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Commons Chamber

Volume 404: debated on Tuesday 29 April 2003

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House Of Commons

Tuesday 29 April 2003

The House met at half-past Eleven o'clock


[MR. SPEAKER in the Chair]

Private Business

Mersey Tunnels Bill (By Order)

Order for consideration, as amended, read. To be considered on Tuesday 6 May.

Oral Answers To Questions


The Secretary of State was asked—

Nhs Staff (Resources And Decision Making)


What plans he has to devolve resources and decision making to front-line staff. [109800]

Power and resources are being devolved to the NHS front line. The old health authorities and regional offices have gone, and new primary care trusts are now in place, which control three quarters of the total NHS budget so that local services can be shaped better to meet the needs of local communities.

Does my right hon. Friend accept that to create a world-class health service we need both investment and reform? Investment is running at record levels. Is it not now time to try to influence, involve and empower all members of the NHS team in taking forward our health service?

I very much agree with my hon. Friend. Clearly, record resources are now going into the national health service, and we have the fastest-growing health service of any major country in Europe, after many decades, including under the previous Government, during which investment was cut back rather than increased. As my hon. Friend rightly says, we need reforms in the system as well as resources, and now is not the time to take our foot off the accelerator of reform. With the extra resources going in, we need to see as much pace on reform. In particular, we need to ensure that we get the balance right in relation to standards being set nationally to guarantee equity in the system, about which we have done a lot over recent years, with national standards and national systems of inspection. Ultimately, however, neither I nor this place delivers health care: it is delivered out there in local communities by local members of staff. Those people, both in the community and among members of staff, should be empowered.

But does the Secretary of State acknowledge that, two weeks ago, Dr. Ian Bogle of the British Medical Association said that new evidence showed that 80 per cent. of doctors had not seen any improvement as a result of the increased NHS spending, and that excessive national targets were preventing additional money from reaching the front line of health care? Does he agree that it is not surprising that the general public have lost confidence that the Labour Government are capable of delivering a first-class NHS?

Of course, Dr. Bogle is a member of the NHS modernisation board, which produced its recent annual report. I do not know whether the hon. Lady has had an opportunity to look at that annual report, but among other things it said that the money was getting through to the front line. Indeed, it went on to say that the NHS was turning the corner. Clearly, there are problems that are still outstanding, but the only way of addressing them is to continue reforms in the national health service and continue putting resources into it, and not to do what the hon. Lady and her party propose, which is to cut NHS budgets by 20 per cent.

Is not my right hon. Friend the Secretary of State anxious that his proposals for foundation hospitals may reduce the improvements that primary care trusts are bringing in representing local communities and that "agenda for change" has the potential to bring in terms of NHS staff pay?

No, I am not anxious about that, for a number of reasons. First, for the very first time under the NHS foundation trust proposals—I think my hon. Friend has seen a copy of the Bill that has now been published—primary care trusts will be represented on the board of governors of NHS foundation trusts, thereby strengthening the link between primary and secondary care, which I know is what she is keen to see, as I am too. I think she is further aware that, in addition to the safeguards already in the Bill, I have given a guarantee that the "agenda for change" pay system, which we have negotiated with the NHS trade unions—to which I am pleased to say both the Royal College of Nursing and the Royal College of Midwives, have given the go-ahead in ballots by votes of 80 per cent. and 90 per cent.—will apply across every part of the national health service, including in NHS foundation trusts.

Does the Secretary of State agree that what most people want to see in terms of resources in the front line is a full range of complementary and alternative therapies? May I take this rare opportunity to congratulate him on his announcement over Easter of £1 million to go into research and development in relation to complementary therapies? Can he explain why that news came out over Easter, as the bank holiday weekend is traditionally used to put out bad news? Is it because he is acutely embarrassed that it has taken the Government so long to see the light, and the need for a greater use of complementary and alternative therapies in the health service?

I know that the hon. Gentleman has a certain regard for complementary therapies. I do not think that they are the talk of the pubs and the clubs in my constituency, but they may well be in his. One of the reasons why we gave the go-ahead for the additional £1 million was in the very real hope that he would not raise this issue at every single Question Time. Alas, my hopes have been dashed.

The NHS is refusing to spend £30,000 for a bone marrow transplant programme for my constituent, Diana Fildes, who has Crohn's disease. Will the devolving of resources start to help people such as Diana in the future? Is it not a mammoth task for family, friends and former pupils to have to seek to raise £30,000 in funding for private treatment? What have we got a health service for if not for that?

I am not aware of the case that my hon. Friend has raised but, if he passes me details, I will be more than happy to look into it and to come back to him.

In making the changes in the NHS, it is important that we get the balance right. It is obviously important—I think that most people would agree on this—that we should have national standards and some national targets in place precisely to ensure that there is equity in the system. None of us—at least on the Labour Benches—wants to go back to the days when, for example, cancer drugs were available in one part of the country but not in another. Equally, having put those national standards and national systems of inspection in place, it must be right that we give both the people who are responsible for delivering the care and the communities that receive it a greater say in how those services are provided to local communities. That is what primary care trusts are about arid it is what NHS foundation trusts in time will be about, too.

Worcestershire Royal Hospital


What assessment he has made of the performance of the Worcestershire Royal hospital. [109801]

The Worcestershire Royal hospital, as part of the Worcestershire Acute Hospitals NHS trust, was awarded two stars in the latest NHS performance ratings, received a positive Commission for Health Improvement clinical governance report recently, and achieved all its waiting list targets for the end of March 2003. I would like to congratulate all the staff at the hospital on their commitment and dedication to the needs of NHS patients.

I thank my right hon. Friend for that reply. He may have noticed that the Worcestershire Royal hospital was shortlisted as one of the top six hospitals in the country by a recent survey in The Sunday Times. Would he add his congratulations on that achievement and does he share my dismay that one Member of the House commented that The Sunday Times survey must be worthless because the Worcestershire Royal hospital did well in it? Does he agree that such comments do nothing for staff morale and nothing for the recruitment of key medical personnel, but have everything to do with undermining faith in our national health service?

The Worcestershire Royal is an excellent hospital that is doing a very good job in improving the range of services available for local people. I would certainly like to emphasise the achievements that have been made in the hospital. I also think it is incumbent on all right hon. and hon. Members to support their local NHS. When that does not happen, it is a cause of great disappointment, not least to staff locally.

Notwithstanding the very real achievements that doctors and nurses have made at the hospital, I am sure that the Minister would wish to say that there are some very real problems at the trust. The district auditor's report identified it as the most expensive in the west midlands, and there are acute car-parking problems and patients cannot make appointments. [HON. MEMBERS: "Oh, dear."] I am sorry that Labour Members feel that patients not being able to make appointments is a matter of no concern. There are also serious waits on trolleys after accidents, and a whole range of problems. Will the Minister tell the House by when the trust will have to clear its accumulated deficit, because the great pressure it is under to meet financial deadlines imposed by the Government is inhibiting its ability to deal with its remaining problems? When will it have to clear its deficit?

I think the hon. Gentleman is right to draw attention to the fact that there are continuing issues. He has referred to the problems of car parking at the hospital, which I understand the local trust is addressing.

In relation to resources, I caution the hon. Gentleman, who I know is a strong supporter of the NHS. It is important to bear in mind that, over the next three years in Worcestershire, the NHS will see a growth in resources of more than 30 per cent., and that is very important. It will help the trust to address those underlying difficulties and it will allow the service to grow and expand to meet the needs of local people. I simply say to the hon. Gentleman in the politest way that I can that it is no good coming to this place moaning about the financial position of local NHS trusts when he and his party will not support the additional investment that is going into the NHS.

The Minister will be aware that the wait for an MRI scan in Worcester is more than 12 months and that the mobile MRI scanner at Kidderminster, where the waits are shorter, is about to be withdrawn. Will he ensure that the static MRI scanners to be installed elsewhere in the county— particularly in the diagnostic and treatment centre at Kidderminster—are not delayed by the county's financial deficit?

I am not familiar with that particular problem, but I will certainly look into it.

Dual Diagnosis


If he will make a statement on services provided to patients with dual diagnosis of mental health and addiction problems. [109802]

As part of the work to modernise mental health services, the "Dual Diagnosis Good Practice Guide" was issued last year. Following the publication of the national service framework for mental health, we have embarked on a radical modernisation of services to improve access to effective treatment and care, to reduce unfair variation, to raise standards and to provide quicker and more convenient services to all people with mental health problems including those with a dual diagnosis of addiction.

Does the Minister agree that such patients have a particular need for supported accommodation and ongoing social services support? However, because they have the greatest problems, they are often the ones who fall through the safety net. Will she consider increasing resources for programmes such as assertive outreach and ensuring that patients with dual diagnosis problems are taken into account?

My hon. Friend raises an important point. Despite the considerable extra investment in our mental health services and staffing increases, we nevertheless need to examine new ways in which to organise the services. I strongly agree with her, as we spelt out in the national service framework, that assertive outreach teams are particularly able to get to some of the people who have fallen out of touch with services in the past, perhaps because they had additional problems such as drug or alcohol addiction, which had knock-on bad effects for their health and for communities as a whole. That is why I am pleased that extra investment for assertive outreach teams is being considered in Tower Hamlets. The existing investment in our mental health system means that 191 additional assertive outreach teams are operating throughout the country to bring people who had lost touch with mental health services back in touch.

A lesson from the first Gulf conflict was that many returning service personnel were susceptible to mental health problems, which were often combined with addiction problems, especially alcohol addiction. Given that fewer than 20 per cent. of the Government's required crisis resolution teams are in place, how can the Minister justify her claim on 6 March that there is

"operational flexibility within the system"
to enable the NHS to deal with the mental health needs of servicemen and women returning from the Gulf, many of whom are likely to be given a dual diagnosis? Is it not the truth that the Department of Health and the Ministry of Defence are woefully unprepared?

No, it is not. As I have spelt out in response to the hon. Gentleman's questions, it is clearly the business of mental health services to deal with any mental health problems that might arise when people return from active service, as is the case with the wide variety of other needs that they address. We have made it clear that people with a dual diagnosis of mental health problems and drug or alcohol addiction are mainstream business for mental health services.

The hon. Gentleman seemed to suggest that we need more investment and an expansion of capacity. As I have said, there are already 191 extra assertive outreach teams. We have 62 more crisis resolution teams, 22 more early intervention teams and there are 25 per cent. more community psychiatric nurses working in the system than in 1997. There are problems and the only way in which to address them is to continue with the investment that the hon. Gentleman and his colleagues have opposed far too often.

Fewer than 3 per cent. of people with an addiction to heroin are receiving medical treatment. How long will we allow a presumption in favour of dual diagnosis to be a smokescreen for stopping proper medical treatment for such people?

The dual diagnosis guidance that we issued made it clear that treatment for the significant number of people who have both a serious mental illness and a drug addiction is part of the mainstream business of mental health services. We need to do work, especially to ensure that we reduce waiting times for people who need specialist treatment services, which also have specialist mental health services alongside. We are making progress on extra capacity and new ways in which to deliver those services. I agree with my hon. Friend that it is unacceptable if people do not receive suitable treatment. We will ensure that we address the problems through the additional investment and new forms of treatment that we are implementing. However, only the investment that we are undertaking will ensure that that happens.

Needlestick Injuries


If he will make a statement on needlestick injuries. [109803]

The Government recognise that the number of needlestick injuries occurring in the NHS is still too high. The Minister of State, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), recently met the all-party parliamentary group on occupational safety and health and agreed that new guidance will be issued to the service in the autumn.

Given that the annual cost of treating NHS workers who have suffered needlestick injuries is estimated to be in the order of £300 million and that the estimated saving from acquiring safer needles could be about £140 million, and given that even when needlestick injuries are subsequently shown not to have caused serious physical harm they almost always cause immense emotional trauma, will my hon. Friend join me in supporting the objectives of the Needle Stick Injury Bill promoted by my hon. Friend the Member for Crawley (Laura Moffatt)?

My hon. Friend is right that needlestick injuries are a serious issue in the NHS. They cause immense distress to staff, especially when they are waiting for the test results to discover whether they have been infected. That is why we support the work of the safer needles network and why the Department works with trade unions and staff on that issue. Safer devices have a role to play. Equally important, however, is excellent training for staff on how to use those devices, and refresher training has been proven to reduce the number of incidents dramatically. On the Bill, health and safety legislation requires incidents to be reported. We want those regulations to be used as much as possible to ensure that we have the fullest possible information so that we can support staff in those difficult conditions.

Nhs Dentistry (South Devon)


If he will review the level of provision of NHS dentistry in South Devon. [109804]

We are committed to rebuilding and restoring NHS dentistry to continue to improve the oral health of the nation. Alongside the proposals in the Health and Social Care (Community Health and Standards) Bill, 26 field sites covering 50 different locations are being set up to test different ways of providing NHS dentistry. One of the largest of these field sites covers the south-west peninsula and builds on the successful personal dental services pilot in Cornwall.

In spite of that answer, is the Minister aware that no dentist in Totnes is taking newly registered patients and that it takes a whole day on public transport to go to and to be treated by an NHS dentist, which is not possible for many people? Would it help if we ring-fenced the dentistry part of the primary care trust budget to relocate dentists into south Devon?

I know that there are problems of access in south Devon because of rurality. If one dentist leaves a town or village, it can mean that people cannot get registered. That is why we are putting in dental support teams across the country where there are still access problems and the hon. Gentleman's area will of course be considered for that. I hope that he will support the Bill that I mentioned to ensure that primary care trusts can commission dental services in the way that he suggests.

Care Workers (Kent)


What plans he has to increase the number of care workers being trained in Kent. [109805]

Training of care workers supports and protects vulnerable people and helps to recruit and retain important staff. That is why we are providing more than £2 million of additional money to councils in Kent this year specifically for training and work-force development, as well as funding through Topss England, formerly the National Training Organisation for Social Care, to help the staff of all social care employers in Kent to undertake training and qualifications.

I welcome that extra investment for Kent. I know that my hon. Friend takes a close interest in all Kentish matters and she is welcome in the garden of England any time.

In addition to that investment, £750,000 has been secured from the Learning and Skills Council by the Kent community care association, working in partnership with Unison and local authorities to train some 40,000 care staff throughout the county. Is it not the case that quality training is crucial to recruitment and retention of care staff? What is my hon. Friend doing to monitor and evaluate the situation? It is all very well getting the cash, but it is essential that it is used to good effect for the benefit of older people throughout the county.

My hon. Friend is right. I enjoyed our meeting with the Kent community care association, which, as an employer in the voluntary, independent arid private sector, has clearly showed its commitment to training staff. However, it has also recognised that in the past it has sometimes been difficult, even when additional resources have gone to local authorities, for a significant number of employers in the independent sector to get access to those funds. That is why we will be putting a condition on the additional money that we will make available over the next three years requiring 50 per cent. of it to be spent in the independent sector.

My hon. Friend rightly said that that will clearly make a difference to the number of people being trained, which is why the national minimum standards, particularly in domiciliary care and care homes for older people, now include requirements that people who are caring for the most vulnerable people in our communities receive the necessary training. That will be monitored by the National Care Standards Commission and will play an important role in improving the status of people who work in care, thus helping us to recruit into that work.

Does the Minister accept that one of the problems facing trainees and care workers in Kent and elsewhere is the fiasco over the past 12 months with the Criminal Records Bureau? Does she accept that notwithstanding the two U-turns that the Government have had to make there are still considerable problems? Does she not feel that it was unwise not to accept the advice of the Opposition prior to the implementation of checks, to the effect that the bureau was over-ambitious in seeking to check everyone from the outset? What is happening to the backlog, as opposed to current applicants requiring a check? The evidence suggests that there is a considerable problem with that backlog despite the fact that current applicants are being dealt with quicker.

I think that the hon. Gentleman arid I will have a chance to pursue that at greater length later this afternoon, but I can offer him reassurance now. I share his concern about the performance of the Criminal Records Bureau, which is why my right hon. Friend the Home Secretary instituted a significant review of its operations and why we, along with other colleagues in government announced last November a delay in implementing some of the bureau's checks for certain groups of workers. We wanted to make sure that we could get the bureau back into the shape necessary to provide protection for vulnerable people—a role in which I believe it plays an important part.

I can assure the hon. Gentleman not only that there are now substantially more checks every week than last summer but that significant inroads are being made into the older applications that had got stuck in the system. My understanding is that the vast majority of those have now been worked through. Not only has the old problem been solved but the bureau is now operating far more efficiently. I am sure that the hon. Gentleman will join me in recognising the important contribution that that will make to safeguarding vulnerable people.

Finished Consultant Episodes


If he will make a statement on the number of finished consultant episodes in the NHS in England in each of the last four years. [109806]

The number of finished consultant episodes in the national health service in England increased from 11.6 million in 1997–98 to 12.4 million in 2001–02. For 2002–03, hospital in-patient activity is expected to increase by a further 4.5 per cent, and outpatient activity by a further 2.5 per cent.

I thank the Minister for his answer, although I note that he did not give a figure for finished consultant episodes for the coming year. The Chancellor of the Exchequer and the Secretary of State have made it clear—[Interruption.] The Minister gave a figure for elective admissions, where there has been a 4.5 per cent. increase, but did not give a figure for finished consultant episodes. The Secretary of State and the Chancellor have made it clear that increased reform in the NHS must accompany increased spending, yet we have all seen in our constituency surgeries that spending does not appear to result in our constituents having fewer problems with the NHS. If anything, the situation is getting worse. Can the Minister tell us when he expects increased spending in the NHS to be matched by increased activity?

I am sorry, but the hon. Gentleman clearly does not understand what he is talking about. The figures that I quoted to him are for finished consultant episodes in the years for which the information is available. I cannot give a figure for the number of finished consultant episodes for this year, because this year has not ended yet. The information is historical, not prospective. The hon. Gentleman asked when the additional investment in the national health service would produce additional activity. It is already doing so. For example, it has helped us to recruit an extra 5,500 consultants for the NHS, almost 50,000 additional doctors and almost 8,500 additional allied health professional therapists. The NHS is busier than it has ever been before. If the hon. Gentleman wanted any confirmation of that, he would just need to ask his local NHS staff, who would tell him that the NHS has never been busier.

Is my right hon. Friend aware that the number of finished consultant episodes—that is, the number of patients treated—at York district hospital has increased over the past four years by 11 per cent., and that in some specialties—in general medicine, for instance—the number of finished consultant episodes has increased by 34 per cent.? Will my right hon. Friend congratulate the York health trust on its achievement? Does he agree that if the Conservative party were ever in a position to implement its cuts—

I join my hon. Friend in warmly congratulating the staff in York on the excellent job that they are doing. He, like me, would probably have concluded from these and earlier exchanges that there are some people who want to talk down the national health service, as a cloak for a broader attempt to undermine the NHS and replace it with private provision and top-up vouchers—something that the Labour Government will never do.

Given that we need more operations than we have at present to clear the backlog, can the Minister explain why the Government have decided to spend so much extra on administration, rather than on front-line care, so that there are now more administrators than beds? Is that not a strange choice?

That is a hackneyed and well-worn contribution, and is simply not true. The right hon. Gentleman reaches that conclusion only by counting cooks, cleaners and porters as managers and administrators. Anyone with common sense—I am afraid that that excludes the right hon. Gentleman—would know what a load of nonsense that equation was.

Gp Waiting Times


If he will make a statement on progress towards the target of no patient's waiting over 48 hours for a GP appointment. [109807]

The most recent data from February this year show that nationally some 86 per cent. of patients are now able to be offered a GP appointment within two working days. In 1997 the comparable figure was only 51 per cent.

I declare a non-registrable interest, in that my wife is a GP.

Is the Minister aware that in West Berkshire there is one surgery that has had a vacancy for some months, which it is unable to fill? Locum GPs are like gold dust: they are so rare. Does the right hon. Gentleman accept that until the supply of GPs is improved, trying to meet the targets will make life intolerable for some GPs, particularly when one member of their practice is absent because of illness, holiday or a recent retirement?

I agree with the hon. Gentleman in one respect—that we need more GPs in the national health service, and we are recruiting more. Since 1997 there are 1,200 more GPs working in the NHS. That is a positive development, which I am sure he would welcome, as would his wife. There are local recruitment problems. That is obviously the case, as all right hon. and hon. Members know from their constituencies. I am advised that in the primary care trust in the area that the hon. Gentleman represents there are now 11 more GPs working than in 1997. That is progress, but I agree that there is more to do. I do not, however, agree that we will not meet the target unless there are significantly more GPs. The work of the primary care collaborative has shown—I do not know whether there are practices in the hon. Gentleman's primary care trust that have taken part in the work of the collaborative—that by looking critically at how we structure appointments in primary care, it is possible to provide patients with better access. One thing that I have learned, both as a Minister and as a Member of Parliament, is that access to the services of a GP and a hospital is the public's top priority. That is what we are trying to meet, and that is what the targets are designed to help bring about.

Does the Minister accept that one of the factors in obtaining an appointment with a GP is coping with rising population trends in areas such as Swadlincote in my constituency? Will he therefore advise NHS management to ensure that we proceed as rapidly as possible with the LIFT—local improvement finance trust—project to rebuild Swadlincote's clinic to accommodate a new GP practice, which would greatly improve access to GP care from that town?

Yes; I agree with what my hon. Friend says. The NHS LIFT programme is a very welcome boost to investment in primary care ensuring that almost £1 billion of investment will go into the infrastructure of the NHS primary care estate. That is long overdue, and it is an essential complement to the work that we are doing to improve services and secondary care. I agree strongly with what he said.

As ever, the Minister's response tells only part of the story. When the Government instructed GPs not to keep patients waiting more than 48 hours, the response from many practices was to stop taking appointments more than 48 hours in advance all together, even if patients wanted them. Is not this merely another target that is being achieved only by moving the goalposts?

No; that is simply not true—it is not the case. The Government have issued no such instruction. If the hon. Gentleman's case rests on some instruction that we have issued, I am afraid that he will be disappointed. The Department of Health has issued no such instruction.

Foundation Hospitals


What recent representations he has received in relation to his plans for foundation hospitals; and if he will make a statement. [109808]

Representations have been received from a number of organisations and individuals about NHS foundation trusts. The Health and Social Care (Community Health and Standards) Bill, which was published on 13 March, sets out our legislative proposals for NHS foundation trusts.

The Government's commitment to a primary care-led NHS with high national standards and free from excessive bureaucracy is most welcome, but does not the foundation hospital ideology run directly counter to those values? Is not the Secretary of State engineering a US-style system of health care rooted in market morality and private provision that is not old values in a new setting, but a mistake of fundamental historic importance—a Trojan horse for Sedgefield privatisers and Darlington money changers, perhaps? [Interruption.]

I got the impression that my hon. Friend was not too enamoured of the proposals. There is a fundamental difference, however, between the US system and the English and British system, and as long as this Government are in power, that will certainly remain the case. Our system is free at the point of use and it treats people according to their need, not their ability to pay. Anybody who wants to advocate the American system, as some Opposition Members do, needs only to look across the Atlantic to see what happens when profit is put before the interests of patients. Some 40 million Americans have no health insurance policy whatever. More charges for patients are not a Labour policy, but a Tory one. That is not what this Labour Government advocate or what NHS foundation trusts are about.

In his Budget statement, the Chancellor said that we needed to recognise local and regional conditions in pay and that the remits for the pay review bodies would have a stronger local and regional dimension. How will the Chancellor's regional pay operate in the NHS and what additional freedoms will foundation hospitals have in setting pay and conditions?

It is right, as my right hon. Friend the Chancellor of the Exchequer said, that we need to recognise that there are different labour market conditions in different parts of the country. That is already recognised and, incidentally, it has been recognised for many years, if not decades, in the NHS pay system. For example, we have a London allowance, although we do not have a Darlington allowance or, for that matter, for the information of my hon. Friend the Member for North-West Leicestershire (David Taylor), a Sedgefield allowance.

What the hon. Gentleman should know—I hope that he recognises this—is that the "agenda for change" pay system that we have agreed with the NHS trade unions has two fundamental elements. First, there is a national framework of pay to guarantee equity in the system, which ensures, for example, that two nurses working in different parts of the country can be guaranteed broadly the same benchmark level of pay. However, the system also recognises that because there are different labour market conditions, there should be some local flexibility. That is what the Government negotiated with all the NHS trade unions—Unison, GMB and the Transport and General Workers Union. As I said, I am pleased that the first two of those unions and the Royal College of Nursing and the Royal College of Midwives have given the go ahead to that. Incidentally, that "agenda for change" pay system will apply to all NHS foundation trusts.

We naturally welcome it when the Government are converted to the importance of market solutions to the problems in the public services. We now have the Chancellor's regional and local pay, the Prime Minister talking about co-payment, PFI elevated to a neo-religious movement, PCTs purchasing from private providers, including private hospitals, and opt-out foundation hospitals on the way—all aimed at greater diversity in provision. The Secretary of State may recall telling the House that

"by and large, we thankfully have one monopoly provider and that is the NHS. As long as a Labour Government are in power, that will remain the position."—[Official Report, 26 June 2001; Vol. 370, c. 500.]
Just when did he decide that a monopoly provider was a bad thing?

What characterises markets—as I am sure the hon. Gentleman understands, given that he is, to use his own description, an unreconstructed Thatcherite free-marketeer—is the ability to charge, which is precisely what he is advocating. It is not what this Labour party or this Labour Government are advocating. [Interruption.] The hon. Gentleman says that that is not what he is advocating. I believe that just before Easter he produced his own patient passport proposals, which clearly set out his determination to develop what he called a "self-pay market" in which more and more people would pay for their treatments in hospitals and in other settings. That is a Conservative policy, not a Labour policy; it is what he wants to do, not what this Labour Government will do.

Is my right hon. Friend aware that the greater autonomy, independence and accountability at the local level that lies at the heart of his proposals for foundation hospitals is widely accepted by Members on these Benches? Is he also aware that we welcome greater local accountability and the extra £40 billion that he has achieved from the Treasury? Does he agree that we shall need that local accountability in order wisely to spend that money over the next few years, and that it is about as much money as can be wisely and effectively spent by hospitals, be they foundation or otherwise? Will he therefore consider introducing the extra borrowing requirements that form part of the present proposals as reserve powers that could be activated later, in better circumstances, by an affirmative vote of the House? That would make it a lot more acceptable all round.

I am grateful to my hon. Friend for his support for the principles of earned autonomy and greater freedom for NHS hospitals: that must be the right way forward. As far as the borrowing powers are concerned, I do not think that that would be a sensible thing to do. If we are to have genuine freedom among NHS providers, that is exactly what it should be.

I say to my hon. Friend and to other right hon. and hon. Members that the NHS foundation trust policy is part of the NHS plan reform programme to open up the NHS so that it can provide more responsive services to the local communities that receive them. The only way of doing that, having put the national standards and inspection systems in place, is to ensure that the local communities who receive those services, and the local staff who provide them, have a greater say. Although these hospitals will continue to be NHS hospitals, they will have much greater freedom from day-to-day interference from Whitehall, so that they can get on with the job of developing services that are more attuned to the needs of local communities, particularly deprived areas that all too often have not had the best standards of service, but the poorest.

Can I say to the Secretary of State that I fully support the concept of foundation hospitals because of the responsible freedoms that it gives to the management of the trusts that are applying for foundation status? The Macclesfield acute hospital, which is part of the East Cheshire NHS trust, is interested in foundation status. It is a three-star trust and hospital. Will he give that application a fair wind?

The hon. Gentleman has a track record of supporting national health service principles and institutions. He has been closely associated with the NHS in his local area. Of course, we will consider all the applications favourably. He knows that, to date, 32 NHS trusts have applied for NHS foundation trust status. I am currently assessing those applications. We intend that, over a four to five-year period, every NHS hospital should have the opportunity of becoming an NHS foundation trust hospital, precisely so that it has the opportunities and freedoms that go with improved performance in the NHS. We set that out in the NHS plan. We said that there would be a process of earned autonomy. The more performance improves, the more freedom will be earned in the NHS. When I meet NHS staff, managers who are responsible for running local services and representatives of local communities, they all say that they want the ability to get on with the job of providing improved, responsive services to the local community. That is precisely what we should encourage.

Given the official Opposition's policy on the NHS, does not their enthusiastic support for foundation hospitals give my right hon. Friend cause for the slightest concern about his proposals? Should not we concentrate on our successful policy of ensuring that all NHS services are brought up to the highest possible standard rather than allowing the 30 or so allegedly best performing hospitals effectively to become free-standing health corporations?

I think that my hon. Friend knows that that is not our policy. Much mythology surrounds NHS foundation trusts. I do not believe that it applies to my hon. Friend, but people initially claimed that only half a dozen or a dozen NHS foundation trusts would be formed. That is not and has never been the case. Our intention is to ensure that every NHS trust gets the opportunity to become an NHS foundation trust. We will put in place the measures, support and assistance, including the extra financial help that is needed, to help raise standards of performance of organisations that are frankly not doing as well as they should.

As my hon. Friend knows, it is a myth that we have a one-tier health-care system in our country. We do not. Some organisations are capable today of using the extra freedoms that NHS foundation trusts will give them, others need extra help to put them in that position. We shall do that and ensure an equity guarantee so that every part of the NHS has the opportunity of taking advantage of the extra freedoms in a framework of national standards and a national system of inspection. Most important, the system is based on the NHS values that the Labour party supports—care for free that is based on need, not ability to pay—not the charging that the Conservative party advocates.

What will the effect of the proposals be on hospitals that are already in difficulties, for example, the Royal United hospital in Bath? There is no problem with its surgical, medical or nursing care, but it has huge historic problems with disastrous management. How does such a hospital compete when it has a financial millstone round its neck every year? How does it get to the starting point?

No Labour Member suggests that NHS hospitals should be forced to compete. That happened in the old NHS internal market, which I helped to get rid of. I certainly do not advocate bringing it back. I know about the problems in the hon. Gentleman's area and in the Bath hospital. Some hospitals are in a different position from others and we therefore need different strategies according to the hospital's individual circumstances. The hon. Gentleman knows that the history of underperformance—not by the staff who are doing a fine job in difficult circumstances, but sadly by the people in charge of the hospital—is the reason for our advocacy, through the NHS franchising system, of bringing in new management to turn the hospital around. When we have operated the franchising policy and brought in new management, it has had a dramatic impact on the performance of the relevant hospitals.

It is worth pointing out that when we introduced star ratings, which set out the relative performance of NHS hospitals, several received a zero rating. Subsequently, three quarters improved their performance precisely because of the sort of measures that we are taking. We will continue to give help, support and advice, including extra financial support, to hospitals such as the hon. Gentleman's that are in difficulties.

I think that I ought to try to make a supportive comment at this stage. My right hon. Friend knows that I am attracted to some of the Government's ideas that he is exploring, although there are other aspects of this policy that I am profoundly worried about. Will he clarify the confusion over the eligibility for trust membership? I have a close personal friend—who is known to one or two other people here as well—who has, to my knowledge, been in hospital in at least 10 different locations in the last three years. According to the guidance in the Bill, he would be eligible to stand for election as a trustee in all those separate hospitals. Could he do that, if he were so motivated—he is certainly very motivated—and will my right hon. Friend clarify the exact constituencies that will be used to elect the boards of trustees?

I know that my hon. Friend takes a close interest in these issues, and that he is attracted by certain aspects of the proposal if not by the proposal in total, although I keep working on him and trying to persuade him that it is a good idea and not a bad one, and that it is very much in keeping with the values to which both he and I subscribe. On his specific question, he will be aware, having read the Bill, that the governance structure of NHS foundation trusts works like this: the majority of places on the board of hospital governors are reserved for members of the local community. It is possible for an individual NHS trust, in putting forward its proposal to become an NHS foundation trust, to extend the franchise still further—for example, to patients who have used the hospital in question—but that will be a matter for the NHS trust to determine. My hon. Friend will also be aware that places on the board of governors are reserved for members of staff, which is important precisely to ensure that local members of staff, who, in the end, are responsible for delivering the services, also have some control over how those services are delivered. Finally, the primary care trusts will also be represented on the board of governors, precisely to address the concerns that were raised earlier. That must be right, because if we want to move to a system that has more locally responsive NHS services, we have to have greater local democratic control. It is good enough for local leisure centres; it must be good enough for local health services.

Angiogram Services


If he will make a statement on waiting times for angiogram services. [109810]

The national service framework for coronary heart disease goal is for a maximum three-month wait for angiography. NHS and New Opportunities Fund capital investment totalling £125 million is now putting in place more than 80 new or replacement angiography suites to support faster diagnosis. Ensuring rapid reductions in angiography waiting times is a priority for the three-year local delivery plans.

I am grateful for that answer, but could I just tell my hon. Friend about the case of one of my constituents? He was in hospital recovering from a heart attack and was due to have an angiogram a day later. He was then discharged, however, and returned home. He subsequently received a letter saying that it would be more than a year before the angiogram would be carried out. I have taken the matter up with the health authority and it tells me that one of the reasons that it is not going to be able to meet its heart surgery waiting time targets is because of this huge blockage in getting diagnoses through angiograms. Will my hon. Friend do all that she can to ensure that our commitment to better and faster treatment is matched by a commitment to better and faster diagnosis?

My hon. Friend is absolutely right. The whole of the patient journey has to be improved in terms of access to services, whether that involves diagnostics or treatment. I know that there has been a particular problem in his area. It lost one of its cardiologists last year, but that vacancy has now been filled and it has funding for a third consultant in that field, which should mean that the angiography should be able to proceed much more quickly. I would say to my hon. Friend, however, that in 1997, only 52,000 angiograms were carried out in this country, compared with the 80,000 carried out in 2001. There is, therefore, clearly more capacity in the system, but we have to build on that even more to ensure that patients get treated as quickly as possible.

Does the Minister agree that, when dealing with patients with heart disease, the sickest must be treated quickest? Does she at least acknowledge that there is a danger that, in meeting elective angiography waiting time targets for the least urgent patients, critical patients could be made to wait longer? Does she think it sensible or ethical, for example, that a patient with critical ischaemia who is at risk of heart attack or sudden death should wait at home for weeks for a day-case slot for angioplasty, or occupy a hospital bed for days or even weeks, running the same risk, while waiting for an angioplasty? What is the Minister going to do about that distortion of clinical priorities?

The hon. Gentleman knows well that clinical priority is always the most important issue in the national health service. He will also know that, because we set targets for heart surgery, this year there will be a maximum six-month wait for such surgery. We have now set targets for angiography. Those targets, together with performance monitoring, shows that we are determined to bear down just as hard on the diagnostic part of the patient journey as on the surgery part. The hon. Gentleman says that targets are not the right way to proceed in the NHS. He will know as well as I do that without targets thousands of people who need heart surgery would not be seen. He knows fine well that clinical priority is always the most important issue for the NHS, but we need to ensure that we make progress at every stage of the patient journey.



What resources the Health Protection Agency will devote to bio-defence issues; and if he will make a statement. [109811]

The Health Protection Agency brings together for the first time the combined resources of the key organisations to fight potential threats to human health. The level of activity and resource deployed against biological threats will vary depending on the nature and scale of the threat.

I am grateful to the Minister for that answer, but does she recognise the concern that, because the Health Protection Agency deals with all infectious diseases, including AIDS and tuberculosis, bio-defence is only a small part of its responsibilities? Is it right to have separate responsibilities for bio-defence for our armed forces and for the civilian population? What reassurance can the Minister give that bio-defence, which is vital at this difficult time, will get real attention from the Government? Would it not provide more reassurance if we had a specific Minister with responsibility for homeland security, including bio-defence issues?

This is an extremely important issue, and I am delighted to give the reassurance that the hon. Gentleman seeks. We are bringing together in one agency all the different agencies that have been responsible for chemical and biological issues, including the Public Health Laboratory Service and the Centre for Applied Microbiology and Research, as recommended by the chief medical officer in his strategy "Getting Ahead of the Curve". That brings together the skills, expertise, knowledge, facilities and resources, so that our services for health protection can be much more effective than they would be if they were spread out over a number of different agencies, as in the past. Whether the threat is naturally occurring, such as SARS, or a deliberate release of a biological agent, the same good, robust public health systems must be in place for notification, surveillance, reporting and treatment. Thanks to the NHS and the new Health Protection Agency, services in this country are some of the best in the world.

When highly contagious diseases were much more common in Britain than they are now, the national health service had the capacity to cope. We even had isolation hospitals, which are now closed. Given the pressure on capacity throughout the national health service, can my hon. Friend assure me that we could provide the beds to cope with a serious outbreak of a disease such as SARS without resorting to the measures that China is having to adopt by building extra capacity?

I am happy to give my hon. Friend that assurance. We have 25 centres with specialist cross-infection facilities. So far, the strategy that we have adopted in this country is proving extremely effective. We ensure that the whole of the NHS has proper information, is on alert and is in touch daily, and we provide the public with information about what they can do. That enables us to contain cases. We give people suspected of SARS appropriate treatment and ensure that they are isolated, so as to minimise the contacts that they make.

Primary Care Targets


What proportion of targets in the NHS plan relating to primary care he expects will not be met. [109813]

Given that the Minister and his Department are now more than half way through their four-year period to deliver the Government's health targets set in 2000, none of which has yet been assessed, surely he cannot dispute that it is proof of the Government's incompetence that he will not say which of those targets he expects not to meet. What confidence can the tax-paying public have that the Government will meet any of these targets when the Department's own figures show that it missed a whopping 31 per cent. of the 1998 targets, scandalously failed to give any information on a further 27 per cent. of those targets, thus missing a staggering total of 58 per cent., which is more than half the Department's 1998 targets?

The hon. Gentleman seems to think I said things that I did not say. I said "None".

We have a number of targets in the NHS plan, some of which have already been met. Many are challenging, but we are on course to meet them. What is certain is that they are conditional on extra investment in the NHS, which is partly funded by the 1 per cent. national insurance contribution. As the hon. Gentleman voted against that, he is not really in a position to talk about targets in the NHS.

National Community Service

12.30 pm

I beg to move,

That leave be given to bring in a Bill to make provision for a national scheme of community service for 16 and 17 year olds.
My Bill would introduce a mandatory one-year national community service scheme for all in that age group.

First, let me make a few related remarks. I realise that there are those who regard the ten-minute rule as a device for parliamentary followers of St. Jude, who, as everyone knows, is the patron saint of lost causes. Personally, I find it an excellent way of exploring the more radical and exotic areas of political policy.

During my 20 years in the House, I have proposed a range of ten-minute rule Bills designed, inter alia, to ban fox hunting, fur farming and animal experimentation; to end quarantine for pets; to ban war toys; to promote vegetarianism; to protect badger setts; and to end employment discrimination based on size. On the constitution, I have proposed a Bill to establish a directly elected mayor for London, another to make voting compulsory and yet another to establish fixed-term Parliaments.

The more perceptive Members present may recognise that a number of those proposed measures are now legislative reality, and I like to flatter myself into believing that I played a small part in helping them on their way.

My proposal for a system of national community service is a response to what many regard as a gradual decline in community values in our country. Such a decline is by no means universal, but in many urban and rural areas the emergence of what is known as a yob culture has given rise to considerable concern. The Government's current Anti-Social Behaviour Bill acknowledges the situation, but like most reactive legislation it seeks to deal with symptoms. I support that Bill enthusiastically—I spoke on Second Reading—but I think that to deal with causes, we must go beyond penalties and punishment.

It is obviously not possible to trace all the causes of the yob culture in a short speech, for they are many and varied; but I believe that they include the way in which our society seems obsessed with material goods and the primacy of what is fashionable rather than what is of abiding value. I have no desire to sound like an apoplectic reader of The Daily Telegraph—[HON. MEMBERS: "Go on!"] No, I decline the invitation. There has, however, been a marked decline in respect in our society—[HON. MEMBERS: "Hear, hear."] Thank you. Support from the Opposition for things said on the Labour Benches is quite commonplace nowadays.

That lack of respect has, I believe, arisen from a lack of consensus on an accepted system of values. In other words, we are finding it difficult to establish common ground. Obviously diversity can enrich a society, but beyond a certain point it weakens rather than reinforces.

The debilitating absence of a commonly adopted values system is evident in all social and economic groups, cutting across class and ethnic backgrounds. From the greed and venality in the boardrooms to the crime in the streets, there is a depressing continuum that we should try to break. In the House, we talk a great deal about building civic pride and a sense of community, but our measures to do so are largely piecemeal and disconnected. We need something imaginative and large-scale that will link us all in a common purpose. A national community service scheme might just give us the means to unite our young people at a significant time in their lives, and by doing so might foster a sense of community purpose and involvement.

The idea is straightforward. All 16-year-olds—some 750,000 reach that age each year—would be required to undertake a 12-month period of community service. The widest possible range of projects would be established through the Government, local authorities, non-governmental organisation, private sector organisations, voluntary bodies, the armed forces, the police, the national health service and so on. All projects would involve residency away from home and could be based abroad. Subsistence would be paid, together with accommodation and provision for holiday breaks during the year.

Some 72 per cent. of 16-year-olds are currently in post-compulsory education, and those who resume education at the end of their community service would be eligible for educational credits. During community service, participants would be required to attend classes in civic responsibility and social skills. The scheme would be compulsory, but a high degree of personal selection within the project range would be available, together with advice on the best available schemes for each individual.

Hopefully, the scheme would offer a worthwhile transition between full-time education and further education or employment. The overall objective would be to help to establish a core sense of sound values, based on practical experience in socially useful projects. Although a compulsory national scheme might seem somewhat alien, the concept already exists in the form of compulsory education to age 16. In addition, the notion of a gap year is much applauded, but in reality it is largely the prerogative of the already enlightened or privileged in our society. My proposal is merely the logical extension of the gap year—taken somewhat earlier—with its advantages and benefits made available to all young people, rather than to the few.

Having advocated such a scheme in this House for some years now, I was delighted to see the announcement in the Chancellor's pre-Budget report of the creation of a gap year volunteer corps, supporting low-income school leavers. The trouble with a volunteer corps, however, is that it tends to attract those who are already well on the way to becoming good citizens. It is because we recognise the value of such schemes in the development of both the individual and the wider social good that we should, I believe, extend the principle to all young people through a compulsory national scheme, which is what my Bill would seek to achieve.

There are not very many takers for this, Mr. Speaker; it appears to be just me.

Question put and agreed to.

Bill ordered to be brought in by Mr. Tony Banks.

National Community Service

Mr. Tony Banks accordingly presented a Bill to make provision for a national scheme of community service for 16 and 17-year-olds: And the same was read the First time; and ordered to be read a Second time on Friday 11 July, and to be printed [Bill 96].

Opposition Day

5Th Allotted Day

Community Services

We now come to the main business. I inform the House that I have selected the amendment in the name of the Prime Minister.

12.37 pm

I beg to move,

That this House expresses its deep concern at the collapse of community services in Britain and the adverse effect on social inclusion, neighbourhood renewal, regional prosperity, and the quality of community life; condemns the policies of the Office of the Deputy Prime Minister, which have resulted in the unfair distribution of local authority grant, causing divisive regional disparities, and centralised decision-making and services; regrets that the only solution the Government has to these problems is an expensive unnecessary additional layer of regional government; further condemns the Government's failure to improve local health care provision by tackling the necessary reform of NHS services; deplores the absence of policies to protect rural communities from the effects of the deep recession in farming; and recognises the Government's total failure to protect community services, resulting in a crisis in school funding, an increase in violent crime, a deteriorating transport system, and a threat to important local services including community pharmacies, sub-post offices and residential care homes.
I am sorry that the Deputy Prime Minister cannot be with us for today's debate. He has had a close family bereavement, and I am sure that the whole House will join me in sending our condolences and sympathy to him and his family.

We have called this debate today in response to a real and growing threat across this country: the breakdown of our local communities. One reason why I regret the absence of the Deputy Prime Minister is that this debate, on the destruction of community life in this country, is not confined to local government. The failure and breakdown of our local communities is being accelerated by the attitude, strategy and tactics of the whole Government: a Government who are convinced that they know how to run people's lives better than they themselves do; a Government who think that communities should fit the model that they prescribe; a Government of red tape, initiatives and bureaucracy, of deceits, gimmicks and hype. Above all, they are a Government who do not trust people, and who do not trust communities to go their own way and live their own lives.

This is, in short, a story about the way central Government deal with local councils and local institutions. The Government tell them what to do, and then blame them when things go wrong. They dictate how they can spend their money, and then blame them for raising taxes. The result is all too familiar; indeed, it is the story of this Government. People pay more and more. That has led to a breakdown of trust between local people and local politicians, but the blame often lies not at the local level, but here in Westminster; more often than not in the Office of the Deputy Prime Minister.

A community should be a place where people feel at home, safe and secure; a place where they feel in control of their own lives and have a sense of belonging. A community can be any size and it does not matter whether it has a rural or urban character. However, in our inner cities, the suburbs and the countryside today, any sense of belonging has been replaced by a sense of helplessness and frustration, alienation and anger. Much of that is a direct result of the Government's policies.

Let us examine one of the biggest problems facing communities throughout the country: crime. Communities break down when local people lose control of their streets, when the elderly and vulnerable are unable to walk outside at night for fear of being attacked, when vandalism and graffiti go unchallenged and destroy local environments, and when the fear of crime has a crippling effect on people's lives. The Government are losing the war on crime.

Given that crime is decreasing, when the right hon. Gentleman talks about the crippling effect of the fear of crime, is he not guilty of stoking up the fear of crime and creating the crippling effect?

Let us start with the fiction favoured by the Government—that crime is going down. The crime figures about which the hon. Gentleman talks are based on the crime survey, which, as he should know, does not include much drugs crime or crime against youths; the so-called victimless crimes. All those crimes are omitted. As a result, the figures underestimate the level of crime. If the hon. Gentleman wants a test of the real index of crime, he should go and talk to people in his constituency and find out whether they believe that crime is going down.

Last year, 97 per cent. of communities in England and Wales saw an increase in some forms of crime. Violent crime is up by 28 per cent. Worse still, gun crime has risen by 80 per cent. since 1997; it is worse in the inner cities, but not only there. New figures reveal that many people in communities throughout Britain today are more likely to be mugged than residents of the Bronx in New York. Unbelievably, that is true in Lambeth, Hackney, Bristol, Birmingham, Nottingham, Reading, Salford, Leeds, Middlesbrough and many other areas. However, far from getting a grip on the problem, the Government are leaving many communities to suffer alone.

The Government promised that local communities would be able to deal with disruptive young people by imposing new all-encompassing antisocial behaviour orders. As only the present Government can, they then made those orders so complicated and bureaucratic that few have been imposed at all. We were promised 20,000 antisocial behaviour orders by now, but we have not had even 1,000. Yet that is a success in comparison with child curfew orders, of which we have seen none at all; not one.

Is my right hon. Friend aware that, as the Rowntree Charitable Trust pointed out, people are in so much despair about the detection of crime that they no longer bother to report it? That is one of the reasons why crime appears to be going down.

My hon. Friend is right. Another reason is that fewer police officers are on the streets today to fight crime. Across the country, local police stations are closing to the public. As the hon. Member for South Dorset (Jim Knight) should know, here in London a decision has been taken to close Hampstead police station outside office hours. Clearly, criminals in Hampstead only ply their trade from nine to five.

The Government are also doing away with local justice; 96 local magistrates courts have closed since 1997 and more closures are in the pipeline. Justice moves further and further from local people. Remote justice is poor justice, but that is the justice that more and more people are being given. As a result, more serious crimes are not only committed, but go unpunished. The proportion of crimes solved has fallen every year since 1998. Across the country, communities are suffering because decent, hard-working people are being oppressed by a lawless minority. That is the result of failure not by our police, but by politicians.

Before the right hon. Gentleman moves away from policing, I draw his attention to the example of Blackpool, where the Tower project is in operation. Police forces from all over the country are coming to have a look at what is happening there. The police are working with the health service, doctors and voluntary organisations to address the needs of drug abusers. That has achieved a substantial reduction in crime. Blackpool is an example of a town where the community does exist and where people work together. The multiplicity of agencies working together has led to a huge reduction in crime.

That was an interesting mini-speech; almost an advert for the hon. Lady's local council. Sadly, of course, Blackpool has many other problems, but I want to return to the questions of crime and of police on the streets, which the hon. Lady did not mention. Until we have more police officers on the streets fighting crime—with the burden of form filling removed from their shoulders—and until we have true neighbourhood policing in this country, we will never be able to reclaim our communities for the honest citizen. That is what we are committed to; an extra 40,000 police officers on our streets. That is a real and necessary commitment that we will meet and which this Government will not.

Will the right hon. Gentleman join me in welcoming the increase of more than 300 officers in the South Wales force since 1997, and the fact that six officers in Maesteg are funded under the Communities First scheme? Will he also welcome the opening of the Maesteg police station, and of a substation in Ogmore Vale? All that has happened in the past few years. Will he join me in congratulating the South Wales force?

I thank the hon. Gentleman for drawing that to my attention. I shall return to the question of local police funding in a few moments, and he will hear what I have to say on the matter then. However, so much for policing for the moment. How many other local services are under threat? Those services include local care homes, railway branch lines, community pharmacies and, of course, the post office network. In recent weeks, my postbag—like the postbags of many other Opposition Members—has been filled with letters of concern about closures of local post offices. Across the country, hundreds of smaller post offices are threatened with closure because of the Government's decision to force people to have their benefit payments paid into their bank accounts.

However, in the face of opposition from local people across the country, the Government have refused to help. When post offices close, communities lose not just a postal counter, but the hub of the community. Opposition Members will continue to fight to keep post offices open, without the Government's help.

Will the right hon. Gentleman reflect on the fact that, during his party's period in office, 3,500 post offices closed?

I am more impressed by the size of the Minister's folder than by the dimensions of his comment. Let us put the matter exactly in context. In every year of the previous Parliament, the Government closed more post offices—548—than at any time in the Parliament before that, under the Conservative Government, when the figure was 100. The Minister's figures are nonsense.

Will my right hon. Friend now reflect on the fact that the post offices that closed under the previous Conservative Government were mainly the result of demographics as people's shopping habits changed? They did not close because the Conservative Government deliberately withdrew the means of funding for the payment of benefits, as the Labour Government have done.

My hon. Friend makes a very good point. Post offices are closing entirely because of the Government's actions and their unwillingness to deal with the consequences of those actions. The Government's heavy-handed actions are not confined to post offices.

Is my right hon. Friend aware of the case of the post office in Flimwell in my constituency? The postmistress was robbed twice in the past month. The Post Office is holding her responsible for half of the money taken in the more recent robbery. It has issued an ultimatum to the Cutmores, who run the office, to hand back more than £1,000. The way that they are being treated is obscene, and the people in Flimwell are certain that there is a hidden Labour agenda to close the rural post office network.

My hon. Friend makes a good point about the treatment of one of his constituents. It is a serious point, and Labour Members should take it seriously. He also raises a point to which the Minister may wish to reply. At his last Question Time, I asked the Deputy Prime Minister about the behaviour of the Post Office and whether it was true that it had an incentive programme for its management to close more post offices. Surprisingly, he did not know, but he told me that he would write to me. Then he told me that the Secretary of State for Trade and Industry would write to me, but nor did she know the answer. Then the Post Office sent me an answer full of such Orwellian, managerial gobbledegook that I can assume only that the answer was yes. May we have a proper answer today? Does the Post Office plan to close as many post offices as it can?

I shall move on from that heavy-handed consequence of the Government's policy to the next one. Many of Britain's communities have relied for years on the willingness of local people to offer their services to help their neighbours and fellow residents. The Government are actively discouraging that. Sometimes it happens on a small scale. In Eastbourne, for example, a or he that operated alongside the local swimming pool has closed because Government regulations have pushed costs up so far that it is no longer economic to run it. But the same applies in the draconian register of interests imposed on parish councillors, which has discouraged people across the country from undertaking an historic and important role. In one ward in Hambleton in Yorkshire, not far from my constituency, none of the parish councils has a full quota of candidates, and two do not have even the quorum necessary to form a council. I asked why that was so, and the answer was the heavy-handed and expensive new code of conduct and all its procedures. As a councillor from Herefordshire put it:
"Parish councillors have done a superb job for nothing over the years. Now they simply won't come forward."
The Government have produced a major solution to a minor problem, and it is driving good people away from involvement in their communities.

Community services are in decline and community involvement is being discouraged. All that is leading to the destruction of community life in both town and country. Let us consider the countryside. The farming industry on which we all rely is in the middle of the worst recession since the 1930s. In England alone, nearly 70,000 jobs have been lost from the farming sector since the Government came to power. Yet their only solution—their policy priority—was to focus on destroying another piece of the countryside's way of life by banning hunting. That is their answer.

In our towns and cities, any semblance of community life is being destroyed. Take Britain's second city, Birmingham.

The Parliamentary Under-Secretary of State, Office of the Deputy Prime Minister
(Mr. Tony McNulty)

indicated dissent.

The Minister says I should take it; perhaps we will.

After 19 years of Labour control, Birmingham is failing on housing, failing on social care for children, and failing on care for the elderly. Indeed, the right hon. Member for Birmingham, Hodge Hill (Mr. Davis)—a Labour Member—said that the elderly deserve better from that Labour council. By any test, Labour in Birmingham has failed.

Might the right hon. Gentleman be interested in the following snippet from Susan Axford, a Conservative candidate, who said:

"This is in spite of massive additional government grants to councils such as Birmingham."?

I rest my case.

The Deputy Prime Minister has shown that he has no proposals to counter the problems. Instead, his sustainable communities plan—unsustainable communities plan, as it is more properly called—proposes 200,000 houses in four new dormitory towns in the south-east. What have the Government done to provide support for those new communities? There is not enough transport, not enough health care and, we discover today, not even enough water. The Government literally cannot run a bath, let alone a policy.

Meanwhile, the Deputy Prime Minister wants to knock down vast areas of empty housing in the north, not least in his home town of Hull. His plan is to bulldoze the north and concrete over the south, and it does nothing to address the root cause of the problems that we face.

The Minister for School Standards is sitting on the Government Front Bench, but my right hon. Friend has not mentioned the impact on areas that face substantial new housing of the funding crisis that is forcing many local schools to make teachers redundant. How will schools find places for people moving into the areas affected by the house building?

That will clearly be a problem in the areas to which the communities plan applies, but it is a problem elsewhere, too, and I shall return to it.

Let me talk first about the Government's latest piece of financial gerrymandering. They have rigged the local government funding formula to reward badly run Labour councils with more money—the very point made for me by the hon. Member for Workington (Tony Cunningham).

As the right hon. Gentleman claims that the Government have rigged the grant system to reward inefficient Labour councils, will he tell us whether his local authority of the East Riding of Yorkshire is an inefficient Labour council, as it has received an increase in grant of more than 8 per cent. this year?

It is in no overall control, I am sorry to say, but that may change. Since the Minister mentions my area, I shall ask him for an answer. Why do schools up and down the country face deficits between £100,000 and £240,000 because of the Government's settlement? Those words are not mine, but those of a leading headmaster in East Riding.

The Minister should answer another point, too. We have had the recent comprehensive performance assessments of councils. Leaving aside the corporation of London, which I accept differs from the rest, I note that five of the best-rated councils received the lowest settlement while one received the highest. Of the worst councils, five received the highest settlement, and one the lowest. Perhaps the Minister would explain how he rewards virtue under his new gerrymandered system. That system transfers £60 from every Conservative council tax payer to every Labour council tax payer in the country. It is greatly to the credit of Conservative councils that, in spite of that increase, the average Conservative council still manages to deliver better services for lower tax than those provided by councils controlled by any other party.

Does my right hon. Friend agree that there ought to be greater transparency? Is he aware, for example, that Lichfield district council raised its council tax by only 3 per cent., while the Labour-controlled Staffordshire county council increased council tax by 18 per cent.? Because district councils collect the council tax, there is sometimes confusion. How can we make it clear that Conservative councils put council tax up by less than others but deliver more?

My hon. Friend makes a good point on the general question of transparency. I predict that the Minister for Local Government and the Regions will tell us that everyone received an increase above inflation. That would be appropriate if the requirements on councils were the same every year and if they faced the same level of costs years on year, but that is precisely what is not happening.

The British public will understand only too well. They know that the blame for the 60 per cent. average English council tax rise since 1997 lies squarely with the Labour Government. All councils are forced to meet more and more Government targets, and to fund more and more Government projects from their own pockets. They take on more responsibilities and costs, from recycling fridges to implementing dozens of inspection regimes. Employer contributions to the local government pension scheme have increased by £300 million as a direct result of the £5 billion a year pension tax that the Government introduced early in the last Parliament.

It seems that £300 million is a recurring figure: it is also the cost to local authorities of the Chancellor's decision to raise employers' national insurance contributions. Good councils are being forced to push up council tax locally because the Government refuse to be honest about what they are doing. By palming extra responsibilities and costs on to local councils without giving them the resources, the Government seek to blame local councils for their tax increases, but local people know the truth.

Does my right hon. Friend recall, from his recent visit to Eastbourne, the palpable anger of people there who face a 38 per cent. rise in the local council element of council tax, which is the fourth highest in the country? My constituents suffer from Labour meanness nationally and Liberal Democrat incompetence locally.

My hon. Friend makes a good point. I am sorry that only two Liberal Democrat Members are in the Chamber to pay attention to it. If there were more of them, they might learn a lesson.

The issue involves not only direct local authority funding, but associated matters. For example, let us consider what has happened to the police precept. This relates to the question put by the hon. Member for Ogmore (Huw Irranca-Davies). Over the past six years, the average English shire authority has been forced to push up the precept by an amazing 127 per cent. In my area, which is also the Deputy Prime Minister's area, the precept has been forced up by nearly 150 per cent. since the Government came into office. While the Government like to say that they are increasing the number of police officers—albeit by only 3 per cent.—it is local police authorities that are actually doing it and local people shoulder the cost. Again, the Government are using local authorities as their covert tax collectors.

Nowhere is that more evident than in recent stories about the crisis in school funding that has developed over the past few weeks. Teachers and teaching unions have warned of job losses throughout the United Kingdom. In some counties, redundancy notices have already gone out.

The crisis is replicated across the country. In Plymouth, up to half the schools may be forced to set illegal budgets next year in an attempt to dig themselves out of the hole into which the Government put them. Heads have already warned that up to 100 teachers and 200 assistants face the axe in September. Pupils in secondary, primary and special schools may have to be sent home because of that situation.

Is the right hon. Gentleman aware that Cambridgeshire county council, which is Conservative controlled, is very pleased with its education funding allocation? It is one of the authorities that has benefited enormously from the redistribution of funding, which is a much fairer system than the previous one.

I am happy to hear that, but it is sad for the rest of the country. The issue is not confined to a single area. I referred to Plymouth, and earlier I mentioned my county, where there are good schools that have strong traditions and perform well but face possible redundancies as a result of shortfalls of between £100,000 and £240,000. That arises entirely from the Government's funding arrangements.

My right hon. Friend may want to contrast the situation in Cambridgeshire with that in Oxfordshire, where the average deficit for each secondary school is £114,000. Some schools have deficits of £250,000. One head teacher wrote to tell me:

"I have been a teacher for 27 years…in all my years of experience I have never known such a critical situation in school budgets."
Does not the responsibility for that lie squarely with the Treasury Bench?

My hon. Friend is entirely right. We have seen the unfortunate spectacle of the Secretary of State for Education and Skills attempting to persuade people that the funding shortage in local schools is nothing to do with the Government—the point made by the hon. Member for Cambridge (Mrs. Campbell)—but everything to do with local councils. It is like watching the Iraqi Information Minister putting on one of his more spectacular performances—and about as convincing.

Even the people closest to the Government do not believe them. One of the Government's special advisers, Fiona Millar, says that her child's school faces cuts because, first, the Government have changed the way that they allocate money to councils. Secondly, there has been a significant increase in the contribution that schools have to pay to national insurance contributions. Thirdly, there has been a significant increase in schools' contributions to the teachers' pensions fund, and fourthly, there has been a significant reduction in the grant that the school receives from the school standards fund. There we have it: at least one of the Government's special advisers is being straight with us. The fact is that councillors, teachers and governors know the truth, and so do pupils and parents.

Is the right hon. Gentleman aware that, in at least one local education authority, 160 more teachers are employed than in 1998? That local education authority is the East Riding of Yorkshire council—in the right hon. Gentleman's constituency.

No doubt that is why a leading spokesman for the area's head teachers said that the Government settlement was the worst that he had ever seen.

No, I must make some progress.

People are paying more, but the money is being frittered away in the waste and bureaucracy created by the Government. The money is not getting to the pupils who need it most—yet one more example of people working hard but being taxed harder. People are paying more and more but they are getting less and less in return.

It is nice to know how good things are in the East Riding of Yorkshire, but does my right hon. Friend realise that, in Essex, the Government are giving away less with one hand than they are taking away with the other through national insurance increases and other costs that they have imposed. There will be teacher shortages in Essex during the next year. In my constituency, almost every primary school—[Interruption.] The hon. Member for Plymouth, Sutton (Linda Gilroy) is shouting statistics. They do not matter. Next year, children in my constituency will not have enough teachers to teach them. That is a fact and it is the Government's fault.

My hon. Friend is right. The sad thing about those statistics is that such figures have tragic implications for the lives of young children and their education. The damage done will be impossible to recover.

The result is that people feel disenchanted with politics and fed up with their local councils. People no longer think that local councils can make a difference to their lives because they are merely branch offices of central Government. The Government are presiding over the slow death of local government. The very institutions that could help to define a community are being broken down.

If we are to reverse the breakdown of our communities across Britain we must—and we will—reverse the destruction of local government. We must recognise that things are often done best when they are done locally. We need to push power down to local people and communities, allow them to take their own decisions and encourage them to be different. We must sweep away the red tape and bureaucracy that restrict local people, and empower local communities to improve their quality of life. That is the Conservative approach.

The death of local government under the Labour Administration is no accident, but a direct result of Labour's age-old belief in centralism. Nowhere is that displayed more clearly than in the Government's commitment to regional assemblies—a proposal to rip the last vestiges of life from our local communities. Masquerading as decentralisation, it is in fact precisely the opposite.

We still do not know what their powers will be because the Government will not tell us. We know that they will require abolition of county councils and the restructuring of district councils. We know that they will erase from our national life the shire counties, which are one of the oldest surviving tiers of self-government in western Europe, predating the Domesday Book. We know that they will cost £2 billion to establish and a further £300 million a year to run. People will pay more and get less. That money could pay for 30 new hospitals, 400 new schools, 6,000 more policemen or 12,000 extra teachers. Regional government will not deliver one more teacher, nurse or policeman but only take power away from the people.


With this policy, we can conclude only that the Government have given up on Britain's communities, and are simply prepared to manage their decline. Our proposals to re-energise local government will aim to sweep away the plethora of national targets, directives and all the other barriers to diversity at local level, allowing local government to work better and be more responsive to local communities and to the people whom they serve. We will push power down to pupils and parents and give them a way out of failing schools. We will extend opportunities for people to buy their own homes and reinvest the money in reviving quality social housing. We will encourage local charities and voluntary groups to play a greater part in community life.

That is a recipe for reinvigorating Britain's communities, and it shows the clear difference of approach between the Government and the Opposition.

They believe in centralisation; we believe in local action. They believe in trusting officials; we believe in trusting the people. They believe in regions; we believe in real communities. We need to rebuild and support those communities and put our trust in the sense of ordinary people, and we will give them back the power to control their own lives.

1.11 pm

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

"commends the Government's policies on community services and applauds its commitment to neighbourhood renewal, social inclusion and the quality of urban and rural community life through the protection and enhancement of key local services; further applauds the Government's achievements of a stable economy, improved economic prosperity and social justice, increased community services investment, reduced crime and safer communities; welcomes this year's increased funding for education of over £2.6 billion, 11.6% extra, and more than £250 million greater than pressures; notes that since 1997–98 spending per pupil has risen in real terms every year compared with a 4% real terms cut between 1992–93 and 1997–98; further welcomes the Government's NHS and social services modernisation to devolve power and resources locally to Primary Care Trusts and to end delayed discharges from hospital; notes that between 2003–04 and 2005–06 social care funding will grow in real terms by 6% per annum on average, building on the improvements already made to community services through the 20% real terms increase since 1997; welcomes this year's fairer funding of local government, producing, for the first time ever, an above inflation grant increase for every local authority and region in England, with a 25% real terms increase in grant since 1997, compared with a 7% cut under the last 4 years of the last Conservative government; notes that Conservative councils have imposed on average 16.2% increase in council tax; and condemns the cynical opportunism of trying to blame the Government for irresponsible tax increases by Conservative councils."
May I start by thanking the right hon. Member for Haltemprice and Howden (David Davis) for this remarks about my right hon. Friend the Deputy Prime Minister's bereavement? On behalf of my right hon. Friend, I extend his apologies to the House for not being able to join us today.

We have just heard a speech that is sadly all too typical of today's Conservative party: a litany of misinformed rhetoric, remorselessly negative in tone, which undermines public services and demoralises the many dedicated people who deliver our public services in Britain. It was also a speech with two gaping holes. The first was the lack of any reference to the state of public and community services when the Conservative party was in power. Indeed, that was a period that could be characterised, in the words of the motion, by
"the collapse of community services…and the adverse effect on social inclusion, neighbourhood renewal, regional prosperity and the quality of community life".
Of course, we heard nothing about the scourge of mass unemployment in those years, and the disastrous neglect and run down of public services. Surely we all remember the mantra "private good, public bad". Of course, we heard nothing about the devastating recessions—not one but two—and mass repossessions, which destroyed communities, lives and hope. That was the reality of the Conservative party's last period in power, of which, of course, we heard nothing from the right hon. Gentleman.

If today's Tory party has no memory, let alone a sense of shame for its lamentable record in office, it also has no confidence in the future. The second gaping hole in the right hon. Gentleman's speech was the lack of any commitment to future funding of public services in Britain: hardly surprising given the Conservatives' pledge to cut 20 per cent. from public service spending. [HON. MEMBERS: "No."] Oh, yes. They are clearly too embarrassed to admit the implications of that.

That fatal combination—the lack of any sense of history combined with—

Does the Minister think that there is not one penny of waste to be cut out of the public services? Is he totally complacent?

If the hon. Gentleman will bear with me, he will hear a great deal of what we are doing to improve efficiency, to drive up standards and to ensure that we get real value for money. A 20 per cent. cut across the board in public services, however, to which the Conservative party has pledged, is a recipe for the decimation of our services, which will damage communities all over the country.

I have always judged the right hon. Gentleman to be a man of principle, so I cannot understand why he is putting to the House something that he must know is not true.

All that I am doing is repeating the pledge given by the Leader of the Opposition, who made it perfectly clear, towards the end of last year, that the shadow Cabinet were looking to make 20 per cent. savings out of public expenditure. That was a public commitment. I am happy if Conservative Members wish to denounce their party leader, but it was a commitment that he gave.

The Minister should know—I am not accusing him of lying—that he is spinning a Labour lie; there is not a single shred of truth in it. What is true, however, is that his Government have stolen £13.4 million from Worcestershire county council in the name of resource equalisation. That theft alone of £13.4 million has forced the county council to put up the council tax by more than the rate of inflation.

The hon. Gentleman is wrong on both counts. The Leader of the Opposition made it perfectly clear in a statement just before Christmas that the shadow Cabinet were looking for 20 per cent. savings in public spending. Conservative Members may wish to denounce that, and may be embarrassed by it—I would not be surprised if they were—but that was what was stated. If those pledges were put into practice—

Several hon. Members rose—

I give way to my hon. Friend the Member for Reading, West (Mr. Salter).

I do not know whether my right hon. Friend the Minister has had an opportunity to read the "Reading Banner" produced by Reading Labour party. If so, he would be able to pray in aid the following quote:

"We are looking at the target of 20 per cent. savings across the board in government spending."
Who said that? The leader of the Conservative party, the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith), did so on the BBC's "The World At One" on 30 December last year.

I am grateful to my hon. Friend. I was about to quote The Daily Telegraph of 31 December, which contains exactly the same pledge:

"The shadow Cabinet are looking at the target of 20 per cent. savings across the board in Government spending".
That was what the Leader of the Opposition went on the record to say.

I shall give way once more to the hon. Member for Buckingham (Mr. Bercow).

Given the litany of public service woes that were so eloquently described by my right hon. Friend the Member for Haltemprice and Howden (David Davis) and the fact that the vast majority of people identify principally with their parish, town, district or county, but not with the amorphous concept of a region, why does the right hon. Gentleman wish to create a nationwide network of regional assemblies on the absurd principle that our main problem in this country is that we are somehow under-governed?

I was very pleased to give way to the hon. Gentleman, and I am only sorry that the right hon. Member for Haltemprice and Howden was not willing to offer him a similar courtesy in the course of his speech. Our regional policy is one of extending choice—those regions that want to elect regional assemblies will be able to do so. Unlike the Tory party, we do not have preconceptions. It said that it was opposed to devolution in Scotland, then denied that and changed its mind. It said that it was opposed to devolution in Wales, and then changed its mind. It said that it was opposed to the people of London having the opportunity of an elected city-wide authority, but it has now changed its mind. I give the hon. Gentleman a forecast: the Tory party's opposition to elected regional assemblies in England will crumble in just the same way when the people of certain regions-I do not pretend all regions in England demonstrate that they want to have an elected regional assembly. We are giving the people that choice.

By contrast, when the Tory party made changes when it was in power, it abolished counties. We have heard great sentimental rhetoric from the right hon. Member for Haltemprice and Howden about the historic counties, but the Tory party abolished counties without any opportunity for the people of Berkshire, for example, to have a say as to whether their county would disappear. It abolished other counties all over the country with people having no say whatever. We are giving people a choice.

The fatal combination—the lack of any sense of history combined with the lack of any confidence in the future—speaks volumes about today's Tory party. It is caught in a limbo of powerlessness and irresponsibility. Like hopeless shades in Dante's "Inferno", Tory Members are left with no ambition other than to score a few cheap points in the vain hope that, one day, they might inherit the poisoned chalice of the party leadership.

Since 1997, the Government have been working to repair the damaged communities and public services that we inherited.

The right hon. Gentleman mentioned damaged communities, but has he looked at the case of St. Edmund's community primary school in my constituency where the very hard-working and loyal headmaster has just resigned? He said:

"The Government has let us down. This is the worst settlement in living memory. I've had enough because the Government is undermining public services."
Nick Butt has just resigned from a big community primary school in my constituency. Is that not a disaster?

Let me tell the hon. Gentleman about funding for Norfolk. When his party was in power— [Interruption.] Let me tell him the facts. When his party was in power, Norfolk county council, which is responsible for education in his part of the country, received an average increase in grant of 2 per cent. per annum in the last three years of the last Conservative Government. The average grant that Norfolk county council has received in the last three years is 5.7 per cent. Will he go back and tell the person whom he has quoted that the figures demonstrate that this cannot be the worst settlement that Norfolk has ever received, because it is almost three times the level that was given when the hon. Gentleman's party was in control?

I am grateful for the Minister giving way while he is on the subject of cuts in schools budgets. Can he explain why, this morning, Dame Jean Else, the head of Whalley Range high school in Manchester, threatened to resign rather than sack 20 of her 165 staff, because she is facing a budget shortfall of £600,000 as a result of what the Government are doing?

Manchester has received, on average, over the past three years an increase in grant of 4.9 per cent.

Let me encourage Conservative Members to contain themselves. [Interruption.]

Thank you, Mr. Speaker. I understand the frustration of Conservative Members. They do not like hearing the truth. However, when their party was last in power, Manchester city council did not get the 2 per cent. increase in grant that Norfolk got. It got no increase at all. That demonstrates how the Tory party let down education authorities all over the country.

When the Minister reads out the increases in settlement for each local authority, will he at the same time read out the increasing costs for each local authority in terms of employer national insurance contributions, pensions and salary costs that his Government have caused through their centralised policies?

I am very happy to tell the hon. Gentleman that we have increased funding by £3.8 billion overall for local government. The increase for education is £2.6 billion and that is a good £250 million more than the combined impact of all the additional pressures to which he has referred. Additional money is going in, and we are well aware that, in individual areas, there are difficulties. This year has been one in which there have been many changes. As he will know, there have been changes to the overall grant-giving formula and changes to try to reduce ring-fencing—a point that the right hon. Member for Haltemprice and Howden made in his speech. I am pleased to say that we are reducing ring-fencing but, as a result of that, the standards fund, which is a ring-fenced fund, has now been rolled into the general formula for standard spending share. That change inevitably produces distributional consequences and, at the moment, we are seeing some of the consequences together with issues that have been well debated.

Will hon. Members contain themselves, as I am trying to give a serious answer to a serious question? All the changes result in different impacts in different areas. That becomes even clearer when it comes to individual schools. It is precisely for that reason that my right hon. Friend the Secretary of State for Education and Skills and my hon. Friend the Minister for School Standards have been doing a great deal of work with us to try to ascertain precisely the position in every local authority. My right hon. Friend will make a statement after the local government elections to help move things forward and to ensure that the difficulties where they exist—we accept that there are some areas where there are difficulties—are properly addressed in a sensible and rational way and not with the rhetoric and sweeping blanket condemnations that are unrealistic and unworthy of a party that did not adequately fund education in its years in power.

The Minister is not answering a very good point. Why does he not undertake to publish the cost pressures on all the schools in the country? These are the predictable national insurance costs, pension costs and the costs that result from the change to the pay structure. They are perfectly calculable and every school has calculated them for itself. Why does he not do that for every authority in the country so that we can see the results? The issue that we are talking about affects not just one or two schools, but hundreds of schools and it is doing serious harm. He owes it to the public to tell them the truth on this matter.

There is an interesting contradiction between the thesis that the right hon. Gentleman put forward in his speech as to why Government were not letting individual communities get on with it and his wish, in an extraordinary Stalinist vision, to have us publish the figures that would detail every cost pressure for every school in the country. He will know that all the factors that I have described—the factors relating to increased pay, increased pension provision and the increased national insurance plus the changes from ring-fenced to general grant and factors such as changes in the school roll—have differential impacts in different schools. It is right that local education authorities, which are better placed to gauge the position, should discuss the matter with their schools. Government, of course, have an interest, and that is why I said that my right hon. Friend the Secretary of State for Education and Skills and my hon. Friend the Minister for School Standards are doing work to ensure that we are better informed about where there are pressures. They have already made significant contributions to help those authorities facing pressures. The extra money that is being given in London and to schools facing particular pressures is all part of that positive response.

Does my right hon. Friend agree that the biggest single factor putting pressure on education budgets is the 5.15 per cent. increase in employers' pension contributions that has been necessitated to clean up the mess that this Government inherited from the 1990s when local authorities were allowed local control and some teachers who should have gone through competency procedures and possibly been sacked were given ill-health early retirements or redundancy retirements with enhanced pensions from the age of 50 upwards? That local control left the teachers pension agency in a huge hole financially and central Government have had to step in this year to sort out the problem.

My hon. Friend makes an absolutely correct and fair point about the significant impact of teachers pension provision. That is one of the key pressures that I identified.

I should now like to make some progress.

We have been clear that repairing the damage that we inherited in 1997 required both investment and reform, and we have been determined to deliver both. Across the swathe of public services, we have committed unprecedented levels of increased investment. Although the Tory party was able to achieve only a 3.1 per cent. annual growth rate on health, we have delivered increases of 6.3 per cent. over the past three years. From this April, we will increase investment by 7.5 per cent. a year for the next five years. That is not just the largest increase in funding that the national health service has ever received. By 2007–08, it will take the proportion of gross domestic product spent on health to 9.4 per cent., which is well above the European average.

Similarly, we have increased spending on education from 4.7 per cent. of GDP in 1997 to 5.3 per cent. Investment will increase further to 5.6 per cent. by 2005–06, which is once again above the European average. Real-terms funding per pupil has risen by more than £670 since 1997, and it will be more than £1,000 higher than when we came to power by 2005–06.

Increased funding also means that there are more skilled people to deliver our key public services. Compared with 1997, we now have nearly 40,000 more nurses, 5,000 more hospital consultants, 1,000 more general practitioners and 20,000 more teachers. An additional 4,000 police officers have been employed in the past 12 months alone, which is the largest 12-month increase in police numbers for 25 years. It was typical of the right hon. Member for Haltemprice and Howden to focus on the closure of an individual police station in London and to ignore the fact that police numbers in London have increased by thousands due to our additional investment.

Additional investment has delivered new and improved schools and hospitals: no fewer than 64 major hospital developments, 121 new primary schools and 50 new secondary schools. It has made possible huge inroads into the massive backlog of sub-standard housing that we inherited from the Tory party. We have reduced the number of non-decent homes in the social sector by 700,000 since 1996, and we are on target to eliminate all such housing by 2010.

Of course, our policies are all about improving people's quality of life, whether they live in rural or urban areas. That is why we are so keen to continue to make progress on educational attainment. The proportion of 15-year-olds gaining five or more grades A to C at GCSE went up from 45 per cent. in 1997 to 51.5 per cent. in 2002. It is why we are so keen on shorter waiting times for hospital appointments. As my right hon. Friend the Prime Minister said yesterday:
"every single waiting time and waiting list national indicator is more positive than in 1997."
It is why we are keen to reduce crime. The British crime survey showed a 28 per cent. reduction in overall crime between 1997 and 2002. It is why we are keen to improve transport services, such as bus services for rural communities. There are more than 1,900 new and enhanced rural bus services, many of which serve communities that previously had no service at all.

The Government are committed to public services and believe in them. We are committed to increased funding and reform to ensure that the public get high-quality services delivered cost-effectively, and nowhere is that more evident than in respect of local government.

As in other areas, we have substantially increased Government funding. It has increased by 25 per cent. in real terms since we took office whereas there was a real-terms reduction of 7 per cent. in the last four years of the previous Conservative Government. However, not only additional funding is required. Increased investment must deliver an improvement to the quality of local services. That is why we introduced the comprehensive performance assessment for local councils. I am pleased to say that the first results, which were announced at the end of last year, demonstrate strong performance throughout local government, including examples of outstanding achievements.

To raise standards of service and to empower local authorities to deliver effectively for their communities, we are extending freedoms and flexibilities and devolving power. Last November, we announced a substantial package of freedoms for all authorities. Measures include: ring-fencing on revenue to fall to 10 per cent. by 2005–06; 60 per cent. of capital resources to be un-ring-fenced in 2003–04; up to a 75 per cent. reduction in the number of plans required of local authorities; the removal of 84 consent regimes, many of which dated back to the previous Conservative Government; more power to charge for discretionary services; more opportunities for local councils to trade; and more discretion on the use of civil penalties. We have an even more radical package on top of that for the very best authorities that achieve an "excellent" rating in the CPA.

On the subject of local government settlements, will the right hon. Gentleman promise the House that he will hold an urgent meeting with Fiona Millar, a chairman of governors in London, who has complained about the fact that the local government settlement has moved money from the south-east to the north? If he does not know where to find her, I advise him to look in 10 Downing street, where she works as personal assistant to the Prime Minister's wife.

I am little surprised that the hon. Gentleman has not been paying attention to the needs of his constituency. He will know that Buckinghamshire county council is one of the southern Conservative councils that did extraordinarily well out of the settlement because it received a 6.4 per cent. funding increase. He and his colleagues continue to peddle the myth that money is being transferred to the north despite the fact that many Conservative councils in the south of England are doing very well indeed. He would do rather better to acknowledge what is happening in his area.

The Local Government Bill, which is currently in another place, will deliver many of those freedoms and create a new framework for capital finance. We are sweeping away the long-standing requirement that was put in place by the previous Government to require Government consent for all borrowing. In its place, we are establishing a prudential regime under which local authorities will have greater freedom to raise finance to buy, build and improve all kinds of property and infrastructure. The only constraint is the proper requirement that they must have the means to service the debt.

Labour councils are fully committed to that agenda. They deliver high-quality services cost-effectively. By contrast, we have seen the nasty face of the Tory party again this year in local government as Tory councils have imposed unreasonable council tax increases on their long-suffering residents. Wandsworth borough council, which is so often held up as an exemplar by the Tory party, has the unenviable record of imposing the highest percentage council tax increase of any council in England this year. It increased its council tax by 57.3 per cent. after cutting it by 25 per cent. last year, which—surprise, surprise—happened to be an election year. That was pretty transparent.

Of course I shall give way to the hon. Gentleman. He has a good connection with Wandsworth council and I hope that he will deplore the unreasonable council tax increase.

One of the Minister's annual mistakes is to consider percentages rather than bills on the doorstep. The bills landing on the doorsteps of Wandsworth are the second lowest in the country and the council's services, by the standards of the Government and the local people, are among the best.

The hon. Gentleman makes a brave effort to conceal the fact that Wandsworth borough council has simply been up to a bit of crude electioneering by cutting the council tax in an election year and whacking it up the next year.

In case anyone should suggest that big increases in council tax this year are a result of a bad local government settlement, I remind the House that this year, for the first time ever, every authority in England received an above inflation increase, which never happened when the Conservatives were in power. Councils that complain that they got increases of only 3 or 4 per cent. this year should remember what happened in the years before 1997 when they often received no increase at all. In any case, it is simply not true that there is a direct correlation between large council tax increases and small grant rises.

For example, let us consider six neighbouring authorities in the west midlands: Birmingham, Coventry, Dudley, Sandwell, Solihull and Wolverhampton. Opposition Members will understand why I do not mention Walsall metropolitan borough council. The authority has special difficulties and there has been an attempt to tackle its problems. Although it is technically controlled by the Conservatives and Liberal Democrats, I shall not bring it into the argument. The other six authorities all benefited from grant increases of just more than 8 per cent. this year, but their council tax increases vary greatly. Tory-controlled Solihull's council tax has increased by 10.5 per cent., which is almost double that of the other authorities. Those authorities just happen to be controlled by Labour—is that a coincidence?

There is a similar story in the south-west. Bath and North East Somerset, Bristol City, North Somerset and South Gloucestershire unitary authorities have similar responsibilities and received similar grant increases of between 7.5 and 8.5 per cent—so much for that nonsense that authorities in the south did not receive decent grant increases.

Hon. Members should wait and hear what I have to say. Tory North Somerset has chosen to increase its council tax by 15.4 per cent., compared with increases of less than half that set by the other three councils in the area—Bath and North East Somerset, which is under no overall control; Bristol, which is Labour-controlled; and South Gloucestershire, which is under Liberal Democrat control. The Conservative council alone pushed up its council tax by disproportionate amounts. The conclusion is clear—Tory councils cost people more. Look at the average council tax this year. In Tory authorities, it is £1,008; in Liberal Democrat councils, it is £934; in Labour authorities, it is £818. This year, council tax increases in Tory authorities are 16.1 per cent.; in Liberal Democrat councils, 10.5 per cent.; and in Labour councils, 10.7 per cent. That tells a story—Tory councils cost people more.

It is clear that today's motion smacks of desperation on the part of the Opposition—desperation to score a few points in advance of Thursday's elections. But the facts tell a different story of recovery from the bleak inheritance left by the Conservatives in 1997. They tell a story of progress, not just this year but over the past six years, and they reveal a clear path for progress in the future. Of course, there are still huge challenges and a need to do much more, but, unlike the Opposition, we in government are proud of our past and present and are confident of our future. They, by contrast, live for today's press conference, afraid to face up to their past misdeeds or admit their plans for future felonies. They have no credible prospects. I can empathise with the right hon. Member for Haltemprice and Howden and perhaps even feel a little sorry for him. [HON. MEMBERS: "No!"] Well, perhaps that is going a little too far, but I do know what he and his colleagues are going through. I know what it is like to endure years of fruitless opposition only to see yet more years of it stretched out in front of you. Reading the Opposition motion I was struck by the utter futility of its language and its mindless, ill-informed and badly argued irrelevance, curiously reminiscent of the far-left Trotskyist reaches of the early 1980s Labour party. Today's motion will go the same way as all the motions of those years, except that these days the paper that it is written on stands a better chance of being recycled and put to constructive use.

Opposition is a tricky old business—I should know, I did enough of it. Many say that it is not healthy for democracy to tolerate an incompetent Opposition for any significant length of time, let alone six years. Of course that is right, but worse still would be to allow the incompetent Tory Opposition to become another incompetent Tory Government. The British people paid a big enough price last time around. The Opposition wanted the debate to offer a wide-reaching showcase for their policies in advance of Thursday's elections, but in their motion they have merely highlighted their deplorable past, their incompetent present and their lack of confidence in the future. The motion invites the contempt of the House. The Tories have nothing to offer, and no one believes that they can form a Government in the foreseeable future. As the House will surely reject this Tory motion later this evening, so the electorate will reject this unprincipled and opportunist Tory party on Thursday.

1.43 pm

On behalf of my right hon. and hon. Friends, I extend our condolences to the Deputy Prime Minister. Taking up the Minister's final remarks, I agree that the Conservative motion could have been tabled by Opposition parties active in the 1980s and 1990s. There is a lot of truth in it—there are problems in our communities up and down the country, and Conservatives are right to point them out. However, the problem for the Conservatives is that they caused many Of those difficulties when they were in government. The problem for the Government is that they are copying many Conservative policies and are not addressing those difficulties. In their bare-faced cheek in tabling the motion, the Conservatives demonstrate that they want completely to reinvent history. They talk about centralisation in the motion, but one must remember what Conservative Governments succeeded in doing to local government financial settlements—rate-capping, ring-fencing, compulsory competitive tendering, the uniform business rate, standard spending assessments, credit approvals in the borrowing regime, supplementary credit approvals and, of course, the poll tax. That plethora of measures introduced by the Tory party centralised the way in which local councils are funded and caused many problems that the Government have not yet addressed.

In other areas, the Conservatives were the first people to start the centralisation that, regrettably, has continued in recent years. It was the Conservative party that introduced national targets in education, and it is interesting that their spokesman is beginning to row hack on that. I listened to the speech of the right hon. Member for Haltemprice and Howden (David Davis), but failed to detect a constructive alternative to, for example, council tax, an issue to which I shall return later. It was interesting to hear what the shadow Chancellor would do about that tax. He was asked in an interview in The Daily Telegraph on 9 April what the Conservatives would do about the council tax, and said:
"we would change the system when we come back to office".
The interviewer asked what exactly would the Conservatives do, to which the right hon. and learned Member for Folkestone and Hythe (Mr. Howard) replied, "I don't know." The truth is that even after six years in opposition the Conservative party do not have an alternative to the local government financial system that the Labour party has put into operation. I shall explain my alternative later in my speech.

The purpose of this debate is, quite rightly, to hold the Government to account for the way in which they are managing public service policy. I welcome both the debate and many aspects of the Conservative motion. It is right that we should focus in particular on education. I am glad that the Minister for School Standards is in the Chamber, because there is concern throughout the country about the effects of the Government's policy on education, particularly the impact of this year's local government financial settlement on schools. Interestingly, today the Office for National Statistics published new figures that show that the number of teachers in England is falling.

So when the Minister for Local Government and the Regions told the House about an increase in new teachers he was not telling the full story. There is a difference between what Ministers are telling the House and what the Office for National Statistics is telling the public, because they count teachers in different ways. Ministers say that even if someone is not qualified but works in the classroom they are a teacher. On that basis, the Government could include almost anyone in the classroom in their definition of teachers. We should therefore be debating the definition of teachers used by the Office for National Statistics, as it includes only qualified teachers. I am surprised that the Government are peddling the line that the number of teachers is increasing when the ONS has shown today that it is going down.

On a point of information, although there is a category of qualified teachers, other teachers are counted, including teachers from foreign countries with qualifications equivalent to English qualifications.

I am grateful to the Minister, but that is not the whole story, as I think he knows. The Government include some unqualified teachers in the definition that they are using and I hope that they will make that clear later.

I had an interesting exchange with the Minister for Local Government and the Regions about whether the new money that all local authorities are getting is helping schools. We see the other side of the equation in our constituencies. The Minister always talks about the extra money, but never about the extra costs, which are severe. It is important that he admit that. I do not necessarily think that he should conduct a school-by-school analysis of the extra cost, but it is important for democratic debate that we have more information on those huge costs, details of which I shall give later.

The hon. Gentleman is getting to the nub of the argument and has highlighted a great mystery. On the one hand, the Government are talking about massive increases in education spending, but on the other hand, all our schools are facing a crisis. Does not the Government amendment provide a clue to where the money has gone, as it talks about £2.6 billion or 11.6 per cent. extra for education, but then talks about

"more than £250 million greater than pressures"?
The Government clearly know what those pressures are and could publish them. Is it not the case that £250 million is not an 11 per cent. increase but is more like a 1 per cent. increase? That is the answer to the great conundrum.

The hon. Gentleman is right. We must see those figures in order to judge the Government's performance. We in the House are not very good at analysing budgets. I am concerned about the lack of financial scrutiny in the House. On this occasion, we must demand to see the figures. The underlying causes of the cost pressures are many. The national insurance increases and the pension transfers alone are adding an extra 5 per cent. to most school budgets.

The hon. Gentleman speaks of the national insurance being an extra pressure. Did not his party support the Government when the House voted on the increase in national insurance? Did he not go through the calculations before he voted for it, to see what it would mean for the public sector?

The hon. Lady is right: we wanted more money in the health service. The fact that the Conservatives voted against that rise in national insurance means that they are proposing cuts to the health service. They complain about the Government accusing them of 20 per cent. cuts, but the fact that they voted against that tax rise, which is funding more money for our health service, proves that they want to cut public services across the board.

My point about how the national insurance rise relates to today's debate on the local government finance settlement and schools is that the Government should have taken that into their calculations for the local government financial settlement. There are rising costs—as I said, 5 per cent. to most school budgets. Schools also have to meet the extra salary costs. An increase in salaries was important, because there were problems of teacher recruitment and retention in areas such as mine. No one denies that many of our teachers deserved an increase in their wages. I assume that that is common ground across the House. The Government knew about that cost pressure when they made the settlement, and they knew that it had to be paid for. They say that there were above-inflation increases for every local authority, but they knew beforehand that there would be above-inflation increases in costs. They are looking at just one side of the ledger.

The Minister may be on fair ground when he says that the standards fund money for education has been rolled into the general pot, but the problem is that that has been lost on the way down from Whitehall to local communities. Calculations that I have seen suggest that £400 million has been lost in that way. That is effectively another cost pressure. On top of that, there was the rather unsatisfactory reform of the local government grant, which has produced some winners, but a great many losers. When those losers have to face all the extra costs, we see the problem.

A further problem in the education debate, which has not been mentioned today, is the underfunding of sixth forms. There was only a 3 per cent. rise in the budget for learning and skills councils. In order to meet the extra cost pressures, which are way above 3 per cent. in sixth forms, schools must take money from elsewhere or cut sixth form teaching. The Government's settlement failed to address the problem.

We have felt this in my local authority, Kingston upon Thames. We were one of the 12 authorities whose increase in total grant was less than the increase in the education formula spending share that the Government said we should be giving to schools, so we have had real problems. With the indulgence of the Chair, I shall read out one or two comments that I received from teachers in my constituency who are trying to grapple with the problem at the coalface.

Helen Goodall, who is the head teacher at St. Philip's, a special school in Chessington, writes:
"I am struggling to come to terms with a deficit of about £145,000. For a small special school this is, of course, extremely damaging and will have long term implications.
I have already informed my staff that all professional development, inclusion activities with mainstream schools, educational visits, equipment and resources etc. will be absolutely minimal. It looks as if I will have to cut staff by two teaching assistants and two teachers.
For a special school with such a good reputation as St. Philip's … the severe cuts in provision will have a very damaging effect on my children and the LEA will have to send more children out of borough at high costs."
That shows the effect on a special school.

Susan Pavlis, the head teacher of St. Andrew's and St. Mark's Church of England junior school in Surbiton, writes to me:
"Along with my colleagues in the Royal Borough of Kingston upon Thames I must express my concern over the level of funding that we have received for the financial year 2003–04.
Compounded with the drop in Standards Fund we, like the majority of schools in the borough, are facing the prospect of cutting our staff at a time when we need to be increasing the pupil/teacher ratio in order to comply with the ever increasing demands made on us … So often we are dismissed as a leafy suburb with no real problems—I am sure you understand that this is far from reality in many of our schools."
That is the problem that head teachers are facing throughout my constituency. Judging from comments from other right hon. and hon. Members, the same is true across the country.

My hon. Friend's point must be underlined. Rural areas like mine in Cornwall and those of my colleagues in Devon are facing the same problem. I challenge any hon. Member in any part of the country, whatever the political composition of the LEA, not to agree that letters are coming in from heads and governing bodies on the same lines as those received by my hon. Friend.

My hon. Friend is right. When the Minister for School Standards replies to the debate, I wonder whether he will tell the House how many letters have been written to the Department. I bet it has been inundated with letters of complaint from head teachers and school governors around the country.

In our earlier exchange, the Minister for Local Government and the Regions said that there would be a statement in the House about how the Department for Education and Skills would deal with the matter. The right hon. Gentleman shakes his head. Could he clarify the Government's intentions? We want to know how they will address the matter and when they propose to tell the House how they intend to address it.

As I said earlier, my right hon. Friend the Secretary of State for Education and Skills has made it clear that he intends to make a statement about his analysis and understanding of the current position as soon as the local govt purdah period is over. That will be on Friday. It is in everyone's interest that that statement should be public at the earliest opportunity, rather than waiting for the House to return on Monday, but I have no doubt that the issue can be debated in the House at a future date.

I am sure that other right hon. and hon. Members share my concern that that information will not be given to the House. The Minister may be right to say that it needs to be given early, but that only shows the magnitude of the crisis. If the Government must make the announcement on Friday because it cannot wait till Monday, they are admitting that there is a huge crisis in the funding of our schools. Why do not Ministers make the statement now? I am sure that the Conservative party and our party will agree to suspend local election purdah, as we agree that there is a crisis.

The Minister appears to have a diary problem. Of course, the House will not sit on Friday, and it is bad enough that the statement will not be made when the House is sitting, but we will not be able to debate it on Monday, because Monday is a bank holiday.

The hon. Gentleman makes a very fair point. I assume the Minister meant that we would debate the matter on Tuesday. Can he confirm, for the benefit of all Members, that an oral statement will be made to the House? Ministers shrug their shoulders as though it were an unimportant issue about which hon. Members were not concerned. Surely the debate today shows that it is important and that hon. Members want to debate it at the earliest opportunity.

If the Minister for Local Government and the Regions is saying from the Treasury Bench that it is impossible to drop the rules on local election purdah before Thursday—he nods in assent—we must ensure that there is time on Tuesday to debate this key issue. Why are Ministers afraid to come to the House next Tuesday to debate a matter that affects every school throughout the country? Ministers seem unperturbed, as though they owe no duty to the House. They ought to learn how important the issue is.

There are other community services that are being let clown by the Government. I have been surprised at the massive public reaction to the proposal from the Office of Fair Trading with respect to community pharmacies. I was worried when the report was published, but I was astonished to receive letters and petitions from my constituents, demonstrating how damaging the proposal would be to far more people than I had imagined. The liberalisation of the market proposed by the OFT could be extremely damaging to the front line of the national health service. If the Government eventually adopt the recommendations and some of our local pharmacies close down as a result, pressure will be placed on GPs and accident and emergency units throughout the country and will be damaging for the rest of the health service. The OFT seems to have misunderstood the role that community pharmacies play in our health service by saving GPs' time and providing medical advice, sometimes out of GP surgery hours.

I am concerned about access for the elderly to such services. I was interested to read a briefing from Help the Aged, which noted that 7 million pensioners do not have cars. It is the pensioner population that is worried about the issue, as I have noticed in my constituency, as pensioners realise that they will not be able to access pharmacy services by going to the out-of-town supermarkets, because the transport will not be available.

The figures underlying the services that the community pharmacies deliver are revealing. Some 33 per cent. of the prescriptions collected by people aged 70 or above are collected on foot. That means that pharmacies are needed in the local communities. The only analysis that I have seen of what will happen if the OFT recommendations are implemented suggests that local pharmacies will be closed down and that the big supermarkets will move in. That would be a disaster for our elderly population and it is another example of the Government attacking community-based services.

The other significant example is the Post Office. We heard a lot about the Post Office from the right hon. Member for Haltemprice and Howden. The Minister was right to remind him of the Conservative record, but the Government cannot have any confidence on that basis. The Minister will know that, under the urban reinvention programme, 3,000 post offices have been targeted for closure. By this autumn, the first 1,000 will have been closed. We can then look forward to another two years in which urban post offices will close in large numbers. That comes on top of the rural post office closure programme, which is ongoing. In my constituency, we have already seen two closures and three more are under consultation. I suspect that the process will continue.

I also believe that the Post Office will take a different approach in the next round of closures. I suspect that it is becoming worried about the individual campaigns that spark up in local areas and that, in the next round, Post Office managers will come to each constituency or borough and decide to close a number of post offices en masse. I give that warning to hon. Members for free. We should be worried about the secret plans of the Post Office for short, sharp attacks on services in our communities. We know how devastating such an approach can be.

The hon. Gentleman is hypothesising about the future plans of the Post Office, but does he agree that he needs to give us the evidence on which he is basing his assertion? Many people in our communities might be deeply worried about the threat to their post offices that he seems to be imagining.

I have been trying to fight some of the post office closures in my constituency, which has involved me in many discussions with senior Post Office managers in which I have tried to change their minds and make them understand the local services that post offices deliver. It is clear from their attitude that they are getting fed up with individual campaigns, and I think that they will return and deal with closures en masse. Those of us who are elected to represent our areas should be very worried about the effect on important community services.

It is not only in respect of those services that the Labour party has had a dreadful record. There are also serious problems in social services. In particular, in residential care homes, 64,000 care beds have been lost since Labour came to power. Even if the Government meet their targets on increasing the number of beds in the NHS, that will still not make up the gap. The Labour Government's spending proposals still mean that there will be fewer hospital and care home beds than under the Conservative Government. [Interruption.]

I hear it said from the Labour Benches that people are being looked after in their own homes. Perhaps Labour Members would be interested to know that Department of Health figures show that, in the past six years, the number of people being cared for in their own homes has decreased by 25 per cent., so significantly more than 125,000 fewer people are now being cared for in their homes. Does that not demonstrate that the Labour party's approach to prevention is resulting in people no longer getting the care because of the tightening of eligibility criteria and the increase in charging for services, which are denying access to those services to too many people?

My hon. Friend is absolutely right. He has done an awful lot of work to expose some of those problems. The Government have taken a chaotic approach to managing the care homes sector, in which many homes have been lost without any plan or way of replacing that care in people's own homes or by other methods. Interestingly, the Royal College of Nursing has taken up that cause in its conference this week. It has identified the link between the health service and the impact on hospitals and the need for more care home beds for the elderly, and it is concerned that the Government need to act.

I am grateful to the hon. Gentleman for giving way. Since the advent of the so-called fairer charging policy and the Government's refusal to fund its implementation, is he aware that thousands and indeed tens of thousands of people throughout the country who can in no sense be described as rich or prosperous are, as a consequence of Government neglect, facing 200, 300 and 400 per cent. increases in costs for the services on which they desperately rely?

The hon. Gentleman is right. Many elderly people cannot afford care and are becoming increasingly reliant on their families. If they do not have families, they are relying on neighbours, and if they do not have friendly neighbours, they are going without basic care.

The final point on which I wish to focus with regard to Labour's record is not mentioned in the Conservative motion, which is why the Liberal Democrats tabled an amendment, although I know that it has not been selected. We wanted to point out the problem that exists in respect of council tax. I was surprised that the motion did not mention council tax, which is one of the big issues that I am hearing about on the doorstep when I travel around the country listening to people in the communities. People are very worried about the impact of council tax. Perhaps Conservative Members did not want to mention it because Conservative Administrations have increased it by an average of 16. 2 per cent.—the highest average increase made by any of the political parties.

None the less, we are seeing the highest ever increases in council tax, which is the most unfair tax in Britain today. We have an unfair tax system in which the poorest 20 per cent. pay a greater proportion of their income in tax than the richest 20 per cent. One sees that the council tax is the worst example of a tax when one analyses its progressivity. Pensioners in particular are hit by it, so it is time we got to grips with the issue. If we are to renew our community services and devolve more power to local government, however we want that to be done—whether through district councils, county councils or regional assemblies—we will have to give lower tiers of government a tax that can bear the burden of raising money locally. That has to be a fair tax. I do not believe that we can raise that money through the council tax, as it is proving so painful.

We must replace the council tax. The Liberal Democrats believe that we should consider how many countries around the world have tackled the problem. In many countries, there is not such a fierce debate about local taxation and Governments have managed to devolve power successfully. Many different types of countries have introduced such a policy. Anglo-Saxon countries—Canada, America and Australia—use local income tax, as well as continental countries. Such countries manage to make the tax work efficiently and ensure that it is administratively cheap to operate. Above all, however, it is fair and can bear the weight of the devolution of more power.

The hon. Gentleman says that a local income tax is a fair tax, but can he explain to the House how it would be fair to require a council such as West Somerset district council, which has only 30,000 residents, to have its own tax inspectors? Is he not really telling us about a hidden agenda for regionalisation?

I am afraid that the hon. Gentleman is completely wrong. There would be no need for his authority to have tax inspectors, which shows how much he does not understand the policy. He should talk to the Conservatives who are operating in local government. For example, he should talk to Sandy Bruce-Lockhart, a very senior Conservative local government politician. He and his colleagues in Kent are coming round to the argument and recently supported a motion in Kent county council in favour of considering the introduction of local income tax.

No, I shall not.

The time has come for such a policy. That is why we are saying that every vote for the Liberal Democrats in the local elections on Thursday 1 May is a vote to abolish the council tax and replace it with a fair tax.

2.9 pm

It is a pleasure to follow the Front Benchers in this debate. I am disappointed that the shadow Deputy Prime Minister—I think that that is the title in which the right hon. Member for Haltemprice and Howden (David Davis) glories—failed to take my intervention. It was most churlish of him and I assure Opposition Members that I shall return his generosity, should they seek to interrupt this short and, I hope, not too contentious contribution.

One of the more gut-wrenching and nauseous statements that came from the shadow Deputy Prime Minister and would-be Leader of the Opposition was that the Conservative party is against the centralisation of power and the erosion of local democracy. The Minister, who has been well briefed on the issue by hon. Members from Berkshire, eloquently cited the way in which the previous Conservative Government, without consultation or reference to anyone else, abolished the county of Berkshire. It is important to put on the record that we think that that was a good thing—not because they did not consult anybody, but because we now have a coherent system of unitary government. The boundaries need to be dealt with, but that can be done elsewhere.

I wanted to ask the shadow Deputy Prime Minister—perhaps his junior colleague can address this in his speech—whether he could explain to the House how policies such as the poll tax and rate-capping enhanced local democracy or empowered local government. I was a local government leader throughout a fair bit of the duration of the last Conservative Government, and I remember everything that they did to help us to empower our local communities. This country has never seen a Government who were more centralising, more dictatorial or more frightened of the ballot box. They were so frightened of the ballot box and of the judgment of the people—I am not a London Member, but I am sure that London Members will forgive me for praying this argument in aid—that, rather than take on the Greater London Council themselves, they had to use legislation to abolish it because they were not capable of delivering on the streets and in the election booths.

I have looked at the wording of the Opposition motion, which I would describe as a "mum and rotten apple pie" motion. I could be cynical and suggest that it has some interrelationship with the local elections of I May. [HON. MEMBERS: "Surely not"] If one tenth of the intemperate—to use the Minister's term—words used in the motion are true, who will vote Labour on 1 May? Perhaps I should be worried in my swing, marginal constituency that the Opposition might just have a case. I therefore propose to market test the contentions in the motion. I hope that that is not new Labour-speak. [HON. MEMBERS: "It is."] Oh, good Lord. Nevertheless, I intend to market test the contention that the impact of Government policies on community services has been bad for local communities. It is worth looking at how extreme is the language used in the motion. It refers to
"the collapse of community services in Britain and the adverse effect on social inclusion, neighbourhood renewal, regional prosperity".
Try telling that to people in the Thames valley. It
"further condemns the Government's failure to improve local health care provision".
"recognises the Government's total failure"—
not even partial failure. That is the language of the Militant Tendency. Many Labour Members have spent a lot of time fighting that kind of extremism, and we now find it raising its ugly head on the Conservative Benches. Most worrying is the reference to a

"total failure to protect community services, resulting in a crisis in school funding".
That is pretty strong stuff. How can we test it? Such deterioration in the quality of public services cannot have happened over the past 12 months—it must obviously be a process of decline that started on 2 May 1997.

I see that the shadow Minister—I assure him that he will only ever remain a shadow Minister—agrees with that proposition. To test it, let me take as an example my constituency of the town of Reading. I am a great believer in talking about what I know, unlike some hon. Members.

I was not of course referring to my hon. Friend the Member for Wolverhampton, South-West (Rob Marris), whose football team is doing nearly as well as mine.

I have a great affinity for the democratic process, so I thought that I should assess the performance of Labour councils in Reading from 2 May 1997 until the present day.

The Minister is nodding; that is a good start.

Then we shall see whether the contentions articulated in the Opposition motion have had any effect at the ballot box. Reading is an ideal indicator seat, because the Conservatives need to win the two Reading constituencies to form a Government. Moreover, it is a town with a tradition of turning mid-term against the party in government. I shall start the test with a bit of recent political history. We had a Conservative council from 1983 to 1986—for three years. That was at the height of Mrs. Thatcher's power, post-Falklands and post-the first real Conservative landslide. We had a brief period of Labour control in the early 1970s, but primarily the town has for a long time had hung councils. It is a swing constituency with swing councils. In 1983, the Conservatives swept to power with 44.9 per cent. of the vote, while the Labour party got 29 per cent. In 1986, the shine was starting to go off the Conservatives, and the town turned away from them. After seven years of Conservative government, they received 32.8 per cent. of the poll at the local elections, and Labour received 36.4 per cent.

In 1990, the triumph of the poll tax—we all remember those happy days—meant that it was pretty grim for the Tories. I accept that that was not a typical year: I do not want to be unfair to the Conservatives. [HO