves itself, it will be extended.

If the Minister genuinely believes that local authorities are dealing with the problem of the 28,000 homeless people in Scotland, what is his answer to the leaders of the housing committees of Scotland's four largest housing authorities who yesterday claimed that there was a major housing crisis because the Government had cut £51 million in real terms of capital allocations? When will he recognise the housing crisis, shed his prejudices against council housing and give local authorities the money that they need to stop thousands of our fellow Scots suffering from poor housing conditions?

Cities such as Edinburgh and Dundee, and to a lesser extent Glasgow, are taking almost a year to process council house sales. If that period is reduced to seven and a half months, extra money will be available to those cities to spend on their public sector stock. It is necessary to bring back into use as many as possible of the 128,000 to 130,000 vacant houses in Scotland.

Industrial Development


To ask the Secretary of State for Scotland when he last met the chairman of the Scottish Development Agency to discuss industrial development in Scotland.

I last met the chairman of the Scottish Development Agency on 24 March at a dinner for UK-Japan 2000, and my hon. Friend the Minister of State met him on 4 June.

Has the Secretary of State examined the distribution throughout Scotland of inward investment projects during the past five years, and has he reached the same conclusion as have the people and council of Cumnock and Doon Valley—that Locate in Scotland seems entirely unaware of the substantial advantages for inward investment of locating in a district that has higher unemployment, as the Secretary of State knows well, than in any travel-to-work area in mainland Britain? Will he ensure that Locate in Scotland is aware of the advantages of locating inward investment in Cumnock and Doon Valley? Will he encourage Locate in Scotland to try to make companies from the overheated south-east of England that want to find alternative locations aware of the quality of life that they will find in Cumnock and Doon Valley?

Naturally we are anxious that, wherever possible, inward investment should go to the areas with the most unemployment, but at the end of the day it is for the companies to decide their locations. If the Government were to seek to direct them, they would not come to Scotland in the first place. Ayrshire has been relatively fortunate for example, with the Caledonian paper factory which, although located in Irvine, produces jobs throughout Ayrshire. I know that the hon. Gentleman will welcome that.

Does my right hon. and learned Friend agree that the Scottish Development Agency, the regional economic development committee and the enterprise trusts have had substantial success in the past few years in bringing industry to Scotland? Will he say by how much unemployment has fallen in Scotland in each of the past three years?

My hon. Friend is correct. Unemployment in Scotland has fallen in the past three years at a higher rate than at any other time in recorded history. It is interesting that Scottish unemployment is now below the level of that of many European Community countries.

May I tell the Secretary of State about the real problem facing areas such as Cumnock and Clydesdale? The town of Larkhall in my constituency is next to the A74. It contains massive industrial sites, but has not been properly served by Locate in Scotland because it seems not to know of it, and it does not let anyone concerned with inward investment know about the area. We expect Locate in Scotland to address the problem, and to represent all communities instead of all parts of Scotland.

I assure the hon. Gentleman that Locate in Scotland has no bias in favour of or against any area. As for the area about which the hon. Gentleman is concerned, the improvement of the A74 to motorway status will make the area even more attractive to investment than it has been in the past.

Employment Training


To ask the Secretary of State for Scotland if he will give the estimated total number of employment training entrants in 1990–91.

Resources available for employment training in Scotland in 1990–91 have been based on an estimate of an average of 28,500 people in training at any one time. Over 55,000 entered employment training in 1989–90.

Why is Scotland suffering such savage cuts in its training budget? Will the Minister confirm that £30 million has been cut from the youth training budget for the next two years? Has he had time to assess the impact of yesterday's announcement of 400 redundancies by Astra Training Services Ltd? That will impact on Scottish skill centres.

We do not need lectures from the Labour party on cutting training programmes. We are spending about six times as much in cash terms on training as did the Labour Government in their last year. We spend a higher proportion of our gross domestic product on training than do the United States, Germany or Japan. In the past four years, expenditure on training has risen by 60 per cent. at a time when unemployment has fallen by 50 per cent. Of course, it makes sense to adjust our training programmes and budgets to take account of falling unemployment and a reduced client group for those programmes. That is the right way to manage the programmes.

During the past few months, the Minister has been in the unfortunate position of having to announce cuts imposed by the Department of Employment on employment training, the technical and vocational education initiative, youth training and the European social fund. The Minister has claimed that next year the Scottish Office will be in control of training. Is that true? Next year, will we be able to control those factors from within Scotland, or will we continue to have Department of Employment cock-ups?

Last year, the average number of people in employment training schemes was 26,000. For 1990–91 we are budgeting for an estimated 28,500, which is an increase in employment training. The training schemes are increasingly successful, to the embarrassment and discomfort of the Labour party, which has tried to undermine and oppose them.

As to the control of training policies, the hon. Gentleman knows that by merging the Training Agency with the SDA to create Scottish Enterprise and devolving control of the policies in detail to the local enterprise companies, we shall achieve the kind of flexibility and diversity within the overall training programme on a United Kingdom basis that will lead to better training and better job opportunities throughout Scotland.

National Health Service


To ask the Secretary of State for Scotland when he last met representatives of the British Medical Association to discuss the current circumstances of the National Health Service in Scotland.

Does the Minister recall that members of the BMA along with all the people of Cambuslang and Rutherglen rejected the plan by Greater Glasgow health board to scrap a new hospital and to turn over care of the elderly to Takare, a private company? Despite boasts that this was a good financial deal for the public, the health board is refusing to reveal details of the weekly costs of the beds that will be paid to Takare. Will the Minister instruct the health board to reveal the true cost to the public of privatising care of the elderly?

The hon. Gentleman has the distinction of being one of the few Members of Parliament to come here to complain that a new facility for the elderly will be built in his constituency, faster than would otherwise have been the case, which will provide 180 beds at a lower cost to the Health Service. I hope that every one of his constituents is aware of his position because he is putting his own political dogma before the interests of patient care.

Ballot For Notices Of Motions For Friday 22 June

Members successful in the ballot were:

  • Mr. Lewis Stevens
  • Mr. David Martin
  • Mr. Archy Kirkwood

European Community Documents

With the permission of the House I shall put together the four motions relating to European Community documents.


That European Community Document No. 10499/89, relating to production and labelling of organic food, be referred to a Standing Committee on European Community Documents.
That European Community Document No. 9825/89 and the Supplementary Explanatory Memorandum submitted by the Ministry of Agriculture, Fisheries and Food on 2nd May 1990, relating to game and rabbit meat, be referred to a Standing Committee on European Community Documents.
That European Community Document No. 10438/89 and the Supplementary Explanatory Memorandum submitted by the Ministry of Agriculture, Fisheries and Food on 12th March 1990, relating to marketing standards for poultrymeat, be referred to a Standing Committee on European Community Documents.
That European Community Documents Nos. 4780/90, relating to health rules for poultrymeat, 4596/90, relating to health rules for fresh meat, 4781/90, relating to health rules for meat products, 4863/90, relating to health rules for minced meat and certain other meat preparations, and 4782/90, relating to the conditions for granting derogations from specific Community health rules on the production and marketing of products of animal origin, be referred to a Standing Committee on European Community Documents.—[ Mr. Fallon.]

Statutory Instruments, &C


That the draft Planning and Building Regulations (Amendment) (Northern Ireland) Order 1990 be referred to a Standing Committee on Statutory Instruments, &c.—[ Mr. Fallon.]

Injurious Affection (Amendment)

3.33 pm

I beg to move,

That leave be given to bring in a Bill to reduce the time limits within which compensation may be claimed under the law of injurious affection.
I am concerned principally with those people in Kent, particularly in my constituency, who will be adversely affected by the channel tunnel rail link and various concomitant works. However, the Bill would also benefit people in other constituencies being immediately affected by motorways or other works of public transport construction.

The law as it stands means that compensation does not become payable until 12 months after the first date of use of whatever is in question. As things are progressing at the moment, it looks unlikely that the channel tunnel rail link will be up and running before the turn of the century.

Constituents of mine and those of my hon. Friends who are just outside the 240 m corridor will not have their properties compulsorily purchased, they will have all the uncertainty until construction is complete, they will suffer nuisance during construction and, when the first train runs, they will have to wait 12 months before they can prove nuisance. The Bill sets out to reduce that period so that people who are injuriously affected by various works of construction will be able to claim within three months rather than 12.

The present arrangements are set out in the Land Compensation Act 1973. When that Act was passed, there had been no major railway construction since the turn of the century. We need to look in detail at our planning and compensation laws to see whether they are adequate to deal with this new phenomenon of the first major railway construction for so many years. In particular, I am worried about those constituents who will not be affected by the much talked about new high-speed rail link but who will be affected by all the concomitant works for freight that are being carried out on other lines. Those people will not be able to get any compensation unless there is negligence in the course of construction.

While British Rail says that the loop lines at Headcorn and elsewhere are merely for intensification of the use of existing lines, those who are affected by them, no matter how closely, cannot claim compensation because the Land Compensation Act specifically excluded intensification of use as a ground for claiming compensation. However, I could show hon. Members the houses of constituents in which cracks are already quite obvious and where there is already subsidence and immense noise pollution.

I am aware that the Government take the matter seriously. They have shown that by the Department of Transport initiative in setting up a committee specifically to look at noise nuisance. However, that committee's deliberations are likely to be long and I do not know whether ultimately they will help immediately those who will be affected by the various construction works.

If a nuisance can be proved within three months, it will not go away in the next nine months. Why is it necessary to wait 12 months if one can prove immediate nuisance? I do not understand that. There are major benefits in reducing the period to three months. First, there is the obvious effect on householders who are suffering uncertainty about the value of their property and about the nuisance. A three-month period would give a shorter time scale in which the Lands Tribunal could work and in which appeals could be made, and would therefore remove the complicating factors that can arise in 12 months.

For example, if a householder sells his property before the 12 months have elapsed, there are additional complications in adjusting the compensation. There would be benefit in the administration of the law, as well as benefit to those householders who are suffering. The complicated adjustment that is necessitated by many interim effects which can arise between three and 12 months, such as adjustments to the value of the property, inflation, market changes and other influencing factors, would also be subject to a shorter time scale, and that would make matters neater and tidier.

My prime concern is that my constituents and the constituents of the other sponsors of the Bill in Canterbury, Gravesend and Dartford are all suffering because of inadequate compensation laws. My Bill would reduce a further period of uncertainty for which there appears to be no good reason and which inflicts further mental suffering as well as suffering caused by physical nuisance.

These matters are causing more problems in Kent than are generally recognised. If my constituents must wait another five, six or seven years for construction to take place, only to be asked to sit back and suffer one year's blight of nuisance, noise, house damage and undervaluing of property, they are faced with a monstrous proposal. A simple change in the law would at least reduce that blight if it could not entirely eliminate it.

Question put and agreed to.

Bill ordered to be brought in by Miss Ann Widdecombe, Mr. Julian Brazier, Mr. Jacques Arnold, Mr. Bob Dunn, Mr. Andrew Rowe, Mr. Roger Sims and Mr. David Shaw.

Injurious Affection (Amendment)

Miss Ann Widdecombe accordingly presented a Bill to reduce the time limits within which compensation may be claimed under the law of injurious affection: And the same was read the First time; and ordered to be read a Second time upon Friday 6 July and to be printed. [Bill 155.]

Points Of Order

3.41 pm

On a point of order, Mr. Speaker. You must be aware, Sir, of the great respect in which you are held in the House in defending the rights of individual Members and the rights of the House of Commons. Will you tell us whether you have made the views of the House known to the other place—the latter-day 1930s appeasers—on the War Crimes Bill? Have the Government made available any knowledge to you that an early statement will be made so that the Bill can be sent back to the other place and their Lordships sent packing in the interests of the democracy of this country?

I am surprised that the hon. Gentleman should ask me whether I have let my views be known on that matter. He certainly heard the views of the Prime Minister yesterday. The matter is one for the Government, not for me.

Order. The hon. Member for Birmingham, Selly Oak (Mr. Beaumont-Dark) has prompted a rash of points of order on an Opposition day. Points of order will take time out of the time for the debate.

On a point of order, Mr. Speaker. You have heard the views of the hon. Member for Birmingham, Selly Oak (Mr. Beaumont-Dark) on the powers of the other place, and there are Opposition Members who believe in abolishing the House of Lords. We are still battling to get that proposal into a policy review before the general election. Apart from all that, I think that there is a matter that you should clarify. Many Speakers go to the House of Lords when they have finished their stint here. I reckon that, on the basis of what was said yesterday about Members declaring their interests, you should tell us what your intentions are, Mr. Speaker, before you consider your response to the point of order.

Perhaps the hon. Gentleman has given me a lead. That is precisely why I shall say nothing.

On a point of order, Mr. Speaker. Whatever your plans may or may not be—I hope that you will be in this place for quite a while yet—may I ask whether there will be some way in which the House will be able to express clearly the fact that, on a free vote, there was an overwhelming majority in favour of the War Crimes Bill, which has been entirely ignored by the other place? There has been much speculation in the press that there will be an opportunity for a debate, when the House can reaffirm its decision. Have you been notified, Mr. Speaker, whether such a debate will take place in the near future?

I have not been notified. However, we have business questions tomorrow, and if the hon. Gentleman is fortunate enough to catch my eye, he may be able to put his question to the Leader of the House. The right hon. and learned Gentleman is in his place and I am sure that he has heard what has been said.

Opposition Day


Eye Tests

3.43 pm

I beg to move,

That this House records its alarm that since Her Majesty's Government ended the provision of free eye examinations the number of eye tests has fallen by over two million; notes that Her Majesty's Government's policy of leaving charges for eye tests to be settled by the market has resulted in a typical charge of £12·00; concludes that charges are deterring many members of the public from seeking eye tests, thereby putting their sight and health at risk; and calls upon Her Majesty's Government to restore a free preventive service for eye examinations.
The Secretary of State will recall that his first reappearance at the Dispatch Box in his current role was to defend the abolition of the free eye test in a debate on a Lords amendment to the Health and Medicines Bill. In the patois of sketch writers, he made a speech which would normally be described as "robust". I remember that he was jolly cross with the rest of us for defending the Lords amendment.

The right hon. and learned Gentleman accused right hon. and hon. Members in all parts of the House who disagreed with him of crying wolf. He said that the idea that people will be deterred from coming forward for an eye test because of a charge was
"contrary to common sense as well as the evidence … We must ask how many people, if any, will be deterred from going to the optician by the prospect—and it is no more than a prospect—that many opticians will charge £10."—[Official Report, 1 November 1988; Vol. 139, c. 923.]
I appreciate that the Secretary of State was asking a rhetorical question, and I apologise for the fact that the rhetorical pause that followed it has lasted 18 months. However, we can now answer the right hon. and learned Gentleman's question. The answer to his question of how many people would be deterred from taking an eye test is 3 million. That is the number who have been deterred from undergoing an eye test as a result of the charge. The Secretary of State appears surprised. That figure has been available from quarterly surveys since charges were introduced.

The figure of 3 million is one which we can quote with confidence because it has been prepared by Professor Hart, professor of statistics at Reading university, using two sources. The first was a survey by the Association of Optometrists, drawing on 400 branches, with data collected from those branches by the Economists Advisory Group. The second was a survey also based on data collected from 1,200 branches of multiples, with data collected by Touche Ross.

I stress that both surveys had a very large base, and were based on work by independent agencies, not professional organisations. The conclusion reached in those surveys, and by Professor Hart, is that, in the year to April 1990, the number of eye tests performed totalled 8·9 million, compared with a figure in the year to April 1989 of 13·2 million—a drop of more than 4 million.

I want to be fair to the Secretary of State. The figures are so dramatic that I can afford to be fair to him. I concede that, in the year to April 1989, probably an extra 1 million people underwent eye tests in anticipation of the introduction of charges. In fact, the Minister of State made a precise estimate of their number. He provided a figure to the Select Committee suggesting that 1·4 million tests were performed in 1987–88 in anticipation of charges and resulted in an unduly high figure for those years. I think that the figure of 1·4 million is rather high, but I shall not quibble. I concede every single one of them. Even if that number is deducted from the fall in the number of tests last year over the previous year, one is still left with a dramatic decline in eye tests of 2·9 million—effectively, a 3 million drop in the number of people going for an eye test last year.

One has to go back to 1981 to find a year in which the number of eye tests was that low. Effectively, the Government have wiped out a whole decade of advance in the eye service.

The line of argument that the hon. Gentleman is now adopting seems rather different from that which he used in the debate on the Health and Medicines Bill on 1 November 1988, when he said:

I predict, with confidence, that the Secretary of State will not save that sum, for two reasons … Eye hospitals will be swamped by references from general practitioners who will no longer be able to refer their patients to optometrists for free examinations."—[Official Report, 1 November 1988; Vol. 142, c. 933.]
Can the hon. Gentleman say whether that has happened, and whether the difference in the two figures that he quoted is accounted for by that factor?

If the eye hospitals had received 3 million additional referrals for free examinations, I assure the hon. Gentleman that he would have spotted the queues in the street. My point is that since charges were introduced 3 million people have not undergone eye tests who would otherwise have done so. That is perfectly consistent with the fact that the number of people going to eye hospitals who previously would not have done so is significantly up. That increase will be matched by the reduction in the number of referrals of people with secondary symptoms who would obviously have been referred there by optometrists had they seen that large a number.

If the hon. Gentleman is going to rely on the surveys published so far, will he agree that he is relying heavily on surveys of opticians, who I have no doubt were trying to be helpful but who have a vested interest in the replies that they give? Is he also going to refer to the survey carried out by the Association of Optometrists using a MORI poll of the general public or to the Royal National Institute for the Blind survey of the public, which show that there is no apparent decrease in the number of tests carried out?

The survey carried out by the Royal National Institute for the Blind gave an estimated 2·7 million reduction, which is substantial—I am sorry to have to tell the Secretary of State that I have seen it and it shows precisely that reduction. I can assure him that I will be referring to the survey carried out by MORI because I believe that it is a prime part of his case.

I must pick up on the way that the Secretary of State has immediately sought to cast doubt on the figures that I gave because they came from opticians. I repeat that the statistics I quoted were derived by a professor of statistics, who is putting his scientific reputation on the line, from data collected by the Economists Advisory Group and by Touche Ross, the chartered accountants. The Secretary of State is suggesting that all those are part of a conspiracy to distort the figures. Is he telling the House that every one of those 400 independent optometrists and 1,200 branches of the multiples is part of a conspiracy to practise a statistical lie—that they are all together in a conspiracy to co-ordinate the same statistical lie?

I am pointing out that the figures that the hon. Gentleman has relied on, quite mistakenly, are all derived from independent opticians and multiple chains. Figures obtained from the general public—surveys of patients, including, contrary to what he has just asserted, questions asked by the Royal National Institute for the Blind—do not support his thesis.

Perhaps my naivety and innocence made me conclude that the people most likely to be able to assist us on the numbers of people coming forward for eye tests are the opticians who carry out such tests. If the Secretary of State is really telling the House—if he is, it will be badly received outside—that that scientific profession is capable of practising a lie for financial gain, I have a simple solution to offer him. In the past year, the profession has offered time and again to agree on a system of independent monitoring with the Secretary of State in which they could both participate. However, the Secretary of State has resisted and rebuffed every one of those overtures. There can be only one conclusion—it is perfectly simple—which is that the Secretary of State does not want their help to monitor the drop because he does not want to know how big the drop is.

Since the Secretary of State advises me to do so, I shall refer to the survey carried out by MORI on behalf of the Association of Optometrists. I assume that it is that survey, and the parallel survey which the Secretary of State has carried out, that have prompted the Government amendment to state that charges will not deter those who need sight tests from seeking them. I do not see where the "will" in the sentence comes from. It is not a question of what will happen in the future: as the Secretary of State knows, we have had a whole year of charges, and the evidence of deterrence is already there.

I understand that the Secretary of State has carried out a survey of his own, similar to the one that the Association of Optometrists commissioned from MORI. I presume that it is those data that the Secretary of State will deploy in his speech—a speech which his junior Minister yesterday assured the House would blow me out of the water. That would be an exhilarating experience, which I look forward to with excitement. The Secretary of State will have to find much more than the market research survey to which he has just referred if he is to succeed in blowing me out of the water.

Faced with the problem, the Government, typically, have opted for market research. Instead of going to the opticians for data, they have asked people in the street whether they can remember when they last had an eye test. The question that the Government have been asking is, "Have you had a sight test at an optician since Christmas?" The problem with that approach—to me, at least, it is a problem, although I suspect that the Secretary of State sees it as a solution—is that it invites over-reporting. It is not just this year that the Association of Optometrists has carried out market research; it has carried out similar market research surveys in each of the last five years, which have resulted in an over-reporting of the number of eye tests by 15 to 25 per cent.

Knowing that he would be asked this question, the Secretary of State commissioned an identical survey from MORI, which put to a sample 1,000 people exactly the question that the Secretary of State devised for his survey: "Have you had a sight test at an optician since Christmas?" The result of the survey, if the answers were correct and if all those who said that they had been to an optician since Christmas had done so, would have been that, in the last financial year, there were not 9 million eye tests but 16 million eye tests.

The only problem that the profession would have had in the last financial year would have been to get all those coming in for an eye test to form orderly queues at the door. Such an approach merely tests popular perceptions; it does not test the reality of those who go to opticians for eye tests.

The hon. Gentleman says that a public survey will plainly lead to over-reporting. I am prepared to agree with him, as a matter of argument. He believes that in the past there has been over-reporting of between 15 and 25 per cent. Does the hon. Gentleman not realise that a 15 to 25 per cent. allowance can be made and that there will still be no fall in the number of eye tests? The hon. Gentleman's proposition is based on the absurd argument that, so long as one surveys only opticians, one can show that there has been a drop, but every time one surveys the public, one finds that there has been no drop in the number of eye tests. I prefer the second approach.

The House will have observed that the Secretary of State is backing himself into a position from which he is successfully protecting himself against any opportunity of obtaining the correct data. From the moment that he says that opticians cannot be included in the survey, he is precluded from finding out how many people are going to opticians.

Let me try to impress upon the Secretary of State the invitation that opticians have been making to him for a year. If he does not trust them, he is casting a major slur on a scientific profession by saying that they are prepared, in conspiracy with Touche Ross, the Economists Advisory Group and Professor Peter Hart, professor of statistics at Reading, to conceal the figures and deceive the House. If that is what he is saying, I invite him to nominate any independent body that he and the Association of Optometrists can together instruct to collect the data. That invitation has been made to the Secretary of State each month for the past year. I ask him again whether he has the courage to accept the challenge.

There is absolutely nothing new to say in this tired old debate between the two sides, except to discuss these surveys. The hon. Gentleman says that we must go only to opticians for our information. He is unaware of any survey of the general public that shows any reduction at all in the number of eye tests. He has seen a survey of the general public which shows that there has been no reduction in demand, but he dismisses it by using the absurd argument that people do not remember correctly when they last had an eye test. Does he not accept that it is sensible to have a survey of the general public, or is he prepared to say that the only source of information on which he will rely is people with a professional, vested interest in the results?

Once again, the Secretary of State's most revealing comment was the last line—that because, as he perceives it, they have a vested interest, he is not prepared to believe what the opticians are saying to him. I find that a breathtaking slur which, by implication, would be applicable not just to optometrists, and could be used to rebut pretty well any medical research one cares to name, all of which is based on scientific research of people no doubt with a vested interest in promoting their own profession.

Over the years, the accountancy profession has developed modest and sometimes quite sophisticated tools for accounting the books. The accountancy profession, can, from time to time, detect fraud, particularly when that fraud is practised on the ginormous scale that the Secretary of State has alleged. I put it to the Secretary of State that all those optometrists who have been charging for eye tests for the past year have accounts and have to make annual returns. Will the Secretary of State accept any independent audit of their books to find out what has happened to their accounts and the numbers treated in the past year, or will he say that the accountants also cannot be trusted because they have some vested interest? It is perfectly clear that the Secretary of State is determined on one point—he will not ask the optometrists how many they are treating, because he dare not do so.

Is it not also true that, if the ophthalmic opticians and the medical practitioners are faking their books, that is a matter of fraud for the Inland Revenue?

I wholly agree with the hon. Lady, who has first-hand knowledge on which to make that assertion. There is a way in which the Secretary of State could assist the hon. Lady and myself. He could repeat his allegations outside the cloak of privilege. Were he to go public and assert that those 400 optometrists who made returns were seeking to practise fraud on the public, on the Department and on the House, the courts might take a considerable interest in the matter.

I have at no stage made any such allegation—[HON. MEMBERS: "Yes, you have.") The hon. Gentleman has such a narrow statistical base for his case that every time I doubt it, he keeps trying to say that I am accusing people of fraud. Obviously, different practices fare to different extents. Some of the multiples have lost out rather badly to independents in the curious market of the past year. All I am saying, and the hon. Gentleman has not denied it, is that nobody has carried out a survey of the general public which shows any fall in demand whatsoever. The hon. Gentleman's entire case is a palpable myth and he should confess that he has based it on an inadequate and narrow survey and allow the House to spend its time on a more serious subject.

I am sorry to detain the House so long on the matter, but the Secretary of State has intervened five times to make exactly the same point. Quite patently, he rests his entire defence on his belief, which I am sorry to assure him is mistaken, that market research has revealed no reduction in the number of those coming forward for eye tests.

I have two responses. First, the figures that I am quoting are not on a narrow base. They include one third of all the multiple branches and more than 10 per cent. of independent optometrists. That is a perfectly adequate large base. Secondly, it is not the case that all market research shows no reduction. I have here an RNIB survey and an RNIB press release. The first paragraph of that press release states that the survey indicates that about 2·25 million people have not taken sight tests in the past 12 months because they would have had to pay.

The very research that the Secretary of State is asking us to believe shows exactly the deterrent effect to which I have referred. The press release goes on to say, as we would expect, that the very people who are most deterred are those on lower incomes. That market research which the Secretary of State is prepared to believe—the Secretary of State will no doubt accept it—will show that those on lower incomes are twice as likely to be deterred and that those on the lowest incomes are three times as likely to be deterred.

The Government's amendment invites the House to congratulate the Government on its policy that
"sight tests paid for by the National Health Service should continue to be available to those on low income".
There are two reasons why that assurance should not persuade the House. First, there is the problem which is familiar with mean-tested benefits and which makes entirely predictable the result when applied to eye tests. Many of those who qualify do not know that they qualify and therefore never come forward to claim the benefits. Secondly, the means test used is a mean means test. It is the same means test that is used to test entitlement for free prescriptions. Anyone with an income that is £10 or £15 above income support levels will be excluded. Anyone with an income of £60 a week is unlikely to qualify for help with eye tests.

To find out whether he or she qualifies, a person must first wade his or her way through form AG I, which comes in 17 pages and 19 parts. One will need good eyesight to get through it in the first place. I was recently sent a form by the Halifax building society inviting me to apply for a £5,000 loan. The form sent to test my entitlement ran to two pages, not 17. At the bottom there was an invitation to phone Tamsin if I had difficulty in filling in the form, and there was a photograph of Tamsin with her headphones on and plugged in, smiling and eager to respond to my queries.

There is no Tamsin to help a person to read the 17 pages of AG1. Moreover, the first thing one reads at the top of the form is the reference to help with NHS charges and the cost of travel to hospital or to visit someone in prison. I have challenged that unfortunate opening statement before and have suggested that the Departments of Health and of Social Security should revise this opening gambit. The only change is that the reference to visiting someone in prison now appears in even bolder type. Thousands of pensioners who are confronted with that opening line will go no further. They are precisely the people whom we should be encouraging to come forward for an eye test and precisely the people whose eyesight may be deteriorating.

The medical consequences of those people being deterred and not coming forward can be predicted accurately from the figures prepared by the British College of Optometrists—not a trade organisation but the scientific and examining body for the profession. The college has prepared figures on the expected referrals from eye tests, from which we can predict the reduction in the number of referrals that is likely to result from a reduction of 3 million in the number of eye tests.

The number of referrals for medical examination will fall by 160,000 cases. Those are the people with disturbing symptoms who are now being missed, members of the public who are unaware that their sight and perhaps health are at risk. Using the figures prepared by the college, we can predict their conditions. Among the 160,000 cases, there will be 26,000 cases of cataracts, probably 25,000 cases of glaucoma, 9,000 cases of macular degeneration, 11,000 cases of hypertension and 13,000 cases of diabetes.

I come to the final absurdity. If only a third of those who are putting their sight at risk fail to come forward in time to avert blindness, the cost to the Government of supporting them will be about £50 million a year. I regret that I have expressed this personal tragedy as a cash figure, but I am trying to find an argument that can connect with the Treasury argument.

What savings do the Government expect from charges for eye tests? The answer is £90 million. That saving would be halved by the cost of those who may go blind as a result of being deterred in one year from coming forward. Those savings will be wiped out in two years. The Government's amendment invites us to congratulate them on having made economies by introducing charges for eye tests, but there are no savings from those charges; there will only be in the longer run extra costs to the health budget for coping with those whose condition is not detected.

Why did the Government get it so wrong? For the answer to that, we need look no further than the speech made by the Secretary of State in November 1988. When Opposition Members and even some Conservative Back Benchers told him that optometrists warned that they would be obliged to charge more than £10 for tests, the Secretary of State said that he did not believe that. He went on to say:
"the charge for the eye test will steadily disappear, that is my strong personal opinion."—[Official Report, 1 November 1988; Vol. 139, c. 927]
Quite why the Secretary of State imagined that optometrists would offer a free eye test once he had stopped paying them is a mystery that he did not explain to the House. The income to the optometrists' profession from test fees is equivalent to the entire profits of the profession. How they were expected to absorb such a major loss is a mystery, the answer to which the Secretary of State did not share with the House.

A year after the introduction of charges for tests, the average charge is £12. A common charge is £15, and a charge of £30 has been recorded. When I challenged the Secretary of State six months ago to produce an optometrist who was providing an eye test free of charge, he cited an optometrist in Dover. On inquiry, all was not what it seemed in Dover. The optometrist there offered a free eye test only if someone bought a pair of spectacles after the test. If someone simply wanted an eye test, he had to pay for it.

I do not deny that it is possible to find the odd isolated case of an optometrist who provides a free eye test. However, those cases are so few as to be of curiosity value. There is not the slightest evidence that, by their competition, optometrists in Dover or anywhere else are having the slightest effect on the market price of tests in the big cities. On the contrary, the quarterly surveys of the Association of Optometrists showed that the price charged over the past year has tended to increase, not decrease.

With regard to the £12 charge, we should get the figures into perspective. Will the hon. Member comment on the family expenditure survey for 1988, which shows that the average family spends £13·64 a week on tobacco and alcohol? In that context, is £12 every two years a large sum of money for a test? Is not the hon. Gentleman insulting the British public when he suggests that £12 will deter them from looking after their health?

I am grateful for the intervention made by the hon. Member for Pembroke (Mr. Bennett), which my hon. Friend the Member for Cardiff, South and Penarth (Mr. Michael) very astutely described as a Labour gain.

The hon. Member for Pembroke has illuminated the mists of ignorance and darkness with which we are trying to reason. We are not discussing the average family. Two thirds of those who visit optometrists do not constitute average families. They are pensioners, and four fifths of pensioners have incomes below £98 a week. We are concerned with people who must find £12 or £15 from a weekly income of perhaps £60, £70, £80 or even £90. While £12 or £15 might be a small sum to the hon. Member for Pembroke, it is not a small sum for that four fifths of pensioners. It is a tragedy for those pensioners that they find the conduct of the social policy of their nation in the hands of people who cannot comprehend what it is like to live on that sum of money.

No, I will not give way to the hon. Gentleman again. He had his chance. I will not give him another opportunity to destroy the Secretary of State's case.

I have one question above all others to which I should like the Secretary of State to reply. Is it still his strong opinion that the eye test charge will steadily disappear? Also, is he still prepared to tell the House that charges of £12 by independent optometrists and of £11·20 in Boots and in Dollond and Aitchisons, which have survived over the past year, will steadily disappear? If so, when will they disappear? How long must we wait until the market works its miracle?

I pause to reflect on the wider lessons to be drawn from the fact that the Secretary of State has been so spectacularly wrong in his predictions to the House. Those predictions were based on the same dogma on which he rests his dramatic proposals for the rest of the Health Service. In 1988 he promised that, by introducing the market, there would be greater efficiency, because competition would drive down prices and widen choice. What has actually happened in the eye service is that the introduction of the market has increased the price and dramatically reduced productivity. It has also reduced the choice available to the public, because 250 branches of independent optometrists have closed.

I noted last month in Ellesmere that an optometrist business that had been operating since 1897 and had survived two world wars and a depression has been driven out of business by the first 18 months of this Secretary of State. Now the public of Ellesmere, if they wish to visit an optometrist, must travel to Oswestry.

The lessons are clear—they are revealing. Competition in health care, in the case of the eye service, has resulted in higher prices, a reduction in the numbers treated, and a reduction in the number of places at which to be treated. Heaven help the Secretary of State if, next April, his new market in hospital care has exactly the same results for the public.

The difference between the two Front Benches is neatly expressed in a letter from the recent junior Minister at the Department of Health who has now departed to the Department of Transport—a man for whom I had high regard until yesterday, when I discovered whom he had appointed as his Parliamentary Private Secretary. I therefore have no compunction about quoting the letter that he wrote to optometrists, in which he himself made the remarkably revealing observation:
"The Government does not have a policy regarding the price of private sight test fees. Private sight tests are commercial transactions between the optician and his or her patient.
I hope this clarifies the situation."
It certainly clarifies it. I regard it as an appalling statement by any Health Minister that his Government have no policy on the cost of an eye test. I cannot accept that that important matter of health policy should be left as a commercial transaction. It should be one of the first priorities of health policy that anyone who needs an eye test should be able to get one irrespective of whether he or she can afford the commercial transaction.

In a spirit of charity, I put to the Secretary of State the thought that we all make mistakes. I have made mistakes in my time—one day when we are both retired, I shall tell him what they were. The Secretary of State can be forgiven for being wrong, but he cannot be forgiven for stubbornly refusing to face up to the fact that he has been wrong. Those who loudly deny their mistakes do not prove the strength of their convictions; they only establish their lack of courage.

I have an example for the Government. The state of Alberta also ended free eye tests in July 1987. Twelve months later, it was found that there had been a 30 per cent. fall in the number of eye tests—a perfect parallel with our experience, but there the parallels diverge. The state Government of Alberta had the sense to recognise reality and the courage to recognise that they were wrong. They brought back the free eye test.

It is now the Secretary of State's turn. I wait to hear whether he has the same good sense and the same courage to restore the free eye test that he took away 18 months ago. In the event that he is unable to do so, I end my remarks by correcting yet another of the mistakes in that speech of November 1988. At the end of his speech, the Secretary of State said:
"I do not believe that any future Labour Government will withdraw this charge".—[Official Report, 1 November 1988; Vol. 139, c. 930.]
He was wrong again. It will be one of the first priorities of the next Labour Government to abolish charges for eye tests and to ensure that no one is deterred from getting an eye test because he or she cannot afford it.

4.18 pm

I beg to move, to leave out from "House" to the end of the Question and to add instead thereof:

"supports the Government in its view that those who can afford to pay for sight tests should do so and that the money which was previously spent by the National Health Service on free sight tests for those who could afford to pay is better spent in other ways in improving health care; believes that this will not lead to the nation's health or sight being put at risk nor deter those from seeking sight tests who need them; and fully supports the Government's policy that sight tests paid for by the National Health Service should continue to be available to those on low income, children and those most at risk of blindness from diabetes and glaucoma.".
Care of the eyes is an extremely important part of any health care system and it is important that we do our utmost to ensure that we maintain a high standard of optical services and give everybody the service that they require to protect themselves against glaucoma and the consequences of diabetes, and to preserve good eyesight. That remains the Government's intention, and will be so.

However, with the greatest respect, that argument is stale. It relates to the extent to which we should allow opticians to charge for the eye test that is made before spectacles are dispensed to people who are not in the exempt category and entitled to National Health Service spectacles. The argument is merely a re-run of one that we had last year. Since then there has been no evidence to change the position that I have described. It is a serious mistake for the hon. Member for Livingston (Mr. Cook) to rely so heavily on that point when, for example, committing a future Labour Government—if we should have one—to spending money on this subject. That is a serious misjudgment of priorities which, if ever carried out, would not serve any worthwhile health purpose.

I begin by reminding the House of the effect of the Government's changes. We continued to pay for the eye test for about one third of the population. The major exempt categories were those on low incomes, children, and people susceptible to certain diseases. The remaining two thirds of the population are no longer entitled to go to an optician for an eye test for which the NHS will pay a fee.

The effect of that change was obviously uncomfortable for opticians. When I refer to their vested interest, I am not referring to an illegitimate vested interest—like the rest of us, they are entitled to lobby from time to time in the interest of their cause. However, our change has put the opticians—the multiple chains and the independents—in the position of deciding whether to charge people who are no longer entitled to an NHS sight test and, if so, how much to charge them. We have now had a year of that so we can see where we are when discussing the possible consequences of the change.

I accept that any reputable optician will prefer the previous system—if I were an optician, I expect that I would. Opticians used to have little cards in the window which read "NHS sight tests free to all." That was a perfectly proper, not unprofessional attraction to people to go in and contemplate buying spectacles. It meant that the optician had a guaranteed income from the public purse for every test carried out, at a fee set by the National Health Service and not, therefore, subject to competition for patients among the different outlets. The change has meant that each optician now has to decide whether, and to what extent, to charge. Opticians no longer have those little cards in the window——

I shall give way to the hon. Gentleman in a moment.

A variety of charges has been imposed. I accept that the average is roughly that which the hon. Member for Livingston described. The hon. Gentleman conceded, fairly, that some opticians are offering the sight test free. I cite Duncan and Todd, Hendrys and Lannies. There are other examples across the country——

As the Secretary of State has specifically mentioned Duncan and Todd, I remind him and place on record the fact that Duncan and Todd introduced the free eye test in Scotland after writing to me to seek an assurance that the next Labour Government will abolish the charge for the eye test, on the basis that it could afford the experiment only until the next general election. If the Secretary of State is citing Duncan and Todd, he should remember that the free eye test will not survive the election unless a Labour Government are elected.

That shows that those opticians are worried about weakening the effect of the opticians' lobby on the Labour party. With the greatest respect, the hon. Gentleman's approach to this issue is extremely naive—which is unusual for him. I recommend that he reads the optical press of 12 months ago when the change was made, when many opticians were contemplating much lower charges and free tests. Immense pressure was brought to bear on opticians. I remember a letter that urged them not to play the Government's game. The hon. Gentleman obviously thinks that it is a coincidence that opticians are still charging roughly the same as the NHS fee, except in the cases that I have cited, where free eye tests have already been introduced. Many opticians regard charging the patients who come into their practice less than others legitimately think to be the going rate for carrying out that work to be somehow letting the side down.

When the Secretary of State evaluates the benefits of free eye tests, he seems to ignore the fact that they are very much a part of preventive medicine. Indeed, as one who has experienced being diagnosed as suffering from glaucoma by an optician, I am convinced that that aspect of the eye test is vital. The Secretary of State appears to overlook that completely.

No. I acknowledge it. I urge everyone to have a regular eye test if there is any reason to believe that they need one. I accept that some diseases can be detected by eye tests. We are arguing about whether it is wrong for people outside the exempt categories to pay—most of them—about £10 to £11 once every two years for an important part of their health care. We are debating the consequences of most opticians having decided in practice to continue to charge a fee such as I have described.

I shall respond to the challenge put to me about when competition will become more widespread. I think that it will become more widespread if the Labour party stops supporting the campaign for free eye tests. Opticians are travelling in hope that sooner or later there will be a Government who will give them back the assured income without competition that they used to have. They are extremely reluctant to allow a competitive market to break out when Her Majesty's official Opposition promises, as far as I can see, no explicit extra expenditure on the Health Service except in this unlikely area and on dental checks, which are about the only items of NHS spending to which the Labour party is committed.

I have studied the policy document of the hon. Member for Livingston and I seriously believe that the Labour party is in difficulties. The party is almost bereft of any health policy and is in danger of giving way to professional and sometimes even commercial lobbying when choosing its priorities.

Listening to the Secretary of State on this point, I am reminded of a gentleman whom I and the hon. Member for Livingston (Mr. Cook) came across last night at a public meeting on health. He was a Conservative-appointed general manager who was talking about NHS consultants in a health debate in a different context. Precisely the same thing struck both the hon. Gentleman and me last night as probably strikes the hon. Gentleman about the Secretary of State now. Cannot the Secretary of State realise that, at least in health, and in many other areas of social policy, too, professionals sometimes react to events and seek assurances out of not commercial self-interest but general care about health standards and their patients? Will he acknowledge that for once, instead of accusing experts or professional groups within the Health Service of commercial, mean-minded motives every time they seek to disagree with him when the best interests of preventive health care and preventive medicine might be their priority?

I do not regard accusing people of having, among other things, commercial motives as necessarily a wicked attack on them. Of course, opticians are skilled professional people upon whose care we all depend. Their prime motive is the care of their patients. But by and large spectacles and eye tests in Britain are provided by commercial chains and organisations as well as independent practices. Outfits such as Dollond and Aitchison and Boots Opticians, with which I have had some contact in my constituency, are perfectly legitimate commercial organisations which have a wholly respectable but commercial interest in the outcome of this discussion.

We should all be worried about—indeed, I believe that we all have the same genuine concern, and that the hon. Member for Livingston is mistaken in choosing this cause for that reason—the consequence for health care and preventive medicine to which the hon. Member for Liverpool, Garston (Mr. Loyden) referred. That is where we must turn to surveys. The whole case of the Opposition that we are threatening the eye care of the nation is based on the proposition that the ending of NHS tests for two thirds of the population led to a reduction in the number of eye tests. I shall seek to demonstrate that that is untrue. There is no evidence to support it. It is wrong. The Opposition's case is based on a total myth.

Will my right hon. and learned Friend also tell the House how much revenue comes from the charges and what would be the impact of their abolition on, for example, the number of hip replacement operations?

The cost of restoring free NHS eye tests to two thirds of the population—including everyone in this Chamber who at present faces the wicked burden of paying £10 for an eye test—would be £90 million. The Labour party wants to spend more than the entire budget of a reasonable-sized, English district health authority on giving everyone in this Chamber a free eye test. That is an absurd choice of priorities, considering all the demands that come piling in on the NHS. It is urged because it is said that the number of people having eye tests has fallen since charges were introduced, but that is not the case.

There have been various surveys. The hon. Member for Livingston correctly cited the surveys that are based on information collected from some, but not all, opticians. I do not doubt the bona fides of those who collected it, but the figures are derived from a section of the profession and some of the chains. I suspect that the tendency to respond to surveys is strongest for opticians who lost out in the extremely turbulent market which was created over the past 18 months.

I believe that the profession and some of the chains created that turbulent market. It was also unavoidable. We had a controversial debate about the change. It was flagged up all over the place that charges were to be introduced in April 1989, with the result that a huge number of people were attracted to come for a free eye test while it lasted. Those who campaigned against us while we were contemplating the changes did not point out that many people would continue to be exempt. As we all know and as the profession concedes, the result was a huge increase in the number of people who had their eyes tested before April 1989. The obvious result was a huge drop in the number of people who had their eyes tested thereafter, if only in the short term. A wave effect was created. I remember that some branches of Dollond and Aitchison stayed open till midnight in the last few days while free eye tests were available to encourage people to rush in. As a result, the first quarter of 1989 saw a big increase in the number of tests while the next quarter saw a big decrease.

Some practices were hit by that. It depended on the business acumen and position of those involved. Clearly, if the market is so transformed in the short term, some businesses lose out, some prosper and others are bought up by chains. Considerable turbulence was created in the market, partly by our changes, but greatly aggravated by the reaction of the profession in response to them. Now, after an interval, attempts are being made to establish the level of demand for eye tests as we return to normality.

The hon. Gentleman relies wholly on figures obtained from some opticians which, I am sure, have been subjected to expert analysis. He has ignored the surveys of the public. It is no good saying that it is all market research. If one wants to discover how many people are having their eyes tested, the only way to produce a reliable estimate is to take an independent sample of the public.

The Royal National Institute for the Blind carried out one survey, but the hon. Gentleman did not appear to have read beyond its press release. It carried out a telephone survey of a small sample. The first question was:
"Have you paid for a sight test in the last 12 months?"
That question is not referred to in the press release because the answer made it clear that there was no apparent reduction in the number of people whom one would expect to give the affirmative answer. The RNIB then further questioned those people who said that they had not paid for an eye test in a series of leading questions about why they had not had a sight test. Most people who do not have an eye rest usually do not have one because they have not thought about it. I have had an eye test in the past 12 months, but in the past when I have not, that has been why. The questions heavily suggested that cost was a reason for not having a test. Yet the survey shows that the number who said that they had had an eye test was in line with past trends.

The other survey—which has already been mentioned—was carried out for the Association of Optometrists by MORI. No doubt trying to anticipate the results of our survey, the association had asked MORI to carry out a survey using similar methods, asking people whether they had been given a sight test by the optician—not the hospital or the doctor—since Christmas. Then, like the hon. Member for Livingston, it tried to ridicule the results.

I regret to say that the MORI poll showed that, if anything, the number of people who had had sight tests had gone up since the charges were introduced. Ten per cent. of those polled—equivalent to more than 4 million people—said that they had had a sight test since Christmas. I agree with the hon. Gentleman that that is a startling figure; he is probably right when he says that there was over-reporting, and that we must take off 15 or 25 per cent. to obtain an accurate figure. However, what he did not add was that the figure is so high that, even if that were done, there would still be no apparent drop in the number of people who had had eye tests.

The Association of Optometrists tried to dismiss the results of what was the best survey so far carried out. It said:
"The Association of Optometrists believe that the phrase `since Christmas' is very loose. Christmas conjures up memories of the festive season, which for most people starts in November."
I do not think that most people think that Christmas is in November. When testing the recollection of the general public, it is best to choose some occasion that they may remember, and the phrase "since Christmas" is probably the best way of prompting memory: most people remember what they did before and after Christmas. The idea that "since Christmas" could be thought to include November is—with the greatest respect—a fatuous attempt to discredit the evidence. Even if people's recollections are incorrect and a proportion of respondents are discounted, there is still no evidence of any decline in demand.

As the Secretary of State has quoted the Association of Optometrists directly, will he do two things? First, will he note that the views with which he takes issue were not obtained by means of amateurish opinion polling, but have been verified by MORI—I hope that he would agree that MORI probably knows more about opinion polling than any of us—and the Association of Optometrists? Secondly, will he respond to another point in the press release to which he referred? The Association of Optometrists and MORI argue that, to focus the question directly, the phrase should have been "since December 31". What does the right hon. and learned Gentleman think?

I have not yet had a chance to contact Bob Worcester of MORI to ask whether he agrees with the phrase "since November". As for the second part of the hon. Gentleman's question, asking people to remember whether something happened after 31 December is less likely to produce an accurate answer than asking them about what happened "since Christmas". Most of us cannot remember exact months or dates. Even if we allow for over-reporting, the survey does not demonstrate any evidence of a reduction in the number of sight tests; quite the reverse.

As the Secretary of State seems to be spending all his speech denigrating those who have sought to reach the truth, will he in the next few minutes give any fresh information that he has perhaps sought himself?

It will be my pleasure to do so. The Government—fulfilling an undertaking that was given when the original Bill was being discussed—have carried out their own survey, which we delayed until the market had settled down and the wave effect had shown some signs of coming out.

We asked NOP to conduct a survey on behalf of the Department into the number of NHS and private sight tests during the first three months of this year. We released the results of that survey today and the details have been placed in the Library. Five sets of surveys were carried out in March and in April and 10,000 adults responded to the NOP questions. It is quite the best sample survey to have been carried out so far and it is adequate for any statistical purposes. The results have been made available together with wholly independent comment on the surveys by the Government statistical service.

The survey asked whether a person had had a sight test since Christmas and, on the basis of the response to that question, some 5 million people had their sight tested in the first three months of this year. That is a startlingly high result. If one extrapolated from previous trends up to 1987, only 3·5 million people should have had their eyes tested in that time. The result implies a substantial increase in the number of people having eye tests compared with the years up to 1989.

The results of the survey are startlingly high. Almost certainly it contained an element of over-reporting and therefore one must discount the results to some extent. The hon. Member for Livingston said that there had been between 15 and 25 per cent. over-reporting and attempted to demonstrate that that rubbished the MORI poll. I pointed out that even that level of over-reporting does not rubbish the poll as it still gets one back to the trend in the number of eye tests that existed before 1987.

If one discounts the figures in the NOP poll by 15 per cent. it still means there has been a great increase in the number of people having sight tests. If one makes the ludicrous assumption that half the people involved in the survey were wrong about when they had their sight test, one still gets back to the trend that existed before 1987. On any view the survey shows that the number of sight tests in the first three months of the year is at least well in line with the increases in the 10 years to 1987.

The past 15 months have been entirely consistent with what any reasonable person might have expected. Before the changes were introduced there was a rush and an abnormally high number of people had a sight test in the first three months of 1989. There was then an inevitable dip, after which the number of sight tests has recovered to its former normal level. I intervened in the speech of the hon. Member for Livingston to say that I did not believe that he has a shred of evidence to contradict the surveys that have been carried out. To date three surveys have been conducted and they all show that the number of sight tests undertaken remain about the same. The hon. Gentleman's case is based on an absurd mistake in response to lobbying from the profession.

On a point of order, Mr. Deputy Speaker. The Minister said that the documents relating to the NOP survey are in the Library. I went there because I wanted to have a look at that survey, but it is not available.

Further to that point of order, Mr. Deputy Speaker. You were not in the Chair at the beginning of the debate, but had you been, you would have seen the Parliamentary Private Secretary to the Secretary of State scurrying round the Chamber handing out the documents to a number of Conservative Members. Could it be that those documents include the report on the NOP poll to which the Secretary of State referred? If so, information is being given to Conservative Members which has been denied to the rest of the House.

I deprecate hon. Members scurrying round the Chamber slipping out pieces of paper, but I have no knowledge of their contents—they might have been betting slips for all I know. I am sure that the Secretary of State is ready to comment on the point made by the hon. Member for Linlithgow (Mr. Dalyell).

One hundred copies of the report are available in the Vote Office. My advisers intended to place them there at the end of my speech, but they will put them there now if hon. Members want that.

I do not mind that. The hon. Gentleman will have an opportunity to speak later and I shall look forward to hearing how he can dismiss the evidence of three public surveys to show that there has been no fall in demand. Presumably he will say that he prefers the returns from 10 per cent. of opticians. I shall greatly look forward to hearing what the hon. Gentleman has to say.

It is total nonsense to keep asserting that people are not having eye tests, but that is the basis upon which the Labour party is committed to spending £90 million of public money, for no worthwhile health advantage.

The Secretary of State has repeatedly said that we have produced no evidence, but he knows perfectly well that we have produced voluminous evidence collected by people of impeccable independence and with statistical experience. He chooses to say that all that evidence is worthless because it stems from optometrists, all of whom are in a grand conspiracy to distort the figures. I have produced figures from 1,600 outlets of optometrists who carry out eye tests and they consistently report a decline in demand. As the right hon. and learned Gentleman has waved aside all those 1,600, can he produce a single optometrist whom he has consulted and a single set of figures from any batch that he can reconcile with the wholly incredible results of his opinion polls?

I have already dealt with the evidence, upon which the hon. Gentleman is relying, that comes from some sections of the profession which have responded to the poll. The hon. Gentleman is rendered speechless by the accounts I have given of the surveys—two of which he knew about—of the public which show that there is no evidence to support his case. The hon. Gentleman has again repeated his commitment that a future Labour Government will spend £90 million on eye tests. In terms of the NHS that sum is a staggering resource as it greatly exceeds the total budget of many district health authorities.

The NHS is well financed now—better than it has ever been—and I expect more to be spent on it. If I had £90 million more at my disposal eye tests would not figure on the first several pages of my priorities for expenditure. The hon. Gentleman has a problem because he cannot get his colleagues to agree to a commitment to spend more on the NHS. The shadow Treasury team is to be congratulated for showing common sense. I do not normally congratulate them, but they realise that following a period when cash spending has gone up by 20 per cent. in two years it is not possible for any Government of any party to contemplate increasing spending at a faster rate than that.

The hon. Member for Livingston has been trying to wriggle out of that problem and I think that he has been in trouble with his colleagues from time to time. Until recently he kept on trotting out a figure of £3 billion that might be produced during the lifetime of a Parliament. Obviously he has lost that argument because when one looks at the Labour party policy document no figure of any kind appears. There is a vague reference to underfunding, but it might take more than the lifetime of a Parliament to put that right. The Labour party is not promising to spend more on health. With the greatest respect to the hon. Gentleman, all that he manages to get in a vague, short and lightweight passage on health is a promise to restore free eye tests and free dental checks. That represents an astonishing set of priorities. I should imagine that the hon. Gentleman got that past his Treasury colleagues with his argument that one can save about £50 million by restoring the free eye test. This afternoon we have exposed that argument as wrong. On that occasion the shadow Treasury team showed a lapse in concentration.

There is no evidence to suggest that the restoration of free eye tests would increase the number of tests undertaken. Therefore, one would increase the number of tests undertaken. Therefore, one would not detect any disease quicker and there would be no saving to hospitals, but that is the argument that the hon. Gentleman appears to have swung across his hon. Friends when drafting the policy document. I hope that the hon. Gentleman will go away and decide whether it is wise for the one and only spending commitment of the Labour party to be devoted to saving £11 every two years for at least a comparatively better-off section of society.

The commitment given by the hon. Member for Livingston (Mr. Cook) is in direct contradiction to the statement of the hon. Member for Derby, South (Mrs. Beckett) a couple of months ago that there were only two spending commitments by the Labour party, and the restoration of free eye tests was not one of them. Surely this is just like the promise to abolish prescription charges in 1965; those charges were abolished in 1965, but they were brought back in 1968 and were set 25 per cent. higher than in 1965.

I am grateful to my hon. Friend for reminding me of the speech of the hon. Member for Derby, South (Mrs. Beckett). If my hon. Friend continues to scrutinise the speeches of Labour's Treasury spokesmen, he will see that they do not mention health at all. There is no commitment by the Labour party because it would not be possible to exceed our spending plans. The hon. Member for Derby, South must have had a momentary lapse when she allowed this commitment to pass. I hope that when she sees the results of the various surveys she will reconsider her position.

Our priorities are to make a better National Health Service, to expand services generally and to devote money to the cause of better patient care, including eye care. Labour's campaign is stale. It is based on a false premise and should be abandoned. Now that we have become used to free eye tests only for those who need the support of the Government, any sensible level of priority should tell us that that is where we should leave the matter.

4.52 pm

I propose to be brief and mainly to confine my remarks to my constituency. Charging for sight tests has placed a financial restriction on public access to a primary health measure. The imposition of the charge has deterred people from taking early steps in perhaps preventing the need for more treatment later and in the early detection of more serious conditions such as hypertension, one of the most common predisposing causes of a stroke, and glaucoma, which is a potentially blinding disease but often treatable. We are told that prevention is better than cure, but paying for access to preventive health care has deterred many and they run the risk of having treatable medical conditions go undetected at an early stage.

I carried out a survey, but perhaps I should have gone to dentists and asked them for information because what the Secretary of State said suggested that information given by opticians cannot be trusted. I went to opticians in Durham and carried out a small survey. I found that at its worst 60 per cent. fewer people were attending for eye examinations than in the year before the charges were introduced. Most disturbingly, the figure proved to be higher for old-age pensioners, especially for those who were not in receipt of income support. Those people have had their right to a free eye test withdrawn and are most likely to suffer the consequences of developing sight-threatening conditions through being discouraged from attending for routine eye examinations. To discourage such people is monstrous, given that many sight-threatening conditions are treatable after early detection.

The Secretary of State does not seem to take any notice of or accept any information supplied by opticians. Letters that I have received from opticians in my constituency show that they are deeply worried. I wrote to every optician in my constituency and they all expressed misgivings. A Mr. Grundy, who has two practices in my constituency, wrote to me saying:
"I am very concerned that because these people are now discouraged from attending for routine eye examinations by charges, they are at much greater risk of developing sight threatening conditions which would in the past have been prevented by early detection and treatment."
I accept that the Secretary of State does not place much credence in that, because it is only a letter from an optician, but it is a damning comment on the situation.

Figures from a practice in my constituency show that 170 old-age pensioners who were not in receipt of income support attended for eye tests in the three months leading up to the introduction of charges. In the three months after the introduction of charges the number had dropped to 63. Even taking into account the distortion of the statistics caused by people rushing to get a free eye test before the charges were introduced, there is undoubtedly a marked drop in that practice's normal testing figures.

A worrying aspect of the survey was that a large proportion of the missing numbers were people who received income support but apparently did not realise that they were entitled to a free eye examination. Obviously, that can be serious for pensioners. At one practice the number of old-age pensioners receiving income support had dropped from 86 in the months leading up to charging to 56 after the introduction of charges. I was told by another practice that the receptionist was spending a great deal of her time trying to allay the fears of worried pensioners who did not know their entitlement and for whom the £11·20 is far beyond their means. Unfortunately, only a proportion of those worried pensioners found that they could have a free sight test. The rest, those not in receipt of income support but nevertheless without the means to pay, had to face the decision that they would have to do without the much-needed sight test.

I earned out a similar survey in my constituency and it produced exactly the same results. It showed a reduction of up to 30 per cent. in the number of people going for eye tests. The Secretary of State does not accept the evidence of opticians, but one optician referred to me the case of an 83-year-old woman who thought that she was not entitled to a free eye test. When she realised that she was, the optician examined her and found a tumour in her eye. She was referred to the eye hospital in Manchester and was told that the tumour was so large, because of the delay in having the eye test, that she would probably have to have the eye removed. Is that the sort of health care that we can expect from the Government? Pensioners are scared to go for eye tests because they cannot afford the cost.

I thank my hon. Friend for his intervention. He gives an example of what can happen if an old-age pensioner or anybody else does not get an eye test in time. There are hundreds of such cases throughout the country, and unless the Government recognise what is happening such stories will become all too familiar.

The figures that I have quoted cover the six months from January to June 1989. When the figures are broken down month by month, it is seen that, in the months before charging, the average number of pensioners attending for routine eye tests ranged from 11 to 29. In April, the month in which charges were introduced, the number attending fell to just one or two pensioners. That was true for every practice that supplied me with information. In the following months of May and June, the figure rose to an average of six or seven. While the initial refusal or inability to pay for sight tests waned slightly, the fact remains that the number of people attending for sight tests has halved. The situation today has hardly improved.

It is an inescapable fact that a sizeable proportion of people, mainly pensioners, no longer attend their optician for a routine eye test. There is no doubt among opticians with whom I have been in contact that there has been no improvement in the past 12 months. While charges remain and while pensioners have to set aside part of their income for the poll tax, there will not be a full return to the pre-April 1989 figures. If nothing else, the Government must consider making all pensioners exempt. Out of a small income, pensioners cannot pay their proportion of the poll tax and pay for a sight test. They will have to make a choice and, as they have to pay the poll tax, they will have to do without the sight test.

Mr. Grundy told me that one of his practices used to rely entirely on pensioners. Now he does not see one pensioner at the practice and has had to reduce the opening times to two days a week. Regular patients at that practice no longer attend, and he attributes the loss purely to the charge for eye tests.

So that I cannot be accused of distorting the statistics by quoting figures for the three months before charging was introduced, I shall quote figures given to me yesterday by Mr. Grundy which leave no doubt about the destructive nature of the charge for eye tests. In January 1988 and January 1989, before the charge was introduced, there were 108 and 118 sight tests respectively. In January 1990, after the charge was introduced, there were 80 sight tests. In February 1988 and February 1989, the figures were 120 and 112 respectively and in February 1990 the number was 68. In March 1988 and March 1989, the figures were 102 and 135 respectively, while in March 1990 the total had dropped to 77.

The figures speak for themselves. In each instance there has been a monthly reduction of between 40 and 60 sight tests following the introduction of charges. That is proof, if proof were needed, of inability and reluctance to pay for a service which should never have been costed. In my constituency—I am sure that it is not unique—there has been a 30 per cent. fall in the number of sight tests. Primary health care is all about prevention and it is imperative that people and prevention are put before pounds.

It is clear from my research and the evidence that has been given to me that the eye-test charge has had a serious effect on the number of people attending opticians. The argument used by some Conservative Members, including, the Secretary of State—I remember clearly the occasion on which he first advanced it—was that market forces would result in so much competition between opticians that charges would be eliminated. That has not happened yet and we wait for evidence that it will. In effect, opticians got together and set the charge for their area. That is not meant to be a criticism of opticians. It is a matter of fact and a natural thing for them to do. They had to do it because there was no alternative.

The criticism must be directed to where the blame lies, and that is with the Secretary of State and the Government generally. There can be no justification for charging for a primary health care measure, especially for one which is able to detect serious medical conditions at an early stage.

It is an especially important test. Even in terms of the Government's philosophy, the charges are not cost effective. It can be said only that the charge is vindictive and that it hits old people in particular. It should be abolished forthwith.

5.2 pm

There are few things that I like less than speaking and voting against the Government. I am happy to say that it is a rare occurrence when I have to do either of those things. For about 99 per cent. of the time I agree entirely with what they do and I support them in Divisions with great enthusiasm and faithfulness. I believe profoundly, however, in following my convictions, and one of my convictions is that one serves the party better by putting convictions above the diktats, arm twisting or threats of the Whips. As I have said on every occasion when charges for eye tests have been debated, the Government are wrong, and for at least seven reasons.

First, charges for eye tests breach the basic principle, which was adhered to for over 40 years, that whatever else is chargeable within the National Health Service, a check or test should be free. I have no objection to charges when a check or test has revealed that glasses or other appliances are necessary, so long as the individual can afford to pay. It is very much to our advantage to know as soon as we can if a person needs attention. It is cheaper to remedy the defect at an early stage and it is very much easier to deal with it. It is also much more likely to be cured.

Secondly, eye-test charges are extremely discriminatory. There are no charges for blood tests, cancer checks, heart scans, barium meals or X-rays. It has been suggested that anyone can afford to pay £12 for a test because some people spend that much on cigarettes, but that argument could just as easily be applied to all other vital tests. It is odd that the Government seem not to understand that eye tests will often reveal the early signs of cancer, blood pressure or diabetes. It is strange that a block should suddently be imposed on one preventive test while other such tests romp along without interference. I do not know whether this means that eventually we are to have charges for other checks. I should like to know whether they are to be introduced.

Thirdly, the money that is saved is not to be spent on projects for which greater need is claimed. It has—[ Interruption.] I hope that my right hon. and learned Friend the Secretary of State will listen, because I am speaking with great conviction. It has been made clear in earlier debates that the money that is saved—it had been estimated that it will be about £70 million per annum—will be spent on preventive medicine. It seems that it will not be spent on hip replacements or anything of that sort. Ministers have said that the money saved will be spent on preventive medicine. But eye tests are preventive medicine. It seems that the Government are saying, "We are saving money on food to spend it on food", or, "We are saving money on clothes to spend it on clothes." I am prepared to admit that there are different and more valuable types of food, or types of clothing, but surely there is no suggestion that eye tests are an inferior form of preventive care and do not amount to important primary health care. It is nonsensical to say that we are saving money on preventive care in the form of eye tests so that we can spend it on other forms of preventive care.

Fourthly, it has been recognised and accepted—my right hon. and learned Friend the Secretary of State has not suggested otherwise—that eye tests can reveal the first signs of many serious diseases. There is no doubt about that. It seems absurd that we should be denying ourselves the ability to spot the first signs of important diseases such as heart disease and cancer by introducing charges. That action has led undoubtedly to a reduction in the number of people seeking eye tests. My right hon. and learned Friend has argued that there has been no reduction, but I must tell him that there are signs that he is wrong. Indeed, the signs cannot be doubted. It worries me that the evidence has been discounted because some of the data have been obtained from opticians. The survey of the Association of Optometrists and the Federation of Ophthalmic and Dispensing Opticians revealed a 32·4 per cent. reduction in the number of eye tests being carried out. The Government's statistics are not suspect—they are plainly inaccurate.

I tabled a question in which I asked my hon. Friend the Minister for Health whether she would ensure that the survey, which has been referred to by my right hon. and learned Friend the Secretary of State, of the number of tests carried out during the first quarter of 1990 would be based on information obtained from the records of ophthalmic opticians instead of the recollection of patients. My hon. Friend replied that the information would be obtained from patients to ensure that the results were clearly independent. Any medical practitioner in any area of medicine will cheerfully tell my right hon. and learned Friend the Secretary of State that memories are notoriously fallible when determining when a test or check was carried out. It is not uncommon for a doctor to ask a patient when he or she last came to the surgery and to be told that it was two years ago, when in fact it was four years ago. And when a patient says that it was four years since he last came to see the doctor, sometimes it is really eight years. People cannot remember accurately. It seems extraordinary to reach important conclusions on the basis of people's memories.

I could understand my right hon. and learned Friend discounting the statistics given by opticians if they had relied on their memories, but they had not. They relied on their records. I strongly resent any suggestion that ophthalmic opticians—professional medical men—would falsify their records for the purpose of the survey.

It is a question not just of falsifying statistics for the purpose of this debate but of defrauding the Inland Revenue. If it is true that ophthalmic opticians are deliberately altering their records, something is seriously wrong.

Did the hon. Lady notice that the Secretary of State shook his head vigorously when she made her point about opticians' records? Perhaps she will ask the right hon. and learned Gentleman whether he thinks that opticians are doing something that borders on the deceitful. Are their records sincerely and accurately kept, or are they not?

My right hon. and learned Friend's speech will be read with great interest outside this House. He said that the profession was honourable but that he discounted its statistics because the profession itself had produced them. Surely that is the same as saying that the opticians falsified their records. That is the only possible interpretation that one can place on his remarks.

Three public surveys have shown that the opticians' figures are wrong. We are debating why they are wrong. It is not for me to comment, because I have not even seen the full results of the survey, but it was not based on records from all opticians. It was based on returns from some opticians. I offered as the most likely explanation for the discrepancy that the opticians most likely to respond to the survey were those who had lost out in the competitiveness of the past two years. The country is full of newly opened opticians' shops.

My hon. Friend the Member for Nottingham, South (Mr. Brandon-Bravo) reminded me that one has just opened in the centre of Nottingham. I do not know to what extent those new businesses responded to the surveys, but they are responsible for the loss of trade by one practice in Durham, which now opens only two days a week. I am making the point that there were three excellent public surveys showing the level of the public's use of outlets, and showing also that the figures produced by the Association of Optometrists were inaccurate.

The "excellent" surveys to which my right hon. and learned Friend refers were all based on memory. I make the point that memories can be fallible, whereas the records of a practice set down in black and white cannot possibly be challenged.

Does my hon. Friend agree, as the hon. Member for the City of Durham (Mr. Steinberg) ought to do, that whereas the records of one practice provide an accurate picture of the number of people who have had their eyes tested there, the best way of identifying how many members of the general public have had eye tests is to question the general public? Opticians' practices are opening and closing all the time. One only has to walk down the high streets of England to see that the nature of optical practice is dramatically changing.

My right hon. and learned Friend may believe that opticians' practices open and close as easily as that, but I assure him that the ones with which I have been connected have been in business since the very beginning of the profession.

The Secretary of State suggests that I wrote to only one practice. In fact, I wrote to virtually every practice in my constituency, and I received a similar reply from them all. I cited one practice as an example, but I could have cited half a dozen more.

I believe that the hon. Member for the City of Durham (Mr. Steinberg) also mentioned that there were slight differences between the responses that he received, which is something that my hon. Friend the Member for Staffordshire, South-East (Mr. Lightbown) will be pleased to hear. He imagined that the responses were all exactly the same, and I am glad to have confirmation that they were not.

Another point of significance in view of my right hon. and learned Friend's remarks is that 10,000 people were involved in the Government survey whereas the AOP survey covered 4 million people. I cannot believe that—surprise, surprise—they all just happened to say much the same thing.

I again draw the attention of my right hon. and learned Friend to the Economists Advisory Group report. The hon. Member for Livingston (Mr. Cook) made mention of Professor Peter Hart, who is surely a reputable man, and one who works, as a statistician, in an honourable profession. He is emeritus professor of statistics at Reading university, and a man of his calibre who produces a report on behalf of the Economists Advisory Group can surely be relied upon to give an honest answer.

Professor Hart reported that the number of people undergoing tests since charges were introduced has declined by 32·4 per cent. The hon. Member for Livingston conceded that there was a sharp increase in the number of tests when the public knew that they would shortly be charged. Even so, that jump is estimated to have accounted for fewer than 1 million additional tests. Therefore, whereas the number of eye tests in 1988–89 was 13·2 million, the usual number was 12·2 million annually. Presumably it is fair to say that the extra 1 million tests are accounted for by people trying to beat the charges. In any event, in 1989–90 the number of tests fell to 8·9 million. That must be a source of worry and concern to my right hon. and learned Friend. That is hard data—3·3 million people, more or less, have been deterred from having eye tests.

Fifthly, it is untrue to say that people who are not eligible for free tests can easily afford the £12 fee. My right hon. and learned Friend argued today that it is likely that tests will eventually be free—but that cannot happen, for two reasons. One is that, as a result of laws passed by our Government, anyone is entitled to go to an optician, undergo a test and be given a prescription—and then take it down the road to a spectacle bar and have it made up there. It is breaking the law for an optician to say, "I will test your eyes provided that you buy your spectacles from us." First, opticians may not get any return or any possibility of a return when they have spent time and professional expertise on testing someone's eyes. Secondly, some 20 to 25 per cent. of all people who go to have their eyes tested do not need glasses, and therefore opticians would not be able to recoup any funds. A figure approaching 50 per cent. of ophthalmic opticians' time could be spent on such people, and if they did tests for nothing they would get no return. How on earth can professional people who have trained for some four years, and who know what they are about, open a practice and keep it open and pay receptionists and all the other charges involved if they get no return for 45 or 50 per cent. of the time that they work? It is not feasible.

I must tell my right hon. and learned Friend that it is highly unlikely that eye tests will ever be free. I do not understand why he said so, unless, perhaps—this thought just struck me—he is saying that people who need glasses would pay extra to make up for other people having tests free who did not need them. There is no other way of achieving free tests.

Sometimes I think that we do not all understand how difficult some people find it to make ends meet. We should always be sympathetic to that. People are being pressurised by mortgage costs and have all sorts of other difficulties to meet in their financial lives. Not everyone who is not entitled to a free eye test has no problem in finding £12 and we have to recognise that. It is not even a case of tests once every two years, because some people need them every six months. A woman who wrote to me recently was in that position because of a congenital eye problem, but she was not eligible for free tests.

I have always worried about the problems of parents, who put their young and growing children first. I wonder how many of us know what it is to keep a young child in shoes, never mind anything else. I am quite sure that many parents will say that there might not be anything wrong with their eyes this time, and "Johnny needs new shoes".

The other category of people who worry me are the elderly. There is no doubt that they are up to five times more likely to suffer from eye disease or degeneration than younger people. While it is perfectly true that not all elderly people need help from the Government, why do we give elderly people free prescriptions? If they are old-age pensioners they get free prescriptions whatever their income. Yet it would be fair to say that many prescriptions are not as important as having an eye test. Why have free prescriptions but make people pay for eye tests? Many old persons may well go blind if they cannot afford an eye test and that worries me greatly.

People can have free eye tests at hospitals, and more and more people outside this place will recognise that and ask their doctors to give them a chit to get such tests at the hospital. We shall be in trouble because the cost of a hospital eye test to the Government is somewhere between £25 and £50. I have checked that and there is no doubt about it; it is true. Where is the economic sense of paying up to £50 for someone to have an eye test in a hospital, but failing to pay £12 to a trained ophthalmic optician to do the test instead? Pretty soon, pressure on eye departments will cause problems, because people will wake up to the fact that they can have free tests there. I do not believe that they have realised that.

My final point knocks on the head for ever my right hon. and learned Friend's obviously sincere belief that there has been no drop in the number of eye tests. Practice closures can be seen all over the country. Some 250 practices closed this year and many rural areas will be without an optometrist. I must warn hon. Members about that. There seems to be a general disinclination in this place to love opticians. I sometimes wonder how many hon. Members, or their mothers, were frightened by an ophthalmic optician. There has been a sustained campaign against opticians. However, it is true that if the closures, which are now inevitable, take place in rural areas, many people who desperately need health care, and who are entitled to get it for nothing, will not be able to get that care. That also worries me.

I predict that there will probably be a loss of some 10 per cent. of ophthalmic practices within the next year because many of them are now working from hand to mouth. However much my right hon. and learned Friend tries to deny it, it is true that many ophthalmic opticians are going out of business. That is neither wise nor right. I beg my right hon. Friends in the Government to consider the possibility of helping the aged, who are in far greater danger than anyone else. If they cannot do anything else, for goodness' sake will they give special help to pensioners?

5.27 pm

The hon. Member for Birmingham, Edgbaston (Dame J. Knight), as is traditionally the case, speaks on this subject with detailed insight and common sense. However, perhaps what is most significant is that, as the first speaker from the Conservative Back Benches, she spoke not one word of support for her own Secretary of State. Not that that is liable to sway him, as he does not seem to be a Secretary of State who wants to listen to information or to consult individuals or organisations in various fields of health care. Indeed, he has something of a track record, and clearly delights in the way that he does not consult those people with knowledge within the field of his ministerial responsibility whom common sense would suggest that he should consult.

If one wants to buy a car, it is likely that one will want to ask friends who drive motor vehicles how they find different cars, and to discover the consumer and public view. The chances are that one will also speak to a car salesman or a mechanic. Similarly, the Secretary of State today laid weight upon a survey which has just been published at last. I find it a completely frustrating feature of this institution that, on the day that we are debating the issue, the information on which the conclusions in the Secretary of State's speech are based becomes available only when his backside hits the green leather at the end of his speech. That does not make for well-informed debate from Conservative Members or from the Opposition.

In the latter stages of his speech, the Secretary of State was like a drowning man clutching at the one piece of flotsam floating past.

Let me explain, in case it is thought that publishing it today was a device, that we intended to publish the survey next week. The hon. Gentleman knows that at the last minute the Labour party decided to table this motion. As my enemies had delivered themselves into my hands by returning to this corny old subject, I was unable to resist the temptation to bring it forward today. It contains the best and the most accurate information that anybody has to hand about the number of people having eye tests.

There is a veneer of plausibility about that, but it contains a number of extremely contentious points. I concede that the topic for debate was changed at short notice, but even if it had been known that the debate would be held at the end of this year, the Secretary of State would not have made the information available until the end of his speech on that occasion.

Does not the hon. Gentleman at least welcome the fact that the debate was brought forward because of widespread and serious concern about the topic?

I agree with the hon. Gentleman.

The Secretary of State is unwilling to consult those who are most affected and those with the best knowledge—the opticians. The Secretary of State's report, published today, refers to the survey of over 1,700 opticians that was carried out by the Liberal Democrats some months ago. On 17 May 1990, the Under-Secretary of State for Health wrote to me thanking me for enclosing the results of the Liberal Democrat optical survey, but he echoed the Secretary of State's argument that there is no point in consulting the professionals because they have an axe to grind. The only people whom the Government want to consult are the consumers; that is the only way to get the answers that the Government want. The Under-Secretary went on to say:
"It would, therefore, be wrong to rely entirely on information supplied by providers alone."
According to the survey that we have heard about this afternoon, it is quite all right for the Secretary of State to rely entirely on information provided only by consumers. The sense of that, both in the English language and in terms of the Government's health policy, is that the Secretary of State is trying to get a judicial blend in order to inform his actions concerning what both the professionals—the optometrists—and patients have found out for themselves. The optometrist surveys that have been referred to in the debate unanimously gave a thumbs down to the Secretary of State's policy. The Secretary of State's survey of consumers alone provides different information and he bases his entire argument on that information.

That is in complete contrast to the logic of the statement made to me on 17 May by the Under-Secretary of State for Health. Dismissing all the surveys that had been made before the Department of Health survey, which has floated down, like manna from heaven, on to the Secretary of State's lap today, the Under-Secretary of State for Health said on 17 May about all the previous surveys:
"They cannot at this stage be taken as a serious indicator of future trend."
By 6 June, the one survey that the Secretary of State has come out with is the definitive indicator of future trend. It is the one to end all arguments and all debate. That is the kind of nonsense with which we are being entertained by the Secretary of State and his colleagues in the Department of Health.

The Secretary of State quoted selectively from today's so-called definitive five-star results. According to the summary on the front page:
"Whilst there is a disparity between NOP's results for NHS sight testing and the known number of NHS sight tests paid for in the first quarter of 1990, there is no evidence, from this survey, of a fall in sight testing in the first quarter of 1990."
A little more detail about the disparity is to be found in paragraph 6.2:
"The disparity between NOP's results for NHS sight testing and the known number of NHS sight tests paid for casts some doubt on the credibility of the results."
I am happy to let those who devised and carried out the survey speak for themselves.

The Secretary of State has ignored the Association of Optometrists, the British Medical Association's ophthalmic committee and the Royal National Institute for the Blind. He bases his entire argument on the survey that has just come into his hands. However, the hon. Member for Edgbaston made the forceful point that many of the questions asked in the survey were unlikely to elicit an accurate response because they depended on human memory rather than on factual information provided from the records of optometrists and opticians.

The hon. Gentleman rightly draws attention to the fact that the Secretary of State's NOP survey shows that there is a clear discrepancy. What he has failed to allude to is the scale of that discrepancy, which appears to be quite colossal. Perhaps the Secretary of State, or the Minister of State who is to wind up the debate, will comment on it. According to paragraph 6.1 of the NOP survey:

"The estimate of NHS sight tests derived from the NOP survey can be compared with data collected from FPCs and Health Boards. 1·058 million were paid for by FPCs in England and Wales and Health Boards in Scotland in the first quarter of 1990. Of these, 0·624 million were adults aged 16 or over; this represents 1·4 per cent. of the adult population. The first two surveys conducted by the NOP suggest that 4·5 per cent… of the adult population had an NHS sight test in the period."
In other words, the NOP survey shows more than three times as many people saying that they remember having a sight test since Christmas than the Secretary of State's own figures suggest. Therefore, I query what value can be placed on the document.

The hon. Gentleman ought to be given a knighthood. I very much welcome his intervention. The Secretary of State is uncharacteristically silent. I have read the speech that the hon. Gentleman made on the subject in a previous debate. I believe that he has touched on a pertinent point. Whether we shall receive a pertinent answer remains to be seen.

I had not realised that my interventions were so popular, which is why I remained silent. The explanation is contained in the report. Many people think that the sight test that they pay for is an NHS sight test. The survey is not reliable in terms of the figures that it publishes about how many people have had NHS or private eye tests. We are concerned with the total number of eye tests. As I said in my speech, one could knock off 50 per cent. for errors. We could find every reason that we liked for error, and we should still come up with a figure that showed no decline in the number of eye tests, compared with the expected trend.

As I am sure the hon. Gentleman appreciates, inflation and interest rates are going up, so why should not the margin of error here go up by a similar amount? That is a feature of the running of the country by this Government.

The hon. Member for Edgbaston made a legitimate case, but the Secretary of State has not responded to it. He has produced a fail-safe survey. It does not purport to be fail-safe, but it is based on individual human memory as opposed to facts held on record by opticians. There can be no doubt which survey is more accurate.

I would concede that simply to consult opticians, as we did in our survey, does not give as good a result as consulting a proper statistical blend of customers and opticians as it is reasonable to draw on customers' impressions as well. However, the input of opticians is critical to any set of findings, whatever proportion of those findings they represent.

The simple truth is that the opticians provide the only reliable facts available. Statistics drawn from the public are bound to include impressions, whereas the opticians provide hard evidence. If the Secretary of State is seriously questioning the accuracy or veracity of the facts provided by opticians, as he did in his speech in reply to the hon.

Member for Livingston (Mr. Cook), he is bound to be casting some aspertions on the opticians. There are no two ways about it, and he cannot get away from it.

I adhere to the view that, whatever one may say about the various surveys that have been carried out, including our own, to base his entire argument, as the Secretary of State has done today, on one survey in preference to or in complete opposition to all the other surveys is surely bizarre and wrong-headed in the extreme.

Given the Secretary of State's track record and the way he goes about things in the Department of Health, I suspect that he did that simply because it is the only survey so far that has given him a fig leaf against the warnings uttered to him by his own Back Benchers and from the Opposition. I suspect that, yet again, as he did with the nurses and the ambulance men in the past and as he continues to do with family doctors, he has now picked another group of professionals in the Health Service and offended and alienated them by the tenor of his remarks today. He will live to regret it, as preventive health regrets the decision to introduce these wrong-headed charges on 1 April 1989.

5.41 pm

I shall not detain the House for long, but I want to make it absolutely clear that I reject what has been said by the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) and by my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight). I have always believed that it is right in principle to charge those who can afford it relatively small amounts of money at the periphery of the National Health Service. That policy was started not by the present Government nor the last Labour Government but by the post-war Labour Government. That Government recognised that it was important to raise additional funds which could not be sustained out of general taxation because of the bottomless pit with which the Health Service is sometimes faced, and successive Governments have followed that principle.

My right hon. and learned Friend the Secretary of State has courageously and correctly faced up to the fact that the Department of Health can raise an additional £70 million of expenditure for primary health care from people like me.

I have been wearing glasses for the past two years. I came to the House in 1979, and at the age of 27 I had the good fortune of not needing to wear glasses. By pure coincidence in 1988 I was driving my car through Lincolnshire when I heard on my car radio that Lincolnshire police were planning to conduct spot sight tests for drivers. I was frightened and worried and decided to have my eyes tested. My right hon. and learned Friend the Secretary of State paid for me to have a free sight test, notwithstanding the fact that I cheerfully paid £98 for my glasses.

The hon. Member for City of Durham (Mr. Steinberg) mentioned various statistics. In 1988 an individual from the constituency of Brigg and Cleethorpes went to an optician in Pimlico for a free eye test. I have not had my eyes tested since; I was issued with these glasses two years ago and no doubt I shall receive a card from the optician inviting me back for a periodic eye test. I am a classic example of somebody who has no business to be receiving taxpayers' money for an eye test. I went to have my eyes tested in 1988 and I have not had them tested since. That is why statistics in Durham are producing those results.

I am sure that, on reflection, my hon. Friend will appreciate that his free eye test was paid for not by the Secretary of State but by the taxpayer. While he and the House will accept that no one is arguing today that those on above average earnings, such as himself or the printers in Wapping and what is left of Fleet street, should get taxpayers' money to pay for their eye tests, would he regard it as reasonable and right that one of my constituents who is earning less than a quarter of average earnings should be required to pay the full cost of a sight test? I cannot accept that. That individual should be entitled to a free eye test.

Plainly, my hon. Friend has not read the motion that we are debating. I am opposing a motion which

"calls upon Her Majesty's Government to restore a free preventive service for eye examinations."
In 1988, quite wrongly, the taxpayer—my hon. Friend is absolutely right about that—paid for me to benefit from such a service. So, with great respect to my hon. Friend, unless we amend it the motion is inviting us to do that and that is why I believe that it should be opposed.

My hon. Friend the Member for Edgbaston argued wrongly for free eye tests for all pensioners. I know that my hon. Friend looks very youthful, but I believe that she would be entitled to such a free eye test. I know that one should not discuss an hon. Lady's age in the Chamber, but we all know from Vacher's when my hon. Friend the Member for Edgbaston was born. I am sure that she would be the first to acknowledge that she and many pensioners in the United Kingdom are on above average earnings and should not receive free eye tests.

I apologise to the hon. Gentleman, but I have given way already and I do not wish to detain the House as other hon. Members want to speak.

The Government's proposals which were put into effect last year enable 20 million people, or nearly 40 per cent. of the population, to receive free eye tests. Those 20 million people consist of all children under 16, those on low incomes, the blind and partially sighted, students under 19 and people suffering from glaucoma. That is not unreasonable bearing in mind the fact that money is being released as a result of the peripheral charge which Opposition Members accepted, when they were in government and when they created the National Health Service, it was right and proper for the Health Service to raise from the taxpayer.

A not too dissimilar argument is whether those of us who can afford to pay prescription charges should do so. I shudder to think of the "ceaseless cascade" of medicine that is pouring down British throats. The Opposition should remember who said that.