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Oral Answers to Questions

Volume 464: debated on Wednesday 17 October 2007

INTERNATIONAL DEVELOPMENT

Migration

1. What assessment his Department has made of the effects of migration on international development projects in Africa. (158517)

As chance would have it, I have with me an excellent DFID publication, which I can commend to my hon. Friend. It is called, “Moving out of Poverty: Making Migration Work Better for Poor People”, and it is the first policy paper of its kind to be produced by the Department for International Development. The report highlights both the positive and negative links between migration and poverty reduction and it encourages developing countries to consider its impact in their national planning. To provide just one example, it examines the positive contribution of migrants through remittances and support for development projects, while also examining the negative impact—the loss of skilled people and the damaging effect it can have on capacity building efforts in sectors such as health and education.

I am grateful to my hon. Friend for that fascinating answer—[Interruption.]—and I mean that most sincerely. However, the massive levels of migration in sub-Saharan Africa are among the biggest causes of poverty. In 2005, there were 15 million people in sub-Saharan Africa living away from their normal place of residence—in other words, 15 million displaced people, which is more than the combined populations of Berlin, Paris, Madrid and Rome. Surely we need to do far more to make it possible for people to stay where they were born and brought up so that we do not have a constant cycle of poverty and oppression.

My hon. Friend says that he is being sincere—and for the record, I have always known him to be so. [Interruption.] I will continue. As to the 15 million displaced people in sub-Saharan Africa, there are many causes: economic migration, bad governance, conflict, climate change, natural disasters, all of which cause people to believe that they have no option other than to leave and search for a better life elsewhere. Everything that DFID does in sub-Saharan Africa is aimed at addressing the root causes of displacement through poverty reduction, humanitarian relief, reconstruction work, efforts to promote participation and good governance and protection of human rights.

Let me provide a few examples. In 2006-07 alone, we provided some £220 million in humanitarian assistance to sub-Saharan Africa and we have allocated £64.5 million this year to the Africa conflict prevention pool. We are the largest donor to the UN’s central emergency response fund, contributing £42.2 million this year. We have also provided—[Interruption.]

May I draw the Minister’s attention to another excellent publication, produced by the all-party group on population, development and reproductive health? It found that there was a correlation between migration and civil conflict and population growth. Will the Minister add that to his list of causes and, in providing aid to the sub-Saharan region, will he take into account programmes to address the issue of population growth?

To confirm, we certainly look at reproductive health in our programmes and we will continue to do so.

Given the centrality of sexual and reproductive health to country-wide health plans, will my hon. Friend tell us how he is encouraging African Governments to prioritise that issue?

We have regular dialogues with African Governments on these issues and all our African programmes focus on them. That will certainly continue to be the case. My hon. Friend is quite right to raise the issue; we can never do enough in respect of it.

It is estimated that 250,000 people have left Zimbabwe for South Africa and 200,000 Darfur for Chad. As the hon. Member for Rhondda (Chris Bryant) says, unofficial figures put the estimate many times higher. This is a human tragedy on a grand scale: it is a human tragedy for the people involved; it is a human tragedy for the countries that have seen those people leave; and it is a human tragedy for the countries to which they are going. What more can the Government do to provide humanitarian assistance not only for the refugees but for the recipient countries, so that those refugees will face a little easier life when they arrive?

My hon. Friend—[Laughter.] I mean the hon. Gentleman, although I am sure that we are friendly. I can tell the hon. Gentleman that we recently gave £8 million to the World Food Programme. I outlined some of the measures that we are taking to deal with the issue in my earlier answer, but it is not possible for one country alone to deal with it. The international community must act together to produce the impact that is so desperately needed—the impact that both the hon. Gentleman and we would like to see.

Budget Support

The Department delivers poverty-reduction budget support to Ethiopia, Ghana, Malawi, Mozambique, Rwanda, Sierra Leone, Tanzania, Uganda, Zambia, India, Nepal, Pakistan, Vietnam and Nicaragua. Poverty-reduction budget support is aid given to a partner Government to support poverty-reduction programmes, and is spent with the use of the Government’s financial management procurement and accountability systems.

It is good news that the Department is being given more money, but it is important to ensure that that money is spent in the best possible way. Is the Secretary of State aware of the World Bank’s assertion that the outcomes of some 90 per cent. of budget support are never audited, which means that we do not know the extent of its effectiveness? Is it not time for an independent and impartial body to monitor and assess the outcomes, as has been suggested by my hon. Friends on the Opposition Front Bench?

I am grateful to the hon. Gentleman, who brings real expertise to this issue, not least because of his service on the International Development Committee.

The Independent Advisory Committee on Development Impact is due to hold its first meeting in just over six weeks’ time, and I believe that that will give the hon. Gentleman some confidence that we take the issue seriously. It is also important to recognise the steps that we are taking on budget support in particular. The Department always conducts a fiduciary risk assessment before entering into budget support, we monitor performance regularly, additional assurance is provided by the internal audit department, and we undertake annual reporting which provides oversight through its corporate reporting and auditing mechanisms.

What funding, if any—direct or indirect, through international monetary funds—is given to the Sudanese Government? If there is such funding, direct or indirect, would my right hon. Friend consider withholding it until such time as the Sudanese Government act in accord with international law, in the context of civil conflict and more importantly and urgently in the context of attempts to bring a cessation to the abomination of human rights abuse in that country?

I find myself in sympathy with my hon. Friend, both because of the longer-term challenge of making progress with the comprehensive peace agreement in relation to the north-south conflict in Sudan and because of the pressing challenge of the humanitarian crisis in the Darfur region. We do give considerable humanitarian assistance to the people of Sudan. I recently visited the al-Salam camp in el-Fasher in northern Darfur and saw, for example, the hugely important work undertaken by Oxfam, a British charity, in providing water and sanitation in the camps.

As well as the humanitarian work that we are doing, there is an important diplomatic dialogue with the Government of Sudan, so that—along with signatories and non-signatories to the Darfur peace agreement—they are clear about their responsibilities. Those responsibilities include an immediate ceasefire, a cessation of aerial bombing and the facilitation of talks between all parties in important talks at the end of this month.

Will the Secretary of State acknowledge that budget support is an extremely important instrument for building the capacity of recipient countries, provided that strict criteria apply? Is he satisfied with recent developments in Uganda and Ethiopia which led to a cut in budget support, and does he feel that their Governments’ attitude to the opposition justifies the reinstatement at this stage?

I defer to the right hon. Gentleman’s expertise, given his examination of the issues in the Select Committee, but the fact that in certain circumstances—for example, the political crisis in Ethiopia—we are prepared to withhold elements of budget support testifies to the fact that we monitor extremely carefully the circumstances in which it is appropriate for funds to flow directly through Government systems.

That being said, I find myself in full agreement with the right hon. Gentleman’s observation about budget support. It is certainly pioneering. At times it involves risks which must be judged very carefully, but it can clearly develop a sustainable means by which countries can help themselves to emerge from poverty rather than finding themselves dealing with innumerable international donors with whom, in many cases, their Governments lack the capacity to engage effectively.

In circumstances where general budget support has been cut, as in Ethiopia, will my right hon. Friend consider very carefully other means of delivering assistance, so that we can help the poorest people in the poorest countries?

I can give my right hon. Friend exactly the assurance that he seeks. Budget support for Ethiopia was withheld in response to the political crisis in 2005, but we do not want the poor to suffer in Ethiopia as a consequence of the actions of Government. That is why, through the protection of basic services programme, we have continued to support development efforts in Ethiopia. In the last year alone, 1.2 million more children attended primary school. Over 70 per cent. of Ethiopia’s children are now in school, and all households in malaria areas will have insecticide-treated bed nets by the end of this year. Those are just two examples of our continuing commitment to the people of Ethiopia.

Health Services

The UK is improving health in Africa through multilateral aid, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, and through bilateral programmes. Fifteen per cent. of DFID’s aid goes to health, totalling some £800 million this year, which will rise as the DFID programme expands towards our target spending of 0.7 per cent. of gross national income by 2013. Last month, the UK launched an international health partnership to improve the effectiveness of international funding for health. Five of the IHP’s first-wave countries are in Africa. They are Ethiopia, Zambia, Mozambique, Kenya and Burundi.

I thank my hon. Friend for that response. I am aware that in Mozambique, for example, those who suffer from HIV/AIDS sometimes face the problem that, even if they have access to antiretroviral drugs, supplies run out and the treatment cannot be sustained. Equally, some people are faced with a stark choice of either paying for their drugs or buying food. What can DFID do to ensure that those who access treatment are sustained on it?

I thank my hon. Friend for that question. The UK is absolutely committed to the challenge of HIV/AIDS. That was one of the key elements of the agreement at Gleneagles. DFID has committed some £17 million in support to the Ministry of Health in Mozambique. That will help to improve, among other things, HIV/AIDS treatment, including the scaling up of access to antiretrovirals. Therefore, some progress is being made. In sub-Saharan Africa, the numbers on treatment rose tenfold from 2003 to 2006, from 100,000 to over 1.3 million. However, with only one in four in Africa able to access HIV/AIDS treatment, much more needs to be done.

Given that we are off track to meet the millennium development goal on maternal health—on the current trajectory, not only will we not meet it by 2015 but we will probably not do so in the next 100 years—what more can the Government do?

That challenge is recognised throughout Government. Recently our Prime Minister met the Norwegian Prime Minister to look at an initiative to deal with that problem. Africa is the continent with the highest maternal mortality rate—there are 830 deaths per 100,000 live births. All our programmes focus on those issues. I go back to the point that I made earlier: ultimately, the UK is one player. It is by different donor countries coming together that we will have the kind of impact that I know we would all like to see.

When I visited Swaziland three years ago, we were told by the Health Minister there that Swaziland had the highest incidence of AIDS in the whole world at 43 per cent., yet thousands of doctors and nurses from Swaziland were leaving to practise abroad. What help and encouragement can the Department give to doctors and nurses from Africa who are working in the west to return to Africa to help in the fight against AIDS?

Brain drain is a high-profile concern for Africa, and a major migration and development concern for the African Union. We in this country have a code of practice under which we will not attempt to recruit health workers from countries whose Governments suggest that that might be detrimental. We are currently looking into this matter via the Global Health Workforce Alliance, which is chaired by Lord Nigel Crisp. The Secretary of State has already met him and discussions are taking place. This issue is of the utmost importance to the Government.

According to Save the Children, the lives of 800 children a day could be saved if their parents did not have to pay for essential health care. Will the Department work with non-governmental organisations and civil society to ensure that the health partnership translates into real action on the ground?

We are absolutely in favour of sustainable partnerships of that kind, which is why the Prime Minister launched the international health partnership only in September. Its aim is to make improvements in the area that the hon. Gentleman raises, and to work on the concerns that he and others have articulated.

All the evidence suggests that educating women in sexual health not only leads to later pregnancy but has a direct and positive impact on the economic performance of their country. What is the Department doing to promote sexual health awareness in Africa?

DFID is carrying out research into sex education. We are funding a community randomised control trial in Tanzania to inform us about the health impact of different adolescent sexual health interventions—we are investing £1.4 million in that. I recently visited Yemen where the population growth rate is such that it will double in 16 years; we are concentrating there on education for young girls, which will have an impact. Education, including sexual education, is vital in dealing with such matters.

Further to the question of the hon. Member for Vale of Clwyd (Chris Ruane), the Minister will know that many British health professionals want to make a personal contribution in poor countries but are too often discouraged from doing so because time spent abroad is not accredited and therefore adversely affects pension accrual, for example. Will the Minister look closely at the policy that my party has proposed to set up a health systems partnership fund? That would make a modest but useful contribution to helping in this area.

The hon. Gentleman may be aware that we were already looking at that issue prior to his party’s announcement. I am happy to inform him that Lord Nigel Crisp, chair of the Global Health Workforce Alliance, is looking into the issue, and that the Secretary of State has already met him.

The Minister will know that our proposals would enable British health professionals to spend time in developing countries helping to build sustainable health systems. The proposals have been supported by VSO and many other NGOs, including the Tropical Health and Education Trust. As the Minister’s party is clearly in the mood for nicking Conservative policies, will he make it a priority to implement as soon as possible our health systems partnership fund?

I think that I have already alluded to the fact that, regardless of whether they are ours or are borrowed from elsewhere, we will pass forward all good ideas to Lord Nigel Crisp, who will be looking into these matters. On nicking ideas, the hon. Gentleman will next be telling us that the target of 0.7 per cent. of GNI by 2013 was his party’s idea.

Comprehensive Spending Review

4. What impact he expects the comprehensive spending review to have on his Department’s future spending plans. (158520)

With the increases in aid announced last week, Britain will deliver on the promises that we made at the Gleneagles summit in 2005 and make faster progress toward the millennium development goals. We will double aid to Africa, invest more in education and health, and increase our support for growth and good governance. We will strengthen cross-government work on climate change and conflict.

I am grateful to my right hon. Friend for that answer. Can he confirm that the settlement in the comprehensive spending review means that the United Kingdom is now on track to meet the commitment to spend 0.7 per cent. of gross national income by 2013 on aid, and that at least half of all new aid will go to Africa, as promised at Gleneagles?

I can give the confirmation that my hon. Friend seeks—we are now on track to meet that 0.7 per cent. GNI commitment. We are the first Government in British history who have given a time scale by which we will meet the UN target, and we took a decisive and significant step toward that goal with the comprehensive spending review announced last week.

Given the right hon. Gentleman’s success in the spending round, will he confirm that the settlement that he secured will allow for the quadrupling of British aid to Burma, including provision for increased cross-border assistance, backing for the Shan Women’s Action Network and other women’s groups, and funds to assist the worthwhile and valuable efforts of exiled pro-democracy groups—all of which have been recommended by the International Development Committee?

Let me begin by paying tribute to the work of the International Development Committee on this issue and, of course, to the high-profile role that the hon. Gentleman has taken on it. I gave very serious consideration to the recommendations of the IDC report in the summer, and I made sure that there was a carefully drafted response that reflected my determination that there should be a significant increase in the work that we are doing in this area. In addition to the terms of the report and the Government response, we have committed £1 million more toward the immediate humanitarian challenges facing Burma, in the light of the terrible events that we have witnessed in recent weeks.

Sustainable Forestry

We are committing over £70 million for sustainable forestry in Africa, including £50 million for the Congo basin forest, to help improve governance, reduce deforestation and safeguard the livelihoods of poor people.

Does the Minister accept that although biofuels can help to combat climate change, unless they are introduced in a planned and sustainable way, natural habitat and forestry will be destroyed? What analysis has he made of the problem, and what steps will he take to resolve them?

I share my hon. Friend’s view that biofuels have an important contribution to make in tackling the impacts of climate change. He is right to say that the increase in interest in biofuels needs to be managed in a sustainable way. We are working with a range of partners, including the World Bank and the African Development Bank, to look at exactly this issue.

The Chinese are almost raping the forests in Gabon. What representation have this Government and the EU made to the Chinese authorities about the way in which they are abusing their mineral and forestry rights in Gabon?

My hon. Friend may not know, but we have been working closely through the European Union with a number of countries, including China, to address how we can improve governance of forests and conservation and reduce the rate of deforestation. UK representatives attended a conference at Beijing to look at exactly this issue, and to see how we can develop that relationship with the Chinese still further.

Zimbabwe

The situation in Zimbabwe continues to deteriorate as a result of the appalling corruption and wilful mismanagement of the Mugabe regime. We are, however, making a major contribution to humanitarian relief and working to protect the people of Zimbabwe from the worst effects of hunger and HIV.

I thank the Secretary of State for those comments. Given that more than 3,000 people die of HIV/AIDS in Zimbabwe every week, does he agree with me that the measure of success is not how much money is spent, but the number of people protected from infection and the number treated? Given those circumstances, what is he doing to ensure that British aid money is used to maximum benefit?

On the specific issue that the hon. Gentleman raises, we are providing HIV treatment to 50,000 people in Zimbabwe this year and helping to keep AIDS-affected children in school. Clearly, this is a hugely challenging environment in which to be working at the moment—significant migration out of the country is taking place, its Government are in a relative state of collapse and its economy is diminishing almost by the day—but I assure hon. Members that we are determined to continue to provide humanitarian support, today and tomorrow, to the people of Zimbabwe.

Has the Secretary of State seen the recently published report by Save the Children, which highlighted the plight of unaccompanied children, some as young as seven years old, crossing the border from Zimbabwe to South Africa? What is his Department doing about that? Has he had any discussion with the South African Government about that important issue?

I assure the hon. Gentleman that through various different channels we are in regular contact with the South African Government on those issues. It is clear that Zimbabwe no longer represents simply a challenge or the humanitarian crisis of one country; given the outflow of migrants, be they children or older people, it is a crisis for the entire region. I pay tribute to the work of the Independent Television News broadcasting organisation, for bringing the plight of those children to the wider attention of the British public in recent years, and to Save the Children. I assure the hon. Gentleman that we continue to work closely with regional partners, including South Africa, to ensure that our humanitarian effort is targeted towards those most in need. Indeed, we have in recent weeks announced £8 million more for the World Food Programme to try to address the hunger needs of such populations.

Prime Minister

The Prime Minister was asked—

Engagements

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

The owner of a local small business wrote to me yesterday, saying:

“I was made redundant…and started my own small business…I am approaching retirement and was hoping the sale would help support my pension which has already reduced by…the raid on pensions made by Gordon Brown.”—[Interruption.]

Under the new tax rules, my constituent’s tax bill will rise from £2,520 to £9,504. Can the Prime Minister tell him what he has done wrong and why he is being penalised?

We have cut capital gains tax from 40 per cent. since 1997, when the Tories were in power. We have, as the Leader of the Opposition acknowledges, the most successful economy. We have created 2.5 million jobs, unemployment is down today, and businesses are thriving.

My right hon. Friend will be aware that last Saturday marked the anniversary of the collapse of Farepak, in which 122,000 small savers were robbed of their money. I have just met the administrator, who tells me that she is unlikely to pay back any money before Christmas this year. In addition, none of the reports will be made public under law. Would he be prepared to meet me and my hon. Friend the Member for Livingston (Mr. Devine) to discuss how we can speed up the process and get justice for the victims of Farepak?

What happened to Farepak was completely unacceptable. We have worked very closely with all those people who have lost money as a result of Farepak and we will continue to do so. I will be very happy to meet my hon. Friend and any other hon. Members who are concerned about Farepak so that justice is done.

In the past four years, the number of people who have died from the hospital-acquired infection clostridium difficile has trebled. Ninety patients died in one hospital trust alone. The Healthcare Commission said last week:

“where trusts…are under severe pressure to meet targets relating to finance and access, concern for infection control may be undermined.”

Will the Prime Minister now accept that the number and extent of his top-down targets are contributing to this problem?

It is because we are concerned about MRSA and C. difficile that in the past few weeks we have taken very special measures: isolation wards; we are about to appoint 3,000 more matrons; and we are about to do a deep clean of hospitals. The right hon. Gentleman raises the issue of targets and cites the Healthcare Commission, so let me quote to him what its chairman, Sir Ian Kennedy, has said:

“Targets or their equivalent are an inevitable feature of a modern 21st century healthcare system…The obligation to meet targets cannot be used as an excuse for failing to meet other managerial objectives.”

He also says—and I hope that the Leader of the Opposition will take this into account—

“targets are not to blame for the trust leaders taking their eye off the ball.”

He adds:

“Managers always have to deal with conflicting priorities and plenty of organisations…do it successfully.”

In other words, it is not targets that are to blame. We have got to invest in the health service. Will he invest in the health service as we will?

It is clear that the Prime Minister has not read the Healthcare Commission report. The report could not be clearer. On the Maidstone hospital, it says:

“senior managers were…reluctant to implement major infection control measures”

because of the need to meet targets. It was not just that one hospital. The report on Stoke Mandeville said:

“The achievement of the Government’s targets was seen as more important than the management of the clinical risk inherent in C. difficile. This was a significant failing.”

Almost one in two hospitals agrees that targets are getting in the way of infection control. The National Audit Office and the Public Accounts Committee both agree. What makes the Prime Minister think that he is right and they are wrong?

The right hon. Gentleman has not done his research. Targets are responsible for waiting lists, which were at a quarter of a million, being almost zero for those people at six months. Targets are responsible for a 17 per cent. fall in heart disease. Targets are responsible for a 40 per cent. fall in coronary disease.

The right hon. Gentleman quotes the Healthcare Commission. I have quoted Sir Ian Kennedy, who is its chairman, saying that targets are not to blame. Let me also quote the new chief executive of Maidstone and Tunbridge Wells NHS trust. He said:

“targets are there for a reason but that should not stop us from focusing majorly on patient safety, that is the number one priority”.

The Leader of the Opposition should recognise that the reason we can invest more in tackling MRSA and C. difficile is that we are spending more money on the health service. He voted against that spending.

Order. I hope that the hon. Member for Dudley, North (Mr. Austin) will not keep shouting. You have a difficulty in Prime Minister’s questions because you keep shouting. You should not do it.

It comes to something when you have to tick off the Prime Minister’s Parliamentary Private Secretary, Mr. Speaker.

The Prime Minister said that he would listen to people, but he is not listening to those working in the NHS. The Healthcare Commission quotes one senior manager saying that

“if anyone says the top priorities aren’t money and targets, they are lying”.

The nurse of the year, who resigned today, says that she is leaving because of bureaucracy, reorganisation and paperwork.

MRSA deaths have quadrupled. C. difficile deaths have trebled. If we are going to deal with hospital-acquired infections, does not the Prime Minister understand that he has got to listen to the people who work in the NHS?

It is precisely because I have been listening to the British people that we have put an extra £100 million into tackling MRSA and C. difficile. It is precisely because we are listening that since I took over this job we are now insisting that every patient who comes to hospital will be screened against the possibility of MRSA. It is precisely because we are listening that we are going to do a deep clean of hospital wards. It is precisely because I am listening that we are going to double the number of matrons.

None of that extra expenditure would be possible if we accepted the Conservative party’s plans on spending. It has a £6 billion black hole in its spending plans, which would mean deep cuts in the national health service. The Leader of the Opposition should listen to the experts on this matter, who are saying that targets are not to blame. We need investment and reform in the health service, and only we on this side of the House can do it.

If the Prime Minister wants to ask me questions, he should call an election. In the meantime, he says that this is all about how much he listens, so let us ask about the other important issue of this week and whether he is listening. His manifesto promised a referendum on the European constitution. The overwhelming majority of people in this country want a referendum on the European constitution. European leaders, the European Scrutiny Committee and his own representative on the European Convention all say that the new treaty is the same as the constitution. Will he tell us why will he not grant a referendum on that constitution?

I see that the right hon. Gentleman has given up on the health service now. Let us come to the European issue.

In 1992, every member of that shadow Cabinet refused a referendum on a far more significant treaty. The Foreign Secretary voted against a referendum on Maastricht. Why is this treaty different? It is different because it is not a constitutional treaty; it is an amending treaty. Why is it different? It is different because we won a protocol in the charter of rights, we got an opt-in on justice and home affairs, we got an emergency brake on social security, and we have exempted the security issues. All those changes have been brought about in the past few months, and that is why not one Government in Europe—apart from the one in Ireland, who are bound constitutionally to have a referendum on anything—are proposing a referendum on this treaty. Just as those on the Conservative Front Bench voted against a referendum in 1992, they should have the honesty to vote against it now. [Interruption.]

Order. Before the next question, may I ask the hon. Member for Peterborough (Mr. Jackson) to be quiet as well? He is not the only one, but if I get him to be quiet I am sure that the others will follow.

The Prime Minister called my right hon. Friend the Member for Richmond, Yorks (Mr. Hague) the Foreign Secretary. I have to say to him that it is just a matter of time.

Let us be clear about what Labour’s representative on the European Convention, the hon. Member for Birmingham, Edgbaston (Ms Stuart)—[Hon. Members: “Where is she?”] Where is she? She has probably been sent for re-education. Let us be clear about what she said:

“The red lines are red herrings. It’s a matter of trust and integrity. A referendum was promised. It should be delivered. If Labour can’t trust the people, why should the people trust Labour?”

It is a simple question: is she not right?

We will do what is right in the interests of the British people. If the right hon. Gentleman wants to trade quotes, he should listen to the chairman of his own democracy commission, who says that the proposal for a referendum under the Tory plans is “crackpot”, “dotty” and “frankly absurd”. I know that the Leader of the Opposition likes pre-rehearsed soundbites—[Interruption.] I know that he is good at PR—[Interruption.]

I acknowledge that the Leader of the Opposition is good at PR, but did he not go too far last weekend when he went to California and said in a newspaper interview:

“look at me and think of Arnold Schwarzenegger”?

That is the last thing on anybody’s mind.

People will look at the Prime Minister and just say, “Here is a man who breaks his promise.” Why does he not admit that the reason he will not have a referendum is that he is scared of losing it? Does he not understand that if he breaks his promise on this, no one will trust him on anything else?

If we were deciding whether to join the euro, we would have a referendum. If the treaty were the old constitutional treaty, we would have a referendum. Because it is an amending treaty that is not fundamental change, we have managed to negotiate red lines in Europe which mean that the national interest is protected. Britain will decide on justice and home affairs; Britain will decide on foreign policy where it is multilateral; Britain will decide on social security; and Britain will decide on national security. We will at all times stand up for the British national interest.

On Saturday evening, I sense that the nation will be watching its television sets as England plays South Africa in what has been an extraordinary Rugby world cup. I wonder whether the Prime Minister would like to send a message to the team.

I think I might be able to speak for the whole House here. I think the whole House wishes to congratulate the England team on a magnificent performance in reaching the final. I think the whole House wants to wish Brian Ashton, Phil Vickery and the whole team our best wishes for Saturday’s match. As someone who, like my hon. Friend, follows rugby, and met the England team recently, I wish to send our best wishes so that England returns with the world cup on Saturday night.

Does the Prime Minister agree with the comments of the Chief Secretary to the Treasury that there is a moral case for rewarding marriage through the tax system?

May I first of all say—and I think I speak for the whole House—that we send our best wishes to the former leader of the Liberal party, who is a distinguished parliamentarian? He is a man of integrity, he is a man of honesty and he is a man of decency. Let me welcome the shadow Chancellor of the Liberal party to his position as temporary leader of the Liberal party. If things go on in this Parliament at this rate of change, every single Liberal Member will have the chance to be leader of the Liberal party.

As far as the tax issues are concerned, it is because we recognise marriage in the tax system that we have made the changes that we have on inheritance tax; it is because we recognise marriage in the tax system that—[Interruption.] It is only possible because we recognise marriage in the tax system. But as far as children’s tax credits and child benefit are concerned, I believe that the duty of every citizen of this country is to support not just some children in our country, but all children.

I thank the Prime Minister for his gracious comments and for his welcome.

Both of us are happily married men, but why has the right hon. Gentleman crafted an inheritance tax system that discriminates against millions of unmarried couples and their children? And why is he lining up with the Tories to defend the principle that these families should not merely be condemned to the everlasting flames of hell, but should be taxed more on the way?

I am grateful to the hon. Gentleman for letting me into the secrets of his marriage. It has always been the case that marriage is recognised in the inheritance tax system. I have not seen him making very detailed proposals to change that in recent years. As far as inheritance tax is concerned, if we took up his proposal and extended it to everyone, that would be a very great additional expense. I do not know how Liberal party policies would be able to cope with yet another spending commitment, because in the last few days we have had commitments to a border police force, high-speed rail links, more money to Visit Britain and reducing VAT on historic buildings—£18 billion of spending commitments in all. The most recent one that I want to draw attention to is more investment in bullying prevention; perhaps they should look at that as a party.

Does the Prime Minister agree that the Treasury Committee, which is looking into Northern Rock, would have a lot more clout if only it could intervene before such financial dealings got out of control? Is he aware that the Notting Hill finance group has got another financial scam—to spend £3.5 billion of taxpayers’ money and raise only £650 million? That is another Northern Rock waiting to explode. And one of them has got previous—he was involved in Black Wednesday.

My hon. Friend is absolutely right. There is a £6 billion black hole in the Conservatives’ promises. They cannot afford to pay for their spending commitments and are back to where they were in 1992—with more spending, lower taxes and less borrowing. Where did that end? It ended not only in Black Wednesday, but with 3 million people unemployed, public spending cuts and 15 per cent. mortgage rates. And the economic adviser to the Chancellor at the time is now the Leader of the Opposition.

Q2. The Prime Minister should be aware that the Royal Monmouthshire Royal Engineers regiment has sent more than 100 Territorial Army soldiers to Iraq in support of hard-pressed regular British soldiers. Will he therefore explain to the House why funding for the Territorial Army has been slashed by millions of pounds, and why the Royal Monmouthshire has been told that it can no longer recruit? (158503)

I shall immediately look into what the hon. Gentleman says about the Royal Monmouthshire, but I can tell him that expenditure on the defence forces as a whole is going to rise by more than £1 billion a year over the next few years. We have just made it possible for there to be extra commitment to equipment in Afghanistan. We will do everything in our power to support the magnificent men and women fighting for our armed forces in Iraq and Afghanistan, and I hope that that would be common ground between the parties.

Does my right hon. Friend share my concerns that obesity is the most important public health issue facing our nation today? Not only does it shorten the lives of sufferers but, ultimately, it affects the whole of society. Does he share my view that obesity cannot be tackled by Government alone, but will he outline the Government’s proposals to deal with this very important problem?

My hon. Friend is a doctor, and he brings to the subject a great deal of knowledge about the damage done to young children when obesity is allowed to go unchallenged. Not only must we deal with the advertising of unacceptable foods and persuade the food labelling authorities to make food labelling better to deal with those foods, but we must have a push on fitness in our schools. That is why we will move from two hours to five hours of sport a week in our schools over the next few years, and every young child will have the chance to enjoy a range of sports. That will be possible only because we are able to spend the money necessary to recruit sports teachers and improve sports education in our schools. That would not be possible if we had a £6 billion black hole in our finances.

Q3. Last Friday, I saw how moved the Prime Minister and the Defence Secretary were at the opening of the armed forces memorial near Lichfield. It has places for the names of 16,000 men and women who have lost their lives serving their country since 1945, but will the Prime Minister take this opportunity to clarify precisely how many troops currently in Iraq will return to the UK before Christmas? (158504)

I join the hon. Gentleman in paying tribute to all those who made that new national memorial possible. It is in the centre of our nation, so friends, relatives and families from all over the country can visit and pay tribute to those who have lost their lives since the second world war. As he rightly says, there are already 16,000 names commemorated in the stone of what is a most magnificent statue and memorial, which has been created using donations from large numbers of people. I hope that all Members of Parliament will be able to help their constituents to visit it.

The hon. Gentleman also asked about Iraq. As I have said before, the numbers go down from 5,500 to 2,500 by next spring. They go down from 5,500 to 4,500 and then to 4,000 in southern Iraq over the next few months.

Q4. In view of the appalling ongoing situation in Burma, I welcome yesterday’s announcement by European Ministers of stronger sanctions against that country, but I especially welcome my right hon. Friend the Prime Minister’s promise of aid if the Burma regime moves towards greater democracy and reconciliation. What more does he think that we can do to help the people of Burma? (158505)

I think that hon. Members of all parties in this House will agree that the Burmese regime is repressive, illegal and undemocratic. The sanctions agreed by the EU this week are an important way to deal with the export and import of timber, but we must move forward and look at investment sanctions as well. Members of the Burmese regime must know that unless they change, we will step up the sanctions against them. At the same time, we support the efforts of Mr. Gambari, the UN envoy who is now in the region. I hope that he will be given the chance to meet a wide range of people in Burma so that he can assess the situation.

My hon. Friend has taken a big interest in these matters over the years and, as she said, we are ready to support a reinvestment programme with funds so that the poverty, injustice and inequality that exist in Burma can be tackled if there is a move towards reconciliation and democracy in that country. Our strategy is not only to push the regime to change, but to offer to a new regime and Government our support for economic development and social improvement. I believe that all countries around the world, including China and the Asian countries, will be prepared to support that initiative.

Q5. This week an English Heritage survey found that 75 per cent. of respondents felt that seaside towns were shabby and unattractive, and that the Government should invest more to preserve what is distinctive about them. My constituency of Torbay works hard to upgrade its facilities and to make it an attractive place, and I am sure the same is true of all our seaside towns. What are the Government going to do to help the renaissance and regeneration of these important contributors to the British economy? (158506)

I happen to agree with the hon. Gentleman that we must do more for our coastal towns over the next few years. We must make them more attractive for tourism and we must aid their economic regeneration. That is why we have increased real-terms expenditure on coastal towns by nearly 40 per cent. over the last 10 years. As a result of employment growth, there has been a 12 per cent. rise in employment in coastal towns over the last decade, compared with 7 per cent. for the economy as a whole. Regional development agencies and local government will be given the resources that are needed so that we can regenerate, where it is necessary, the coastal towns that can serve our economy by being great tourist attractions as well as lovely places to live in.

Q6. Is my right hon. Friend aware that in my constituency 7 per cent. of people were claiming jobseeker’s allowance in 1997 and that the figure is now just 3.1 per cent.? Does he agree that the main reason for that success is the implementation by the Government of the new deal and the creation of better pathways into work? (158507)

There are two and a half million more people in jobs than in 1997. Two million people have been helped by the new deal since 1997 either to get training or a job. A large number of people are coming off incapacity benefit as a result of the measures we are taking. More single parents are going into work; there are now 700,000 single parents—not more than 1 million—on the inactive register. We have taken the number of people on income support and other benefits down by 1 million over the last 10 years, but that is possible only because we have a new deal that is able to help people get back into work. Unfortunately, the Conservatives would scrap the new deal. Let the debate begin: do we want a new deal that will help people to get jobs and equip them for the future so that British workers can get British jobs, or do we want a £6 billion black hole in public expenditure?

Q7. Is the Prime Minister aware that during the past year Army families were forced to call the Ministry of Defence special housing helpline 400,000 times? After 10 years of Labour Government, how does that dreadful state of affairs square with his pledge in Basra to uphold the military covenant? (158508)

I am grateful to the hon. Gentleman for raising the question of Ministry of Defence accommodation, because as part of the spending round we have agreed that over the next 10 years £5 billion will be spent on accommodation. That is not simply for renovating existing barracks; it will also make it possible for young servicemen and their families to become owner-occupiers for the first time. I hope the hon. Gentleman will support the additional expenditure. I have to tell the Conservatives that when we decide to make additional expenditures on defence, housing and health—where I am grateful to the hon. Gentleman, because he had to apologise for the Leader of the Opposition when the right hon. Gentleman said that hospitals would close—I hope that the Opposition, instead of having a black hole in their figures, will support that extra public investment.

Q8. Earlier this year, my right hon. Friend visited Ceres Power in Crawley, which is developing a low-energy fuel cell that will probably make sure that many of our homes have low-energy output in the future. In last week’s comprehensive spending review, the important environmental transformation fund was announced. How will Ceres Power and similar companies be able to take advantage of it? (158509)

I was very grateful for the chance to visit my hon. Friend’s constituency; she is a wonderful MP, representing the interests of her constituents. Last week, we announced that we will continue with our programme that is doubling science investment, and one of the major beneficiaries will be the environmental and energy industries. I see not only British inventions flowing from that but new British jobs in the years to come. Again, I hope that there will be all-party support for the rapidly increasing science budget so that British inventions can create British jobs for British workers.

Q9. Is the Prime Minister aware of the anger and concern about the proposed changes to hospital provision in south-east London, particularly the cuts and downgrades proposed to our own hospital, Queen Mary’s, Sidcup? Can he confirm that the consultation will not be a sham and that he will actually listen to what local people say—or is this just another example of London being let down by Labour? (158510)

I think that the hon. Gentleman will acknowledge that in London alone there have been 27 new hospital schemes over the past few years; there are 44,000 more NHS staff; there are 650 more dentists; and there is more investment going into the hospital service than ever before. I hope that he will not fall for the scare stories peddled by the Leader of the Opposition about hospitals that are not closing and about the effects of the Darzi report. We are investing more than ever in hospitals and the health service in London, and that is possible only because the economy is moving forward and we are able to create the wealth in this country as a result of a Labour Government.