House Of Commons
Wednesday 4 July 1990
The House met at half-past Two o'clock
[MR. SPEAKER in the Chair]
Medway Tunnel Bill Lords
Order for Third Reading read.
To be read the Third time tomorrow.
Oral Answers To Questions
To ask the Secretary of State for Scotland when he next intends to meet the chairman of British Steel to discuss the future of the Scottish steel industry; and if he will make a statement.
I would expect to meet the chairman of British Steel whenever appropriate. I have asked the Scottish Development Agency to carry out an analysis of the prospects for the steel industry in Scotland.
If the Secretary of State does not think that this is an appropriate time, he never will. When he meets the chairman of British Steel, will he inform him that the letter that he sent to the right hon. and learned Gentleman is not only an insult, but the biggest cover-up since Watergate? Did the right hon. learned Gentleman notice that it contained not only no guarantee for Ravenscraig beyond 1994, but no guarantee for the Clydesdale and Imperial works beyond the end of this week?Will the Secretary of State give an undertaking that Scottish Office resources and the resources of the Department of Trade and Industry will be fully at the disposal of the SDA, and that its study will cover all three plants and be based not only on present market demand, but on the potential market demand for Scottish steel plant if the necessary investment that should have been made was made now?
The correspondence that I have had with Sir Robert Scholey was about Ravenscraig, so it is not surprising that there was no reference to Clydesdale or to other plants. I can confirm that the study that I have asked the SDA to carry out is not limited to any one company or plant; it is on the future prospects for the steel industry in Scotland as a whole.
May I thank my right hon. and learned Friend for his staunch efforts on behalf of British Steel? Does he accept that the letter from the chairman of British Steel is quite unacceptable and that we expect much better from the chairman and directors of British Steel in terms of looking after Scotland, the community and the work force? I hope that he will pursue the chairman for as long as necessary to obtain satisfactory answers.
I note my hon. Friend's remarks. We have told Sir Robert Scholey that we hope that he will reconsider his unwillingness to date to meet the representatives of the work force at Ravenscraig. It appears that it would be of mutual benefit not only for them to hear his point of view, but for Sir Robert to hear what they have to say about the plant in which they work.
Does the Secretary of State accept Sir Gordon Borrie's comment that he had hoped that the exchanges between the Government and the chairman of British Steel would have yielded information on whether a reference of that decision to the Monopolies and Mergers Commission was justified? As Sir Robert Scholey, not surprisingly, has not given that information, will the Secretary of State make it clear to British Steel that if it is not prepared to operate the plant in Scotland, the Government will invoke the Monopolies and Mergers Commission's powers to ensure that genuine competition operates, that Britain's trade interests are brought into effect and that, if necessary, the assets of British Steel in Scotland will be offered to somebody who is prepared to invest in the monopoly?
I am not certain that the hon. Gentleman has thought out the implications of what he said. Taken literally, it would imply that the Liberal Democrat party wishes to denationlise the assets of British Steel. The hon. Gentleman must appreciate that, as the Government do not own those assets—it is not Labour party policy to reacquire them—short of reacquisition there is no way in which a company can be obliged to dispose of its facilities.
On competition law, the hon. Gentleman must accept that it is for the Director General of Fair Trading to make a recommendation to Monopolies and Mergers Commission. That is the correct procedure of which, I think, the hon. Gentleman is well aware.
I congratulate my right hon. and learned Friend on his powerful fight for Scottish steel. Has he clarified whether, in the event of the Ravenscraig closure, British Steel would automatically offer the plant for sale at a negotiated price, or whether the chairman of British Steel would reserve the right not to sell the plant if he considered that a sale would be contrary to the commercial interests of British Steel?
The position of British Steel is as described in its prospectus, in which British Steel said that, in the event of there being no future requirements for its steel-making assets in Scotland, it would be prepared to make them available to an alternative private sector purchaser. Sir Robert said in his letter to me that British Steel intends to continue to honour that commitment.
Does the Secretary of State agree that British Steel's assumptions of the likely market demand for steel are far too pessimistic, given the expected increased demand in Europe and the need to roll back the formidable import penetration in our domestic market? There is great confusion about exactly what the Secretary of State is doing to test the assumptions and the rather doubtful theories that are included in Sir Robert Scholey's letters. Will the right hon. and learned Gentleman tell us specifically what steps he is taking? Does he remember that one of the things that might have been thought simple and that he urged on Sir Robert Scholey—the need for Sir Robert to meet the work force and explain the situation—is specifically repudiated in a letter on the basis that it undermines local management? Is the right hon. and learned Gentleman prepared to take such a brush-off?
I have already made it clear to Sir Robert that I feel that it is unfortunate that he is not prepared to meet his work force, and I have urged him to reconsider. In considering the prospects for the steel industry in Scotland, the SDA will wish to take account of any information on likely market trends that is available to it. We would expect that information to be taken into account when the SDA's analysis is prepared and presented.
To ask the Secretary of State for Scotland if he will list the hospitals currently under consideration for closure by Scottish health boards.
There are no closure submissions before Ministers at the moment, but I am aware that several boards are proposing rationalisation of their services.
Does not that answer show how out of touch the Secretary of State is with Scottish health boards? He does not know that several hospitals are earmarked for panic closure in the Lothian region, part of which he represents. The health board has earmarked for closure Longmore hospital in my constituency. Will he ensure that the board gives him sufficient evidence—which I understand is not available—to show that the breast cancer unit and geriatric facilities can be transferred to another unit, thereby preserving the quality of service? The experts tell me, as they told the Minister of State when he visited the hospital, that that is impossible.
If the hon. Gentleman had done the House the courtesy of listening to my reply, he would have heard me say that there are no closure submissions before Ministers at the moment. I am as aware as the hon. Gentleman of the proposals before Lothian health board. It will be for the health board, once it has considered the responses to its proposals, to decide whether to make closure recommendations to the Scottish Office.I am well aware of the extremely valuable work of the breast cancer unit at Longmore hospital. Much of the discussion is about whether that valuable work could continue if the breast cancer unit transferred to an alternative location. Obviously, we would expect the health board to consider that issue carefully before making any recommendations.
Can my right hon. and learned Friend say anything about Mearnskirk hospital in my constituency where Greater Glasgow health board is proposing, perfectly sensibly, the withdrawal of acute beds? My right hon. and learned Friend will soon receive a submission from Eastwood district council. Will he assure us that it will be fully considered, along with the other proposals being made by Greater Glasgow health board, to ensure that this important site is retained, at least in part, within the health service and is developed in accordance with the wishes and needs of the people of Eastwood?
I am aware of such proposals. I am happy to give my hon. Friend the assurance that they will be carefully considered to ascertain whether the objectives of my hon. Friend and Eastwood district council can be accommodated by the health service.
The Secretary of State will be aware of the size of Clydesdale constituency—almost 800 sq m with a population of 100,000. I wrote to him last week informing him of Lanarkshire health board's decision to build a new hospital at Wishaw and to upgrade its hospital at Hairmyres. It is threatening to remove acute medical services in the Clydesdale constituency. Will the Secretary of State assure the House and my constituents that he will not agree to a diminution in acute medical provision in Clydesdale?
I note carefully what the hon. Gentleman said. The health board has not put any proposals to the Scottish Home and Health Department, but, if and when any recommendations are put, I assure the hon. Gentleman that we shall take into account his points and those made by others who have commented on the proposals.
Does the Secretary of State agree that the reason for many of the proposed closures is the chronic underfunding of the health service in Scotland? In the past six years, has not the Scottish Office underfunded pay awards to the health boards, excluding Glasgow, by £150 million? In Lothian alone, underfunding of pay awards amounts to £20 million—almost the exact amount that Lothian will have to make in cuts. Does not that show that Lothian's problems are due not to mismanagement but to underfunding and that, therefore, the Secretary of State will be responsible for any cuts or closures in Lothian.
The hon. Gentleman is incorrect. In the current year, the Government have made available an extra £158 million, or 8.3 per cent., over the previous provision to meet priorities, including out-of-line pay and price increases. The allowances made for pay have been exactly the same for Lothian as for other health boards in Scotland. The fact that Lothian is facing a cash crisis does not arise from provision for pay, which is equal for all health boards in Scotland.
To ask the Secretary of State for Scotland what proposals he has received in relation to the future of elderly and day-care patients at the 800-year-old hospice at Linlithgow.
No proposals have been received concerning St. Michael's hospital, Linlithgow.
In view of the dismay of the 13,500 people who signed the petition, would not it be wise at least for the Scottish Office to discover the legal and historic advice about church land being disposed of when it was given, in this case in 1138, for the maintenance of the ministry, the fabric of the church and the care of the poor? In order to avoid a cause celebre in the Court of Session, should not Scottish Office lawyers consult scholars on the legal position before the idea of disposal proceeds further? Should not the idea be nipped in the bud?
I understand that Lothian health board's examination of the matter is at an early stage, but I am happy to assure the hon. Gentleman that his points will be drawn to the attention of the board. I shall ask it carefully to examine the legal position on the feu disposition in respect of that hospital. I am grateful to him for drawing it to our attention.
Health Service, Tayside
To ask the Secretary of State for Scotland when he next intends to visit Tayside to discuss the health service.
My right hon. and learned Friend has no plans to do so at the present time.
If the Minister decides to visit Tayside, instead of using his ministerial car will he perhaps get on his mountain bike, with which he featured in the newspapers on Sunday? While he is taking his time over the Ochil hills to Tayside, will he consider the £1.8 million underfunding of pay awards in Tayside which blows the myth that privatisation will be good for the health service? Have not any savings from privatisation been more than offset by the underfunding of pay awards?
It is a fact that what the hon. Gentleman calls privatisation—which is competitive tendering—has made £80 million available for patient care in the health service. It is also a fact that the Labour party has committed itself to abolishing competitive tendering, in the unlikely event of its taking office. We have had no explanation of where the extra £80 million would come from. The health service has never been better funded. Funding has increased by more than one third in real terms, and the hon. Gentleman will be aware of the service development that has taken place in Tayside.
When my hon. Friend meets Tayside health board will he draw its attention to the fact that it is probably the finest health board offering the best value services anywhere in the country? Nevertheless, there are causes for concern. For instance, Stracathro hospital is under threat. Moreover, it is to be hoped that the self-governing hospital proposals in Forfar which are very welcome will now be seen to be producing results.
My hon. Friend is right to draw attention to the exciting proposals for self-governing status which have come from the doctors in Forfar, and to what has been achieved in Tayside. In common with other health boards, those in Scotland are now treating far more patients and making significant inroads into reducing waiting lists and waiting times.
Does the Minister understand the widespread anger about, and opposition to, Tayside health board's rundown, closure and withdrawal of hospital services throughout Angus? How can the Minister justify the closure of specialist services at Arbroath infirmary, and the possible closure or rundown of maternity services in Arbroath, Brechin, Forfar and Montrose and of orthopaedic, general and emergency services at Stracathro, as well as the closure of perfectly viable laundry services at Sunnyside hospital? Is that what the Tories mean when they say that the NHS is safe in their hands?
If the hon. Gentleman arranges to come and see me to discuss these matters—which he has not done—I shall explain the background to them. The hon. Gentleman asked me to justify the changes. The reason is perfectly simple: the medical advice that we are receiving in respect of maternity services suggests that they should be provided where the full range of services provided by a district general hospital are available. A balance has to be struck between meeting the needs of rural areas and meeting the requirements of patient safety. The hon. Gentleman will have to take a more sophisticated approach to these matters if he wishes to continue to represent the interests of his constituents.
Will my hon. Friend pay particular attention to the future of Stracathro hospital, which serves part of my constituency and where many of my constituents are members of staff? Will he acknowledge that many of us would find it intolerable if the services of that hospital were so whittled away that there was no general hospital between Aberdeen and Dundee?
The reforms that we propose for the health service will mean that hospitals will be able to attract funds according to the patients whom they treat and the services that they provide. To hospitals such as Stracathro—which I know well because it is in the area where I was brought up—the White Paper proposals and particularly the option of self-governing status offer new opportunities.
To ask the Secretary of State for Scotland what has been the level of central Government grants in support of housing expenditure in Ross and Cromarty district in the last three years for which figures are available.
In the three years to 31 March 1990, Ross and Cromarty district council received housing support grant in excess of £11.2 million, and croft housing grants of more than £294,000 were approved.
Is the Minister aware that last year the district council carried out a major housing survey of its needs and projected expenditure and that it is estimated that a rolling programme of £60 million will be needed next year for new build, to improve council stock and to bring private sector housing up from below tolerable standard to reasonable standard? Given the number of representations that both the district council and I are receiving from many communities in Ross and Cromarty—and from many housing schemes in individual communities—will not the Minister have to look again at his spending allocations for the district authority? There is no way that it will meet over the next five years the obvious needs that have been identified by the council.
I welcomed the opportunity to meet the hon. Gentleman's district council last summer and I am aware of the problems that he mentioned. The amount of housing below tolerable standard has been reduced by more than half over the past 10 years, but I am aware of the extent of such housing in the hon. Gentleman's constituency. A rural housing study is being carried out in depth, almost from Muckle Flugga to Mull of Kintyre, and we hope to come forward with a concerted strategy in Scotland by September.Part of the answer may lie in the extent to which the private sector will come in to support local authorities and Scottish Homes in partnership projects.
Question 14, Sir. Sorry—I mean No. 6.
Inverclyde Enterprise Zone
To ask the Secretary of State for Scotland if he will make a statement on the operation of the Inverclyde enterprise zone.
The Inverclyde enterprise zone was established in 1989 and has a 10-year life span. It is, therefore, much too soon to assess its impact on the local economy.However, in addition to the 870 jobs already created or planned, I am pleased to be able to inform the House that the American electronics company Sorensen Ltd. yesterday announced the takeover and expansion of Domain Power Ltd. which is expected to create a further 400 new jobs in Inverclyde.
I am sorry, Mr. Speaker. I think that I was expressing hope when I referred to question 14.The enterprise zone suffers from large areas of dereliction. Where those areas surround listed buildings, there is a major problem of persuading investors to come into the zone. I refer to the engine works in Arthur street in Greenock and the Gourock ropeworks in Port Glasgow. I wish that the Minister would show a smidgen of the concern about and commitment to the community that were shown by his grandfather, who built the engine works in Arthur street. With regard to the Gourock ropeworks, is the Minister aware that the people of Port Glasgow deserve a quick solution to the problems of dereliction surrounding that fine listed building? Let us have some action on that building and the area of dereliction surrounding it.
It is more likely to have been my great-grandfather. The buildings to which the hon. Gentleman referred are being given close attention, but it is primarily a matter for their owners. The Inverclyde enterprise zone has some geographical difficulties in that it is split among 11 sites covering 274 acres. However, the SDA has already spent or committed £14.3 million towards clearance of dereliction and factory construction. That is a reflection of the way in which it is approaching the matter. The hon. Gentleman might like to know that unemployment in his constituency has fallen by more than in any other constituency in Scotland, bar one, over the past three years. That is a reflection of the success of the Government's policies in the Inverclyde area.
Does my hon. Friend accept that no other enterprise zone has greater prospects, contains finer buildings or a finer work force, is on the Clyde or has such magnificent prospects? My hon. Friend should encourage Scottish Enterprise to promote that enterprise zone with vigour because no place could be more vigorously successful than that part of Scotland.
My hon. and learned Friend is absolutely right. The enterprise zones in different parts of Scotland are one aspect of the Government's policies to promote the development of enterprise and the regeneration of the economy. The overall success of those policies is revealed by the fact that the fall in unemployment over the past three years has been the biggest single fall for the past 40 years. The dramatic improvement in employment is a reflection of the success of our policies.
Is the Minister aware that the recent decision to allow the Braehead development, which is a monstrous plan, to go ahead will do irreparable damage to the Inverclyde enterprise zone and to nearly every industrial development in Renfrewshire? Will the Minister make a statement about that? I have never seen such a stupid planning decision, particularly when we consider that Inverclyde district council, Renfrew district council and Strathclyde council are totally opposed to the abominable Braehead plan.
The hon. Gentleman will know that that decision was given the closest and most careful consideration. However, there are a number of encouraging initiatives in the hon. Gentleman's constituency, including those at Ferguslie park and Renfrew and the developments at Linwood. Unemployment has fallen in the hon. Gentleman's constituency by more than 2,200 in the past three and a half years.
Order. Mention has been made of question No. 14, which leads me to the conclusion that hon. Members would like to get on to that question. There is interest also in question No. 11, so we should now move on rather more rapidly.
Floods, Tay Valley
To ask the Secretary of State for Scotland how many applications he has received for grants following the floods in the Tay valley; and how many have been for funds to restore the environmental damage caused by the floods.
Thirty-two applications have been received from farmers in Tayside for the repair of elevated floodbanks at the enhanced rates of grant announced on 28 February 1990. A further five applications have been received for arterial drainage and ditching operations at ordinary rates.With regard to environmental damage, three farmers within the Breadalbane environmentally sensitive area have notified damage to grant-aided trees and fences.
I thank my hon. Friend for that reply. Is he aware that the worst break in the Tay was at Braecock farm and that a temporary repair was carried out there? Downstream, farmers and the village of Capath will be at risk unless the colossal damage that was done at Braecock is properly, fully and adequately repaired. What proposals does my hon. Friend have and what hope can he give people downstream of Braecock that the work will be carried out properly?
I am glad to reassure my hon. Friend that the three downstream owners who are to carry out repairs to flood banks will also qualify for enhanced grants. The Scottish Office is ready to pay 60 per cent. of grant, and approval of the repair proposals will be given immediately when the owners are ready to accept the contractor's tender.
Is the Minister aware that Labour-controlled Tayside regional council convened a meeting last month with representatives of local authorities and farming, environmental and other bodies? That meeting called on the Scottish Office to pay £25,000 for a feasibility study to solve the flood damage problem. Will the Minister take this opportunity to say that he will respond positively to that call and pay the £25,000?
The hon. Gentleman is correct that a meeting took place on 21 June. A steering group was formed to appoint an independent consultant and oversee the hydrology study. We have offered to fund it up to a quarter, to a maximum of £10,000, which we consider generous, taking all the circumstances into account.
Local Government Finance
To ask the Secretary of State for Scotland if he will make a statement on the implications of the Government's review of the poll tax for local authorities in Scotland.
The House will be informed when the review has been completed.
When the Secretary of State meets local authorities in Edinburgh on Friday, will he inform them at least that there will be no capping of local authorities in Scotland? How will he react to their fears, published in the press today, that the poll tax is likely to increase by 25 per cent. in Scotland in the oncoming year? [Interruption.] If Conservative Members wish to intervene, I am happy for them to do so. How will the Secretary of State react to the farcical protests by the hon. and learned Member for Perth and Kinross (Sir N. Fairbairn) and the hon. Member for Tayside, North (Mr. Walker), who say that they want to use the Act of Union, which the Government have abrogated by imposing unfair taxes on Scotland?
I have already said that in the current financial year it is not necessary to take selective action. Indeed, evidence suggests that Scottish local authorities have had lower levels of expenditure than local authorities south of the border, no doubt because accountability is beginning to apply.On the second part of the hon. Gentleman's question and the various predictions by local authorities about possible levels of community charge next year, I have noted that one of the points that they have raised is that a number of people are seeking to evade their legal responsibilities and refusing to pay their taxes. The hon. Gentleman might help his constituents by paying his lawful taxes so that law-abiding members of the public do not suffer.
My right hon. and learned Friend will be aware of the generosity of support for Scottish local authorities by taxpayers thoughout the United Kingdom. What steps is he taking to ensure that the revenue support grant that those authorities receive is spent as efficiently as possible?
My hon. Friend is corrrect that it is in the public interest to ensure that local authorities are properly accountable to their electorates for the way in which they use available resources. One of the great advantages of the community charge as compared with the old rating system is that it ensures far greater accountability, because all adults who benefit from local services now contribute towards their cost.
Is the Secretary of State aware that the only sensible outcome, which is desired by the vast majority of Scottish people, is the total abolition of the poll tax? As he may find that slightly difficult, will he in the meanwhile demand from the review committee the abolition of the 20 per cent. minimum payment rule, backdated to 1 April 1989, an improvement in the rebate system, again backdated to 1 April 1989, and a vast improvement in revenue support grant next year to ensure that the odious burden of warrant sales is not imposed on thousands of our fellow Scots and that Scottish local authorities will not be forced to increase the poll tax by a massive amount and to cut services and jobs next year?
I note what the hon. Gentleman says. The House and the public will be even more interested to know whether the Labour party is continuing to insist on imposing a roof tax in Scotland, which has been rejected not only by the Leader of the Opposition for England and Wales, but by the vast majority of people in Scotland. We understand the Labour party's embarrassement and sensitivity on that issue, but Opposition Members must realise that it will not go away.
To ask the Secretary of State for Scotland what recent representations he has received about the setting up of an assembly in Edinburgh with legislative powers.
In the past six months, five letters in support of an assembly have been received.
If my noble Friend believes, as I do, that an assembly in Edinburgh would weaken and injure the Union, why are Government supporting an assembly in Belfast?
There is no contradiction in the Government's approach. It reflects the different circumstances in Scotland and in Northern Ireland. A Scottish assembly would be a taxation nightmare in Scotland and as the Under-Secretary of State, my hon. Friend the Member for Stirling (Mr. Forsyth) has estimated, it will lead to an extra 25 p in the pound income tax for the Scots.
Does the Minister accept that if we had an Administration subject to democratic accountability in Scotland, matters such as the threatened closure of 640 hospital beds in Lothian region would receive at least as much attention as the solicitors' monopoly is currently receiving? Does he further accept that such exposure to democratic accountability would be an invigorating experience, not just for Ministers, but for Scottish Office civil servants?
I think that the hon. Gentleman can represent his constituents perfectly well in the House of Commons—[HON. MEMBERS: "And you."] Indeed, I am one of the hon. Gentleman's constituents. The hon. Gentleman can represent his constituents in the House on health matters.On the hon. Gentleman's point about devolution, I believe that
Those are not my words—they are the words of the Leader of the Opposition a few years ago, and they are as valid today as they were when he uttered them."We will get guaranteed disharmony, disunity, conflict and competition throughout the whole of Britain. The dominant issue of politics in Britain will be the jealousies of region against region, nation against nation, argument against argument. That will be very bad news for Britain".
Does my hon. Friend agree that all Scottish taxpayers should be made aware that a Labour-inspired Scottish assembly would increase taxation beyond belief, as was confirmed by the Leader of the Opposition who said that only one in 15 taxpayers would face an increase—that is, the Scots?
I agree entirely with my hon. Friend. If Scotland were funded at the average United Kingdom per capita level, Scotland would have been £2.7 billion worse off in 1989–90. To fund the balance in Scotland and to maintain expenditure in Scotland at its current level would require an additional 25p in the pound.
Does the Minister agree that it would be helpful to have a bit less heat and a bit more light? Does he further agree that the Law Reform (Miscellaneous Provisions) (Scotland) Bill is an excellent example of the need for a Scottish Assembly because treatment of it has been superficial and inadequate? When the Scottish Constitutional Convention concludes, will the Minister undertake to meet it to try to work out a reasonable and sensible answer to all this?
The answer is no. The Scottish Constitutional Convention is unrepresentative of Scotland—[Interruption.] The Scottish National party is not taking part. The hon. Gentleman must await my right hon. and learned Friend the Secretary of State's statement on the Law Reform (Miscellaneous Provisions) (Scotland) Bill.
Scottish Office Expenditure
To ask the Secretary of State for Scotland what representations he has received recently about Scottish Office expenditure.
I receive regular representations on all aspects of Scottish Office business, including expenditure.
What representations has my right hon. and learned Friend received from the Opposition about their plans to spend up to £50 billion extra across the United Kingdom, to have a Scottish assembly with tax-raising powers, which would cost Scottish taxpayers something like 25p in the pound, and a roof tax? Has he received any explanation from the Labour party in Scotland about how it proposes to pay for that?
One of the most worrying aspects of the Opposition's proposals is that not only do they propose substantial increases—
On a point of order, Mr. Speaker. It is about the Minister's answer—
Order. We have not heard it yet.
The Minister is not entitled to answer for the Opposition.
Order. Let us hear his answer. We have not heard it yet.
One of the most worrying aspects about any proposals for new taxation is that they would impose an even greater burden of taxation on Scotland than on the rest of the United Kingdom. That would clearly be the consequence of the Labour party's proposals.
Will the Secretary of State consider adding one new item of Scottish Office expenditure in the light of yesterday's announcement by the Department of Transport of a motorway link up the A1 as far as Newcastle? Does he recognise that the press statement saying that it would help Scotland added insult to injury? Nothing is more damaging to Scotland than creating the same impression on the east coast of England as exists on the west coast—that the motorway network stops at the border. Will the Secretary of State urgently review his road programme?
The right hon. Gentleman will be aware that not only are we proposing significant improvements to the A1 in Scotland, but we are making more dramatic and radical progress in transforming the A74 into a motorway on the west coast of Scotland than any previous Government ever contemplated. We have begun construction work on the total reconstruction of the A74 to full motorway status, making quicker progress than has ever been known in the roads programme of any Transport Department in the United Kingdom.
In spite of that answer, does the Minister accept that the absence of Scottish Office expenditure and of any visible strategy on fast, modern communications between Scotland and the south has become a major liability for the Scottish economy? In addition to the lack of decision on the A1, how on earth can he defend the total absence of a Scottish Office strategy in the past three years to ensure fast, direct links between Scotland and the channel tunnel? Will not that be seen with hindsight as one of the great omissions by the Scottish Office in the past three years, with tremendous long-term implications for the Scottish economy?
I do not think that the hon. Gentleman knows what he is talking about. For the first time, we have plans to link the motorway network of central Scotland with the motorway network in the south. In addition, we have the electrification of the east coast railway line between central Scotland and London. We have also had a more remarkable improvement in civil aviation between central Scotland and London. We have also had a more remarkable improvement in civil aviation between central Scotland and south than at any time in our history.
To ask the Secretary of State for Scotland what steps he is taking to assess the arguments advanced by British Steel for the closure of the Ravenscraig strip mill, as outlined in the recent letter to him from the chairman of British Steel.
I refer the hon. Gentleman to the reply given a few moments ago by my right hon. and learned Friend the Secretary of State to the hon. Member for Motherwell, North (Dr. Reid).
Does the Minister agree that it is immoral for a man who has just received a 79 per cent. pay rise to show such a lack of concern at the social impact of his decisions? Sir Robert Scholey has made it clear that to protect his private monopoly, British Steel will not sell the strip mill to a competitor. Will the Minister urge his right hon. and learned Friend the Secretary of State to insist that that statement be referred to the Monopolies and Mergers Commission and use the threat of resignation to make sure that that happens?
Sir Robert Scholey has a responsibility to his company and to the steel industry, not only in Scotland. In regard to the other points in the hon. Gentleman's question, Sir Robert pointed out in his letter to my right hon. and learned Friend that there are no fewer than 15 major competitors to British Steel within Europe alone. Competition is a matter for the Director General of Fair Trading.
May I refer the Minister to what the Secretary of State said about the analysis that he has instructed the Scottish Development Agency to carry out? Is he aware that the right hon. and learned Gentleman gave the impression that clear and precise directions were given to the Scottish Development Agency? But I have a letter from Mr. Scott, the chief executive, who says that
Exactly what will the Scottish Office involvement be in setting the final terms of reference? Will the Minister give an assurance that the terms of reference will include the feasibility of an independent Scottish steel industry and that the preparation of a business plan to attract investment for that objective will not be ruled out?"the precise terms of reference of the remit for the study have yet to be settled."
The terms of reference for the SDA were deliberately made extremely broad. They included the analysis of prospects for the steel industry, the identification of opportunities for it and the ability to assist the Government in the discharge of our responsibilities in relation to any possible contraction of the sector. The kind of detail to which the hon. Gentleman refers is a matter for the SDA to resolve when it decides how to embark on its study.
Has the Secretary of State made a study of the impact on the local economy if Ravenscraig were to close, and if not, why not?
The hon. Lady will know that there are a number of initiatives in the Lanarkshire area, and have been for a number of years—in particular, the Monklands initiative, which is a major initiative. In addition, my right hon. and learned Friend the Secretary of State invited consideration of the possible impact of the hot strip mill closure on the area. Any other initiative that may be necessary will arise as a result of the SDA report or other developments, and will be reacted to at the appropriate time.
May I put it to my hon. Friend arid to his right hon. and learned Friend that they are giving their English colleagues a great deal of concern? We can understand the interest in what happens in Scotland, but we are talking about part of the British steel industry. My hon. Friends are concerned with Scotland, but, as British Ministers in a British Government, will they take account not only of Scottish interests—which, from an English point of view, they seem to be fighting for far too strongly—but of British interests as well?
My right hon. and learned Friend the Secretary of State and I, and our other colleagues, are Ministers in a territorial Department. It would be surprising if we did not direct our attention primarily to the interests of that territory.
To ask the Secretary of State for Scotland what are the latest figures for cervical cancer (a) patients and (b) deaths in Scotland.
The latest figures show 443 patients suffering from cervical cancer and, regrettably, 191 deaths.
Does the Minister agree that that, and the Government's lack of interest, is appalling? Recently, the hon. Member for Harlow (Mr. Hayes) made an appeal regarding the 2,000 needless cervical cancer deaths nationally. The Government have been repeatedly asked by family practitioner committees and cytologists to spend an extra £20 million. Had they done so, we might have saved the 2,000 people who have died from this invasive carcinoma. Why do the Government have such a shocking and appalling record, and when will they spend the £20 million that we need to achieve 90 per cent. protection?
I agree with the hon. Gentleman that the figures for loss of life through cervical cancer are disturbing. I also agree that many of these deaths are preventable. In 90 per cent. of the cases where cervical cancer has been diagnosed, there has been no screening. I should have thought that the hon. Gentleman would recognise that the Government have put in place a call and recall system for cervical screening, the aim of which is to ensure that all women between the ages of 20 and 60 are screened before 1993, on the basis of regular screening at least once every five years. In some health boards, screening will take place every three years. A screening programme is in hand and it is extremely important that women in Scotland respond to invitations to take part. In addition, the new GP contract gives incentives to doctors to provide screening services for all their patients. I should have thought that the hon. Gentleman would welcome that.
To ask the Secretary of State for Scotland if he will make a statement about trends in the numbers in higher education since 1979.
I am glad to be able to tell my hon. Friend that the number of full-time students attending higher education in Scotland rose by almost 25 per cent. between 1979 and 1989, to nearly 85,000. 1 hope that this excellent trend will continue.
Does my hon. Friend agree that those statistics underline the Government's commitment to the future of higher education in Scotland, and does he join me in welcoming the decision by Stirling university to double its intake in the near future?
My hon. Friend is an authority on Scottish universities, having attended St. Andrews and graduated there, and having been a lecturer at Aberdeen and Glasgow universities. I am delighted to be able to reassure him that the Government are committed to continuing further expansion, even above the dramatic levels of improvement that we have achieved in the past few years.
Despite the Minister's statement, fewer than 10 per cent. of working-class youngsters get to university in Scotland, while failures from the English public school system receive first preference at certain universities, especially Edinburgh. What does the Minister intend to do about that?
Access to university must depend on academic qualifications. I am delighted to say that more than one in five school leavers in Scotland now enter higher education, which is much higher than the United Kingdom average. The Government are committed to increasing the population in higher education, and hope that it will be as high as 30 per cent. of the relevant population in six years' time.
Did my hon. Friend notice the recent remarks of Lord Chilver, the chairman of the Universities Funding Council, commending the broadly based Scottish education system? Does my hon. Friend acknowledge that that system, based on a four-year honours course, puts additional financial burdens not only on the universities but on the students? Will he ensure that resources are made available in both sectors, to maintain our excellent record in terms of the additional number of students that we have gained in the Scottish universities?
Lord Chilver certainly had some kind and complimentary things to say about the quality of Scottish higher education. The fact that in Scotland a substantially higher proportion of the relevant population enters higher education shows that the four-year degree course is no disincentive. Overall expenditure this year is up by 11 per cent. on last year. That is the highest-ever level of student awards, and reflects the Government's commitment.
When it is cheaper to produce a graduate in this country than in almost any other western European country, the United States or Japan, why are the Government intent on cost cutting and standard cutting? Why is the Minister satisfied with one in five of our youngsters' receiving higher education, when in Japan, Sweden, America, Canada, France and Denmark the proportion is already one in two?
The hon. Gentleman might like to reflect on the fact that we have the most generous support for students in the western world. Eighty per cent. of full-time students receive support in this country, compared with 12 per cent. in Japan. The expansion that we are achieving was not achieved by the Labour party. I am delighted that we are moving down this road, and I am sure that the Scottish economy will benefit from it.
To ask the Secretary of State for Scotland what representations he has received about the proposed changes set out in part II of the Law Reform (Miscellaneous Provisions) (Scotland) Bill; and if he will make a statement.
I have received a number of representations. I am pleased to be able to report to the House that, as a result of informal discussions with the Law Society of Scotland in the past few weeks we have today reached agreement with regard to the proposals in part II of the Bill.The Law Society of Scotland has informed us that it is able to accept that the solicitors' monopoly with regard to conveyancing should cease. The Government for their part accept that the provisions in the Bill allowing persons other than solicitors to provide conveyancing services should be limited to independent qualified conveyancers. The provisions will not apply to the financial institutions. The Government and the Law Society of Scotland have also agreed that the provisions in the Bill with regard to multi-disciplinary practices should be made the same for solicitors as for advocates. There are also some detailed points in part II which I have recently discussed with the Law Society of Scotland and am considering. On that basis, the Law Society of Scotland has informed us that it is able to welcome part II of the Bill and is anxious to see it appear on the statute book. I am also able to inform the House that the Scottish Consumer Council has indicated that it, too, welcomes the agreement that has been reached. I would like to thank the Law Society of Scotland for the constructive and helpful discussions that we have had, which have enabled us to reach this amicable agreement.
That is clearly a major statement—and a major retreat—by the Secretary of State. I am sure that he made it freely, and without any undue pressure. Substantial concessions have been made, however, and it is important to add that that is a tribute to the pressure applied by the Labour Members on the Committee. There are two outstanding questions that the Secretary of State has not addressed. Clearly, there is major concern about the other important measures in the Bill being rushed through in Committee, and about there being insufficient time to deal with them. Perhaps the Secretary of State can advise the House what proposals he has for the other parts of the Bill.Finally, can the right hon. and learned Gentleman give an assurance that the agreement that he has announced today is accepted by all his own Back Benchers, as we have had the privilege of watching Tory Members and Ministers fighting like ferrets in a sack about the proposals?
With regard to the hon. Gentleman's first question, I can say without fear of contradiction that the views of Opposition Members on the Committee considering the Bill have been of less significance than usual in terms of the development of policy. As for the attitude of my hon. Friends, they must speak for themselves, as they often do, and I have no doubt that they will continue to do so. As for the other parts of the Bill, I am sure that the House as a whole hopes that there will be an opportunity to consider properly in due course the licensing and other provisions that hon. Members believe are important.
I thank my right hon. and learned Friend most warmly for his announcement and for the agreement that he has reached with the Law Society of Scotland. I thank him also for listening to his own Back Benchers' representations that in future rural solicitors should be able to compete fairly and play their full part in the community.
I thank my hon. Friend. From my point of view, one of the most important questions that we addressed was the need to end the solicitors' monopoly over conveyancing. I am grateful to the Law Society of Scotland for agreeing to that proposition.
In preparing for the humiliating climbdown that the right hon. and learned Gentleman has just announced, did he have time to reflect on what he said in 1976—that a separate Scottish legal system needed a separate Scottish Parliament? Have not the tawdry and undignified scenes in the Corridor outside the Committee Room demonstrated the Government's inadequacy and inability to get their business through the House?
I can understand that the hon. and learned Gentleman, who is a distinguished lawyer, is disappointed about the Government's ability to reach agreement with the Law Society of Scotland on matters of this kind. I appreciate that he may have other interests in that respect. However, we have demonstrated that with good will it is possible to reach agreement. That is something which I am delighted to report to the House.
I warmly and wholeheartedly congratulate my right hon. and learned Gentleman on his achievement. He has done a great service to the people of Scotland, the institutions of Scotland and the integrity of the House. Does he agree with me that, given good will and some reasonable compromises on the later parts of the Bill, there is every reason to believe that the Law Reform (Miscellaneous Provisions) (Scotland) Bill can be enacted in this Session of Parliament, having been considered at reasonable hours?
I very much agree with my hon. Friend. It will assist the Committee to know that with regard to that part of the Bill which has given rise to the greatest public interest both the Law Society of Scotland and the Scottish Consumer Council, which have occasionally adopted different views on certain matters, have enthusiastically endorsed the proposals?
The Bill began its life in the other House in February 1990. It has taken the Secretary of State from February to the beginning of July to discuss and enter into an agreement with the Law Society on part II. How on earth does he expect the Committee to discuss, in the three weeks that remain before the recess, something on which it has taken him six months to reach agreement with the Law Society of Scotland? Does the Secretary of State also accept that although he has been a member of the Committee since it began its work, the words that he has expressed at the Dispatch Box are the first words that he has uttered on the Bill as he left everything to his junior colleague, the Under-Secretary of State for Scotland, the hon. Member for Edinburgh, West (Lord James Douglas-Hamilton)? Does he appreciate that there is simply not enough time to get the Bill through its Committee stage?
I am happy to pay a fulsome tribute to the Under-Secretary of State for Scotland, my hon. Friend the hon. Member for Edinburgh, West (Lord James Douglas-Hamilton), who has done a superb job in Committee. It is only in the recent past that the Law Society of Scotland has felt able to state its willingness to agree to the proposals that have been put before the House today. I pay tribute to the Law Society for its constructive contribution.
Although I recognise that the Secretary of State and his colleagues must feel very humiliated by this eleventh-hour decision, can the right hon. and learned Gentleman tell the House what discussions he has had with the Department of Trade and Industry about competition policy, given that that is included in the Bill? The problems did not become apparent in February, but when the Green Paper was published last year clear antagonism was expressed. Why has it taken so long to recognise that the Bill is totally unrepresentative of the wishes of the legal profession, particularly in Scotland?
The hon. Lady must appreciate that it is not just the interests of any one profession that the Government must take into account. We discussed competition policy with the relevant Departments arid I am delighted that the opportunities for greater choice are preserved on the basis of what I reported to the House today.
Sir Nicholas Fairbairn.
He has been called twice. It is ridiculous.
I thank my right hon. and learned Friend for the agreement that he has reached with the Law Society of Scotland. I remind him of Churchill's words
"In War, resolution; in defeat"—[Interruption.]
Order. The hon. and learned Gentleman should ask a question, and please not give us reminiscences.
Order. Let us have the question.
Order. We are reaching the end of Question Time—
I want to raise a point of order.
I will take the point of order, but it may affect the time available to the Opposition Front-Bench spokesman.
Mr. Speaker, you must have observed—[Interruption.]
Does this matter appertain to order during questions? If so, please make the point of order brief.
Will the hon. Gentleman sit down for a moment, please?
I wish to raise a point of order which is germane to the Law Reform (Miscellaneous Provisions) (Scotland) Bill.
If it requires my immediate attention, I will take the point of order now, but we are in the middle of Question Time and I want to call the Opposition Front-Bench spokesman.
It is important that you take my point of order now, Mr. Speaker. You have observed what happened in the course of Question Time. A specific question was used by the Secretary of State to make what was, in essence, a statement and not an answer to the question. The whole issue is certainly important and germane to Scotland. You know what happened yesterday in the House, when there was an endeavour by the Government and by Ministers to abuse the procedures of the House and to abuse Parliament. I ask you to do your duty Mr. Speaker, as it is your responsibility to protect Back Benchers—
Order. Will the hon. Gentleman please now sit down? I trust that I speak for the whole House when I say that I hope that there will not be a repetition of the disgraceful scenes that we had yesterday—[Interruption.] I am protecting Back Benchers.
No, you are not.
The question was on the Order Paper and the Minister has a right to give his answer to that question. I wish to call Sir Nicholas Fairbairn, and then the Oppositon Front-Bench spokesman, to conclude the discussion on the question. I will not hear the hon. Gentleman any more.
Further to that point of order
I must order the hon. Gentleman to resume his seat.
No. On a further point of order, Mr. Speaker. [HON. MEMBERS: "Name him."] It is—
I should be very reluctant to take severe action in the case of such a senior Member. I order the hon. Gentleman to resume his seat.
I am not going to resume my seat.
In that case, under the powers granted me, I reluctantly say that if the hon. Gentleman does not obey the Chair, I must ask him to leave the Chamber. I am reluctant to do so.
I will leave the Chamber, but something will have to be done about the chairmanship of the House.
I have to order the hon. Member to leave the Chamber.
We should all walk out. This is a disgrace.
I hope that we shall not have a repetition of the scenes that we had yesterday. I receive a great deal of post and representations from members of the general public. The reputation of the House is in the hands of its Members. It is up to us inside this Chamber to set a good example to those outside.
On a point of order, Mr. Speaker. I will continue the question that I was asking. It was in response to a question from the hon. Member for Aberdeen, South (Mr. Doran) who asked whether the Secretary of State would make a statement. Given good will and consideration of the requirements of the people of Scotland and its legal services, will my right hon. and learned Friend accept my congratulations on what he has done today and remember the words, "so far, so good"?
I am grateful to my hon. and learned Friend.
This is not a precedent because we are now past the end of Question Time, but, in view of the point of order, which should not have been raised then, I call the Opposition Front-Bench spokesman.
My criticism of the fact that there is no statement is directed at the Secretary of State for Scotland. I entirely understand that you. Mr. Speaker, had to call question No. 14. It is unfortunate that an important announcement has been compressed into this unsatisfactory parliamentary space. However, I welcome what the Secretary of State has said as far as it goes. It is a remarkable retreat, although I fear that it is not a matter of intellectual conversion but has been forced on the Secretary of State by his total isolation and the evident lack of confidence in his competence among Conservative Back Benchers.Will the Secretary of State confirm that the effect of what he has said is that the banks, building societies and larger institutions will not now take on conveyancing work? Will he note our strong view that, however valuable the lobbying of the Law Society of Scotland may have been, the matter should not be decided by a deal on that basis but is an issue for the Standing Committee and, ultimately, the House? I did not like the way in which the Secretary of State suggested that the matter was settled. Is he not, in effect, accepting the amendments to part II of the Bill which have been standing in my name and those of my hon. Friends for some time? Finally, I have an important question. Do I understand from what the Secretary of State has said that he does not intend to proceed to a guillotine and expects to avoid that? That must imply that large sections of parts III and IV of the Bill will have to be dropped if progress is to be made. I am certainly prepared, as my hon. Friends will be, to be constructive, but we must make it clear from the beginning that the only way to save the Bill from the chaos created by the Secretary of State's mismanagement is to enter into talks and to drop the parts that are not agreed in the rest of the measure.
The hon. Gentleman, in questioning my right to make the remarks that I did today, should reflect that the question of his hon. Friend the Member for Aberdeen, South (Mr. Doran) was to ask me to make a statement. The hon. Gentleman is not entitled to complain that that is exactly what I have done. The hon. Member for Glasgow, Garscadden (Mr. Dewar) is quite correct that the Standing Committee and, ultimately, the House will determine whether the proposals in the Bill are acceptable, but they will wish to take into account the views of outside organisations which have taken an interest in the issue. The hon. Gentleman is also correct in saying that a number of the amendments that he has put down relate to matters to which I referred earlier. That will be relevant at a later stage. Of course I understand the hon. Gentleman's interest in discussing these matters with other members of the Committee. The use of the guillotine is a matter for my right hon. and learned Friend the Leader of the House. However, in the light of progress and of the agreements to which I referred earlier, I think that the matter has been overtaken by events.
Statement—Mr. Secretary Clarke.
On a point of order.
I will take points of order later.
That is no way to deal with Scottish legislation—
These matters should be dealt with through the usual channels and not decided by the Law Society of Scotland.
Order. I will take points of order later, in their usual place. I call Mr. Secretary Clarke.
Yesterday I gave a full response to 32 questions about the establishment of national health service trusts. I said then that 199 national health service units had expressed interest in NHS trust status. These included single hospitals, groups of hospitals and non-hospital facilities. I understand that about 60 to 70 of those units which have expressed interest in trust status are likely to submit applications in the first wave for April 1991. I also explained that there would be three months of full public consultation on each application which will be undertaken by the relevant regional health authority. I stressed that, ultimately, my decision would be based on my assessment of whether, in the light of all relevant factors, NHS trust status for a particular unit will benefit national health service patients in that locality.I do not propose to go over the ground that I covered yesterday in answer to hon. Members' questions. However, there are a few further points that I should like to make. First, I wish to state again, absolutely and categorically, that NHS trusts will, as their name makes clear, remain fully part of the national health service. Their staff will be national health service staff, their property will be national health service property, the bulk of their funds will come from contracts with health authorities, and the overwhelming majority of their patients will be NHS patients. NHS trusts will be established by the Secretary of State. Their chairmen and a number of the non-executive members will be appointed by the Secretary of State. They will be accountable to the Secretary of State for the performance of their functions, and they can be dissolved by the Secretary of State. I am glad to say that there is a great deal of interest in trust status within the national health service. Already in the few days since the Act received Royal Assent, we have received 12 applications. A further 25 or so units have informed my Department that they will be submitting early applications, and a substantially larger number expect to apply by 20 July. Twelve is the up-to-date figure at 3.15 when I left my office, but applications are coming in all the time. The first 12 applications are from Bradford acute services, Leeds general infirmary and associated hospitals, St. James's university hospital, Leeds, Central Middlesex hospital, North Middlesex hospital, Southend district services, Crewe acute services, the regional adult cardio-thoracic unit, Liverpool, Royal Liverpool children's hospital, East Gloucestershire district services, Mid-Surrey health authority general unit and the royal national orthopaedic hospital. That first list includes major teaching hospitals, such as Leeds general infirmary and St. James's university hospital Leeds. St. James's is the largest teaching hospital in Europe. The Royal Liverpool children's hospital has an international reputation. Its application states that the promoters believe that
Clearly, all those applications and the others that arrive will need to be tested through the consultation process that we have set in place, and I shall want to look carefully at the proposals and the comments made on them before deciding whether to approve applications. Finally, I re-emphasise the very real benefits that we see flowing from trust status. Trusts will be able to use the range of powers and freedoms which I have previously outlined for the benefit of patients, to improve above all the quality of service which they provide to our patients in our national health service."local control and management is the most appropriate organisational model for the largest acute paediatric hospital and community child health services in Western Europe".
The House will recall that yesterday the Secretary of State assured the House of the enthusiasm for his plans. If there is so much enthusiasm for his plans, why is he so afraid of letting local people decide for themselves whether their hospitals go self-governing? Why does he have to take that decision for them? Is not the real reason why the Secretary of State will not allow local people to ballot that he knows that he would lose?May I press the Secretary of State on the interesting shift in the text overnight? Yesterday, the right hon. and learned Gentleman told the House that trust hospitals
But today the Secretary of State told the House that their staff and property will belong to the national health service. Was he not right the first time? Why does not the right hon. and learned Gentleman admit that trusts will be able to hire and fire what staff they please, or to impose what conditions they please, and to buy and sell property for financial gain? Why does not he admit also that trusts will belong to the NHS only in the sense that at a late stage of the Bill's progress, he stuck "NHS" in front of their names? Will the Secretary of State come clean on what he means by a process of consultation? Will he confirm that in an article in The Times on Monday, when he was asked whether he would let a trust go ahead "despite overwhelming opposition", the right hon. and learned Gentleman replied, "Yes"? If that is his intention, why not tell us that now and admit that the consultation is a fraud—the fake product of Ministers who love to lecture and hate to listen? If the Secretary of State wants fair consultation, will he reveal who he will appoint as the chairs and directors of the trusts? [HON. MEMBERS: "Tories."] Before the public are consulted about the future of their hospitals, will they be told which industrialists or friends of the Tory party he is to put in charge of them? If the right hon. and learned Gentleman wants fair consultation, will he respond to the many doctors who have reported that they were put under pressure either by bribery or blackmail to agree to go self-governing as the price of development funding? As the Minister who commended to the House the Rover deal, will the right hon. and learned Gentleman give an assurance that this time there will be no hidden sweeteners to go self-governing? Is not the real reason why the Secretary of State cannot allow fair consultation that he cannot convince the public? Does not he understand that he can spent £3 million on the most expensive election address in history, but that he will not persuade the public that fragmenting the NHS will make it more efficient, or that turning their hospitals into business enterprises will make them more caring? I warn the Secretary of State—[HON. MEMBERS: "Oh!"]—that if, after consultation, he goes ahead against the will of local people, ignores their views, and makes their hospitals self-governing against their wishes, they will vote for a Government who will listen to them, and who will take their hospitals back into their local NHS."will be free to determine the terms and conditions of service of the staff they employ, to acquire, own and dispose of assets".—[Official Report, 3 July 1990; Vol. 175, c. 862–63.]
We are here considering the future of probably the most important public service in the country, and how best to raise the quality of care that it gives to its patients. The hon. Gentleman's roustabout, knockabout nonsense does not rise to the importance of the subject matter, which he reduced to almost ridiculous proportions.The hon. Gentleman persists in arguing that the whole exercise should be reduced to ballots, to pursue what he described last week as his desire to have a by-election in every place where the staff of a hospital apply for NHS transfer status. No process of public consultation that I can recall on any important issue has been subjected to local referenda, of whatever electorate—certainly not by his Government or any other. Childish political ranting of the sort that we have just heard is no way to determine the future method of management of great hospitals such as St. James's hospital, Leeds, the Royal Liverpool children's hospital, or the others that I listed. NHS trusts will employ national health service staff. They will be their own staff. Just as Nottingham district health authority, which is in the national health service, employs national health service staff, so if any hospitals become NHS trusts, they will employ their own staff as NHS staff. It is absurd for the hon. Gentleman to keep repeating that somehow their staff, property or premises will cease to be national health service staff, property or premises. If the hon. Gentleman continues to deploy that sort of argument as his contribution to public consultation on such important matters, I can only believe that he is deliberately trying to alarm and deceive the staff who work in the hospital to get them to come to an opinion that is contrary to the facts. I do not want that sort of contribution from the hon. Gentleman or anyone else, although criticism of the proposals will be welcome if it is constructive. We are seeking a serious process of local public consultation, during which those most affected can properly consider the proposals being put forward by the staff and managers of the hospitals, make comments on them and give their view about their probable effect on services. That will serve the purpose that public consultation is meant to serve, in all such ministerial decisions, by helping me to make a better informed decision that takes into account every serious proposition on the issue. The Labour party, which has no policies on health care, will use the whole process for rent-a-mob demonstrations, usually in the high streets of our towns, but occasionally on the Floor of the House.
Order. I appreciate the importance of the statement, but we have an important debate today on the arts. It is a rare opportunity to debate the arts. [Laughter.] I assure hon. Members that it is no laughing matter. So great has been the pressure to take part in the debate that I may have to impose a limit of 10 minutes on speeches. Therefore, I ask for single questions to the Secretary of State. If hon. Members inadvertently ask more than one question, I should be grateful if the Secretary of State would answer only the first.
I know that my right hon. and learned Friend is aware of the position that I sought to describe yesterday, but other colleagues will not be aware of how large the Trent-region is. It provides cardiac surgery to the north in Sheffield and cardiac surgery to the south in Leicester. Local medical and surgical opinion in Nottingham rightly sought to have that provision in Nottingham in the Queen's medical centre. Under local management, would that local decision be possible and not subject to an external veto?
I am grateful to my hon. Friend for waiting 24 hours for the answer to his question. More serious cardiac services are usually a regional specialty. Under the new arrangement the regions can continue to provide them as a regional specialty, and that includes deciding on the best location for them. However, where a hospital has opted for NHS trust status, one reason for doing so would have been because it wished to put forward its plans for the development of services in that hospital. Whether an NHS trust would be likely to proceed with the desire to develop cardiac services, as my hon. Friend has described, would depend on its ability to interest GPs and districts in providing the contracts for that service, if it was opened.To that extent, taken with all the reforms the change will open the way to better, more local decisions, which are more influenced by the doctors, nurses and managers in great hospitals like the Queen's medical centre, which serves both our constituencies.
How can the Government justify their belief that when a private organisation such as a trade union takes action that could affect the public it should have a ballot, but that a public organisation which wishes to make a change in policy should not consult even when the public will be affected? Does not the right hon. and learned Gentleman realise that his statement today against extending people's right to have a say on this matter was the argument that his party has used every time that the House has considered an extension of the franchise?
With the greatest respect, that is a quite extraordinary analogy. A trade union that takes industrial action is asking its members—a definable group; a quite clear constituency—to break their contracts of employment with their employers. It was wrong ever to have had a position in which a member of a trade union could be subjected to the discipline of the trade union, sometimes in a closed shop, without being allowed any say before the action started on whether he or she wished to break his or her contractual relationship with the employer.I see not the slightest resemblance between that process and the process of public consultation which Governments of all complexions regularly allow to take place on all kinds of complex, special interest subjects. It so happens that the management of the NHS is one of the more complex matters with which Ministers and the House must deal. There is no defined electorate that could cast a vote in a ballot because no one knows in which hospital he or she is likely to be a patient. There is no group that owns the hospital or knows that its members are bound to be patients of that hospital. The ballots for which the Opposition ask are part of the demonstration campaigning which they propose to lay on this summer. They know perfectly well that they would play no part in the decision-making of any political party which really believed that it would be in government.
In many respects, do not the new national health service hospital trusts correlate to the old hospital management committees and hospital boards? Is it not strange that the Opposition were content for the best part of 30 years to support the old structure but, for some peculiar reason, are not prepared to support the new one?
I agree with my hon. Friend. During the first 25 years of the health service, we had local management. To some extent, we are reversing the 1972 changes. This is particularly ironic for me, because I was in the House at that time. I was the Government Whip on the Committee that considered the Bill that created district health authorities. The then Labour party fought to the death to defend the old local arrangements against the bureaucracy which it said we were creating. Now that we are reducing that bureaucracy, the Labour party is defending it.
Everything come to he who waits, Mr. Speaker. How far will we be able to trust self-governing trusts? Will they be run on the same basis as trust ports? The Secretary of State for Transport is encouraging the use of private Bills to privatise trust ports. Will not similar patterns begin to emerge for self-governing hospital trusts, in that those who are trusted to run one may decide to run away from that trust because of pressure from the right hon. and learned Gentleman?
There is really no resemblance between NHS trusts and port trusts. I happen to think that privatising some of the trust ports is one of the best ways that one can find of improving their performance and the service that they give to industry. I have always been in favour of industrial privatisation. I am against the privatisation of the health service. I have always been against the privatisation of the health service and I will continue to be against it. The NHS trusts will be within the national health service, owning property that is NHS property, employing staff who are NHS staff and treating NHS patients who will not pay for the treatment. They bear no resemblance to the commercial world in which the port trusts work.
My right hon. and learned Friend will know that, to date, I have not managed to support his broad reforms, but I recognise that there is great merit in the concept of NHS trusts. Therefore, I read with particular concern the leaflet on NHS trusts, which stated:
Precisely how will that be done?"Those with an interest—staff, GPs, health authorities, community health councils and, above all, the local public—will be asked their views … and will have an opportunity to express an opinion".
It will be done by the process of consultation over three months which I am asking regional health authorities to conduct. I shall ask them to publish the results of that consultation and come back to me with their comments so that I can make a better-informed decision.I am grateful to my hon. Friend for reading that passage in my booklet. Like him, I would emphasise the "general public". The difficulty with public consultation is that it becomes dominated by overnight committees, various interest groups and trade unions—[HON. MEMBERS: "Ah."] Oh, yes. The Labour party is pouring the community charge into all kinds of front organisations which will respond to the consultations. The general public's interests are most affected by how well local hospitals are run for their benefit. I hope that in the middle of this political process, which the hon. Member for Livingston (Mr. Cook) is trying to stir up, the ordinary member of the public will give his or her views on what he or she would like from local hospitals.
Will the Minister tell the truth and say that opting out of hospital services is a small step to privatisation? Patients will have to pay for treatment or to stay in hospital, in the same way as the Government introduced charges for eye tests and dental services.
I always tell the truth, and I do not believe that the hon. Gentleman believes the proposition that lies behind his question.
Does my right hon. and learned Friend agree that the great national teaching hospitals—I am concerned with the royal national orthopaedic, the last on his list—are particularly suited to NHS trust status, provided that there is balanced local consultation and that the eventual structure is right and rational? Will he reassure opinion that that will be done properly, with careful thought, and that site and buildings ownership will be properly settled so that those hospitals will be assured of a viable long-term future—particularly, of course, the RNOH?
I am grateful to my hon. Friend. The last application that I received before leaving the office was a letter which states simply:
"The Staff of this hospital wish you to consider the Royal National Orthopaedic Hospital for National Health Service Trust status."
I am sure that the staff's opinion will be rejected by the hon. Gentleman if it does not coincide with his own.The new bodies must be established carefully. Before any application is approved, we will ensure that the people appointed to the board are competent, that their plans have been well drawn up and considered and that they are likely to be successful in delivering them. The point of consultation is to ensure that there is no chance of an ill-thought-out application getting through and that the approved applications enhance the service to patients.
As the right-wing extremists in the Tory party fear the ballot box, will the Secretary of State spell out in some detail how consultation will take place? For example, if all the nurses at Broad Green and Alder Hey hospitals in Liverpool say, "No, we do not want this ideological dream of the Tory party", will he still go ahead and pursue these aims? Will he still say yes to hospital trusts? Does he agree that the only people who are pursuing these proposals with vigour are the petty bureaucrats whom he appoints, who are looking not to the interests of the patients but for knighthoods and peerages?
I will obey your injunction, Mr. Speaker, and answer only the first question. I do not answer for the right-wing extremists in the Conservative party. The hon. Gentleman should address that question elsewhere.
Will my right hon. and learned Friend confirm that the criterion by which he will reach judgments on applications is the quality of service that will be provided to patients? In the context of Leeds and the two applications from the great teaching hospitals, will he consider whether mergers of trust hospitals would be desirable and whether, as a consequence, rationalisation of district health authorities would be necessary?
I agree with my hon. Friend's premise that what matters is whether the change in status is likely to improve the quality of care to patients. In Leeds, it will be necessary to have a serious local discussion about the prospects of mergers of district health authorities, in which some are interested. Mergers of hospitals will not necessarily arise, but people wish to consider how the plans for both those great hospitals interrelate. The aim must be to set up a structure for managing and delivering the health service in Leeds that is likely to improve, to yet higher levels, the high standard of care in that city.
How can anyone have confidence in the Secretary of State promising local public consultation that will be worthy of that term when his track record in managing the health service shows that he imposed a contract on doctors, against the clear evidence of consultations with them, and shows the total lack of consultation with ambulance workers throughout months of a damaging dispute which cost millions of pounds? The evidence of those consultations, as he confirmed from the Dispatch Box this afternoon, will come from political appointees, who will be appointed by him to an extent unparalleled in the history of the health service.
I negotiated an agreement with the representatives of the GPs involving the stipulation for the first time of the services that GPs should provide to the public under the contract. I accept that that was later repudiated by the GPs, who said that they wanted the money without the description of services.I did, indeed, resist the ambulance men's claim for a double-figure pay settlement and a high formula, because the health service could not afford it. The hon. Gentleman's test of democracy appears to be that people should be allowed to write their own contract of employment and specify the figure for their own pay. He says that it was undemocratic that I did not accept the GPs' and ambulance men's assertion of what they wanted. In both cases, I defended the public interest and, in the forthcoming consultation, I shall be bearing in mind the public interest—and not just special interests—in reaching my decision.
As the public have never been balloted on hospital closures, on the location of specific regional facilities or on internal reorganisation of facilities in hospitals, why should they be balloted now?
I agree with my hon. Friend. No Government of any political complexion have carried out a ballot on any decision in the health service since it was first created. The question of NHS trust status is one of the most complicated issues that has been put before the public during the lifetime of the NHS and it is particularly unsuitable for resolution by ballot.
The two teaching hospitals in Leeds provide a world-renowned service. They move at the frontiers of knowledge and during my 30 years in Leeds I have been surprised that provincial hospitals can be so good. What will happen now that the motive is a contract? How on earth will the hospitals be able to maintain university standards in conjunction with the university of Leeds given that the Government's proposals fly in the face of that aim?
After April next year, all the hospitals in the national health service, whether self-governing or directly managed, will enter into contracts for the services that they deliver. They will not be commercial contracts—
I advise the hon. Lady to read the White Paper, even at this late stage. There will be an agreement with the health authorities or the GPs, who will stipulate what services they want and what quality they require in exchange for an allotment of national health service resources to the hospital that will deliver those services. The separation of purchaser and provider has been welcomed by most people who have commented on the running of the health service. Even the Opposition are reported as saying that they accept the other way of describing the arrangements, which is that the money will follow the patient. I do not understand how the Opposition can have accepted the principle of what they have been describing for the past 12 months as the internal market but then continue their strident opposition to 1 he reforms that enshrine that concept.
Does my right hon. and learned Friend agree that the Opposition did not want the statement today—[HON. MEMBERS: "We asked for it."]—because they do not want the public to hear that there is genuine enthusiasm among all sectors of the service? [HON. MEMBERS: "Where?"] Those hon. Members who ask "Where?" should look at the ballot of consultants at the London hospital which came out in favour of self-governing status. Does my right hon. and learned Friend agree that Labour Members are interested only in trench warfare on behalf of their party political allies, the National Union of Public Employees and the Confederation of Health Service Employees?
I entirely agree with my hon. Friend. We continue to face strident demands for public consultation, which we have always said we want, from a party that will not even listen to the answers that we give to its alleged questions on the subject. My hon. Friend is also right to point out that numerous ballots of consultants have come out heavily in favour of NHS trust status. I do not rely too heavily on ballots because I am consistent in my argument that straightforward ballots of any group, however important, cannot in themselves determine one way or the other the future management of a hospital. There are plenty of hospitals where staff and consultants have voted in favour of an application.
I am sure that the right hon. and learned Gentleman will agree that there are those who want self-governing trusts, but some of them are concerned that officials will restrict their operations. The Secretary of State said that the trusts would be getting their contracts from health authorities. But will health authorities attempt to thwart such trusts and other hospitals that refuse to enter into contracts with them for particular services?
I agree with the hon. Gentleman. There are those in the service who are keenly in favour of local management of hospitals and NHS trust status. They constantly ask me to reassure them that they really will be given the local freedom to manage and develop hospitals as they wish. I keep giving them that assurance. They will be free from district health authority, regional health authority and Whitehall control of their day-to-day affairs. The contracts that we are describing will be entered into by every hospital and those contracts will be placed by the health authorities and by the patients on their assessment of the quality and value for money of the care that they are likely to receive under those contracts. Any other interference with self-governing hospitals' status and decision-taking will be ended by our reforms and they will be protected by the NHS trust documents that set them up.
Is my right hon. and learned Friend aware that many medical experts believe that this transfusion is just what the hospital service needs? Will he confirm that what he is now endeavouring to do, together with other health service measures, is to put the genuine public interest first over and above the partial and vested interests of some doctors, some bureaucrats and the Labour party?
I entirely agree with my hon. Friend. The longer the process of introducing the reforms continues, the more opinion is changing—which it is doing quite rapidly—within the service in the direction that my hon. Friend describes and for the reasons that he gave.
Is the Secretary of State aware that even tonight my local hospital, King's College, is considering a massive programme of cuts, ward closures, cancellations and bed closures? If the hospital was a trust, would not people like myself, my hon. Friend the Member for Peckham (Ms. Harman) and those who live in Dulwich and Bermondsey have the last vestige of democratic accountability removed from them because those cuts could be made without regard to local people?
No hospital will acquire trust status unless it can demonstrate that it is well managed, can achieve financial stability and has proposals for delivering the services that it wants within the resources that it is likely to get.London health authorities, like all health authorities, face problems, but, like other authorities, they must deliver their services within the available resources. If London hospitals are allowed to disregard that, they will do so at the expense of other health authorities in the home counties from which the money would be drawn to cover the deficits. It is perfectly possible, as many London hospitals demonstrate, to deliver a good quality of service in acceptable quantities and stay within the generous allocations of funds that are nowadays made to the national health service.
With an aging population and the ever-increasing costs of the national health service do not we need a dynamic, progressive and efficient health service? If hospitals feel that by governing themselves they can deliver better patient care, why should they not be allowed to do that? Incidentally, it is not compulsory, it is optional.
I agree with my hon. Friend. Anyone who is seriously interested in the quality of health care wants it to be delivered by an efficient and well-run organisation. It is absurd to say that because something is a public service, it is wrong to look at efficiency, better decision-taking and the better use of resources and their delivery. The more important the service, the more important it is to get the right structure of management for it.
If the Secretary of State were to go into hospital for a serious operation, would he trust the doctors and nurses to have his life in their hands? If so, why does he not trust them to give their opinions about the national health service?
The answer to the first question is, of course, yes. On medical matters, I pay considerable regard to their opinions. However, I would not necessarily find totally compelling the opinion of a surgeon on what car to buy or on a subject that was outside his immediate professional expertise. The doctors and nurses work inside the service and management matters a great deal to them; it will have regard to their views. If health care policy had always been dominated by the expressed opinions of doctors in ballots, we would not have had the national health service in the first place because they voted by 9:1 against the contract that Nye Bevan originally offered to them in 1948.
Since the creation of NHS trusts will tend to increase the power of comsumers at the expense of that of producers, does my right hon. and learned Friend agree that only someone who was totally obsessed with protecting the power of trade union bosses and did not care a jot about how much he alarmed poor old patients would describe the matter in the terms used by the hon. Member for Livingston (Mr. Cook)?
I wholly agree with my hon. Friend. If there is one key to the changes that we are trying to make in public service to improve people's quality of life, it is that we want our public services to be dominated by the interests of consumers—in this case, patients—not by the interests of producers. The Labour party is an old-fashioned syndicalist party, completely dominated by trade union interests, and deeply resistant to change of any kind in the public sector.
May I advise the Secretary of State that St. James's hospital covers a large area of my constituency, and the constituents of Rothwell, who are served by the Leeds Eastern health authority, have made representations to the effect that they vigorously oppose the trust system for St. James's hospital? How will the consultation procedure apply to my constituents? Are not we witnessing an extension and a bigger stake of private hospital services in the national health service?
I would seriously ask the inhabitants of Rothwellto look at the applications being made by the people who work at St. James's hospital, to look at what they propose for the development of services, and to consider their arguments.
How are they to do it?
The application documents are public documents. We shall have a public consultation process. I trust that those who are promoting self-government for St. James's hospital will make sure that their case is available and is put across to the people of Rothwell. With respect, I do not think that the hon. Gentleman is doing any service to his constituents by turning round the proposals of local doctors as though local doctors are seriously suggesting turning the hospital into a private one. That is total nonsense and does not help the process of serious public consultation.
Does my right hon. and learned Friend agree that patients of the royal national orthopaedic hospital, for example, come from such a wide area of the country that the only conceivable ballot of those interested would have to be a general election? [HON. MEMBERS: "Hear, hear."] Does my right hon. and learned Friend believe that our winning the next general election will put an end to the spurious demands for inappropriate consultation?
My hon. Friend has made a valid point. It would be pointless to carry out a ballot of the residents of the immediate locality about the future of the royal national orthopaedic hospital, the Royal Liverpool children's hospital or quite a large number of hospitals that I have mentioned. The first point that was put forward by the proponents of the Royal Liverpool children's hospital is that
They go on to set out other reasons, too. That applies to quite a number of the applications that we already have. Again, it shows that the idea of reducing the matter to a simple local ballot is an attempt to reduce the issue to ward politics, which is what Opposition Members are doing, whereas we are interested in the future of the service. At the general election, people will want to judge which party is putting most effort into trying to keep up and improve the quality of our national health service."it is inappropriate that a hospital providing services to the vast majority of DHAs in the North West of England and Wales is managed by only one DHA."
How can the House take the Secretary of State's argument seriously when hon. Members have had lectures from him over the years about the need to make local councils more accountable and the need to make trade union officers more accountable through votes and political influence? It is now suggested that a major change in the national health service cannot be put to the consumers of whom he spoke so movingly because the Secretary of State does not know how to define them. How can he conduct serious consultations if he does not know who should vote, and how does he know whom to consult?
The point has just been answered extremely well by my hon. Friend the Member for Mid-Kent (Mr. Rowe). There is no definable electorate. No doubt that is only one of the reasons why no Government have suggested that local changes of this sort should be put to the views of the local electorate. If the Labour party has no views of its own on how to run the health service and says that the matter should be reduced to a yes/no referendum of the local population, it shows that it is in a desperate situation.
Southend-on-Sea has again given a lead to the country, with the support of its Members of Parliament, in being among the first 12 to apply. Does the Secretary of State accept that apart from the advantage of local management, the other advantage that we see, and which others should see, is that this is a way of escaping from the bureaucratic nightmare of being, for years and years, an underfunded district in an overfunded region? Will my right hon. and learned Friend explain that the proposals can help some areas, such as Southend?
For years, Southend has suffered from being a low-funded district in a well-funded region and has been badly affected by the RAWP system. I congratulate Southend district health authority on the quality of the care that it succeeds in providing with much lower resources than would be available to an equivalent population in most other parts of England. Other parts of the reforms will help Southend, such as the new system of allocating finance, to be introduced in April. That will put into the district health authority's hands the cost of providing care for its residents and will enable it to have more control over its use. Southend has shown that it wishes to get out of the present situation and to put to better advantage the good qualities of management and care that it has shown when facing its difficulties over recent years.
On the point about consultation, is the Secretary of State aware that today in Liverpool, while the area health authority is grappling with the problems of the pan-Liverpool plan for the NHS, four of his place henchmen have drawn up a secret agenda to start charging for breast cancer treatments for women under 50 years of age, and for treatments for people who are suffering from other complaints? Is he aware that they are selling off parts of Liverpool hospitals? Is he aware that those things are already on the agenda? Is he further aware that 1 he regional drugs unit in the city is underfunded, thus bringing on an epidemic of AIDS because of prostitutes and drug addicts? Who is telling the truth in all this? Is the Secretary of State telling the truth? Are the people of Liverpool lying? There is an agenda.
Area health authorities were abolished nine years ago. It will remain illegal to charge for national health service treatments.