Q9. If the Prime Minister’s Government succeed in closing four A and E departments in west London, those departments will be replaced by privately owned clinics and out-of-hours services. Some of those leading the closure programme have already profited by up to £2.6 million each from their ownership of those primary care services. Does he think that personal financial gain should debar GPs and others from taking part in decisions on hospital closures? (147460)

I do not think the hon. Gentleman is right in any part of his question. The first point I would make is that the NHS in north-west London is going to be getting £3.6 billion this year. That is £100 million more than the year before. Under this Government, we are increasing the investment. As for the changes he talks about, if they are referred to the Health Secretary, he will of course consider whether they are in the best interests of patients, and that is the right process to follow.

The Prime Minister will, I am sure, be aware of the strong contribution made to the British economy by the inbound tourism industry. Does he therefore share my concern, as expressed by the Tourism Alliance, that changes to visas are likely to suppress the number of visitors coming, particularly from Brazil? What can we do to ensure that the Border Agency does not become a growth suppressant to the UK?

I am happy to say to my hon. Friend that the National Security Council met recently to consider some of these border issues and has decided not to put visas on to Brazilian nationals. We want to work with the Brazilians and ensure that we enhance border security; but, in defence of the Home Office and the UKBA, there have been great improvements in the time spent processing visas and we are looking at a number of steps to ensure that we attract tourists from the fastest-growing markets, including China and elsewhere.

Q10. Does the Prime Minister accept that families face a triple whammy in meeting the costs of child care? Places are plummeting, costs are going up and the average family has lost more than £1,500 a year in support. Therefore, does he also accept that any measure he may announce next week to help with the costs of child care will be small remedy for a crisis of his own making? (147461)

I do not accept what the hon. Lady says, because it is this Government who extended the number of hours to three and four-year-olds and introduced, for the first time, child care payments for vulnerable two-year-olds. We have also lifted 2 million people out of tax altogether. Someone on a minimum wage working full time has seen their income tax bill cut in half. I know that the hon. Lady wants to try to put people off a very major step forward—when we will be helping people who work hard, who want to do the right thing and who want child care for their children—but that is what we will be announcing, and I think it will be welcome.

Q11. Britain is in a global race not just with our traditional competitor economies but with countries such as Brazil, Russia, India and China. Ahead of the Budget next week, will my right hon. Friend tell the House what assessment he has made of where we would be likely to finish in that race if we abandoned our deficit reduction programme and relied on some magical faraway tree of money, as the Opposition recommend? (147462)

My hon. and learned Friend makes an important point. One of the most important reasons for continuing to get our deficit down is that it is absolutely essential to have the low interest rates that are essential for home owners and for businesses. If we listened to the Labour party and abandoned those plans, we would have more spending, more borrowing and more debt—exactly the things that got us into this mess in the first place.

The price of petrol and diesel at the pumps is set to rise to near record levels in the near future, and the resulting rise in the cost of living is causing real problems for our constituents. We know what the Government have already done, but will the Prime Minister reassure the House today that further action will be taken to cut the toxic fuel duty tax and bring petrol and diesel prices down, to help hard-pressed motorists, families and industry?

Of course I will listen carefully to what the right hon. Gentleman says, but petrol and diesel prices are 10p a litre lower than they would have been had we stuck to the absolutely toxic plans that were put in place by the Labour party. We have taken action, and we are doing everything we can with the cost of living. That is why we are legislating to get people on to the lowest gas or electricity tariff, why we have taken 2 million out of tax and why we have frozen the council tax; and I hope that we can do more to help people.

Q12. The Prime Minister is right: this Government do have a good record on fuel duty. We are paying 10p a litre less on the mainland and 15p a litre less on islands than under Labour, but the rising price of fuel in a widespread area such as Argyll and Bute is causing real problems, and I hope that there will be good news in the Budget. For a start, will the Chancellor be able to announce that the September fuel duty increase inherited from Labour will be cancelled? (147463)

I am grateful for what my hon. Friend says about what the Government have already done on fuel duty. He omitted to say that we had also taken the step to help far-flung and island communities such as the one he represents with special conditions, to try to help with this major aspect. In many cases, people who live in his constituency do not have a choice but to use a car, and we have to respect that.

Q13. Will the Prime Minister benefit personally from the millionaires’ tax cut? (147464)

Let me say to the hon. Gentleman that I will pay all of the taxes that I am meant to. [Interruption.] Let me just point out one small point. I had a letter this week which I thought people might enjoy. It is from Ed who lives in Camden. It says this: “I am a millionaire. I live in a house worth £2 million which I got through a combination of inheritance and property speculation. I am worried that if I sell my house and buy another one, I will have to pay the 7% stamp duty that the wicked Tories have introduced. Under Labour, we talked about fairness but we never made the rich pay more. What should a champagne socialist like me do?”

Q14. I know that the Prime Minister recently visited the ACE Centre in Oxford, and I am sure that he shares my view that it does a fantastic job helping young and disabled people to communicate more effectively using technical aids. What guarantees can he give that augmentative and assistive communication aids will be made available to more young people than is currently the case, so that everyone who could benefit from them is able to do so? (147465)

I am really grateful to my hon. Friend for raising this issue. The ACE centre, which was previously in Oxford and is now located in my constituency, has done incredible work for people with disabilities over many years. It is making the most of the extraordinary changes in technology. When I visited it recently, we looked at a whole raft of ways in which we could make sure that the NHS is making these things available to more people, and I am very committed to working with my hon. Friend and the ACE centre to make sure that that happens.

Q15. Prime Minister, you gave a promise to protect the defence budget in its entirety, but you did not. The Defence Secretary, who has left the Chamber, promised to balance the budget, but the National Audit Office said he failed. Prime Minister, will you now guarantee that there will be no— (147466)

Order. The hon. Gentleman has been here 16 years. He should not use the word “you” in the Chamber. I am sorry, but he knows the rules. Come on, quickly, finish the question.

Will a commitment be given to protect the defence budget further in this Parliament?

The commitment I can give is that the £38 billion black hole that we inherited has been got rid of. Freezing the budget across this Parliament at £33 billion gives us the fourth largest defence budget in the world, and we are determined to use that money to ensure that we equip our forces with what they need for the future. That is in massive contrast to the record of the Government whom the hon. Gentleman supported.

Given the appalling nursing care standards revealed at Stafford and the Government’s welcome boost to apprenticeships across the professions, does the Prime Minister agree that now is the time to re-examine whether the nursing profession should remain all-degree or whether we should get back to training at patients’ bedsides?

My hon. Friend makes an important point. I do not think we want a de-professionalisation of nursing—huge improvements have been made in the professional skills and training of nurses—but we have to get back to ensuring that patient care is at the heart of nursing. No one can be a good nurse without those things, so we need to return to such values.

Prime Minister. I do not expect you to know the full details—

Order. We must get out of this bad habit of Members using the word “you” in the Chamber. “You” refers to the Chair. Please address the House through the Chair.

Mr Speaker, I do not expect the Prime Minister to know the full details, or indeed to be directly responsible, but against the background of “We’re all in this together”, does he think it fair that the lowest-paid workers in this place have been offered a 1% increase, while senior managers have been offered 5%?

That is a matter for the House authorities, not for me. The point I would make, however, is that we have frozen public sector pay at 1%, which we think is fair. The extraordinary thing about Labour’s position is that it supports that 1% increase for public sector workers, but thinks that people on welfare should be getting more than 1%. That seems to be an extraordinary set of priorities.

Whenever alcohol is too cheap, more people die. I know the Prime Minister wants to reduce avoidable early mortality and cut violent crime. Will he meet me so that I can explain to him the evidence base behind minimum pricing and how abandoning this policy would critically undermine the future efforts of those who want to do something about this?

I am always happy to meet my hon. Friend. We have had many discussions about this issue over the past two and a half years. There is a problem with deeply discounted alcohol in supermarkets and other stores, and I am determined to deal with it. We have published proposals, and are considering the results of the consultation on them, but we must be in no doubt that we must deal with the problem of 20p or 25p cans of lager being available in supermarkets. It has got to change.

I am sure the Prime Minister is aware of the Visteon pension action group, whose members we are meeting outside at 12.30 today. We would like to invite him to join a cross-party group of MPs who will be meeting them on this important date—the fourth anniversary of their campaign.

I shall consider the hon. Lady’s remarks carefully. I have a meeting almost straight after Prime Minister’s questions with the leader of her party to discuss the Leveson proposals, and it might not be possible to rearrange my diary, but may I say how important it is that we support pensioners and achieve proper dignity for people in old age?

Does the Prime Minister agree that the results in Eastleigh, where Labour failed to gain anything at all, show that the Leader of the Opposition’s policies are completely without support in the country?

I welcome the hon. Gentleman to the House of Commons, and if he asks questions like that, I think he will get along just fine.