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Commons Chamber

Volume 450: debated on Wednesday 11 October 2006

House of Commons

Wednesday 11 October 2006

The House met at half-past Eleven o’clock


[Mr. Speaker in the Chair]



That an humble Address be presented to Her Majesty, That she will be graciously pleased to give directions that there be laid before this House the accounts of the Contingencies Fund, 2005-06, showing—

(1) a balance sheet

(2) a cashflow statement, and

(3) notes to the account; together with the Report of the Comptroller and Auditor General thereon.—[Mr. Michael Foster.]

Oral Answers to Questions

Northern Ireland

The Secretary of State was asked—

Water Charges

1. What plans he has to assist those on low incomes following the introduction of water charges in Northern Ireland. (92585)

As part of our investment and reform programme for water services, we are introducing measures to guarantee that more than a quarter of homes, about 200,000 households, spend no more than 3 per cent. of their income on water and sewerage charges. To ease further the burden for all customers, all new charges will be phased in over three years and for pensioners we are making available the option of choosing a water meter.

I very much welcome my hon. Friend’s statement. Can the House be assured that those eligible for assistance will receive it automatically and will not have to go through any cumbersome application procedure?

My hon. Friend makes an extremely important point. We want to be proactive in ensuring that those who are entitled to the additional support actually receive it. That is why we have already put in place data-sharing arrangements with the Housing Executive and the Rate Collection Agency, to ensure that people entitled to the relevant benefits actually receive the support. That is a mark of how serious we are about ensuring that those on lower incomes receive the help and support that we are making available.

Should not the details be left to the Northern Ireland Assembly? Will the Minister give an unequivocal guarantee that no irreversible decisions will be taken before 24 November?

I remind the hon. Gentleman, who has detailed knowledge of the history of these matters, that the process was begun under the Executive and the last Assembly, and that we have followed through the work they began. Of course, delaying the process beyond the start of April 2007, when it is due to come into force, would put a big hole in the budget for next year. An incoming Assembly would be free to reverse the process, but it would have to find the money to keep the investment going into water and sewerage services that they desperately need. If we are not to do that by asking people to pay a fair share domestically, the money will have to come from other parts of the budget—from health, education and training and skills—and I do not think the people of Northern Ireland would welcome that either.

Mr. Eddie McGrady (South Down) (SDLP): I would like to reiterate my total opposition to the introduction of water rates, which are already collected under the regional rate. However, the Minister’s colleague wrote to me on 9 September citing Government policy in respect of rates and said:

“The Government’s view is that a rate relief scheme based on ability to pay best reflects the situation in Northern Ireland.”

How does the Minister square that statement of the Government’s policy and philosophy with the fact that he is not abiding by it in respect of the water rates, the little-mentioned sewerage rates or the general rate itself? Why the contradiction?

The hon. Gentleman has to face up to a simple fact: domestic households pay in council tax and water charges about £1,300 in England and Wales, £1,250 in Scotland and £668 in Northern Ireland. That is not sustainable if we want the investment in water and sewerage services that is needed to bring them up to the standards required. The process is a way of ensuring that people pay a fair share—not more than their fair share. At the same time, we have what we call an affordability tariff—help for those on lower incomes—that is far more generous than anything that applies elsewhere in the United Kingdom. We should be commended for a package of measures that gives the investment we absolutely need, is fair to everyone and gives support to those on low incomes.

Mr. Nigel Dodds (Belfast, North) (DUP): The Minister will be aware that the General Consumer Council for Northern Ireland has launched legal action in an attempt to win more time for consultation, because people across the communities in Northern Ireland, especially vulnerable people, are very worried about what the Minister proposes to do. Will he give a guarantee that he will extend the consultation period, in line with what the General Consumer Council and all the parties and the people of Northern Ireland are seeking? Can he at least give that assurance?

This matter has been under consultation since 2001. The idea that the consultation period has been shortened is absolute nonsense. The matter comes before the court tomorrow, but on the general principle the consumer council supports the introduction of water charges. It has worked with us because it recognises that, if we are to have the investment we need to bring water and sewerage services in Northern Ireland up to an acceptable level, people—domestic consumers—have to pay their fair share. The consumer council supports that policy. I am absolutely convinced that we have consulted properly, thoroughly and rigorously on it, and we shall not delay it any longer.

Ring-fenced Funds

2. What assessment he has made of the merits of using ring-fenced funds to target specific policy areas in Northern Ireland. (92586)

I have established three ring-fenced priority funding packages—children and young people, skills and science and environment and energy—to redirect resources specifically to improve the prospects and life chances of future generations in Northern Ireland.

I am sure that the House will be pleased to hear about the progress of that approach, but are there other ways in which different Departments can work together—for instance, through cross-cutting budgets in respect of areas such as renewable energy?

There are indeed and I welcome my hon. Friend’s point. That is exactly what is happening. For example, we are seeing £60 million invested in renewable energy schemes and environmental protection schemes to make Northern Ireland the leader of the green agenda in the United Kingdom. There are also 100 per cent. grants to low-income households to install solar panels on their roofs, alternative microgeneration schemes and a change in building regulations, so that, from April 2008, no new build in Northern Ireland—whether it be a hospital, a school, a factory, an office or a home—can proceed without microgeneration designed in from the beginning. That will contribute to the fight against climate change, as well as reduce bills.

The Secretary of State will be aware that the DUP was the only party to argue for a reduction in the number of Government Departments. Does he agree that it is imperative for the funding for the distribution of essential life-improving drugs such as Herceptin, beta interferon, Enbrel and Remicade on the one hand, and for mental health provision on the other, to be ring-fenced? Sadly, in those two areas, money is often siphoned off when there are shortfalls within the national health service.

The hon. Lady will know that the Labour Government have doubled in real terms the health budget in Northern Ireland, but she has made strong arguments on those matters and I pay tribute to her. It is exactly the joined-up government approach that we are carrying forward and I hope that the devolved Executive will also carry it forward—and sooner rather than later.

I congratulate the Secretary of State on the ring-fenced funding and I ask him to think seriously about further ring-fenced funding for education. While there are wards in North Down where 70 per cent. of young people go to university, only 4 per cent. do so in the Shankhill. Such disparities cannot go on and extra ring-fenced funding will help to overcome them.

My hon. Friend is absolutely right. Although Northern Ireland has excellence at the top of our schools system, it has a very poor achievement rate down the ability ladder. What we need is everyone having opportunities in schools so that Northern Ireland can be world class. That is why I have ring-fenced funding for children and young people. For example, I have provided extra money directly to head teachers in about 400 schools in the most disadvantaged areas—including the one that my hon. Friend mentioned—to enable them to run breakfast and after-school clubs, providing high-quality care, so that parents can work if they wish to and children can get a better start in life. We are also offering a new pre-apprenticeship programme to young people at 14, so that they stay engaged in education and are fully prepared for further vocational education. That is our agenda.

Victims (Funding)

Since 1998, the Government have provided £36.4 million of help to victims. As part of her remit, Mrs. Bertha McDougall, the Interim Commissioner for Victims and Survivors, is carrying out a review of how well current funding arrangements are addressing need. Her final report is due around the end of this year and I look forward to seeing her findings and recommendations, which will help to inform our consideration of any new funding arrangements.

The Minister will be aware that in a recently published report, Bertha McDougall stated that there was a

“lack of co-ordination, which had led to confusion, duplication of funding, gaps in funding, over-administration and an incomplete picture of provision.”

In advance of the interim commissioner’s final report, is there not a need to look further into how to end the duplication and to ensure that the money gets through to the people who need it most—the people who have suffered: the victims and the survivors—rather than be spent on administration? There should also be greater flexibility with respect to the Northern Ireland memorial fund. The funding should be geared towards meeting the specific needs of individual victims rather than provide generalised funding through grant arrangements.

The hon. Gentleman makes some very fair points. I congratulate Bertha McDougall on her work to date as interim commissioner. She is doing a sterling job in reviewing these issues. As the hon. Gentleman said, she has identified a lack of co-ordination, duplication of funding arrangements and the fact that, in some cases, bureaucracy is preventing victims, through no fault of their own, from receiving what is due to them. That is the very reason why we asked her to examine the issues and the very reason why she will make proposals in December. I greatly share the hon. Gentleman’s aspiration for a more focused and targeted approach to funding for victims and for people who need Government support, so that they receive it in a proper and effective way. I am confident that, once the review is complete, we will be in a position to take those matters forward.

I thank the Minister for the comments that he has already made on this important issue. Does he recognise that, as we look to political progress in the talks in Scotland and beyond, every stage of progress has brought mixed feelings for victims in Northern Ireland? They do not reject the language of moving on, but they fear that they are being left in some sort of forgottenhood. Does he recognise that the promises made to victims in the Good Friday agreement have not been upheld? The Government and all the parties can do more to deliver those promises. Will he encourage the formation of a forum for victims and survivors to do the business that the parties and Governments have failed to do in addressing the needs of victims on truth, remembrance and recognition?

Again, there is much in what my hon. Friend says that I genuinely share. Bertha McDougall, as the interim victims commissioner, is examining the possibility of bringing together individuals to look at some of the issues that deal with the past. What has happened in Northern Ireland over the past 35 years and the impact on victims and survivors has been devastating to their lives, cannot be moved on from and will always need to be remembered, but it needs to be put into a context where we offer support and accommodation to examine those issues in detail. We will very shortly introduce into the Commons an order to establish the victims commissioner permanently. We are committed to an expenditure of about £5 million a year on victims currently, and we have spent more than £36 million to date. I am certainly discussing the points that my hon. Friend mentions with the victims commissioner now, and I hope that we can make progress on them in the near future.

Has the Minister examined the Alliance party’s proposals for an international commission to define a strategy that deals not just with the past, but with the legacy of the past and the victims of what has happened in the past three and a half decades? Do the Government share my view and, indeed, that of the Alliance party that Northern Ireland must have a strategy to address its past if it is successfully to implement a vision for a shared future?

Yes, I have seen the Alliance proposal and I congratulate David Ford MLA on bringing those ideas to the table. I am also very encouraged that the Committee on the Preparation for Government in the Assembly has looked seriously at issues that relate to the past, and we certainly need to give careful thought to how we deal with such issues. I welcome the paper from the Alliance as a contribution to that debate. There is certainly the potential for some form of consultation on dealing with the past, and we continue to keep that under review. No doubt, that will be discussed as we head for Scotland today and over the next few days as well.

Since victims groups were probably the most strongly opposed to the Government’s abortive Bill to give an effective amnesty to on-the-run terrorists, will the Minister give us an assurance today that the Government will not agree to this week’s demand from Sinn Fein that that legislation now be reintroduced?

I am grateful to the hon. Gentleman for raising that issue. He will know that the Government attempted to take action on this issue. That attempt was not successful. The Government withdrew the Bill, and I can assure him today that there is no prospect whatsoever of the Government reintroducing the legislation that was before the House last year.


4. What steps he is taking to assist back into work those in Northern Ireland who are economically inactive. (92588)

Despite the fact that the Northern Ireland economy is supporting its highest ever number of jobs and has below-average unemployment, it is still one of the worst economic inactivity hotspots in the UK. In Northern Ireland, a person of working age is 74 per cent. more likely to be receiving incapacity benefit than a working-age person in England. Therefore, we are implementing the pathways to work programme for people who receive incapacity benefit and have increased funding over the baseline by an additional £3.7 million over the next two years from the new skills and science fund to achieve that.

I thank my hon. Friend for that answer, but given that the economic success of any community depends on the economic activity of individuals, is it not important to monitor closely how pathways to work can work best for individuals? In doing so, can we ensure that that programme is available to all the people of Northern Ireland, so that everyone can share in the success?

My hon. Friend may be aware that the pilots operating in six areas are showing extremely encouraging results, with up to five times more people finding work in those areas following the interventions than in other areas. By the time we roll out pathways to a further four areas this month, we will be covering about a third of the on-flow on to the benefit. I hope that we will be able to roll out the programme further across the whole of Northern Ireland over the next year or so, meaning that everybody in Northern Ireland coming on to incapacity benefit will have the benefit of pathways to assist them back into work and economic activity.

In March this year, we were told that one of the key issues that the Government have to address in supporting the economically inactive back into the workplace is skills. What progress has been made in that area?

The hon. Gentleman is right, in that the economically inactive are twice as likely to have no qualifications as those who are in work, so developing key skills and giving people access to skills training is an essential part of our approach. In respect of those who have been inactive for some time, confidence-building measures and helping them to deal with the health conditions that often keep them on incapacity benefit are vital first steps. Both interventions need to go forward together, and they will as we roll out pathways to work.

Equality Bill

5. What he expects the effect of the proposed Equality Bill for Northern Ireland to be; and if he will make a statement. (92589)

The single equality Bill will bring together all existing Northern Ireland equality and anti-discrimination law in one legal instrument and, as far as is practicable, harmonise protection and extend protection to new grounds where appropriate. The resulting legislation will be more consistent and coherent, will clarify rights and responsibilities and will simplify the law to make it more effective.

The former Secretary of State for Northern Ireland, the late right hon. Member for Redcar, was instrumental in setting up the Equality Commission for Northern Ireland, which is responsible for dealing with sexual discrimination, disability discrimination, fair employment and race relations. The single equality Bill has been consulted upon for several years, but when will this legislation finally become law?

I pay tribute to my former right hon. colleague, Mo Mowlam, who put a lot of work into ensuring that the single equality Bill came before the House. As Ministers, we are determined that Northern Ireland will not fall behind the rest of the United Kingdom in terms of the introduction of legislation. There is potentially about one year for work to be undertaken and we are committed to undertaking the legislation either by a Bill in the House or via the devolved Assembly if that is the appropriate way forward. As the direct rule ministerial team, we certainly wish to see the legislation before the House.

Will the Minister accept that any proposed equality Bill needs to ensure that, for example, the public sector recruitment ratios that have shown in recent years a significant under-representation of the Protestant community are addressed and reviewed so that genuine equality of opportunity is offered to each section of our community?

I certainly understand the hon. Gentleman’s point. I wish to see more people from the Protestant community employed in the sectors that he mentioned. I ultimately want to see people treated as equals and not on the basis—[Interruption.]

Order. There is far too much noise in the Chamber and that is unfair. [Hon. Members: “Hear, hear!] I am glad so many hon. Members agree with me.

I wish to see a situation in Northern Ireland in which all individuals are treated as equals and on their merits. That is what the legislation is about and that is why I hope that we will bring it before the House in due course.

Rating Reform

6. What steps he is taking to help those on low incomes during the introduction of rating reform in Northern Ireland. (92590)

The Government are committed to introducing a fair rating system for Northern Ireland based on the current value of people’s homes. Through housing benefit and the new rate relief scheme, more than 185,000 households in Northern Ireland will receive assistance in paying their rates. In addition, those in full-time education and training, as well as all 16 and 17-year-olds and young people leaving care up to the age of 21, will be exempt from rates.

I am very grateful to my hon. Friend for that comprehensive and welcome response, which is an example of reform tinged with sensitivity. As he now wears proudly the mantle of champion of the elderly, is he not aware of the 250,000 pensioners in Northern Ireland and will he not look at special support for a group that may be property rich but are often cash poor?

I am grateful to my hon. Friend. He will be aware that I have taken on the role of older people’s champion. Older people, for this purpose, are determined as those over 50, and I am 49 and a half, so I am just about there. The Government are committed to introducing a fair rating system, and the number of people who will receive benefits for their rates will increase as a result of the changes that we are bringing forward. Under the old rating system, some 175,000 people had help with their rates. Under the new proposals, 185,000 will have help and more of those will have greater benefits than before. I am committed to ensuring that people on low incomes have the best deal possible from this Government in paying their rates.

What help will be given to pensioners paying their rates who live in their own homes but support a family member in care? If there is a 5 per cent. cap in England, why is there not one in Northern Ireland?

We have tried to put in place a new benefits system that will help those in need to pay. There are many well-off pensioners who might not benefit from any schemes, but there are many low-income pensioners who will benefit from rate relief. The circumstances differ, but overall more people will benefit under the proposed new scheme.

I have taken a decision not to cap the rates in due course. That will affect approximately 3,000 properties. There are 700,000 properties in Northern Ireland. I am concerned about ensuring that the system is fair for the vast majority of properties—those who live in the largest properties can afford to pay a significantly increased contribution to their rates. That is my objective, and I hope that the hon. Gentleman, and in due course the Assembly, will share it.

I welcome the Minister’s answers relating to those on low incomes, but unfortunately, unlike the hon. Member for Ealing, North (Stephen Pound), I do not believe that they will work out in practice. Does the Minister accept that the parameters of low income are far too tight and that many people with pensions and very small savings will not qualify for any relief? Does he accept that people with disabilities will require their homes to be specially adapted before they qualify? There is a plethora of single-person households, carers and all the rest who will not qualify for relief.

No, I am afraid I do not accept that. To give an example, a pensioner couple living in a house worth £500,000 with a combined pension and income of £21,000 and £15,000 in savings will still benefit under the rate relief scheme. I believe that the scheme is fair and appropriate, and I commend it to the House.

By the very nature of the scheme, more people will be paying higher rates, and that will lead to a lower disposable income across Northern Ireland. That will lead to lower demand for goods and services, and that will lead to fewer jobs. How does the Minister square that with his intention to make more people in Northern Ireland economically active?

Our figures show that 55 per cent. of the population of Northern Ireland will pay the same or less in their rates than currently. We are not raising one single extra penny from the rating system in Northern Ireland. We are rebalancing that system and ensuring that it is fair for all.

Northern Ireland Assembly

Substantial progress has been made in recent months, including a report of the Independent Monitoring Commission, which opens the way to a settlement at the summit at St. Andrews that will start later today.

I thank my right hon. Friend for that reply. The whole House should welcome the progress that has been made and hope that more progress will be made this week. Have any specific discussions taken place that will allow the hundreds, if not thousands, of people who have been forced into exile over the past 30 years to return to their homes in safety?

As my hon. Friend knows, the security situation has been transformed these last years under this Government, with not one soldier on the streets on 12 July for the parading season for the first time in nearly 40 years, and with last week’s IMC report confirming that the Provisional IRA no longer has a war machine and no longer poses a terrorist threat. That opens the way for delivering a political settlement, starting in St. Andrews today.

Thank you, Mr. Speaker.

Is the Secretary of State aware of how damaging it would be to the prospects for restoration if the Government were to return to the issue of on-the-run terrorists being given what amounts to an amnesty? Although we welcome the earlier answer from the Minister of State that no legislation is to be brought before the House, will the Secretary of State reassure the House and settle the nerves of my colleagues and me by assuring us that no other procedure will be used to allow on-the-run terrorists to return?

There is no other procedure. There is no prospect of an amnesty. The legislation was tried; it was withdrawn when support for it collapsed, not least in this House, and we have absolutely no intention of bringing legislation back. That, I think, should reassure the hon. Gentleman. What we shall look for in the next few days is delivery—not promises—from Sinn Fein on policing and respect for the rule of law, and then a commitment from all the parties to a power-sharing Executive.

First, may I wish the Secretary of State and the Northern Ireland parties well in their negotiations at St. Andrews?

Secondly, may I ask the right hon. Gentleman to confirm that he believes that if power sharing and devolution are to be durable in Northern Ireland, as we both want, they must be based on every political party and every potential Minister recognising the authority of the police and the courts as legitimate, and giving those institutions full practical support?

I am grateful for the hon. Gentleman’s support. The discussions will be critical. The politicians have a window of opportunity, which may not be available again for many years to come.

I am happy to agree unequivocally that Sinn Fein and everybody else must sign up to the rule of law. Anyone who seeks to hold ministerial office in Northern Ireland must support, co-operate with and report crime to the police, and ensure that the Police Service of Northern Ireland is able to do its job of enforcing law and order.


The Prime Minister was asked—


Before listing my engagements, I am sure that the whole House will join me in sending our sympathy and condolences to the families of those members of our armed forces who have lost their lives in action in Iraq and Afghanistan over the past few months. We pay tribute to their courage, their bravery and the importance of the work they do. This country is proud to have the armed forces that we have.

This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today, including, of course, hosting the talks on the future of Northern Ireland.

The excellent accident and emergency and maternity services at Hastings Conquest hospital are testimony to the massive improvement under Labour’s national health service—[Hon. Members: “But.”] There are no buts. However, may I ask my right hon. Friend how local people can challenge the bizarre proposals by bureaucrats to downgrade those valued and cherished services?

My hon. Friend is right to say that there has been enormous progress in the health service. Waiting lists are down by some 400,000. The number of deaths from heart disease has fallen since 1997 by about 150,000. We now have no one waiting for more than six months; when we took office, thousands were waiting more than 18 months. There have been improvements in cancer care, treatment for cataracts, and in accident and emergency services.

Any changes that are proposed locally will have to be fully consulted on, and the decisions will be taken locally by those who are responsible for the local health service. That is the sensible way to proceed. This Government have put enormous investment into our national health service and it is important that the right decisions on its future are taken locally.

There we have it: no buts, just cuts.

I join the Prime Minister in sending our condolences to the families of those soldiers who have given their lives in Iraq and Afghanistan over the past few months. We must make sure that they did not die in vain.

The Home Office has explained that it is moving prisoners at risk of escaping to open prisons. The Home Secretary is apparently happy with that. [Interruption.] Is the Prime Minister?

As the Home Secretary has just pointed out, absconding is at its lowest for 10 years, so the idea that we are going to put the public at risk is absurd. No people will be put in open prisons who are a risk to the public. [Interruption.] As the Home Secretary has just pointed out, the figures on absconding are the lowest for 10 years. Let me point something else out to the right hon. Gentleman. When he was advising the Home Secretary at the Home Office under the previous Administration, many, many category A prisoners as well as other category prisoners escaped. I am pleased to say that under this Administration there have been no category A escapes.

But the public are at risk and the Home Secretary knows it. I have a memo from the governor of Ford open prison that could not be clearer. It states that

“this will mean almost inevitably that the abscond rate”—

that is, people escaping—

“will go up in Cat D prisons”

and that

“medium term burglars and robbers”


“likely to abscond.”

Whatever happened to tough on crime?

Hold on a minute. I know the Prime Minister has only a few more goes. Let us look at something else that he said. He said that any foreign national convicted of an imprisonable offence should be deported automatically. The Home Secretary is now bribing prisoners with up to £2,500 to get them to go home. Whatever happened to automatic deportation?

The Home Secretary is, very sensibly, making sure that we can ensure that all those foreign secretaries—[Laughter.] There is not much of a recovery after that one. He is making sure that all those foreign prisoners can be returned as early as possible. It will obviously cost money, but in order to ensure that it happens more quickly we are making sure not that they are given a cash payment—that is absolutely wrong—but that we pay for their return before their sentence is completed, so that we reduce the pressure on British prisons and so that, when their sentence is completed, prisoners are returned immediately. That is the only way we will get the foreign prisoners back quickly.

Let us look at what happened. Of the 1,000 prisoners who were released and who should have been deported, only 86 have been sent home. That is not automatic deportation.

Let us look at another thing the Government said. The Secretary of State for Health told us that this was the best year ever for the NHS. Will the Prime Minister confirm that, since then, 20,000 jobs are being cut, 80 community hospitals are under threat and 60 major hospitals face cutbacks? Would he describe it as the best ever year for the NHS?

I am delighted that we have got on to the national health service. There are not 20,000 jobs going in the national health service. Since the Government came to power, there are 250,000 extra people employed in the national health service. Let me point out to the right hon. Gentleman, since he is launching a campaign on Saturday about cuts in the national health service, that his policy proposal earlier this week was for an independent commissioning board that would apparently be free to commission all services. [Interruption.] Nobody on the Government Front Bench is in favour of an independent commissioning board. It would be free to commission all services, and we know from the right hon. Member for West Dorset (Mr. Letwin) that there would be no limits to independent commissioning. Therefore, under the right hon. Gentleman’s proposal, if the board wished to commission maternity services, paediatric services or diagnostics from the private sector, it would be able to do so without limit. How does he put forward that policy proposal on the Monday, and then launch a campaign asking me to intervene in local decisions and provide more money at the end of the week?

I do not know why the Prime Minister is attacking our health policy. One of his Health Ministers has said it is worth looking at and the Chancellor is going around briefing everyone that he would introduce it. I know that the Prime Minister and the Chancellor do not talk any more, but if he read the newspapers he might find out what his Chancellor thinks. The Prime Minister is living in a fantasy world. In the real world, community hospitals are closing, nurses are facing the sack and beds are being lost. No wonder Labour is not trusted any more with the NHS.

Let us look at something else that the Prime Minister told us. He told us in January—Labour Members will enjoy this one—

“I’m absolutely happy that Gordon will be my successor. He needs the confidence of knowing he will succeed me and that’s fair enough.”

Does the Prime Minister still think that today?

Let me just say—[Interruption.] I do not resile from anything that I have said, but let me just go back for a moment to the NHS. The right hon. Gentleman has just proposed a campaign, saying that he would reverse all those decisions that are being taken by local decision makers on the NHS. Let me read to him from his campaign document—

Order. The Prime Minister has gone on too much about the Conservative party’s campaign document. [Interruption.] Order. I have given the Prime Minister and the Leader of the Opposition some elbow room, and I ask both to take my advice, or sooner or later it will be my instruction.

I am simply explaining why I will not accept the policy on the NHS proposed by the Conservative party. I assume that the right hon. Gentleman is launching this policy proposal because he wants us to accept it, and the reason I will not accept it is that his proposal is for an independent board to take all commissioning decisions and to allocate resources. That would mean no accountability for politicians in this House about the decisions that are taken, and it would mean that, since there are no limits to the private sector involvement, none of these services that he will protest about at the end of the week will be guaranteed under his proposals made at the beginning of the week.

It was a pretty straight sort of question, and the Prime Minister has told us that he is a pretty straight sort of a guy. Does he back the Chancellor as his successor? Yes or no? I do, does he?

I am sure that the right hon. Gentleman is a lot happier talking about that than he is about policy, but I will talk about policy. I will talk about the policy on the NHS, our policy and his policy, because in the end the issue for the country is who has the right policies for the future, and it is the Labour party that has made record investment in the NHS, which he voted against. It is this party that has delivered better waiting times, improved cardiac and cancer care and accident and emergency departments, and his policies would put all of that at risk, and that is why we will stick with our policies,not his.

Everyone can see that the Government are divided and paralysed. We have a Prime Minister who does not trust his Chancellor, a Chancellor who has been accused of blackmail, the latest Home Secretary wants the Prime Minister’s job, the Deputy Prime Minister does not have a job but is still being paid, and all the while hospital wards are closing and the prison system is in chaos. How many more months of this paralysis have we got to put up with?

There is no paralysis. We have record investment in the health service, which is delivering the results that we say. The reason it is important that we resist the right hon. Gentleman’s “campaign against the cuts” is that the changes that we are making in the NHS are necessary to make it fit for the modern age, when it is changing rapidly, when new technologies and treatments are coming in, and when 70 per cent. of cases are now day-care cases. He can make all the remarks that he wants, but it is this Government, on welfare, on pensions, on energy, on the NHS, on education, who are driving forwards, while his party has a series of policies that face both ways and have no credibility whatever. If he wants to be taken seriously as a leader he should get serious on substance.

Last week the Government confirmed that paid maternity leave will be increased from six to nine months from April next year, making a huge difference to the lives of about 400,000 women a year and many expectant mums in my constituency. Given that I will not be able to hang on that long, will my right hon. Friend consider putting in a good word with the Chief Whip for me?

That is an interesting suggestion. First, I offer my congratulations to my hon. Friend and hope that all goes well for her piece of individual delivery. Over the past few years, we have improved maternity pay and maternity leave, we have introduced paternity pay, we have expanded child care places by about 1 million, we have given free nursery education for three and four-year-olds, and we will expand that still further, we have given the right to flexible working for the first time, and we are ensuring that in maternity pay and maternity leave we are prepared to go even further. That is the difference between a Government who deliver on policy and one who do not.

I join the Prime Minister in his expressions of sympathy and condolence to those who have lost their lives since the House last met. We should never forget that each and every one of them leaves behind a grieving family and friends, and we should not forget the thousands of Iraqi and Afghan civilians who have also lost their lives.

Turning to Northern Ireland, with which the Prime Minister will be engaged later today and for which he has the support of the vast majority in the House, will the right hon. Gentleman confirm that the Government are still committed to the “Shared Future” agenda, which the Government published in March this year and which advocates integration, not separation, for the Northern Ireland community?

I certainly can confirm that. The “Shared Future” agenda is essential for the people of Northern Ireland, and we published an action plan to achieve it earlier this year. Obviously, what is necessary now is to get political stability within the right political framework for the future, and we hope that we can do that.

The Prime Minister knows that the 24 November deadline is only some six weeks away. In the past, deadlines have come and gone. What is different about this deadline? And if it is not met, what will the Government do?

It is a few hours before the talks begin, and it would probably not be sensible to speculate about what will happen if they do not work. It is important to recognise that this deadline is not merely a deadline in legislation. If we are to make progress in Northern Ireland, it is necessary to realise that the issues will not change—the issues have been there all the way through. We have not had a power-sharing Executive in Northern Ireland over the past few years—since 2002—because we have been unable to resolve the outstanding issues, which will not change or go away and which will still be there, irrespective of what happens. In my view, this is a one-off opportunity to build on all the progress that has been made and put in place a future for the people of Northern Ireland that will last, that will allow prosperity, that will allow people to celebrate the diversity of Northern Ireland and that will allow people to pursue their political objectives in a peaceful way. I think that that is an historic opportunity, and we should seize it.

Last month, the hon. Member for Gainsborough (Mr. Leigh) and I visited the Democratic Republic of the Congo, where we saw the excellent work being done by the charity War Child for street children and child soldiers. Today, Amnesty International has expressed grave concern about the number of child soldiers still being held by warlords. Will the Prime Minister guarantee that the Government will put pressure on the new Government in the DRC to take immediate action to get those child soldiers released from the hands of the warlords?

That is a problem in the Congo, and it is a problem in other parts of Africa, too. We have a clear position: we put maximum pressure on any governmental or non-governmental bodies that engage in a form of child slavery and oppression that is truly disgusting. I assure my hon. Friend that we will continue to do everything that we can to eradicate it in the Congo and elsewhere.

Q2. In a major land-swap deal, Shrewsbury and Atcham borough council wants to build a museum on the site of Charles Darwin’s birth and recreational facilities on land near Shelton hospital. Both sites are owned by the Government, and the council has unfortunately experienced a lot of red tape in purchasing the land. Will the Prime Minister use his good offices to help the council secure the land, rather than making it proceed through a compulsory purchase order, which would cost Shrewsbury’s taxpayers more money? (92521)

I am happy to look into the matter for the hon. Gentleman, and I hope that he makes a speedy recovery. I know a little bit about the issue, and I am sure that it is worth while, but I need to check whether it is possible to intervene in a helpful way. I will get in touch with him as soon as I can.

Q3. Dame Pauline Neville-Jones, the former chairman of the Joint Intelligence Committee, said this month: “There is a growing issue that it is too easy to steal someone’s identity, and ID cards are one of the ways of addressing the issue”.Does my right hon. Friend agree with her, or does he feel that we should not try to identify criminals but understand them better, and perhaps give them a hug? (92522)

What Dame Pauline Neville-Jones says is very sensible, and is yet another example of the Conservatives’ policy of facing both ways, as she chairs their security commission. The reasons why identity cards are important are simple: 70 per cent. of the cost will be necessary for the new passports in any event; identity fraud and abuse is a major question; and apart from the benefits for the individual in having secure identity, it is impossible to say that we are serious about tracking who is in and entitled to be in this country and who goes out unless there is such an identity system. Therefore, anyone who is serious about dealing with illegal immigration must get serious on the subject of identity cards.

Q4. Will the Prime Minister give serious consideration to the petition delivered to Downing street last month on behalf of the residents of Potters Bar protesting at the closure of one third of the beds at Potters Bar hospital, a modern, purpose-built community hospital that only opened in 1995? Will he consider that issue affecting an excellent community hospital? (92523)

Yes, but as the hon. Gentleman will know, the reason being put forward for the changes is not that they will diminish community facilities but that they will provide them in a different way—[Interruption.] I am sorry, but that is a change going on throughout the health service for perfectly good reasons. His petition to me, of which I have read the reports, makes the point about the differential in funding between different parts of the country. It is true, for example, since he has said it in his local newspaper, that there is a 20 per cent. gap between the funding per head in his constituency and that in my constituency, but that is based on the figures for mortality though cancer, mortality through coronary disease and low birth weight. Actually, it is

“the fact that the most NHS resources should be given to those areas where the disease burden is highest.”

That is a quote from the Conservative campaign document.

Given the latest obesity figures, will my right hon. Friend join me in congratulating the Labour councillors in Hull who introduced the “Eat Well, Do Well” scheme, which has doubled the uptake of healthy free school meals in Hull?

I am delighted to congratulate them, and I am sure that it is an important part of the public health drive in Hull and elsewhere in the country. The reason it is important is that, as we extend community facilities, as we see changes in school dinners and in competitive sport in schools—which has increased to 80 per cent. from the 50 per cent. that we inherited—and as we are able to provide greater local community services in which public health is a major part, the general health of the nation will be improved, which will reduce the long-term costs in our health care system.

Q5. On 29 April this year, on behalf of my constituents, on an issue of major importance, I asked the Home Office a simple question: how many foreign prisoners had been released from Peterborough prison in the previous 12 months? Five months on, I have yet to receive a satisfactory reply. Having once described himself, with his customary humility, as a pretty straight kind of a guy, why is it impossible to get a straight answer to a straight question from this Prime Minister and his Government? (92524)

Obviously, I do not know the figures in respect of Peterborough, and I will have to look into that and reply to the hon. Gentleman. Let me make one thing clear. In removing foreign prisoners, in relation to which, in certain instances, there are difficulties in the courts and elsewhere, we are keeping figures on foreign prisoners for the first time in years. Under the previous Government, no such figures were kept at all.

Q6. I join in the House’s welcome for the package of measures announced by the Secretary of State to support our troops serving bravely in the difficult theatres of Iraq, Afghanistan and the Balkans, but will my right hon. Friend think more widely about what further measures of support can be given to our troops serving overseas? Is it right, for example, that people serving valiantly in other countries should be asked to pay council tax in this country? (92525)

I thank my hon. Friend for his welcome for the measures that were announced yesterday, including the important tax-free bonus of more than £2,000 for completing a six-month operational tour. The separation allowance announcement is also important. In addition, we are considering other issues, one of which is the council tax, which he mentioned. The Ministry of Defence is discussing that with the Department for Communities and Local Government. There is another specific issue involving soldiers from Commonwealth countries who fight for our armed forces, but have difficulties with naturalisation because of residence requirements. That is something that we want to look at as a matter of urgency and I hope that we can announce changes in the next few weeks.

Q7. Two businesses alone in Pembrokeshire contribute some £200 million to the Exchequer between them in tax every single month. Given the enormous sums now being raised in tax from companies and householders in Pembrokeshire, will the Prime Minister please explain to local people why their NHS dentists have disappeared, why their last full-time fire station is being downgraded, and why the excellent Withybush hospital in Haverfordwest is being earmarked for closure? It is an appalling record of public service cuts. (92526)

I shall just point out where the money has gone in the hon. Gentleman’s area. It has gone on 400 more consultants, 7,500 more nurses, and 100 more dentists. In education, there are 1,700 more teachers and 5,700 more support staff. Class sizes are also at historically low levels. The hon. Gentleman might also want to know that unemployment is at a historic low, interest rates are at a historic low, inflation is at a historic low and the economy is the strongest it has ever been.

Q8. Will my right hon. Friend take a personal interest in the negotiations taking place between the Bulgarian authorities and the UK authorities on the transfer of Michael Shields from a Bulgarian jail to the UK? What qualities does my right hon. Friend believe Bulgaria would bring to an enlarged European Union? (92527)

It is important that we continue with the enlargement process, because it helps countries to make political and economic progress. I understand my hon. Friend’s concern about the individual case and I know that she has raised it with me before. We will continue to raise it with the Bulgarian authorities, but we have to be careful about interfering with another country’s independent judicial process. I can assure her that we will monitor the case closely and we are in touch with the Bulgarian authorities about it.

Q9. When the Prime Minister wrote to his Secretaries of State on 19 May, setting out key challenges ahead, why did he not mention tourism—one of the country’s main industries—in his letter to the Secretary of State for Culture, Media and Sport? (92529)

Tourism is of course a vital priority, not only for the Department for Culture, Media and Sport, but for the Department of Trade and Industry. I am pleased to say that we are improving the quality of tourism all the time—especially as a result of the investment in skills—and attracting more and more people to places in this country such as his constituency, for good reason. We will continue to do everything we can to support our tourist industry.

My right hon. Friend will be aware of the strength of feeling on both sides of the House about climate change. I have written to him recently on behalf of many constituents to request the introduction of a climate change Bill. Am I likely to be satisfied and happy with the reply when I receive it from my right hon. Friend?

Nothing would please me more than to make my hon. Friend happy and satisfied, but we will have to wait for the Queen’s Speech and the outline of the Bills it contains. However, my hon. Friend is right to emphasise the priority that we attach to the climate change issue. It is why we introduced the climate change levy, which is saving millions of tonnes of carbon a year, and it is why it is important that we work with the EU and other countries. Last week in Mexico we made real progress on a framework for when the Kyoto protocol expires in 2012. It is also why we announced recently a five-fold increase in renewable energies. An immense amount is happening here and I assure my hon. Friend that we will continue to take the issue very seriously, but I am afraid that she will have to wait for the Queen’s Speech to see whether her satisfaction is complete.

Q10. This week, soldiers from 16 Air Assault Brigade have been returned to Colchester garrision after their dangerous deployment in Afghanistan. I am sure that the House will salute their courage and send its best wishes for recovery to those who have been injured and its condolences to the families of those who lost their lives serving their country—Captain James Phillippson, Private Damien Jackson, Captain Alex Eida, Private Andrew Cutts, Corporal Bryan Budd and Corporal Mark Wright. Will the Prime Minister confirm that UK troops are in Afghanistan to help rid the world of terrorism? If that is the case, does he share my dismay that the majority of EU and NATO countries have not deployed their troops to Helmand province? (92530)

First, I join the hon. Gentleman in paying tribute to the Paras and the extraordinary work that they have done in Afghanistan. It is hard for anyone to imagine the trial that they have been through or the courage with which they have met it. It is also very clear from what is happening in Helmand province that they have been successful in pushing the Taliban back. The struggle is by no means over, but it is essential that we continue with it.

The hon. Gentleman is also right to say that it is important that all members of NATO should play their part. However, to be fair, Canadian and American soldiers in the area are also losing their lives, and Spain, Italy, France and Germany have all lost troops there. I was with the Finnish Prime Minister last week and I can tell the hon. Gentleman that even the relatively small contingent from Finland has lost troops there.

The situation is very difficult. We want to make sure that NATO does more, and that is what the Defence Secretary said at the meeting the other day. It is important that we all make it clear why our troops are in Afghanistan. The country was used as a training ground for al-Qaeda. It was from there that terrorism was exported and the 11 September attacks—in which more British lives were lost than in any other terrorist incident—were launched. If we allow Helmand province or any other parts of Afghanistan to return to the grip of the Taliban and al-Qaeda, they will yet again become a training ground for terrorism. That is why the work that our Paras did was not only immensely brave but immensely necessary.

Sometimes it is important that we do not merely support our troops in the obvious way by saluting their courage, but that we also have pride in the success of the work that they are doing. It is absolutely vital, for our security and for that of the whole world. We should be extremely grateful that we have men and women in our armed forces who are prepared to risk their lives and make that sacrifice.

Scrambler Bikes (Licensing)

I beg to move,

That leave be given to bring in a Bill to require scrambler bikes to be licensed; and for connected purposes.

I do not know whether you, Mr. Speaker, have ever ridden a motorbike. The closest that I ever got was when I hired a Vespa on holiday in Greece. I think that I was the only person in that country to wear a helmet, and I certainly rode considerably more slowly than any Greek person did—even the octogenarian grandmothers carrying 15 chickens on the back of their bikes. However, I know that many bikers derive enormous pleasure from their motorbikes. They describe the sense of excitement and the adrenalin rush in almost ecstatic terms, saying that only a biker truly knows why a dog sticks its head out of a car window.

I want to do nothing to undermine bikers’ sense of enjoyment and excitement, least of all in the Rhondda and the valleys. I know that many bikers come to the valleys because it is an enormously exciting and pleasurable place to go biking. For example, one can go over the Bwlch into the constituency of my hon. Friend the Member for Ogmore (Huw Irranca-Davies), or over the Rhigos, or over into Llanwonno—wherever one goes, there are beautiful places for biking. It is easier if one is on a motorbike rather than a pedal bike, as I know to my cost.

Part of the thrill of biking is the sense of danger that is attached to it. It is true that in this country two-wheel drivers are 40 times more likely to suffer a serious injury or to die than four-wheel drivers. Some 585 motorcyclists were killed and 6,063 were seriously injured in road accidents in 2004. Motorcyclists represent only 1 per cent. of the traffic in the UK, but 19 per cent. of the deaths and serious injuries. The more we can do to enhance safety and to make sure, for instance, that drivers in their cars look out for motorbikes when they turn on to a main road, the better.

However, my Bill has nothing to do with those licensed road users. It is about the thousands of unlicensed vehicles, many of them supposedly designed to be ridden off-road. The problem is pretty simple. The law makes it clear that if a bike is driven on the road, it must be registered with the Driver and Vehicle Licensing Agency, taxed and insured, and have a standard number plate, proper brakes, audible warning instruments, brake lights and indicators. The exhaust must also conform and—this is important—must not be too loud or altered in any way. In addition, the law states that the rider must hold a driving licence for that class of vehicle and must wear an approved protective helmet. Furthermore, if the bike is used at night, it must comply with lighting regulations and have lights fitted and working.

I am sure that all Members would agree that all that is fine and dandy, but, by definition, it applies only to vehicles designed for use on the road, when they are on the road. There is a whole other category of bikes that are not licensed because they are, in theory, designed to be used only off-road. That is where the problem begins. Every evening and every weekend in the Rhondda there are literally thousands of unlicensed, uninsured scrambler and mini-motorbikes on the road. I suspect that the Rhondda is not unique in that and that all hon. Members have experience of that phenomenon.

In theory, those bikes are only to be used on private land. In practice, they are driven over public land, bridleways and paths, private land without permission and, notably, on the road. Often, they are unsafe vehicles with poor tread and unreliable brakes because they do not have to go through an MOT. Often, they are driven by children—not only under the legal age, but sometimes as young as eight, nine, 10 and 11. Often, they are driven recklessly and dangerously, and as they are often driven by children, it is difficult to expect more. Often, they ruin areas of natural beauty, digging up beautiful areas of the countryside. Often, they are fitted with so-called silencers, which actually make the vehicles louder rather than quieter—something that the industry must work on. In every instance, by definition, they are not insured, so when there is an accident, the innocent party often not only has the problem of the crash, but has to face increased insurance premiums later in the year.

For people in the Rhondda, that means a deafening racket reverberating around the valleys nearly every evening and every weekend. It means that pavements and roads—especially, for some bizarre reason in cul-de-sacs—become virtual race tracks. All too often, it means that a 10 or 11-year-old is put in charge of a lethal weapon that can go up to 60 mph. I believe that that is simply wrong. One person e-mailed me yesterday to say:

“In Aberavon on the beach we suffer continually with damage to the dunes and nature areas from motor bike enthusiasts driving at speed over the beach and in the dunes every day”.

The situation is getting worse. According to Revenue and Customs, there has been a twentyfold increase in the number of Chinese-imported mini-motorcycles coming into the UK. The number rocketed from 7,000 in 2001 to 144,000 in 2005, the last year for which figures are available. No wonder that, in Reading, 44 per cent. of all calls to the council’s antisocial behaviour hotline are to do with mini-motorbikes and the noise that they create. No wonder that Kent police received 4,000 calls about them last year alone. No wonder people complain about the problem at every single PACT meeting in the Rhondda, or that my local chief superintendent, Jeff Farrar, says:

“the menace of scrambler motor bikes is the biggest single issue ruining people’s lives in the Valleys”.

The police have tried all sorts of things. They have tried stopping all the vehicles at the areas where they regularly congregate and arresting the riders in one fell swoop. They have tried providing information about what is legal and illegal. They have tried using new on-the-spot fines legislation, which has been successful, and impounding vehicles. However, their biggest difficulty is that they are hamstrung when they see someone driving a bike illegally. They cannot give chase, because if they did and a youngster came off the bike and was injured, it would be quite likely that the police officer involved would be suspended pending an investigation. Additionally, such a chase would of course be dangerous to the general public.

The main problem is that the police cannot identify the bikes because they do not have licence plates. That is why I believe that we should license all bikes, regardless of whether they are designed to be driven on the road. The relevant legislation is section 1(1) of the Vehicle Excise and Registration Act 1994, which says:

“A duty of excise…shall be charged in respect of every mechanically propelled vehicle which is used, or kept, on a public road in the United Kingdom and shall be paid on a licence to be taken out by the person keeping the vehicle.”

The provision should be amended so that it covers not just on-road vehicles, but all off-road vehicles.

Who supports the proposal? The British Motorcyclists’ Federation does, with its 130,000 members, as does the Trail Riders Fellowship. The Greater Manchester police authority supports it—I am sure that many hon. Members’ police authorities do—and has been calling for such a scheme for a while, as has my hon. Friend the Member for Telford (David Wright), not least because a friend of his was knocked down on a piece of open land by an unlicensed, unidentifiable bike that drove off. The fact that the bike had no number plate meant that it could not be tracked and justice has thus not been done. Licensing is not the only thing that we should do. I have mentioned the noisy silencers, and it must be time that either the industry acts to make biking quiet, or the Government take action to ensure that everyone can enjoy their right to a peaceful existence.

We must accept that many local authorities have been slow to make proper legal provision for bikers. As one constituent wrote today:

“if proper motor cross tracks are made this will stop 90 per cent. of people riding where they shouldn’t”—

I agree. Proper, well-designed tracks in areas where noise will not impinge on the local population are vital if we are to win the battle. Biking is a great sport—I am sure that my right hon. Friend the chairman of the party agrees—but the illegal use of scrambler and mini-motorcycles is bringing biking into disrepute. It is time that we abolished the false distinction in law between on-road and supposedly off-road biking.

Question put and agreed to.

Bill ordered to be brought in by Chris Bryant, Jessica Morden, Philip Davies, Anne Snelgrove, Ms Barbara Keeley, Rosie Cooper, Mrs. Madeleine Moon, David Wright, Mr. Iain Wright and Mr. Tom Watson.

Scrambler Bikes (Licensing)

Chris Bryant accordingly presented a Bill to require scrambler bikes to be licensed; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 20 October, and to be printed [Bill 223].

Opposition Day

[18th Allotted Day]

NHS Workforce and Service Development

We now come to the main business: the 18th allotted Opposition day, which is a debate on NHS work force and service development. I inform the House that I have selected the amendment in the name of the Prime Minister.

I beg to move,

That this House, while welcoming past increases in the number of doctors, nurses and other health professionals working in the NHS, is alarmed at the recent reports of up to 20,000 posts to be lost in NHS hospitals and cuts in training budgets; is deeply concerned about the lack of training posts for junior doctors; condemns the severe shortage of posts for nurses and physiotherapists leaving training; regrets the complete failure of the Government to remedy flaws in the implementation of the European Working Time Directive in its application to doctors’ hours; further regrets the unemployment of specialist medical staff; believes NHS services are being cut back as a result of both financial deficits and staffing shortages rather than in the interests of patient safety; and calls on the Government to ensure that the NHS fully utilises the potential of healthcare professionals available to the service.

The purpose of this debate is straightforward. The NHS is, in a real sense, its staff. The number and quality of health care professionals in the NHS is key to the quality of health care provided, and I am sure that Members on both sides of the House share a deep gratitude to doctors, nurses, therapists, scientists and health care professionals of all types across the NHS for their tremendous work. Improving the number of NHS staff is central to improving services.

Under the Conservative Government, the number of doctors increased by 23,000 and the number of nurses by 55,000. Under the present Government, according to the work force census, there are 33,368 more doctors, contrary to what the Government amendment says. There are 85,305 more qualified nurses and midwives than in 1997. The number of administrators has, of course, increased by 107,000. Under Labour, not only have the resources been badly used—according to the Office for National Statistics, productivity has fallen by 1 per cent. a year during the life of this Government—but now deficits are hitting those very staff. We know, and have debated, the scale of the deficits—today’s debate is not primarily about that subject—and the Secretary of State has had to admit not only that the deficit last year was £1.3 billion gross, but that it was higher than she had previously estimated. It is now £547 million net.

Those deficits across the country are directly impacting on services. Decisions being made for short-term financial expediency have a direct impact on those staff. It is on that issue that we want to focus today—the impact on the staff of the NHS and, by extension, on the services that they provide, of the mismanagement of finances across the NHS.

There is one Opposition policy of which we are aware—their wish, as they say, to share the proceeds of growth between investment in public services and tax cuts. Can the hon. Gentleman tell us how much money will be removed from the NHS budget as a result?

The answer is straightforward: no money would be removed from the NHS. On the contrary, what my right hon. and hon. Friends have said means that the NHS will be able to participate in the enhanced economic growth that will be the product of our economic policies, and so can deliver more resources for the NHS in the future. I know that it depresses Labour Members that the Leader of the Opposition has frequently said that he will give priority to the NHS and has expressed his determination not only to increase its resources but to give it freedom from day-to-day political interference. We have said all of those things, and the public agree with them. The hon. Gentleman has to understand that we are putting that forward not on the basis of political advantage, but because it is in the interests of the national health service.

Can the hon. Gentleman confirm that, despite all the cuts that he claims will be made, staff will be safe and no jobs will be lost under a Conservative Government?

I am interested in what the hon. Gentleman says. He will forgive me if I am wrong, but I think that his local hospital is part of the Mid Yorkshire Hospitals NHS Trust. Is that right? [Hon. Members: “Tooting.”] I beg his pardon. I will give way to him again if he cares to tell us how he thinks that the deficits at St. George’s hospital, Tooting, will be resolved other than by giving the NHS, including hospitals such as St. George’s, much greater freedom to enable them to use resources more effectively. Frankly, under this Government, that is not happening. Hospitals such as St. George’s are living under a regime of regulation and control, and the financial imposition of costs by the Secretary of State is causing them enormous damage. Perhaps he can comment on the fact that the Government admit that a 25 per cent. increase in the cost of hospital services in the past three years has eaten up all the money that has been provided to hospitals such as his.

The hon. Gentleman mentioned money at St. George’s. He will be aware of our new walk-in centre and our new Atkinson Morley wing, which is preventing deaths by cancer, and he will also be aware that we have doubled the number of nurses in the past nine years and have 500 more doctors. Can he now answer my question? Will all the staff that might be cut throughout the country because of the devolved powers of their trusts be saved by a Conservative Government?

I cannot, of course, make that promise. How could I make it? If the Secretary of State and the Government would care to call an election tomorrow and disappear—[Interruption.]

If the Labour party would vacate the Government Benches and give us the opportunity to take up the responsibilities of government, we would ensure that NHS resources are used more effectively to deliver services for patients, that the staff the NHS recruit are front-line staff who deliver those services for patients, that accessible services—which are demanded by patients and GPs—can be commissioned by GPs on their patients’ behalf, and that the threat that is the consequence of the Government’s policies is lifted. Unfortunately, I cannot promise that, because the Government are not going to disappear tomorrow and the hon. Member for Tooting (Mr. Khan) is asking me about jobs that are under threat now. I cannot promise that I can restore those jobs—of course I cannot. But I can promise that we will have policies that never lead, through gross mismanagement, to the problems that we face today and for which the current Government are responsible.

Let me tell the House how many jobs we are talking about: 20,000. I heard what the Prime Minister said; he had the effrontery to stand up at the Dispatch Box at Prime Minister’s questions and say that there is no such threat of 20,000 job losses. He might like to look at some information I have, namely, that 64 NHS trusts have announced up to 20,000 posts that will be cut in the hospital sector alone. If the Prime Minister tries to deny that, let me refer him to the NHS Confederation, which is in no mood simply to support my party on this matter. It wants to minimise the effect of what might happen and it has issued a briefing. Labour Members seem to be reading only from the Labour Whip crib sheet, when what they should be doing is reading the briefings they have been receiving from organisations that know something about this matter. [Interruption.]

Order. Ms. McIsaac, I have already asked for some calmness in the Chamber and you are not helping me. You are not being as helpful as you usually are in such situations.

There is a lot of laughter on the Labour Benches, but there is not much laughter in my constituency, where 750 doctors, nurses and key medical workers are being sacked by this Government.

I understand exactly what my hon. Friend says. When the casualties of the Buncefield oil depot incident—happily, there were very few—were taken to an accident and emergency department, it was the one at my hon. Friend’s Hemel Hempstead hospital, and that accident and emergency department could have shut under this Government. Labour Members might like to explain why such things are happening. Indeed, they might like to explain—

I will in a moment, but to my hon. Friend the Member for Christchurch (Mr. Chope).

Labour Members might like to explain why the Prime Minister gets up and issues a denial in this, when the NHS Confederation says:

“The figures being widely quoted of up to 20,000 may turn out to not be too far off the total reduction in workforce numbers this year”.

In fact, what the NHS Confederation is saying is worse than I thought because it is talking about an overall reduction of 20,000, whereas I am talking only about an announced 20,000 posts to be cut in the hospital sector. One might have imagined that there would be at least some compensating increase in posts in the community sector, but that is not, apparently, the experience of the NHS Confederation.

When I attend the Conservative NHS action day stalls in Christchurch on Saturday, I know that I am likely to be asked what our policy is in response to the National Institute for Health and Clinical Excellence decision to deprive those in the early stages of Alzheimer’s of much needed medication. Can my hon. Friend assure me that we will overrule that decision by NICE when we get into government?

I am happy to be able to agree with my hon. Friend’s first sentiment, but on Alzheimer’s drugs I cannot give him the assurance for which he asks. [Interruption.]

Order, this behaviour certainly will not help the debate. Those who are listening to our proceedings will wonder why we are behaving in this way in a debate on such an important issue. I know that there is some excitement around, but things are getting to a stage where we are having a bawling or shouting match. Labour Members should understand that the Secretary of State’s turn to speak will come, and I will seek the same courtesies for her as I seek for the spokesman for the Opposition. I know that the Speaker should not intervene for so long, but the Chamber is getting far too noisy—and perhaps one Member will be disciplined if we continue in this way.

Thank you very much, Mr. Speaker.

I was endeavouring to explain something to my hon. Friend the Member for Christchurch, with which he may or may not agree. NICE has to do an exhaustive job of trying to assess whether it is in the interests of the NHS that a treatment be provided because it is both clinically effective and cost-effective. That process has been extremely useful because it has increasingly exposed what is cost-effective and clinically effective about Alzheimer’s drugs. They are effective for patients, especially for those with moderate and severe Alzheimer’s—dementia. However, in respect of mild dementia, they are not regarded as sufficiently effective to be a treatment that should be recommended on the NHS. Frankly, it is my opinion that in an independent national health service such decisions must be made independently and we must ensure that there is a correct statutory framework. On this matter, one important issue remains in my mind. Because of the nature of the regulations prescribed by the Government, the benefits that NICE can take into account apply only to the national health service and to publicly funded social care. The benefits to carers and their families beyond that point cannot be taken into account. We must look into that—and that might, of course, have a bearing on the outcome of any appraisal undertaken by NICE.

As my hon. Friend knows, hundreds of jobs have gone at Hinchingbrooke hospital, with hundreds more likely to go, and the hospital is now subject to a closure threat. It seems to me that the strategic health authority’s review is in fact cover for a slash-and-burn policy conducted by this Government. What does my hon. Friend have to say about that?

To some extent, my hon. Friend and I share that hospital. Patients from my constituency go to Hinchingbrooke hospital. That anticipates something that I was going to say. It is disgraceful that “reviews”—in inverted commas—should be taking place that are in fact driven by finance. The implication—[Interruption.] Members might like to listen to this point. The implication of that for staff working at Hinchingbrooke is that the maternity unit has to be closed because it is not safe, but that is not true as it has one of the finest patient safety records in the country. That is financially driven.

Frankly, I do not think that the strategic health authority should be the body doing that. We are supposed to be moving—this is what the Government say—towards a structure in the health service that is increasingly geared towards the decisions of local commissioners such as primary care trusts, practices through practice-based commissioning, and patient choice. However, on the contrary, we have a strategic health authority that has just been established and that has inherited a financial problem—many of my colleagues right across the east of England are in the same position. Because of a £233 million deficit, it will decide which hospitals stay open and which are shut. That is a disgrace. In a year or two services will be shut down by the strategic health authority, but in subsequent years we will have to re-establish them because they are required to meet the needs of patients.

May I ask the hon. Gentleman about a news story that I read on the Conservative party website? Does he agree with the Leader of the Opposition when he says that

“the NHS matters too much to be treated like a political football”?

Absolutely, and that is exactly why my right hon. Friend and I explained on Monday how we could take politicians out of the day-to-day management of the NHS. However, as we heard from the Prime Minister at lunchtime, he is so keen on having the NHS as a political football that he is not prepared to allow it greater independence. I am sure that when the time comes, the Chairman of the Health Committee will want to ask the Secretary of State what the NHS political football game looked like on 3 July, when she sat down with the chairman of the Labour party, Ministers and political advisers, including Labour party staff, in order to debate their “heat maps” and to decide where in the country hospitals were to be shut. Frankly, that is not acceptable. It is the Government who are indulging in that political football game, not us.

I will carry on for a minute. I have taken an intervention and I have yet to get on to the issues that we really need to reach.

We need to understand that all the deficits are having major consequences for staff. As I said, we might have imagined that, at the same time as jobs in hospitals were being cut, they were being created in the community. Members will recall that back in January, a White Paper was published the purpose of which was to state that precisely that shift of patients would happen. Well, what do we find? The work force census showed that in the last year for which figures were available, there were 485 fewer health visitors, 760 fewer district nurses, and even 36 fewer midwives. Yet the Government seem to think that those people are somehow magically going to increase in number and be available to provide services.

The Prime Minister made a speech on this issue last month. The action plan for social exclusion says that all additional health visitors and community midwives will be upskilled in order to undertake early interventions with families. Health visitors in my constituency used to visit every family, but that service disappeared about seven years ago. There simply is not the number of health visitors to enable that to happen.

I am grateful to my hon. Friend for giving way. Is he aware that in the first six months of this year—in other words, almost from the moment that the Secretary of State sat down after presenting the White Paper in this House—10 community hospitals across England were closed under this Administration, with devastating effect? That is the exact reversal of the Government policy set out in that White Paper—a vision that many Conservative Members shared, but which has not been delivered on the ground. It is that sense of betrayal—the difference between the words and the reality—that is so undermining confidence in this Government.

I entirely agree with my hon. Friend. Let me give an example. If the Government were serious about supporting community hospitals, they would have taken the technical step that would have helped: unbundling the tariff to enable patients to be discharged from acute hospitals and transferred to community hospitals, with the money going with them. The Government keep talking about it and saying that it will happen, but they have not done it.

I am most grateful to the hon. Gentleman for giving way. I cannot help thinking that we might be losing the focus of this debate. Surely what matters in the health service is patient outcomes and patient care. As I still work as a GP, I can point to the fact that it now takes only two weeks to see a cancer consultant and to the fact that waiting lists are falling and GPs are providing much more care in their own practices, thereby significantly reducing the need to refer people to secondary care. Those are significant improvements in patient care, which surely is the purpose of the health service.

I am grateful to the hon. Gentleman. Patient care does indeed matter tremendously, and in pursuit of that, patients in his practice will no doubt find things improving when he returns to full-time work in the NHS after the next election.

May I just answer the hon. Member for Dartford (Dr. Stoate), because there is an important point here? In their amendment to this motion, the Government say that

“death rates from cancer and heart disease are falling faster than ever before”,

and the Prime Minister said at Prime Minister’s questions that deaths from coronary heart disease had fallen since 1997. Indeed they have, but as it happens they have not fallen faster than ever before. In the seven years before 1997, the death rate for circulatory diseases and the cancer death rate fell slightly faster than in the seven years since that date. The right hon. Member for Rother Valley (Mr. Barron), the Chairman of the Health Committee, made a point earlier about the use of the health service as a political football. Well, a good starting point would be to tell the whole truth about what is going on.

Yesterday, the Government—[Interruption.] Let me finish this point. Yesterday, the Government published health profiles across England and said that cardio-vascular disease death rates have been falling since the mid-1990s. They have not—in fact, they had been falling for at least a decade before that. Let us be honest about what is going on. There is a long-term secular reduction in both coronary heart disease and cancer death rates, which is very much to be welcomed. That has not happened simply as the consequence of the 1997 election, or of additional money. It has happened in virtually every developed country across the world, so let us be honest about these things.

I am very grateful to my hon. Friend. In my view, Labour Members simply do not understand the reality of what is going on. Two weeks ago, there were thousands of people on the streets of Epsom protesting against the loss of services at our local hospital. We now face the loss of services not only there but in Guildford—ironically, given the Secretary of State’s clumsy party political intervention at St. Helier before last year’s local elections—and we are losing community services and district nurses. The podiatry service is now being provided by Age Concern, and it looks as though we are going to lose sexual health advice for teenagers. What is going wrong? Labour Members seem not to understand the reality of our health service today.

Frankly, the quality of management at the top of the health service is what is going wrong, and that stems from Ministers. I hope that the Secretary of State will have the grace to apologise for trying, for political reasons, to steer a capital project to St. Helier, rather than to where the evidence pointed to. She had to backtrack on that in August.

I am going to carry on because, as the hon. Member for Dartford rightly said, we have got to get to the points that really matter. There are a lot of NHS staff out there who want to know what the Government are actually going to do now about these problems. There are junior doctors worrying about whether they will find training places. I am glad that the Government said that they are going to find between 22,000 and 23,000 places in August 2007; indeed, I raised precisely that issue with the Secretary of State back in January. Of course, and as I recall from last year’s flu statistics, she has always had problems understanding what is England and what is the United Kingdom. In this instance, she has gone for 22,000 to 23,000 training posts in the UK, in order to meet a demand for 22,000 such posts in England, so the figures do not quite add up.

No; I am carrying on for a bit.

I do hope that the Secretary of State will also make it clear that, wherever possible, such posts will be run-through training posts that give the junior doctors concerned greater assurance that they can qualify and get their certificate of completion of specialist training in due course.

It is not only doctors who have problems. As the Royal College of Nursing made clear in its surveys, many nurses are leaving college unsure that they will find jobs; indeed, many do not find jobs. In some cases, half or more of the graduate output do not find jobs. Some 100,000 nurses are due to retire in the next five years, and over the next three years there will be a 20 per cent. reduction in the number of nursing training places. What are the prospects for nurses? I met a nurse in my surgery just last Friday, who said:

“I have just qualified as a nurse, and finished my degree in children’s nursing at the beginning of July. I have been applying for jobs since May and am still unemployed…for one interview I attended, 45 candidates were being interviewed from over 120 applications. I am at a loss to know what to do.”

I also received a copy of the following letter from a lady, who writes:

“My daughter will qualify as a psychiatric nurse in August after three years of training…She and her fellow students have been informed that there will be no training posts for them in Cornwall on qualification…The situation now is that she will not have a job in the Health Service within her chosen profession. And she will not be able to find employment abroad without one year of post qualification training.”

Let us consider physiotherapists. How many Members present met members of the Chartered Society of Physiotherapy when they came here in July? Well, I met the students from the Royal London: 99 students completed the course, but only one has a job.

A lady writes to me:

“My daughter is one of hundreds of newly qualified physiotherapists unable to get a job because of the crisis in the NHS…My local hospital has a waiting list of 10 months to see a physiotherapist.”

Somebody writes from Norwich that of 96 students leaving physiotherapy training only five found jobs. A letter from Lincolnshire states:

“Not one student from Nottingham (which is a centre of excellence for physiotherapy) has been able to find employment as a physiotherapist in the NHS. This abysmal situation appears to be directly due to the budget deficits across the NHS.”

I have a question for the Secretary of State, because a practical issue is involved. In Scotland, as she knows, the Scottish NHS guarantees nurses and physiotherapists a year of employment following their graduation. Will she say that the same thing will happen in England?

I agree that we should be honest about the debate. Part of the reason why death rates for cancer and heart disease are falling is that our Government have set targets—[Hon. Members: “Ah.”]—Yes, targets. There is faster treatment: 99 per cent. of people diagnosed with cancer receive treatment within four weeks of diagnosis. Will the hon. Gentleman tell us whether his policies will reflect that or whether their NHS plan stands for no honest solution from the Opposition?

I am sorry that the hon. Lady was clearly not even listening to what I was saying. As yet, there is no discernible change in the trend reduction in deaths from cancer, even as a consequence of the additional investment in the NHS cancer plan. We might wish it otherwise, but that is the case. The fact that death rates continue to go down is much to be welcomed, but it has much more to do with things such as the reduction of smoking, as well as with the quality of service. When we compare our cancer death rates to those in other countries, we see that early identification of tumours will be absolutely instrumental in their further reduction. The cancer plan said that there needed to be awareness of symptoms and up-front investment for prevention, but that has not happened.

Ultimately the question is one of money and value for money. If we are to have more local control and accountability, can my hon. Friend give the House an assurance that, through Parliament’s Committees—especially the Health Committee and the Public Accounts Committee—we will still be able to follow the money? Ultimately, the House must remain responsible for all public money spent.

I am grateful to my hon. Friend, who properly defends that important interest. Nothing we have said would deflect from it. The service would be publicly funded, where propriety and value-for-money considerations would remain the responsibility of the inspection bodies throughout the process, all the way down to the point where GPs exercise commissioning responsibilities. It needs to be so, because the service uses public money.

I do not want to take more than about half an hour, as many Members want to speak.

Deficits do not affect only trainees; they have a direct impact on existing specialists. A report suggests that, by December, 61 cardio-thoracic surgeons will be without a consultant appointment in the NHS. I am advised that 37 ear, nose and throat specialists do not have posts at present. The Royal College of Anaesthetists tells me that whereas in previous years there have almost always been about 30 advertisements a month for new anaesthetist posts—last year there were 31 in July and 29 in August—only 17 were advertised in July this year and only four in August. The president of the royal college rightly says that a great number of people in other countries are looking for anaesthetists. My concern is that if we make life difficult for too long, they will go; we will lose the specialists we need.

The Government should note that the British Orthopaedic Association has already told them that the average retirement age of orthopaedic surgeons has gone down by three years over the past seven years. Such is the extent to which we are losing services.

To go back to my hon. Friend’s comments about physiotherapists, does he agree that with the Government’s drive for more people to be looked after at home and closer to their homes, physiotherapy services, and physiotherapists, are absolutely crucial to ensure well-being and treatment, especially of an older population?

My hon. Friend is absolutely right. The situation for stroke patients, for example, is utterly depressing. Even if they are able to secure early and intensive rehabilitation, sometimes treatment cannot be followed up to maximise their chances of recovery, owing to the lack of physiotherapists in post. We must have more physiotherapists. The Government said that we needed more physiotherapists and that there would be 60 per cent. more. People went into the profession as a result. A physiotherapist told me: “I knew what was intended so I went into the course. Now there are no jobs.” That is a deeply depressing fact; it is a cruel irony played on people who took up such courses.

No, I am sorry.

Not only have we lost specialist posts but training budgets are being cut. The Secretary of State might like to tell us whether it is the case that, as reported, training budgets across the country will be cut by 10 per cent. this year. She might like to consider the example of Leicester, where the strategic health authority says that it will cut £52 million from the training budget. The University Hospitals of Leicester NHS Trust told Leicester university that it will cut clinical academic funding by 20 per cent. That will mean the loss of 15 per cent. of the medical school staff, who spend more than half their time treating patients. Some of the senior staff, who are integral to the trust’s delivery of service, will be lost.

To be fair to the Government, in 2002, they introduced the GP returner scheme and 550 GPs used it, but the money has disappeared. In 2006-07, there will be no money for the scheme; it is disappearing across the country.


I want to mention one more important issue. The problem is not just deficits. In April 2004, Members may recall that we warned the Government about the impact of the European working time directive. I shall not rehearse all the arguments, but it was clear that if the Government did not secure an amendment to the directive there would be serious consequences for services. The Government claimed that would not be the case. The right hon. Member for Barrow and Furness (Mr. Hutton), now the Secretary of State for Work and Pensions, said that they would maintain access to services despite the working time directive. But what has happened?

I shall quote from a document about changing maternity and paediatric services produced by the Manchester SHA. Manchester itself—not the whole north-west—is a good example, as it is not generally driven by deficits and ended last year with a health economy in surplus. The document states:

“Staffing pressures on the 13 units providing in-patient care are getting worse. Already children’s wards and maternity units have to close on occasions because there are not enough staff to cover them safely. We will not be able to staff all these units by 2009 when the European Working Time Directive becomes law and doctors are not allowed to work the hours they currently work. This is already resulting in units being closed frequently. In 2002 there were over 200 closures to the admission of children and young people across 13 hospitals, due to either a shortage of doctors or a shortage of specialist nurses.”

If the Government had done what they said would do, they would have secured an amendment to the directive. Their replies to me make it clear that they tried to do so when they held the presidency. They took the matter to the Employment Council in December 2005 but they failed, and they have not attempted to do anything since. They must do something.

Will the Government do what Lord Hunt—then a Health Minister—said he would do on 4 March 2003? He said that if there were difficulties, the further extension of the working time directive, due in 2009, could be deferred until 2012 and that instead of a 48-hour week, it would be possible to go up to 52 hours. Will the Secretary of State do that?

No, I am not giving way, as I am moving towards my conclusion, but before I do so, I want to be fair to the Government. We are talking about work force planning and because I wanted to understand the Government’s approach towards it, I looked at their evidence submitted to the Health Committee, which is currently investigating the matter. Here it is. The Government say that there is now “a streamlined framework” for work force planning. There are workforce directorates within strategic health authorities and they work with the social partnership forum, with the workforce programme board, with the national workforce group, with the workforce review team, with NHS national workforce projects, with Skills for Health and with NHS employers. There is even a diagram to explain it all—and all that is supposed to be the “streamlined” framework! Whatever it is, it is certainly not yet streamlined enough. We need a much better system because out there in the NHS, staff have no idea what the work force plans look like, as even now, posts are being cut.

The staff of the NHS are, as we have said, its greatest asset. They work miracles daily and we need them to be motivated and inspired, but at the moment they are demoralised. The Secretary of State has gone from her “best year ever” in May to a “very difficult year” by September. NHS staff are seeing a feast turn into a famine. They see promises of expansion turn into cutbacks and they see the advertising campaigns of three or four years ago to recruit new nurses and therapists turning into the cruel irony of people leaving training unable to pursue their vocations and find jobs. They see sham consultations over service reconfigurations driven by short-term financial expedients.

The staff also note how the effects of the European working time directive are dressed up to suggest that services have to be shut down because they are deemed unsafe. Frankly, that is a slur on NHS staff. People are working across the country to save their local NHS services. Labour Members should not decry that as a Tory conspiracy; it is happening because people are angry about the loss of their local NHS services. They do not want to block changes, but they want them to be guided by evidence and to take account of needs for accessible services.

The new chief executive of the NHS says that more than one in four of district general hospitals have to be downgraded. He then tells us, in an interview in The Guardian, that he “understands the politics” of it. Well, we do not need an NHS chief executive who understands politics, but one who is focused on patients. We need a chief executive who is not spending all his time trying to work out what Ministers want him to do, but assessing what is in the best interests of patients and the NHS. We need an NHS free of the Secretary of State and the chairman of the Labour party sitting down with their advisers, trying to decide which hospitals to close.

I am an optimist. I believe in the NHS and I believe in what NHS staff can achieve, but they can do so only if we give them the framework, the resources and the freedom to deliver. That is our objective, so I commend the motion to the House.

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

“welcomes the Government’s historic investment in the NHS since 1997, trebling funding by 2008; pays tribute to the commitment of NHS staff; recognises the ongoing investment in their training and development; notes that there are now 32,000 more doctors and 85,000 more nurses, and that overall there are over 300,000 more staff working in the NHS; acknowledges that as a result of the Government’s investment and reforms and the hard work and dedication of NHS staff, virtually no-one now waits more than six months for their operation whereas in 1997, 284,000 people waited longer than six months with some patients waiting up to two years; further notes that over 99 per cent. of people with suspected cancer are now seen by a specialist within two weeks of being referred by their general practitioner, up from 63 per cent. in 1997, and that death rates from cancer and heart disease are falling faster than ever before; and further recognises the need to ensure NHS services continue to change to benefit from new medical technologies and treatments which mean more care can be delivered in local communities and people’s homes.”

Mr. Speaker, the hon. Member for South Cambridgeshire (Mr. Lansley) has spent nearly 40 minutes telling us, as he always does, what is wrong with the NHS. I want to start by congratulating the staff of the NHS—more than 1.3 million committed and dedicated men and women, many working in very difficult circumstances. There are more than 300,000 extra staff—my right hon. Friend the Prime Minister slightly understated the increase in Prime Minister’s questions—than there were in 1997. I particularly want to thank them for the improvements that they have made in looking after patients in recent years. We have seen dramatic improvements in waiting times, for example.

With additional new money, the NHS has improved dramatically. We have perhaps forgotten that in the 1990s we used to worry about the number of years that patients had to wait for treatment, whereas today we worry about the number of weeks. That is not from the Whip’s brief, as the point comes from the director of public health at Stockport primary care trust. Does my right hon. Friend recognise that that professional view represents the reality of what is happening out there?

I shall give way again in a few moments.

In 1997, 284,000 people were waiting more than six months—some for more than two years—whereas today almost nobody waits more than six months and the vast majority are treated far more quickly than that.

I am sure that my right hon. Friend would want to congratulate workers at Lancashire teaching hospitals on their dedicated work in ensuring that the quality of lives in Lancashire continues to improve. Does she support the continuation of the work at those hospitals and will she ensure that it does not go to the private sector, which would put them at risk?

I join my hon. Friend in congratulating the staff at those hospitals. As he well knows, the Government and I have supported both investment and reform from the outset, including, where it will help cut waiting times and secure even better care for NHS patients, the use of the independent sector.

While she rightly congratulates existing staff, what does the Secretary of State say to those newly qualified midwives and physiotherapists who were promised a job in the NHS only to find that they cannot get one? Why has she made such a mess of work force planning?

We have never made promises to NHS staff that either we or the Opposition could not keep. What we are saying to newly qualified staff, some of whom are indeed struggling to find a job, is that we will do everything possible to ensure that they get one. In some parts of the country, NHS hospitals are working with other organisations to ensure that, if a permanent job is not available for newly qualified nurses and midwives, they are at least taken on temporarily so that they can continue to build their skills and contribute to the NHS.

I want to make some progress before giving way again.

I also want to thank NHS staff for dramatic improvements—belittled, I have to say, by the hon. Member for South Cambridgeshire—in cancer care. I do not think that any of the 50,000 cancer patients who are alive today because of improvements in cancer care would want to belittle them and neither would the hon. Gentleman’s view be shared by cancer patients who have seen dramatic improvements over the last 12 months. Just 12 months ago, fewer than seven out of 10 patients with most suspected cancers could count on being seen, diagnosed and then beginning their treatment within two months. Today, nearly 95 per cent. of patients are doing so. That is the result of the incredibly hard work of staff, more money, which the Conservatives voted against, and the targets set for cancer care that the Conservatives would abolish.

On that very point, I would greatly appreciate it if my right hon. Friend would keep certain facts to the forefront of the debate. In North Tees hospital, for example, 100 per cent. of all breast cancer patients are seen and treated within 62 days. That is a superb achievement, which no one in the House should ever do anything other than congratulate.

My hon. Friend is absolutely right. It is a superb achievement when 100 per cent.—well beyond the target that we set—are being seen, diagnosed and beginning their treatment. That is one of the ways in which survival rates from cancer will be improved.

Ministers have frequently asserted—they are right to do so—that early intervention is vital to help children with speech and language difficulties. As the Secretary of State knows, I have a strong and continuing personal interest in that subject. Given that the Vale of Aylesbury primary care trust is now turning away new referrals and inviting hard-pressed parents to seek help privately, what does the Secretary of State say to those parents who, in a million years, cannot afford to do so and who, without immediate and practical help, will find that their children’s future prospects are permanently damaged?

First, as the hon. Gentleman knows because I have written to him on this point, I have already ensured that the Nuffield speech and language unit—an issue that he has specifically raised on many occasions—will continue to treat patients. [Hon. Members: “What about the Vale of Aylesbury?] Funding for the Vale of Aylesbury primary care trust has increased by more than 30 per cent. over the past three years, by £40 million. In Buckinghamshire PCT, over the next two years, there will be an additional £91.5 million. However, what we must do—Opposition Members refuse to accept this—is support the NHS in making decisions that are often difficult, to get better value for that money, to release the savings that it needs to pay for more speech and language therapists, for new drugs and for all the other services that need improving. The hon. Gentleman is not willing to accept that, any more than are other members of the Conservative party.

Although I do not doubt the Secretary of State’s sincerity, I hope that she will visit Cornwall to see for herself the impact of the reforms that she and others have been implementing in areas such as my constituency. Despite the protestations that her Department is not enforcing the diversion by local trusts of NHS resources into the private sector, is she aware that, in fact, patients who are facing unnecessary, enforced minimum waits, including waits of more than nine weeks for breast care at the moment, receive unsolicited calls from NHS managers inviting them to be seen sooner in the private sector? Will she come to Cornwall to see the results of those reforms and their impact on the financially hard-pressed service there at present? In fact, it is a financial mess. People are waiting unnecessarily and the money is going into the private sector instead.

My hon. Friend the Under-Secretary of State for Health will indeed shortly visit Cornwall; I hope to do so in the near future. There are indeed some real challenges not only in the hon. Gentleman’s constituency, but across Cornwall, in ensuring that the enormous amounts of extra money that we have put into the NHS in his part of the country are used to the best possible effect to ensure that patients get the best and fastest care everywhere. However, the NHS in the south-west has made superb use of the independent sector—for instance, at the Shepton Mallet treatment centre—to speed up the treatment of patients who need orthopaedic operations and to do so in co-operation with the rest of the NHS in an integrated fashion.

No, I am going to make some progress before I give way again.

Every debate about the NHS is important to all of us, but I was looking forward to this one with particular anticipation. This week, we have had the first sighting of a rare bird—Conservative policy on the NHS—but what a disappointment. What we heard from the hon. Member for South Cambridgeshire today and from the right hon. Member for Witney (Mr. Cameron) earlier this week was the mishmash of confusion and contradiction that we have come to expect from the modern Conservative party.

The leader of the Conservative party says that he will guarantee the NHS the money that it needs—a guarantee from the party that starved the NHS of funds for 18 years and a guarantee from the party and the leader who voted against the increased, record funding that we have put in? Conservative Members pretend, and they do so to NHS staff, that they can promise a blank cheque, but they also promised a new economic policy—a new fiscal rule, no less—that would mean £17 billion less for public services, including the NHS, this year. On top of that, their policy commission on taxation wants £90 billion of tax cuts. It does not begin to add up to a policy.

Hon. Members on both sides of the House are unanimous in praising NHS staff for their achievements, but are they unanimous in their views on funding “Agenda for Change”, particularly NHS staff pensions?

My hon. Friend makes a very important point. Of course, what the hon. Member for South Cambridgeshire did not bother to mention, as he talked about NHS staff, was that he is against the agreement that we have just entered into on public service pensions. He is against it, just as he was against proper funding for “Agenda for Change”.

Does my right hon. Friend agree that the British people might remember what the state of the NHS was before 1997, when people lay dying on trolleys in hospitals, when people sometimes had to wait five years for cataract surgery and many years for operations and when the Conservatives would not put the necessary resources into the health service? They are a disgrace and an embarrassment when they talk about the national health service.

My hon. Friend is absolutely right, and the position is in fact even worse than she and I have described. The Conservatives now say that they want fair funding in the NHS—fairness from the Conservative party?

Not yet; in a moment.

I, too, have a copy of the Conservative party’s campaign pack. The Conservatives claim that

“some areas with a low disease burden, but deemed to be socially deprived, receive much more funding than areas deemed to be affluent but with a high burden of disease.”

They go on to complain that

“some areas of Manchester receive 66 per cent. more NHS funding per head than some areas of Bedfordshire and Hertfordshire”.

Let me tell the House about some areas of Manchester—north Manchester, for instance, where a baby is twice as likely to be stillborn and 10 times more likely to die before the age of one as a baby in south-east Hertfordshire or South Cambridgeshire. [Interruption.] The hon. Member for Beverley and Holderness (Mr. Stuart), from a sedentary position, and the hon. Member for South Cambridgeshire complain that inequality in infant mortality is widening, but they want to take the money away from areas where infant mortality is worst—[Interruption]—north Manchester, where an adult is 50 per cent. more likely to die prematurely of cancer than one in St. Albans, South Cambridgeshire or south Oxfordshire.

In north Manchester, every GP has to look after about 2,500 patients; a GP in South Cambridgeshire has, on average, about half that number. That is why NHS funding this year is £1,600 per person in north Manchester and £1,000 per person in St. Albans, south-east Hertfordshire, South Cambridge and south Oxfordshire.

I shall give way to the hon. Member for Reigate (Mr. Blunt) on St. Helier; he has been very persistent.

Since we were last here, the Secretary of State has had to reverse the quite disgraceful decision that she took on 19 December 2005, to overrule a consultation that had the full support of the local medical community to build a new hospital at Sutton, not at St. Helier, and to site the thing at St. Helier, at the request of the hon. Member for Mitcham and Morden (Siobhain McDonagh). The Secretary of State was then taken to judicial review by Reigate and Banstead council and Surrey county council. The case would have gone to court in about a month’s time; but, in August, she gave in. Will she repay the costs of the legal action that had to be taken, because her action was so unreasonable, to Reigate and Banstead council and Surrey county council?

My decision was made precisely on the grounds of health inequalities and fairness, in which the hon. Gentleman and the Conservative party simply are not interested. The reason why things have moved on is that, unfortunately, the financial situation in south London, in that part of the NHS, is worse than those involved believed it to be when they came up with the plan for a new hospital. It is, I am afraid, no longer clear that the proposal for a new critical care hospital and nine new community hospitals is affordable in the way that the local NHS originally planned it. It therefore makes sense to look afresh at that model of care—which, in principle, is the right one—to ensure that it is affordable before any further decisions or arguments take place about where the hospital is sited.

May I suggest that my right hon. Friend has omitted another strand of Tory party policy that is very clear? The Leader of the Opposition made it clear on “Any Questions?” in 2001 that he did not want to fund the NHS in the same way that it is funded now. He said that we should have more social insurance schemes, and he has never resiled from that comment. What effect does my right hon. Friend believe that that policy would have on our most deprived areas?

My hon. Friend is absolutely right about the views of the right hon. Member for Witney. Indeed, let us remember that only last year he wrote the Conservative party manifesto that proposed to take millions of pounds out of the NHS for everybody and put it into subsidising private care for a few. That is what the Conservative party means by fairness.

No, I want to make some progress.

Conservative Members and the Conservative party refuse to accept that overspending has to be put right where it has taken place. They refuse to accept that it is wrong that a minority of hospitals and other organisations have overspent—some of them, I am afraid, for many years—at the expense of the majority who have been in balance or in surplus. Conservative Members have a simple solution to the overspending that has taken place in Bedfordshire and Hertfordshire even though the hon. Member for South Cambridgeshire did not come clean about it today. They want to take the money away from north Manchester and all the other parts of the country with the worst health needs and the worst health inequalities.

What does the Secretary of State say to the excellent staff at the QEII hospital? Two weeks ago, she met the senior management in Bedfordshire and Hertfordshire and two senior clinicians have now told me that she made it perfectly clear that the QEII will go, Hemel will go and our new hospital at Hatfield will go. Will she now put it on record that that is not her view and that that will not be the end result? The irony is that the end result would be one hospital in Stevenage, which is Labour, and one hospital in Watford, which is Labour.