With your permission, Mr. Speaker, I will make a statement about business to be taken by the Council of Ministers of the European Community during January 1978. The monthly written forecast was deposited on Tuesday 13th December.

At present four Council meetings are proposed for January. Fisheries Ministers will meet on 16th and possibly 17th; Finance Ministers possibly on 16th, Foreign Ministers on 17th and Agriculture Ministers on 23rd and 24th of that month.

Fisheries Ministers will continue their discussion on current fisheries proposals. The agenda for the proposed Finance Ministers' meeting has yet to be settled.

Foreign Ministers will consider relations with Spain, Cyprus, Turkey and Yugoslavia, the enlargement of the Community and the GATT multilateral trade negotiations. They will also probably consider Euratom-United States relations in the light of the new United States nuclear export and non-proliferation legislation resulting from President Carter's statement on 7th April 1977.

Agriculture Ministers will resume their discussion on common agricultural policy price proposals for 1978–79 and agricultural monetary questions. They may also give further consideration to support for agricultural producer groups and the organisation of the potato market.

I thank the Minister for the statement.

I wish to ask the hon. Gentleman three short questions. He did not mention, in discussing the agenda for various ministerial meetings, the subject of direct elections. Does he think that the Council of Ministers—I imagine it will—will want to decide the date of those elections? In the light of the vote in this House last week on this subject, will the Minister give his EEC colleagues an undertaking that, provided there is the political will to provide parliamentary time, it will be possible to hold elections in this country next year, if that is what the Community decides?

Secondly, on the subject of farm prices, will he give an assurance that there is no reason why we should suffer again the delays that occurred last year as a result of which the Council of Ministers ended by approving the wider institutional increase in farm prices, which were the figures with which they had begun? May we give the Commission reasonable support in its proposals, which seem to be courageous ones?

Finally, the Minister did not mention one cause of concern—namely, the directive on doorstep selling and mail-order firms. I hope that before the next ministerial meeting our representative will reflect the widespread alarm and disquiet that is felt on this proposal.

On the subject of direct elections, the Government have made plain both in this House and at meetings of the Council of Ministers the difficulties that we would face if the House decided on a first-past-the-post system. I am certain that at forthcoming meetings—this is a continuing process of review—we shall be making our views clear on how we see the situation. We shall do our best to brief our ministerial colleagues about how we see the future, but it would be rash at this stage to give undertakings about specific target dates, because we believe, as we have said candidly, that if we were to meet the target date it would have to be a regional list system. The House has exercised its right to choose the other system, and therefore we have complications that we shall have to work out and evaluate.

I understand the point put by the hon. Gentleman about farm prices. The fact that we have already had an initial discussion by the Council of Ministers shows that it is determined to take this matter in good time and keep it in the right perspective.

The hon. Gentleman will recall that the Government have made their own anxieties clear about the directive on doorstep selling. There is much anxiety, not only in the House and in the country but in the Government as well, about the process, of which this directive seems to be an almost classic example, of harmonisation for harmonisation's sake, which we think does little good for the cause of the Community. Therefore, we shall not be encouraging an early adoption of the directive.

Will the Agriculture Ministers be discussing the possible extension of these temporary measures to support farm prices—I am thinking particularly of milk—until a more permanent and far-reaching reform of the common agricultural policy can be carried out?

We have made plain—it was spelt out in the letter from my right hon. Friend the Prime Minister to Mr. Ron Hayward—that we are looking for significant changes in the whole operation of the common agricultural policy. We see that as a long-term strategy which will have to be approached very carefully and practically. In the meantime, we do not want to see unnecessary disruptions, although, as I have said repeatedly, our immediate objective is to balance the interests of producers, which are of course important, with better recognition of the interests of the consumers.

Will my hon. Friend be kind enough to tell the Minister of Agriculture, Fisheries and Food that, whilst we appreciate his good efforts in price negotiations, it will be useless to keep the price increase to a very low figure if, as part of the deal, we have to agree to the automatic realignment of the MCAs? Will my hon. Friend also tell the Minister that the consumers cannot be forced to pay increased prices on that basis because they cannot afford it any longer?

I shall convey what my hon. Friend has said to my right hon. Friend the Minister of Agriculture, Fisheries and Food.

Will the hon. Gentleman advise the Minister of Agriculture, Fisheries and Food, on the contrary, that there is little point in discussing monetary arrangements within the Community unless there can be discussion about some revaluation of the green pound? Will he also reassure the Minister of continued strong support in the House for his firm stand on the fishing question and the necessity for securing a fair share for our own industry, with an adequate conservation régime to go with it?

In the discussions on direct elections, would it not help the Foreign Secretary to have with him in Brussels someone from the Conservative Front Bench in order to explain why that Front Bench voted to ensure that there will be no direct elections next year at all?

It is not for me to deal with that point about direct elections, as I am sure the hon. Gentleman will agree. My right hon. Friend the Minister of Agriculture, Fisheries and Food takes seriously all the points made in the House about the monetary arrangements in the common agricultural policy. On the fisheries issue, we of course recognise the very strong feelings in this House, in the industry, and amongst the public in general. There is widespread recognition that the proposals so far put forward by the Commission do not begin to meet the needs of the United Kingdom in a fair and effective common fisheries policy, when and if one is to be introduced. But in saying that I must emphasise that there are indications that, as a result of the very strenuous presentation of the British case by my right hon. Friend, there is beginning to be a deeper recognition in the rest of the Community of the special needs of the United Kingdom.

We note what my hon. Friend has said about the changes—which I hope to be genuine—in the attitude of our colleagues towards the fishing question. Will he ensure that, at the talks on 16th January, whoever speaks for the United Kingdom conveys to the French delegation the distaste and anger of my constituents in Hull at the behaviour of the French deep-sea fleet in Norwegian waters in knowingly taking 2,650 tons of fish beyond its quota, which means that we lost that fish from our quota, with the result that our people in Hull had to tie up their boats? As a result, men are now unemployed in Hull who should be catching fish off the Norwegian coast.

This point has been forcefully represented by me and other members of the Government in the Council of Ministers. But we cannot over-emphasise the importance and priority which should be given to conservation, because, unless something meaningful and effective is done on conservation, there is genuine danger that, while we prevaricate in the Community, the stocks will be irreparably damaged.

Will the agriculture Ministers be dealing with the import of Irish beef into this country, which is causing so much concern to our farmers?

I am sure that the matter will be dealt with by the Agriculture Ministers.

In the light of the coming discussions on Euratom and of President Carter's energy outlook, when are we likely to have a report from my right hon. Friend the Secretary of State for Energy on the discussions this week in the Council of Ministers on the fast breeder reactor?

I will bring that point to the attention of my right hon. Friend the Secretary of State for Energy. The Government and the Community are very anxious to maintain good relationships with the United States, and to make sure that we are as far as possible talking the same language about this vital area of policy. Therefore, we shall be having very full discussions in the New Year about how we can best co-ordinate what we are doing with the lead given by the United States.

To save the time of the House, I propose to put together the three motions to approve Statutory Instruments.

I am glad to have the opportunity of raising in the House an issue with which I have been concerned for many years, both in the Chamber and in discussion and correspondence with Ministers of successive Governments. It is the problem of the young school leaver who is unable to claim supplementary allowance if he attends certain types of short-term courses at technical college or other centres of the kind. I have a considerable file of correspondence with the Department of Health and Social Security, the Department of Education and Science, and the Department of Employment, as well as with the Supplementary Benefits Commission. I know and understand the point of view expressed by the Commission. One of the difficulties if one knows extremely well the present chairman and the previous chairman of the Commission is that one knows all too well some of the problems which face the Commission.

I want to put the issue in its setting. On Tyneside and in South Shields in particular, and the area immediately around it, we have some of the most distressing examples of the problems arising from unemployment. We have an unhappy record in the matter. The latest figures, which I received only yesterday, show that in the South Tyneside local government area no fewer than 1,078 young people under the age of 18 are unemployed—447 young men and 631 young women—and registered with the careers service.

I accept and welcome the efforts of the Government to get as many young people as possible into practical training schemes of one sort or another, and all the other arrangements that have been made, such as job creation. To give some balance, I am told that Government special measures are providing training facilities over the same area for 492 young people in the same age category who would have had to be added to the 1,100 unemployed whom I mentioned.

That would have been the position it ii had not been for the initiative taken by the Government and the special schemes that we all welcome. In spite of all that effort, I am sure that we are all deeply disturbed about the level of unemployment that remains, and especially the impact that it is having on young people, very many of whom leave school with no job prospects.

We are all concerned to try to encourage young people to stay on at school wherever possible. We do not want to take action that would discourage them. Equally, it must be understood that many young people resent the idea of being compelled to stay longer at school. There is a better chance that they will take the opportunity of education courses in the setting of a technical college, an adult college, than if we attempt to persuade them to stay on at school.

I am glad to say that some young people are staying on at school. In the past the figures in the North have not been very creditable. Not as many young people stayed on and passed into secondary education, as we used to call it as we wished. In your country, Mr. Speaker, there has often been a record of more children staying on at school than in Scotland, and, alas, in the North of England we have had to make up for a bad position.

The House will be aware that if young people stay on at school the parents may be able to claim some financial support. However, the anomalies that arise cause a great deal of difficulty. If the young people concerned merely stay at home and do nothing, they are almost certain to be entitled to supplementary allowances of one sort or another. However, if they seek to take some valuable form of part-time education, even though they are to all intents and purposes clearly available for employment, they are likely to miss all forms of support. This is a real difficulty.

If young people take a part-time course at a technical college of not more than three whole days or six half-days a week, and give an undertaking of their availability for work, they can claim supplementary allowance, and in most cases they will secure it. I had quite a long struggle to establish that provision. It is a concession that was introduced quite a few years ago. There are still a few offices that we hear about from time to time where the information has not wholly seeped through. Some misleading information is still given to young people about their rights in this regard.

If a young person seeks to take a relatively high-level education course after leaving school, a course that is beyond what is normally available in school, he or she will probably be given an education grant and receive some financial support. There is some continuing feeling that although support is obtainable if a young person takes a so-called advanced course, if he takes a non-advanced course—in fact, a fairly elementary course or a follow-up course—it is almost certain that he will be ruled out on making application for financial support.

The point that I am chiefly seeking to make is that if all young people taking courses were to opt to take one of a variety of three-month courses, even though they may guarantee that they will take up the offer of a job and break the course if a job becomes available, they would not be likely to be eligible for financial support, and certainly not for supplementary allowance. Bearing in mind a letter that I received only recently from a colleague of my hon. Friend the Under-Secretary of State, it is conceivable that they might be considered for unemployment benefit. Of course, only a small number of the young people that I am talking about are likely to have any insurance qualification for unemployment benefit. They are more likely to apply for supplementary allowance.

In these cases it is, to put it mildly, unlikely—indeed, it is almost automatic that they are ruled out for application for supplementary allowance—that they will receive financial support by means of supplementary allowance, because they are taking what in education circles is known as a part-time course, but what in my hon. Friend's Ministry is considered for the purposes of employment regulations as a full-time course. We are talking, for example, about general engineering preliminary courses. Some City and Guild courses may have examination qualifications available to them.

From the college point of view—I am speaking specially about the situation that arises in my constituency of South Shields in the internationally known marine and technical college—there are quite a number of three-month courses in operation. It would be relatively simple to take more of those who have left school and are out of work and, in suitable cases, put them into appropriate courses. However, that is not always possible under the rules and regulations as they stand.

I pay tribute to the eagerness of the staff and others at the marine technical college who do all that they can to bring more and more young people into practical and useful training courses. However, if they try to do that they appear to be set back by the rules and regulations. They have to try to design special three-day a week or six half-day-week courses, which are rather wasteful of staff, as against making fuller use of courses that are likely to be available in any case.

Despite all the correspondence and discussion that there has been on this matter, I plead with my hon. Friend and his colleagues to see whether some further progress can be made.

Among those who have done a great deal of work in trying to analyse the situation, bring out the facts and devise ways of better working are people associated with the trade union council in South Shields. Such people, in co-operation with the college, have put forward many proposals and ideas in an attempt to resolve this matter. I pay tribute to them and to all those in the town who have sought to obtain practical answers to this worrying problem of more than 1,000 young people who are still on the unemployed and the special careers registers.

Despite past regulations, I suggest that a further attempt should be made to deal with this matter. Frankly, I do not mind how this financial problem is met. If it were found possible, after all the argument, to include this type of course in education, it would fall outside the responsibility of the Minister who is to reply to the debate. I know that would please my friend—I am sure I may use that expression—the present chairman of the Supplementary Benefits Commission, who feels that this matter should be dealt with on the education side.

At the moment it does not come within that category. Both the Department of Education and Science and the local authority insist that three-month courses cannot be accepted in the education category. They rule them out as part time and, therefore, not suitable for consideration by them.

That is why we come back to the Supplementary Benefits Commission and the DHSS to appeal for further consideration. A concession was made to me nearly seven years ago. Enough time has now gone by to enable both the DHSS and the Supplementary Benefits Commission to make a further concession to me this morning. I ask for greater flexibility to enable the technical college to tackle this desperate problem in my area.

I fully appreciate the difficulties and anomalies that will arise no matter what solution we try to achieve. We are attempting to bring a number of different Departments together. However, I hope that my hon. Friend will at least agree that the long-term objective, which the Government have declared, is to find ways of ensuring that young people leaving school are in some way provided with training facilities and opportunities. None should be left out completely, because of the serious damage that may cause in future years.

Despite all the difficulties, I hope that, even at this late stage and after so much discussion, my hon. Friend will agree to encourage as much flexibility as possible to allow benefit to be paid to the progressive and eager young people at the marine and technical college in my area.

I recognise that similar problems arise in other parts of the country. Therefore, any change or re-examination of the system that my hon. Friend may set on foot could have widespread beneficial effects at this difficult time.

I am pleased that my hon. Friend the Member for South Shields (Mr. Blenkinsop) has chosen this subject for debate today. It was extremely courteous of him to send me a note before the debate on the principal points that he wished to make.

My hon. Friend's interest in this subject goes back a long way. I read with interest a previous debate that he initiated on the availability of benefit for people taking part-time courses. Indeed, he has taken an active and important part in the process of policy-making in this area. Thus, he spoke with considerable modesty.

The debate gives me an opportunity to explain the Supplementary Benefits Commission's attitude to the payment of supplementary benefit to those taking part-time educational courses. To avoid any misunderstanding, I should emphasise that by "part-time" I mean courses at which attendance is necessary for part of a week as opposed to courses which are full time but last for part of a year. I do so because the latter are also known as part-time courses in education circles where the natural unit of time is the academic year.

I should like to deal with these part-year courses first as I believe that they admit of no compromise. In social security terms, the natural unit of time is the benefit week, and any activity which occupies all or a large proportion of a person's normal working hours within that period is regarded as full time. Therefore, a course which involves full-time attendance for a short period—for example, a 10-week intensive course—is regarded as a full-time course.

The Supplementary Benefits Commission's view is that it would be precluded from paying benefit to a student on such a course by Section 7(1) of the Supplementary Benefits Act 1976 even if the student undertook to leave if he were offered work. These are the terms in which my hon. Friend the Joint Under-Secretary of State for Health and Social Security wrote to my hon. Friend the Member for South Shields on 25th November this year, and, as I said, I am advised that they admit of no compromise.

I should add that the same view is taken where a worker had a temporary job for, say, one month only, in the middle of a spell of unemployment. While that job lasted, he would clearly be in full-time work and would therefore be excluded from supplementary benefit under Section 6(1) of the Supplementary Benefits Act 1976. He could not argue that he was a part-time worker only on the grounds that his work had occupied only part of the year.

That appears to be not only good legal sense but good common sense, too, and the position under Section 7(1) of the Supplementary Benefits Act, which relates to education, is, for practical purposes, exactly the same. A short full-time course must be treated as precisely that. I accept that in the field of education such a course might be termed part-time, but this is a difference of terminology between the education and social security systems and it cannot be allowed to govern the clear position under Section 7(1) of the Act. Under that section the Commission can pay full-time students only if they are in genuinely exceptional circumstances—for example, orphans or others lacking normal parental support, those with severe disabilities, and so on.

The letter to which my hon. Friend referred and a subsequent letter made clear the distinction between supplementary allowance claims and unemployment benefit claims. In unemployment benefit, apparently the same judgment does not hold. There it would be prepared to examine special cases, whereas with supplementary benefit allowance there is an almost automatic bar.

I shall be touching on this point later. All that my hon. Friend has said this morning will be carefully considered by the Departments concerned. I am advised that it could not be accepted that a course of short duration could be an exceptional circumstance for the purpose of Section 7(1) of the Supplementary Benefits Act. That is why I say there is no question of paying supplementary benefit to a student attending full time but part-year courses. In the remainder of my speech I shall therefore be using "part-time" as meaning for part of a week.

Supplementary benefit, as my hon. Friend knows, is a benefit of last resort payable to those who are unable to provide for themselves by working. It is payable to people who have so recently entered the employment field that they have not yet paid sufficient contributions to ensure entitlement to unemployment benefit. Supplementary benefit is also payable to those whose entitlement to other benefits is such that their resources do not meet their requirements as calculated on scales laid down by Parliament, so that some supplementation is necessary.

But no benefit can be given indiscriminately and free of conditions, and the Supplementary Benefits Commission imposes certain conditions on those who apply for benefit. I shall not detail all of them here, but mention just one. This is that fit people under pension age should, with certain exceptions, such as the heads of one-parent families, be required to register for employment as a condition of receiving the benefit, just as they are as a condition for receiving unemployment benefit. Such a requirement entails that they should register at an unemployment benefit office and be available for, and willing to accept, any suitable employment. This has long been an accepted feature of the scheme. The Commission is, in effect, saying that it will replace the unemployment benefit that someone is unable to draw, but on similar conditions as to availability for work.

It follows, therefore, that those who are not available for work because they have prior commitments, for example, if they are attending colleges of further education, cannot receive supplementary benefit.

In the Commission's view, there already exists adequate machinery for ensuring that support is available to young people who wish to continue their schooling after age 16 in worthwhile courses. This is by way of the various subventions administered chiefly by the Departments of my right hon. Friends the Secretary of State for Education and Science and the Secretary of State for Scotland, and in some cases by the Manpower Services Commission under the Youth Opportunities Programme announced earlier this year by my right hon. Friend the Secretary of State for Employment. They have the expertise to assess which courses and which individuals are worthy of public support, and the Supplementary Benefits Commission's officers do not.

The social security system does, of course, have a role to play in the maintenance of families containing students aged from 16 to 19 doing full-time courses to GCE A level or Ordinary National Diploma standard, but that role consists of paying child benefit—plus appropriate increases of any other form of social security benefit that happens to be in payment at the time—to the parents, in the same way as for schoolchildren under age 16. The parents may also be entitled to child tax allowances, though, as the House knows, these are being phased out by stages as the new child benefit is phased in.

Here I must pay warm tribute to my hon. Friend, because it was largely as a result of his initiation of the earlier debate that the Commission's policy wa3 re-examined in 1971 to see what might be done to help unemployed young people who were seeking usefully to fill in their time by attending courses, generally in colleges of further education on a part-time basis. The outcome was that it was decided to allow supplementary benefit to be paid to these young people, subject to certain safeguards designed to ensure that the Commission was paying benefit to young school leavers who are genuinely unemployed and not to students in further education.

These safeguards were: first, the course had to call for only part-time attendance of not more than three working days a week or six half-days; secondly, the claimant and principal of the college had to accept that the claimant could terminate his studies at any time; thirdly, the claimant had to maintain registration for work, continue to claim through the unemployment benefit office and be available to seek, pursue and take up at once suitable work if it became available; fourthly, claimants who had given up work or abandoned a full-time course in order to take a part-time course would not be eligible.

These provisions have operated without causing difficulty and have been generally welcomed as permitting some time-filling part-time courses to be undertaken by the unemployed school leaver without his title to benefit being affected. I stress that the school leaver must be prepared to abandon this course should an offer of suitable work be made.

With the recession in the economy, to which my hon. Friend referred in some detail when speaking of its effects in his constituency, there has been renewed interest in the Commission's "three-day week" concession. Various proposals were advanced which, in effect, asked the Commission to underwrite training and retraining far removed from the original concept. The funding of this retraining was clearly inappropriate to the functions of the Supplementary Benefits Commission. As one example, there was a proposal that the Commission might pay supplementary benefit to unemployed school teachers in their twenties or older while they attended a three-days-a-week, one-year refresher course in mathematics.

A reappraisal of the Commission's policy earlier this year led to the conclusion that the rules formulated after my hon. Friend's March 1971 debate had generally stood the test of time well but needed to be restated with one or two additional points to reinforce the nature of the concession. Reinforcement was necessary because the Commission's experience of the workings of its policy had demonstrated certain points of difficulty. It was, for example, evident that some young people were attending colleges of further education primarily to secure educational qualifications and were not inclined to give up their studies even though they had prospects of work. In other cases the Commission was being asked to pay benefit to people nearer to retirement than they were to leaving school and it was therefore necessary to restate the limitations of the scheme.

These points have therefore been restated as follows: first, only very exceptionally will benefit be awarded to anyone over the age of 21; secondly, where the course offered leads to a recognised qualification, for example, O or A levels, the Commission will look closely at the question, especially in the case of a very recent school leaver, whether the claimant is genuinely interested in getting work and is prepared to leave the course at once if suitable work becomes available, even if this should happen just before examinations. The accent must be on the nature of the course rather than the acquisition of qualifications. Thirdly, the "three days" can be taken as comprising up to 21 hours' instruction, which can be spread over five or even six days in the week. Fourthly, courses will almost always be held in Colleges of Further Education, and not at school, that is, there should be a complete physical break from school. Further than that the Commission cannot go.

My right hon. Friends the Secretary of State for Social Services and the Minister for Social Security and I concur with the Commission's view, as we have told the House before in Answers to Questions and in the debates at the beginning of this year on what is now the Social Security (Miscellaneous Provisions) Act 1977. The Commission is glad to be able to help young people who are first and foremost unemployed but who wish to occupy some of their time with useful study while waiting for work to become available. But it is not its function to help—except sometimes in vacations—those who remain first and foremost students and who in reality have never severed their ties with the world of education.

The distinction between young people whose chief purpose is to find permanent work and others whose chief purpose is to continue their education without substantial interruption is clear enough, I would have thought, in principle. In practice there are, of course, borderline cases, as there always are where a line is drawn in a continuum, but the normal independent appeal tribunal machinery is available, should the individual school leaver think that the initial decision on his claim is wrong. My information is that my hon. Friend's constituents are by no means slow to make full and proper use of that appeals machinery when they feel that the local office has gone wrong—which is, of course, exactly as it should be. Those who work in the office are just as much my hon. Friend's constituents as those who appeal.

Simply to try to avoid the necessity for so many of these appeals, the dangers of varied results according to who may be sitting on the tribunal, and the differences between one area and another, I want to see a coherent scheme which is flexible. That is what we are really after.

I have noted what my hon. Friend has said. He may be assured that his remarks will be carefuly considered by my Department.

I remind the House that the setting of limits to the extent to which the Supplementary Benefits Commission can and should be involved in the maintenance of students is, in principle, no longer a matter of controversy, if indeed it ever was. In its second annual report, Cmnd. 6910, which my right hon. Friend the Secretary of State for Social Services presented to the House in September, the Commission said in Chapter 8:

"We were pleased to note that during the debates in Parliament on the Social Security (Miscellaneous Provisions) Bill, both Ministers and leading Opposition Members of Parliament cited, with approval, the passage in the Commission's first Annual Report (paragraph 5.11) in which we said:—

'This is not to say that it [the Commission] sees students support as a proper function of the supplementary benefit scheme. On the contrary, it considers that the needs of students should be looked at as a whole, in an inter-grated grant system designed to provide for students' vacation as well as term-time maintenance. In this way, responsibility for student support would rest wholly with the Department of Education and Science, the Scottish Education Department and local education authorities, who, unlike the Commission, are expert in the eduation field and are in a far better position to make judgments about the particular needs of individual students.'"

Some progress has been made towards this objective in that the vacation element for the short vacations in the student grant has been increased to the point where it now equals the amount that a single non-householder would get by way of supplementary benefit. Any extension of these arrangements to the long vacation would have to be the subject of discussions with my right hon. Friend the Secretary of State for Education and Science and could not be entertained until there were appreciable funds available which could be directed to educational improvements.

My hon. Friend said that the Department of Education and Science does not support full-time courses of short duration. That is correct, but I understand that local education authorities have power to do so. My hon. Friend will appreciate that we are in no position to instruct local education authorities about the exercise of their discretionary powers. I trust, however, that what my hon. Friend has said in this debate will not go unnoticed.

I thank my hon. Friend for having initiated this debate and for his courtesy and consideration in presenting his case. All that my hon. Friend has said in the debate will be carefully noted by the Government Departments concerned.

I am glad to have the opportunity to raise the problems of the Health Service in the Northumberland area. I am glad that the Minister of State is here to reply. I know that it is not without some personal inconvenience that he agreed to be here. But it is important that he should be here, because when he answered a Question which I put to him on the subject some weeks ago he either did not fully realise the situation in Northumberland or was wrongly advised about it. His Answer was received with disbelief and dismay by health workers in Northumberland, and it was that which convinced me that I should raise the matter again today.

The debate must be seen against a background with which all hon. Members are familiar. The serious shortage of funds is a problem in many parts of the Health Service throughout most of the country. It has been difficult to maintain standards and achieve improvements during a period when public expenditure has been restricted because of the battle against inflation. I hope that the Government will continue to fight to make good the lost ground as quickly as the economic conditions will allow.

It is a tragedy that at such a difficult time the Health Service should have to carry on its back the crippling burdens of increased administrative costs that were brought about by the misguided reorganisation of the Health Service by the right hon. Member for Leeds, North-East (Sir K. Joseph). That has not helped and it is deeply frustrating to many of the devoted professional staff who are struggling to maintain services to see that the administrative superstructure has been growing at a time when every penny is needed to maintain and improve services at the hospitals and at the general practice level.

Despite these difficulties, the Government have rightly set themselves the task of trying to do something about the great differences that exist in the resources for the Health Service in different parts of the country. I do not hesitate to commend them for what they have done so far by means of the Resource Allocation Working Party formula. They have sought to redistribute resources to regions which are under-provided but which have a high need. Equalisation is bound to take longer than it was originally believed. It could take at least 10 years because of the present economic circumstances.

The Northern Region is the third poorest in England and therefore it rightly benefits from the Government's policy. In the years 1978–79 and 1979–80 the region will be allowed a growth rate of 2 per cent. per annum, which is twice the national average rate.

I now come to the difficulty. The Northumberland area of the region is the fourth poorest area within that region. It is a poor area within a poor legion. The problems of the area are all too apparent to one who is proud to represent it. It is an area where family incomes themselves are low, and it is generally a low wage area where people's ability to meet claims upon private resources for medical attention is even smaller than it is elsewhere in the country, so that the Government cannot expect them to undertake such payments.

Geographically, Northumberland is an area of long distances and separation of the people from medical facilities. Obviously, this presents problems both for individuals and for the medical and hospital authorities. The other day in my Saturday morning constituency surgery I was talking to one of the many people who come to me to point out that in order to see a specialist at the nearest place where such facilities are available from Berwick one has to go to Newcastle, making a journey of 60 miles each way from Berwick, with costs of nearly £4. If someone has to go for a fortnightly consultation or special treatment, at £4 a time the cost becomes quite serious.

This constituent put the question quite simply: "Why do I have to meet this cost when someone in Newcastle can take a 10p or 20p bus ride to obtain the same specialist consultation?" I speak here of a constituent who is not able to obtain any help with such travel costs from the Department of Health and Social Security.

Thus, my constituents start at a severe disadvantage. Almost all of them are a long way from the medical facilities which they need. Moreover, as I have said, the hospital authorities themselves have to contend with the problems presented by the extent of area to be covered, which means that their resources have to be widely distributed.

Northumberland has nothing like a district general hospital in the whole health authority area since its resources have had to be spread over the whole area. I should add that I have always taken the view that this is right and that the creation of a district general hospital must not have priority over ensuring that we maintain locally based hospital services a long way from the place where such a hospital might be. It is important that services in Berwick and Aldwick, for example, are maintained. We have good small hospitals there, but the maintenance of these services is an expensive operation made essential by the scattered nature of the population and the long distances involved.

There is another feature of the Northumberland area of which the Minister of State is aware and to which I drew his attention some weeks ago. It is a massive provider to the rest of the region of hospital beds in the mental handicap and mental illness fields. Prudhoe Hospital, for example, has over 1,300 beds for mentally handicapped patients, and I believe that, at the latest count, fewer than 70 of its patients came from Northumberland.

Northumberland is quite happy and proud to be able to offer to the region a mental illness and mental handicap service of the quality which is still maintained at Prudhoe and in other psychiatric hospitals. But it is a costly business, and the county is conscious of the need to bring standards of staffing and accommodation in those hospitals nearer to the standards which are being set nationally. At the moment, it does not have the resources to do so.

There are other psychiatric hospitals in Morpeth, one with 900 beds and the other with 750, and similar problems are confronted there. The community health council has drawn attention to the serious under-funding in the psychiatric hospitals. It claims that the Prudhoe Hospital is under-funded by £1 million a year on current revenue allocation and that St. George's hospital at Morpeth is £750,000 short.

In order to draw attention to these particular difficulties as part of the general problem, I raised the matter at Question Time on 22nd November. I put the issue to the Minister of State asking him about the psychiatric hospitals, and he told me about his response to the representations which he had received from many quarters. I then asked:

"Is it not the case that under the region's revenue plan for the next two years betterment funds are being steered away from the Northumberland area, so that if essential improvements are to be made in these psychiatric hospitals it can only be at the expense of the other medical services in Northumberland, despite the fact that the hospitals serve the whole region?"

The Minister of State replied:

"The hon. Gentleman has got the wrong idea, because half of the betterment funds for this year going to the Northumberland Area Health Authority have been directed towards psychiatric hospitals. In any case, the region is a receiving region under the Resource Allocation Working Party formula and is therefore likely to enjoy a growth rate of at least 2 per cent. on current forward projections for the next decade. Therefore, the second point raised by the hon. Gentleman is not true either."—[Official Report, 22nd November 1977; Vol. 939, c. 1302.]

Of course, half the betterment funds for the Northumberland area went to the psychiatric hospitals this year. It was the only way the area health authority could seek to make any progress at all. But the work it has done in the psychiatric hospitals this year brings revenue consequences in the two years about which I asked the Minister. I did not ask what the area had had this year. I asked about what the region proposed to do for the area in the next two years. There is no way in which the area health authority can continue to stand by the psychiatric hospitals as it did this year with the resources which will be available to it in the next two years.

The second point on which the Minister claimed that I was wrong, when he seemed to assert that the 2 per cent. growth will be available to the area in the next year, still stands. The truth is that the 2 per cent. will not be available to the area at all. The region gets a 2 per cent. allocation, but it is expected that in the next year only less than 1/2 per cent will be available to the area health authority, and over the two years only little over 0·9 per cent.; which is less than the nationally expected rate of betterment and less than half the level available to the region.

The share of regional betterment funds going to the Northumberland area has been drastically reduced. The figure is apparent from the proposals made by the region in 1976 for these two years. It was then proposed that Northumberland should receive 13·1 per cent. of the regional betterment funds. It is now proposed that it will have only 3·5 per cent. There has been a large shift of emphasis in the use of regional betterment funds towards providing for the revenue consequences of major capital schemes such as the Freeman Road Hospital in Newcastle and other facilities in places such as Darlington, in some of which the problems of the National Health Service in terms of waiting lists are less severe than they are in the Northumberland area and in which levels of provision are such that they do not justify so drastic a switch of funds from an area which is at present so weak.

In other words, I believe sincerely that I was right to say that betterment funds are being steered away from Northumberland. Certainly, everybody working in the National Health Service in the Northumberland area believes it.

It follows that the psychiatric needs cannot be met out of betterment funds. I quote now from a letter sent to me—before I asked my Question—by the area administrator of the Northumberland Area Health Authority. He says:

"Our complaint is that the revenue planning assumptions adopted by the Regional Health Authority last month are markedly different from those published last year. Northumberland's figures have been reduced from £374,000 to £139,000 for 1978–79 and from £464,000 to £217,700 for 1979–80, with the result that the planning work done in the intervening year has been completely undermined.

"As one of the most underfunded areas in the Region, the Authority expected its betterment funds for 1978–79 and 1979–80 to be closer to the regional level of growth and certainly above the national level. In fact, it would seem that the Region intends that Northumberland should have less that the national level in 1978–79 with the effect of leaving the Area further from its target allocation than it will be at the end of 1977–78. Even the proposals for 1979–80 do not envisage North-umberland Area Health Authority being any closer to its target allocation than it will be at the end of 1977–78.

"In arriving at this decision the Regional Health Authority appears to have given no particular weight to the national policy of improving services for priority groups such as the mentally ill and the mentally handicapped. Had it done so, Northumberland, which provides so many of these services for the Northern Region, must have received a considerably larger proportion of the betterment funds available.

"It would also seem that the Region has effectively nullified the recommendations of the Resource Allocation Working Party report in that the funds made available for equalisation appear to have taken third place behind the wish to protect the revenue consequences of capital schemes and the needs of the regionally managed services."

The area administrator goes on to say that there has been no consultation with the area or its officers on any of the matters which he has mentioned, and he adds that his authority has requested an urgent meeting with the regional health authority. I understand that this has now taken place.

What will be the consequences of this financial situation. First, it is plainly impossible to do much to improve the position in the psychiatric hospitals, and this at a time when other areas within the region which do not carry our large responsibility in the psychiatric field can spend their betterment funds quite freely on the general medical services. North-umberland hoped that by spending quite a hit of its money on the psychiatric hospitals last year it could have turned its attention in the next two years to some very pressing problems in the other fields.

But if one tries to deal with the psychiatric problems, other very necessary projects become threatened. One of the projects which is threatened is one of the most hopeful signs that we have seen in the Health Service in our area in recent years. I draw the Minister's attention to the fact that one of the projects which will be threatened by this would be the new orthopaedic wing at Ashington Hospital, which serves my constituency. I remind the Minister that the orthopaedic wing of Ashington Hospital has one unique feature about it. It is the only case that I have come across in recent years of an administrative block in the Health Service being turned into a ward block, rather than the other way round. It is a very commendable and necessary project. There are severe orthopaedic waiting lists in Northumberland and there is serious under-provision in that sphere. If the costs arising from that project cannot be met, it will not be able to open as expected. With the problems in the orthopaedic field added to in other ways, that is very serious.

I remind the Minister that Northumberland's request for a third orthopaedic surgeon in 1978–79 has been rejected in favour of Durham—a district of much smaller population which is already better served. There is even doubt about the provision of alternative orthopaedic beds for children from Northumberland who are being treated by consultants from Northumberland once the Sanderson Children's Hospital in Newcastle is closed.

It is not simply that. If the Ashington orthopaedic project, of which I very strongly approve, does not go ahead, it will hold up increased provision for general surgery because the reallocation of physical resources in Ashington was going to provide for that. We shall have lengthening waiting lists, which are already serious, in general surgery if this is not done.

As well as those problems, it is well known that there is insufficient geriatric provision in Northumberland. The revenue needed to run the new block to replace Castlegate Ward in Berwick seems to be threatened again if the financial allocations remain as they are. In Berwick we have an old workhouse building which is to be replaced by a new geriatric block with more beds in it. It will inevitably cost more to service because of its larger occupancy. It is a very necessary project for which the area has been fighting for a long time and which was inherited from the previous regional hospital board. We have been working for this for a long time. If the running costs of that are to be threatened, the under-provision in our area will be made worse.

Perhaps the most serious matter of all is that the nursing staff in several Northumberland hospitals are well below acceptable numbers. The strain on this hard-pressed nursing staff is appalling. It is a miracle that they manage to cope. They cannot achieve the standards which they want to achieve and which they have been trained to achieve if they are filling in for the jobs of two people in their particular hospital.

I receive very moving tributes from constituents who have been in hospitals in my constituency, such as Berwick, Alnwick and Rothbury, and in Ashington Hospital, to which many from my constituency go, to the dedication, skill and care of the nursing staff. But the constituents say "Cannot something be done to provide more staff? These nurses have far too much to do. They are having to cope with far more than is reasonable." The constituents, who pay particular tribute to the nursing staff, point to the inadequacies of present staff levels.

The Minister may well know that in the current year there had to be imposed something of a moratorium on nursing appointments, on overtime and hours worked by part-time staff, which has presented very serious problems. It is hoped that this may be able to be relaxed increasingly, but a complete embargo had to be brought in on new appointments in the area. No overtime could be worked, except in cases of sudden emergency, without the express permission of the area nursing officer.

It is also the case that recruitment of good youngsters into nursing in an area of high unemployment has had to be held back. The number of nurses in training in Northumberland has been drastically cut. There are very good youngsters who want to go into nursing both in the general field and in the psychiatric field At a time when good school leavers are available, it really is a great tragedy, as I know the Minister himself will feel, that we cannot be taking some of these keen, good youngsters into nursing and giving them the training.

All this falls far short of the objectives which the Minister has held out to the poorer areas in the National Health Service. I cannot believe that he is happy about it.

On page 4 of "The Way Forward", which is the document in which the policy is set out, there is a very significant phrase:

"It will be particularly important to redistribute within regions in keeping with the national approach".

That is what I am arguing to the Minister is not happening within the Northern Region.

I put two points to the Minister by way of conclusion. First, I very much hope that he can do something with the new resources which the Chancellor of the Exchequer is seeking to make available to the Health Service to remedy the problems that have been described. Much of those new resources is committed to capital projects, which will give something of a boost to the construction industry. There are many desirable projects not just in Northumberland but throughout the country that one wants to see go ahead. I believe that some of that money is available for revenue raising and could be used for betterment purposes. I hope that the Minister will try to see that these resources and any new resources which an improvement in the economy can bring about will find their way into an area which is seriously under-provided.

I put a second point to the Minister. It is not sufficient—I hope that he will not seek to do so—to argue that this is simply a matter for the region and if the region feels that it is necessary to steer its funds in some other way, we must leave it at that. I hope that he will involve himself personally in trying to ensure that his national policy is carried out. I repeat the phrase:

"It will he particularly important to redistribute within regions in keeping with the national approach".

The regional health authority is not an elected body. It is not responsible to the electorate, as is a local authority. The Minister cannot say, as his right hon. Friend the Secretary of State for the Environment could say, "I have allocated the money via the rate support grant. Now it is up to the local authorities to decide how they spend it". It is not that kind of a system. It is a system in which the Minister himself retains a great deal of responsibility. Moreover, the Minister is dealing with a regional health authority none of whose members comes from anywhere near my constituency. There are no members of the regional health authority who live in or near the part of Northumberland area whose interests I am representing today. Its ability to make wrong decisions about the Northumberland area has been well illustrated in the past, for example, when it set out to amalgamate ambulance stations. I am glad to say that it has seen the error of its ways. But it is an illustration that the regional health authority is a remote body and one that does not have the same kind of direct democratic responsibility to the areas about which we are concerned, which would obviate the necessity for the Minister to take a hand in this matter himself.

I believe strongly that if the policies to which the Minister is committed, in the execution of which he and his right hon. and hon. Friends have devoted a great deal of effort, are to be carried out, and if an area which is now under-provided for, with very serious needs, is to be improved, and if there are to be any improvements at all over the next two years, he must take a hand and try to ensure that the national objects of equalisation are carried out in the Northumberland area.

I think that it is important front time to time to consider these matters of funding the Health Service. It is a matter of considerable complexity, and it might help the House, therefore, if I explain, first, the background to current methods of allocating resources in the national context. I shall then move on to explain the position as it affects the Northern Region and, in particular, the Northumberland Area Health Authority. In doing so, I hope that I shall be able to explain to the hon. Member for Berwick-upon-Tweed (Mr. Beith) why it is that I shall not be taking a direct hand in the decisions of the Northern Region in the allocation of funds, in the way in which he asked me to do in the concluding part of his speech. I hope that at the end of my remarks he will have a better understanding of how ministerial influence is exercised on these matters.

Perhaps before going any further I should reassure the hon. Gentleman that I have no information which leads me to believe that the Ashington Hospital orthopaedic block, which was a particular matter that he raised, will not open in April 1978, as is, I think, currently planned.

I turn to the main theme. The hon. Gentleman is quite right in saying that the Government are committed to a fairer sharing between regions of the resources available for hospital and community health services and to remedying the even greater deficiences within the regions Last year we received the second report of the Resource Allocation Working Party, which was set up with members from the Department and various disciplines in the Health Service. It advised my right hon. Friend and myself on principles and methods for allocating capital and revenue resources to the National Health Service authorities on as objective and fair a basis as possible and according to the health care needs of their populations. We accepted the recommendations. They were used as a basis for distributing resources in 1977–78—that is, the current financial year. It is our intention to continue the process for 1978–79.

The measures of relative need obtained by using the working party's suggestions are an indication of how the available resources should be distributed among health authorities in proportion to relative needs. Obviously it will not take place overnight. The imbalance of the past 30 years, or perhaps of the past 100 years, cannot be corrected at a stroke, to coin a phrase. We must do all we can to direct as much of the additional resources available for the health services to the more deprived regions and areas, but the pace of change should not be so fast as to put at risk essential services which already exist in the better-provided regions. This includes the teaching hospitals, which are helping to provide the doctors and dentists of the future in the hon. Gentleman's constituency as well as in any other.

It is common ground between us that the Northern Region is one of the most needy regions in terms of the resources available for health care services. On the basis of the RAWP report, the Northern Region was the third most needy region in England for the financial year 1977–78 and we gave it an increase in resources of about 3 per cent. in real terms, which was more than twice the national average. This meant that the Northern Region received about one-seventh of the total of additional revenue resources available for the health authority services in the current year. Earlier this year, the region was told that it should plan on the basis that, for the next two years, it would receive an annual addition to its revenue funds of about 2 per cent., based on a growth of revenue resources for England of 1 per cent.

It is up to the regional health authorities to make allocations of funds to the area health authorities in their regions. Regional health authorities have been asked to apply the same principles to allocations to the areas within their regions as we as a Department apply to allocations to the regions. The RAWP said that the pace of change within a region must depend on local circumstances, including the plans for the development of services in the regions and as resources become available. The actual use made of the available resources must, therefore, be related to national and local priorities.

How did the Northern Region set about allocating its funds to the areas? It might be helpful if I go through the history of the methods used by the regional health authority. At the beginning of this year, the Northern Regional Health Authority published its strategic plan for the next 10 years and explained its revenue planning assumptions for the years 1977–78 to 1979–80. My Department had issued details of revenue planning assumptions for each region in May 1976 based on the White Paper, Cmnd. 6393, which represented the Government's view of the future level and distribution of public expenditure. They were not commitments but were described as assumptions which might be made as the basis of forward planning.

The region worked out a target for each of its areas based on the funds available to it. This obviously showed that some areas were above the regional average and others, including the Northumberland Area Health Authority, were below the regional average. The region made the assumption that the below-average areas would receive the major share of the additional resources available.

But the Northern Regional Health Authority had to remember that there was a substantial programme of major developments to be commissioned during the period to 1979–80 and beyond. These developments included major schemes at Freeman Hospital, Newcastle; Darlington Memorial Hospital; Sunderland General Hospital; the Newcastle Dental Hospital and School; the South Cleveland Hospital. The regional health authority considered that the impact within the region of the revenue implications of these schemes was so great that it would be unrealistic for it to disregard this factor in deciding allocation principles for the next few years. It had to take a view, therefore, as to how much of the betterment funds—that is, the increment of additional funds in any year compared with the preceding year—should be earmarked for revenue consequences of capital schemes.

The RHA decided for planning purposes that in the year 1977–78, 75 per cent. of the betterment funds should be earmarked for revenue consequences of capital schemes, reducing to 70 per cent. in 1978–79 and to 65 per cent. in 1979–80.

On this basis, the regional health authority planned to allocate to Northumberland AHA in 1977–78 £21,000 for revenue consequences of capital schemes, plus betterment funds of £319,000. This was to be followed in 1978–79 with £124,000 for revenue consequences, plus betterment funds of £240,000 and in 1979–80 with £41,000 for revenue consequences, plus betterment funds of £423,000. These capital schemes in the Northumberland AHA were not for major developments. These figures were published in the regional strategic plan in January of this year.

In February of this year my Department issued further guidance to regional health authorities on revenue allocations for hospital and community health services and at the same time informed each region of its revenue cash allocation for this year. That resulted in further future adjustments.

First, it was recognised in the further guidance that even in the regions receiving the biggest increases this financial year would be a year of consolidation rather than development. So in March 1977 the regional health authority published its recommendations for the allocation of revenue funds this year including several refinements.

The first of the refinements was that the cost of providing for revenue funding of major schemes and certain other developments of regional significance should be a first charge on the allocation to the region and funded specifically to the areas. The remaining betterment funds were allocated to areas on the basis of the distance of the actual allocation for the previous year from target allocation. Every area is given a target to which it must move gradually over the years. This element of the allocation apportioned a sum directly and solely in proportion to the degree of deprivation revealed by the comparison of the actual allocation with the target allocation.

The second refinement was that all the additional revenue consequences of the smaller capital schemes this year should be met by the area from its total revenue allocation. This was considered feasible because the total sum available for developments was considered to be sufficiently large to ensure a substantial increase in allocation for almost all areas.

When these refinements were put into operation the region calculated the allocation of betterment funds to Northumberland as £341,800 for 1977–78. This included £40,000 towards the revenue consequences of minor developments at Ponteland Health Centre and the upgrading of a villa at Prudhoe Hospital. The final proposed revenue cash allocation for Northumberland reached about 88·63 per cent. of its target.

I have explained the history of methods used for the calculation of the planning assumptions of the regional health authorities up to March this year so that the hon. Member might understand the background to the current position. I hope that it has not taken too long, but I think that it will have been useful.

In May of this year, my Department followed up its earlier advice by issuing a circular giving planning guidelines for 1977–78 together with revenue planning assumptions for 1978–79 and 1979–80, based on the public expenditure projections contained in what is now Command 6721. Again, the regional health authority studied the guidance given by my Department and examined the various methods of distributing the additional funds. It came to the conclusion that account had to be taken of certain commitments for the two years about which we are talking before it could calculate the distribution of betterment funds to areas.

Those commitments were the needs to fund certain schemes commencing during 1977–78, to fund the consultant and senior medical staff expansion programme, to fund the regional training programmes and, finally, to fund the development of the Northumbria ambulance service. But these commitments, of course, had the effect of reducing the balance of betterment funds, so that further assumptions were required. The regional health authority realised that its policy of using 70 per cent. of the additional funds to meet the revenue consequences of capital development in 1978–79 and 65 per cent. in 1979–80 would not redress inequalities between areas as quickly as if the distribution had been based solely on the recommendations of the Resource Allocation Working Party, but it considered that it was necessary to give support to the additional running costs arising from these developments.

In addition, the regional health authority was able to assess target allocations for all its areas on the basis of the national average rather than the regional average. This showed that all the areas in the region were below the national average and that, therefore, it would be appropriate to plan to remedy the deprivation in all its areas rather than in only the more deprived of them.

The regional health authority met in September and considered a paper prepared on the basis of revenue planning assumptions for 1978–79 and 1979–80. It decided to adopt these proposals, and area health authorities were subsequently advised about their revised planning assumptions for the next two financial years. As a result, the Northumberland Area Health Authority was given allocations of £139,000 in 1978–79 and £217,000 in 1979–80. Even over the past 12 months there has been a continually changing situation, and the resource assumptions for the future were adjusted in the light of the events. But in no sense can it be said that betterment moneys are being steered away from the Northumberland Area Health Authority, because it has been allocated betterment funds on an increasing scale for the next two years. There are other factors which the hon. Gentleman mentioned in his speech, and we shall certainly consider those as well.

We are now getting to the nub of the argument, because clearly what concerns the hon. Gentleman and the Northumberland Area Health Authority—this is, what the hon. Gentleman said today and not what he said in his supplementary question on 22nd November—is not that the funds now available to the area health authority are to be cut, because they are not. In real terms, the authority will receive an increase in revenue in the coming financial year. The real concern is that its expectations have been drastically reduced, based on the planning assumptions given in 1976. That was not what the hon. Gentleman said in his supplementary question on 22nd November, but that is what he really wanted to say. If I am correct, I think that I have considerable sympathy with him.

To be fair to the regional health authority, it should be said that when it issued its planning assumptions in 1976 to the area health authorities it was stressed that they were tentative and could not be regarded as commitments. It was also made clear that they might be subject to further refinement following consideration of the final RAWP report. It was also made clear that some changes in figures issued only on planning assumptions were inevitable and could be significant.

As I have already mentioned, it is not yet possible to indicate the revenue allocations that will be made to the regions for 1978–79, but the Northern Region will receive a share of the £10 million revenue money which the Chancellor of the Exchequer made available to the NHS in September after representations by the regional health authority to consider its allocations.

I am listening with interest to what the Minister is saying. I hope that he will avoid using the word "refinement" when referring to a reduction from £364,000 to £139,000. Let us not mince words. It is not simply a variation of expectations: it is a very drastic reduction.

It is a reduction in assumptions, but in actual fact the area is to get more money next year than it gets this year. It is equally important to put that on the record. There has been talk about steering betterment money away from the area health authority. Betterment money will go to the area health authority. However, if the hon. Gentleman is complaining that the authority is not to get as mach as it at one time hoped, that is a different matter. As I have said, I have great sympathy with him.

The hon. Gentleman also said that expenditure on psychiatric hospitals can be only at the expense of other medical services in Northumberland. That is a very positive emphatic statement and there is not a great deal of room for qualification. As I have just said, Northumberland's funds are growing—marginally maybe, but growing. Therefore, the extent to which betterment expenditure on psychiatric hospitals is at the expense of other medical services is a function entirely of the size of the betterment programme. Except in the most generfil sense, of course, £1 spent on the Northumberland psychiatric service is £1 which cannot be spent anywhere else in the NHS.

Since the last-mentioned allocation of £10 million was made, the Chancellor has made £400 million available to the construction industry, of which £38 million is being made available to the NHS. In the next financial year £2·3 million of that money will be made available to the Northern Regional Health Authority. Obviously there are limitations on the way it must be used. It has to be used to promote employment in the construction industry in the next financial year. It seems to me, however, that that money is tailor-made to spend on improvements to psychiatric hospitals. That having been said, the way that money is spent is a matter for local decision.

I have tried to explain how the allocations to Northumberland Area Health Authority's planning assumptions have come about. I fully acknowledge that this would be of little solace to the area health authority, and it does not help it to move more quickly to its target allocation. But this must be accepted all over the country in terms of restraint on the rate of growth to funds in the NHS.

That Northumberland is an underfunded area is not in doubt, and I know that the regional health authority is sympathetic to its problems and appreciates this fact. Whether the regional health authority has any room for manoeuvre between now and early in the new year when firm revenue allocations are decided is another matter. However, I know that the regional health authority will consider very carefully the case being presented so forcefully on Northumberland's behalf by the hon. Gentleman today.

The Northumberland area management team met the northern regional team of officers on Tuesday of this week to explain Northumberland's problems in financing and improving its health services. Today, member representatives of the area health authority are meeting the regional health authority, and I am assured by the regional authority that they will receive a careful hearing.

My own officials, as part of their normal duties, monitor the allocations made to areas within the regions. I have arranged that they will consider and discuss with regional health authority officers the planning assumptions that have now been issued. I personally want to be assured that the revenue allocations being planned for the areas, particularly in a gaining region, are as equitable as possible, bearing in mind, of course, the serious limitations imposed on the Northern Region because of the substantial capital developments coming on stream in the next few years.

In other words, I feel that Northumberland probably needs to move towards its target allocations at the fastest possible speed. In the ultimate, however, as long as the Northern Region can conform with the guidelines that we as departmental Ministers issue, the final decision on how fast that pace should be is a matter for the Northern Region. I am sure that the region will take into account the things that the hon. Gentleman has so forcefully said this morning.

It is good of the Minister to be here today. I would not keep him from his holiday but for a very serious matter—that is discrimination against Liverpool Airport. It has been going on for some time. I am sure that it is not something on which his Department has a conscious policy, but it is there nevertheless. No one quite knows what the Department's policy is towards Liverpool Airport. We have been waiting quite a while to find out, because the White Paper on airport policy has still not been published. It was promised for last spring, then for the autumn, and we now are told that it will be available in January 1978. I understand that the Minister has run into problems, and I do not begrudge him the extra time, but the uncertainty causes its own problems.

The discrimination is part of a total Government approach against Liverpool. It may not be an intentional discrimination—we do not know—but the pattern is roughly as follows. The Government make a great song and dance about what goodies they are bringing into Liverpool. There are Press conferences, statements and walkabouts. Naturally, these attract a good deal of attention, and while all that is going on they slide out other decisions under the sort of smokescreen that is created.

Consider the rate support grant. On the face of it, Liverpool is getting about £300,000 more next year. But no one mentions that improvement grants will be more than £4 million less than in 1974, that council house improvements are £2 million less than last year, or that the local authority fund for mortgages for the purchase of old houses is down £3·2 million on 1974. In this context the partnership arangements, which will bring £5 million more to Merseyside and Liverpol in particular, are merely to offset the losses.

If the Government intended the special development area status to give Merseyside a new lease of life, surely they would insist that the 2,100 acres of derelict land in Liverpool should be sold off, albeit by public auction, because 60 per cent. of the inner city's derelict land is owned by the local authority and by nationalised industry. Instead, however, the Government are moving jobs away from the inner city to the outskirts of the town. A total of 80,000 jobs have been moved out of the centre and 100,000 have been created on the periphery. All this contributes to the movement of industry from the inner area to the outskirts.

Last year 15,000 tons of freight was shipped from Liverpool Airport, in spite of its disadvantages, which is double the amount shipped through the East Midlands Airport and is second only to the figure for Manchester Airport.

I am told that Speke Airport is willing and ready to expand its freight side if only the Government will give a lead to developing derelict land in the inner area, establishing small firms and industry and allowing this natural asset only five miles from the city centre to be developed and expanded. There is no doubt that, while one Government Department realises the problems of Merseyside and offers a few extra coppers, another Department pulls the carpet from under Liverpool's feet.

But it is not only Government Departments that are at fault. The trouble also lies with many of the quasi-official organisations for which the Minister cannot or will not answer. But make no mistake about it: they are part of a conspiracy to run down Liverpool. This becomes clear when one considers the part that those organisations are playing. Take British Airways. There are three return flights a day between London and Liverpool but there are 10 from Manchester, to be increased by one next April. British Airways has no figures to give evidence of losses at Liverpool and gains at Manchester. I am told by people at British Airways that things are going well and the Liverpool service is making a profit. Subsequently, however, I am told that it is making a loss. Will the Minister get the facts and figures to determine whether there are losses or profits?

I have heard it rumoured that £900,000 was lost by British Airways in the manoeuvring from Mancheser to the outer regions. That loss may be £9,000 or £90,000, but it appears to be a loss which relates not to Liverpool but to Manchester.

Then there is the question of punctuality. Liverpool-to-London flights should take 45 minutes by jet, but the jets have recently been replaced by Viscounts, so that instead of having a fast, streamlined jet service we have 10-year-old planes trundling over the runways and taking much longer. This makes the service far less competitive with rail, and people think twice about paying double the cost to travel by plane. The timing by rail is much tighter and the differential is closer.

Take a typical month, which was last July, when nearly every day one of the three 'planes arrived late. Some aircraft were 40 minutes late, some 50 minutes and some over an hour late—and all this on a 45-minute journey. In a letter from British Airways, I was told that in June this year 79·4 per cent. of 'planes arrived within 15 minutes of their scheduled time, but on a 45-minute journey that represents one-third of the time. That is a damning record, and it has nothing to do with what is going on at Speke itself.

The airport prides itself on the speed with which it can turn the 'planes round. It is a most efficient organisation which is run almost as a family concern. There is very great pride among the men in getting the 'planes turned round fast if they arrive late. This friendly family concern is an organisation in which everyone pulls his weight.

On 16th and 17th March last, 33 aircraft arrived at Liverpool from St. Etienne. The Minister may recall that we had a debate on this in the early hours one morning, and I take this opportunity to remind him that 2,528 passengers passed through the terminal in each direction. As for the aircraft, TriStars and 707s were all accommodated. Speke could have better facilities, I suppose, but it coped that day.

If only one 'plane can fly to either Manchester or Liverpool, it is always the Manchester 'plane that gets off and the Liverpool 'plane that is cancelled. During the recent strike by air traffic control assistants, the Liverpool flights were written off while the Manchester flights were continued, albeit on a decreased scale.

The discrimination is even more glaring when one considers the numbers of people turned away at London because 'planes are full. I mention the 4.25 flight from London. It is often full, and so many people were being turned away that British Airways said that it would put on a Trident to take the load. It has not yet materialised, yet the promise was made a year ago. People are still being turned away and revenue is being lost. British Airways has told me in a letter that it is ready to increase the service to Liverpool if there is evidence of demand. What more evidence does it want than to have to turn people away?

There is then discrimination in local newspaper advertisements. "Fly to Manchester", they say, but it is only in a small footnote that one learns that one can fly to Liverpool as well.

Then there are little touches. A hot breakfast is served on the Manchester flight, whereas passengers flying to Liverpool get only a cup of tea. The timing of the flights seems to have been chosen for inconvenience. There is a 10-hour gap during the day during which nothing flies to Liverpool, and at weekends there is hardly anything.

British Rail has been running identical hourly services between London and Liverpool and between London and Manchester for many years. It would not do that if it were not profitable. It costs less than half to go by rail. If British Rail can run identical services to the two centres, the Minister may well want to consider why British Airways does not do the same.

The plot thickens a little when one considers the Civil Aviation Authority. it is clearly aiding and abetting British Airways. I can remember that for many years the fares between London and Liverpool and between London and Manchester had always been identical—that was, until this year. The Minister may remember that attention was drawn to the fact that there was to be discrimination a year ago as between the flights, but subsequently the CAA changed its mind and the fares remained the same for the last year. This year, it has done it without my knowledge and the increase has crept in under the floorboards. We now have an increase of £3·40 in the fare to Liverpool. The cost of a London-to-Liverpool return is £45·40, while a London to Manchester return costs £42.

The CAA, with which I have been in correspondence, has suddenly discovered, after a long time, that the air journey from London to Liverpool is a few kilometres longer than the journey from London to Manchester. It is amazing that it did not discover this before. Because it is further, the CAA says that it must charge accordingly. That might be a forceful argument, but the CAA has not replied to the rather damning evidence that the fare for the Manchester to Belfast return flight is £41 whereas Liverpool to Belfast return costs £41·80, although the air journey from Manchester is 30 kilometres further. The Minister will clearly want to ask the CAA why there is this discrimination.

Then there is the navigational service charge that the CAA makes. There is a difference between the charges paid by airlines for technical services at Liverpool and those at Manchester. Aircraft landing at Liverpool pay a higher fee than those landing at Manchester. Someone should explain why this is so. In fact, because of the efforts of the county council and the airport, that is to change, but we are always battling to get on an equal plane with other airports. I am sorry about the pun.

Then there is the anomaly of IATA fares. Flights to Canada, the United States and the Caribbean have the same fares if they are from Manchester, but from Liverpool the fare is higher. The fare from Liverpool to Miami is £42 dearer than from Manchester to Miami. If that is not discrimination, I do not know what is.

I hope that the Minister, while sorting out what goes on in the CAA and British Airways, will also look at the cost of aviation fuel. It is no good saying that the Government have no control, because their stake in North Sea oil is well known. Perhaps the Minister will be surprised to hear that the cost of jet AI fuel at Liverpool Airport is 10.1p. per litre, while at Manchester it is 9.9p. per litre. Airline companies uplifting a large amount of fuel from Manchester obtain a considerable discount, so it is not unreasonable that charter fares from Manchester are cheaper. Perhaps the Minister can see why feelings are so high on Merseyside.

In a recent answer the Minister suggested that my concern was a constituency one, but he was completely wrong. Speke Airport is not in my constituency. It is the concern of the whole region. It is in the constituency of the hon. Member for Liverpool, Garston (Mr. Loyden). I cannot see him in the Chamber, nor can I see any of the other Labour Members from Liverpool. I am slightly surprised that they have not felt this subject important enough to assist our discussion.

Liverpool Airport is prepared to compete on equal terms with any other airport in the country. The people there take pride in their work, but they cannot be expected to have the ground taken away from under them whenever they try to take fresh initiatives. The Minister knows that there are applications for licences from Aer Lingus. There are other applications in the pipeline, and I hope that he will have this debate very much in mind when he considers them. I underderstand that there is a possibility of a development of flights from Sydenham, in Belfast, with small aircraft flying to Speke. That link would be a remarkable achievement, and I hope that the Minister will take an interest in it.

The future of Liverpool Airport is in many ways symbolic of prosperity for the people of Merseyside, who see dereliction and decline all around them. Surely, one rôle of the Government is to raise up people, give them hope and let Speke Airport take off from the ground.

I congratulate my hon. Friend the Member for Liverpool, Wavertree (Mr. Steen) on a brilliant exposition of the clear discrimination against Speke Airport. My hon. Friend the Member for Wallasey (Mrs. Chalker) and I have come here to listen attentively to these accusations because we are very concerned about the future of Liverpool Airport.

Why does the publication date of the White Paper on the Government's proposed airport strategy keep slipping away out of our grasp, rather like the date of the next General Election? On 5th July I asked the Minister when the strategy would be published and he replied:

"My right hon. Friend hopes to make this"—

a statement—

"in the late summer".—[Official Report, 5th July 1977; Vol. 934, c. 480.]

Then I heard from Merseyside County Council that the Minister had written to it saying that it would definitely be in the autumn. As we waited anxiously, I asked in November what had happened to the strategy and received the shocking reply:

"A White Paper will be issued early in 1978."—[Official Report, 30th November 1977; Vol. 940, c. 226.]

—not in January, but early in 1978. May we know the Government's intentions now? Can the hon. Gentleman please give us a definite date?

I hope that in replying to the debate the Minister will not hide behind the lack of any statement on airport strategy. In view of the clear evidence of discrimination against Liverpool Airport presented in this debate, as he is the guardian of aviation policy, will he not hide behind the narrow cloak of his responsibilities? There is evidence of a conspiracy against Liverpool Airport. Will the hon. Gentleman undertake to investigate the very important issues raised today?

Speke Airport is essential for Liverpool and Merseyside. Will the hon. Gentleman promise to set up an inquiry into the clear evidence of shameful discrimination against Liverpool Airport, which has been so cleverly and brilliantly exposed today by my hon. Friend?

The hon. Member for Liverpool, Wavertree (Mr. Steen) has conferred, somewhat predictably, his Christmas gift on the House. He is an indefatigable supporter of Speke Airport. I understand the hon. Gentleman's anxiety not to be rendered Speke-less—if he will forgive me.

That is a cracker.

I shall first refer to the question touched on by the hon. Member for Wirral (Mr. Hunt) because it goes to the heart of the problem. That is the question why the White Paper on the Government's strategy has not yet been published. I hope that the hon. Gentleman will realise that when the Government embarked on this widespread process of consultation we did it after giving a great deal of thought to the choices facing us. We had to decide whether to impose a policy from Whitehall or to allow everybody—or most people who might wish to do so—to offer a view about a national airport strategy to remove the present chaos so far as airports in this country are concerned. If we were to do that, we were bound to take time.

Even until the past few weeks we have been hearing from people who wanted to make contributions, often important contributions such as those from the Highlands and Islands and local authorities in certain areas. Perhaps they should have made their contributions earlier, but I do not think it would have been right to reject them.

I understand the anxiety that this waiting period has produced. I said at the outset that this would happen. I am sorry that there has been this slippage, but the consultation period is now over and Ministers are considering a draft White Paper. I have every reason to hope that it will be issued in January, but, because I have learned from past difficulties over speculating on a date when, or even a quarter in which, it might be published, I am over-cautious and have said "early in the new year".

The hon. Member for Wavertree and the hon. Member for Wirral invited me, despite the fact that the White Paper has not yet been published, to prejudge the issue, but I cannot do that. I shall comment on some of the specific points which have been raised, but I do not propose to divulge to the House my Department's thinking on the matter, because the Government strategy is not a matter solely for my Department.

The hon. Member for Wavertree has in the past, and also in his remarks today, drawn attention to the importance of Liverpool Airport to the economy of Merseyside and to the uncertainty which the current position of Liverpool will mean for that area. I am anxious that that position should be resolved as soon as possible, and I hope that my words today may be of some comfort in that regard.

The hon. Gentleman at the beginning of his speech mentioned issues on which I have no expertise and which are unrelated to Liverpool Airport. He sought to establish that there was a conspiracy, as he put it, to run down Liverpool. I regard that as a fanciful and somewhat hyperbolic argument. The hon. Gentleman's enthusiasm for Liverpool, which he has been proud to flaunt before the House on numerous occasions, is something to which he is entitled, and, indeed, it is shared by Liverpool Members on both sides of the House. Liverpool is a great city, and they are entitled to be proud of it.

The hon. Gentleman asked me to establish an inquiry into the subject of discrimination. I do not know whether it is to be carried out under the 1921 legislation.

That would do.

I must reject that suggestion at once. We have already one matter under that procedure in operation. We must not take up too much of the judiciary's time on that sort of matter.

I shall take up some of the points which the hon. Gentleman raised with British Airways. I do not believe that British Airways is engaging in a campaign of discrimination but, since the hon. Member has raised the matter, I feel that British Airways should be able to respond to those points in detail—points on which I am unable to have a ready answer this morning. Indeed, those matters are not even within my Department's area of responsibility, because they fall within the commercial judgment of British Airways.

I should like to advert to the matter of aircraft arriving late from Liverpool Airport. I do not know whether the hon. Gentleman is seeking to establish that Liverpool Airport is being selectively discriminated against in that regard. I arrived back from Singapore recently and arrived three hours late at Heathrow.

The point is that when a short domestic flight arrives a quarter of an hour or half an hour late and the total journey is only three-quarters of an hour, that is a very different matter from arriving two or three hours late from a destination across the globe. I would say that there is discrimination against those who travel to Liverpool Airport. For example, when two flights are arriving from Heathrow to Manchester and Liverpool invariably the flight to Liverpool arrives later than the other.

Always.

I agree.

The hon. Gentleman makes an assertion and I shall examine it. On the topic of aircraft arriving late, he will be aware that British Airways has had difficulty with its Trident fleet. Happily, the situation is gradually being resolved. But it has been a serious matter affecting British Airways, and it is right that in the interests of safety that body should have taken the action that it took. Some of those aircraft were withdrawn, and it has had a serious effect on the services provided.

The hon. Gentleman in his intervention said that it takes a longer time to travel from Liverpool to London I would remind the hon. Gentleman that that journey is slightly longer than the flight from Manchester to London.

I think the Minister has missed the point. It is also a matter of costs.

I am coming to that matter. The hon. Gentleman went on to accuse the Civil Aviation Authority of aiding and abetting British Airways in this appalling conspiracy. I cannot comment on the Manchester to Belfast or the Liverpool to Belfast situation. It is a matter which the CAA will examine if there is an anomaly, but it is the CAA rather than the Department of Trade that deals with the subject of fares. I gather that the CAA when investigating this matter decided that there should be this disparity, for the reasons mentioned by the hon. Gentleman.

The hon. Gentleman also mentioned the matter of distance. That was the reason which motivated the authority in doing what it did in terms of disparity.

The Minister has got it wrong and he has the distances wrong.

If I am wrong, no doubt the hon. Gentleman will pursue the matter further with me, but essentially it is a matter not for me but for the CAA.

The hon. Gentleman from time to time when making his case tends to overlard the arguments with a bit of emotion.

Why not?

The hon. Gentleman replies "Why not?" We now know precisely where we stand.

I am well aware of the views expressed to the Department about the study we have undertaken into employment on Merseyside. It would be inconceivable that my Department, whose Secretary of State represents a Merseyside constituency, should be unaware of the serious social and unemployment difficulties affecting that part of the United Kingdom. I know that it is argued by some that the airport confers great industrial benefits on Merseyside. That is not the view taken by everybody connected with this subject, and we must weigh the two arguments. I have already said that my right hon. Friend will be announcing his decision shortly.

As was made clear in the consultation documents, our objective is to provide an airports system that will encourage the development of air services in the regions. The over-abundance of regional airports has tended in the past to encourage the spread of services thinly, thus reducing their value to air travellers, and particularly business men. This dispersal of air services has also, to some extent, contributed to the use of London airports by travellers from the regions. I believe that the regions outside the South-East in general, and the North-West in particular, would benefit from a concentration of air services. It is not the Government's job to make airlines operate services which in their judgment are not commercially viable, but it is a matter for British Airways and other airlines that operate in this area. I hope that a clear lead from the Government in identifying airports for future development will go some way to assist the development of a wider range and frequency of services from the regions.

The terms of route licences, including fares, are matters for the CAA and not for me. In setting the terms of licences the authority must carry out its duties under the Civil Aviation Act 1971. Under Section 3(1)(a) of that Act services should be provided at the lowest charges consistent with safety and an economic return to efficient operators on the sums invested in providing the services.

The hon. Gentleman has complained, not only today but on previous occasions, about the slightly higher fare on the Liverpool-London route compared with the Manchester-London route. It is not simply a question of distance. It is also a question of cost. The costs of the Liverpool-London route are higher. Because of that, the previous situation, under which the fares of the two groups were equal, caused operators to lose money on the Liverpool-London route. It was a question of relative costs which caused the CAA to authorise this slightly higher charge.

I am sure that the CAA would wish me to rebut the allegation that it has aided and abetted this deliberate conspiracy on the part of British Airways. It is anxious for me to establish, or at least assert, to the House that it seeks to involve itself in no discrimination against Liverpool. That is also the view of British Airways. The authority merely licenses routes. It cannot initiate applications. The number and variety of routes from Liverpool will depend on the view that airlines take of the viability of such services. I am assured by the CAA—and this goes to the conspiracy argument—that it would treat all applications for new routes on their merits and in acordance with the policy guidance given to the authority.

The hon. Gentleman has in the past touched on the question of Aer Lingus services from Liverpool. The service that Aer Lingus apparently has in mind is a Dublin-Liverpool-Amsterdam service. I can confirm that an approach has now been made—it was forecast by the hon. Gentleman long before it was actually made—to the Department of Trade by the Irish authorities. But it presents us with a number of difficulties in relation to the interests of our operators and the fact that the service is not provided for in the existing air services agreement. The question is under consideration by the two Governments and the airlines concerned. I cannot give any possible indication of the outcome, but the hon Gentleman will realise that it is not a simple matter. We have to have regard to the operation of the air services agreement and the value that exists in running this additional service both for Aer Lingus and for British Airways.

The point is that whenever Liverpool tries to make its airport work and profitable, it is stopped. It has constantly gone out for new business and there is always an obstacle.

The points made by the hon. Gentleman will be taken into account in resolving this problem, but it is not as simple as that. That is all I ask him to acknowledge today. I will ensure that British Airways and the CAA are made aware of what he has said. However, I am sure that they read Hansard—although I do not know that a corporate body can read Hansard. But those who are its members can do so.

I am grateful to the hon. Gentleman, quite genuinely, for pursuing this matter, because it is by dint of the fact that hon. Members, local authorities and environmental groups have taken up the cause not only of their own local airports but of interests that sometimes are adverse to their local airports that we have been able to have such a balanced argument about our airports. As I said during the debate on the Consolidated Fund Bill on Wednesday, when I replied to a debate about services to the Highlands and Islands, the Government will not be able to please everybody, or anybody for that matter. It is a difficult determination to make.

We are trying to embark on a totally new strategy in this country, and we are justified in doing so. But constituency interests enter into the matter, and, quite naturally, hon. Members on both sides of the House fight for their constituency interests, even though sometimes they might collide with the national interest—I am not introducing the argument on Liverpool in this context.

That is the problem that faces the Government. I believe that it is our duty to bring out the White Paper, and that we should do it as soon as possible. I hope that the House will then find time to debate the serious issues which will affect the whole of the country under the considerations which the Government have been rightly obliged to give to this matter.

I am grateful for the opportunity to raise the question of the registration of acupuncturists and the control of their premises. This is a subject of great public importance in the context of health and safety.

First, I want to refer to the outbreak of viral hepatitis B, relating to the practice of acupuncture in the Birmingham area in the past few months. The area medical officer to the Birmingham Health Authority has reported upon 20 clinical cases of viral hepatitis B, all of them traced to the same acupuncturist. He states that he is not aware how many of them have been primary cases or how many have been secondary cases—silent carriers of the virus—but when I spoke to him on Tuesday he confirmed that there is a total of 35 cases and that he does not know where the chain will end.

Viral hepatitis B is one form of infective hepatitis transmitted by direct injection with infected blood or blood products. It usually has a long incubation period of between six weeks and six months, and carriers of the virus are often unaware that they are carriers. The fatality rate is high, and the infection may also be associated with progression to chronic liver disease, including liver cancer. It is a notifiable disease and must be regarded as a potentially serious one. That is why I am speaking today.

The medical officer claims that acupuncture, tattooing and ear-piercing can, if done by unskilled persons, cause serious outbreaks of the infection. I do not want to dwell too much on tattooing or ear-piercing, but he is concerned at what he considers to be the contribution that they make to the viral hepatitis virus.

The outbreak of viral hepatitis B related to the practice of acupuncture is just one instance where unskilled persons using unsterile instruments, and working in unhygienic surroundings can cause serious lethal hazards within the community. The practice of the acupuncturist to whom these cases are related is conducted in the front living room of his home. A mattress on the floor serves as a couch. There is no wash basin in the room. The state of cleanliness leaves a great deal to be desired.

On submitting himself to medical examination at the time of the outbreak, he himself was free of the disease, and it seems fairly obvious in the circumstances that he must have contaminated his needles unwittingly on a carrier, and then used them on other patients without adequately sterilising them, thus perpetuating the infection.

One of the difficulties about this practice was that the acupuncturist concerned kept no records at all of his patients, their visits, the dates, and so on. Obviously, this created difficulty in trying to trace patients and thus institute preventive measures. This outbreak of hepatitis associated with acupuncture came as no surprise to the medical profession, according to the medical officer in Birmingham, as the practice of acupuncture has not been regulated or checked in any way in this country. As he has told me, the medical profession can move in only when the damage has been done. That is a rather serious situation. When the authorities moved in, they were frustrated. They could not carry out a follow-up operation because of an absence of records of the acupuncturist's patients.

At present there is nothing that can be done to prevent a similar situation from arising. That is the gravity of the situation. There is no legislation to control the practice and practitioners of acupuncture—or is there? There appears to be some confusion. Government Departments are not clear. Some think "Yes" and some think "No". I refer to my Question in the House on 7th July when I asked the Secretary of State for Health and Social Services if he will introduce legislation to seek to compel the registration of acupuncturists and enfore proper standards of hygiene and safety in their practice." My hon. Friend, the Under-Secretary replied:

"My right hon. Friend does not consider that new legislation to introduce compulsory registration of acupuncturists would be justified. Application of the Professions Supplementary to Medicine Act 1960 can be extended to provide for the creation of a registration board for acupuncturists should they themselves seek this and should the Council for Professions Supplementary to Medicine and the Privy Council agree following consultation with existing registration boards for other professions registered under the Act."

I do not want to pursue that part of the answer in great detail. I want to base my submission today on the premises rather than the theoretical argument about the registration of acupuncturists.

The rest of the answer to my Question—which is the most important part—continues:

"Registration would not in itself ensure hygiene."

I accept that. I think that is readily understandable. The answer continues:

"A self-employed acupuncturist offering services to the public already has a responsibility under Section 3 of the Health and Safety at Work Act 1974 'to conduct his undertakings in such a way as to ensure, so far as is reasonably practical, that he and other persons (not being his employees) who may be affected thereby are not thereby exposed to risks to their health or safety '. Failure to comply with the provision of the Act can lead to prosecution which is the responsibility of my right hon. Friend the Secretary of State for Employment."—[Official Report, 22nd July 1977; Vol. 935, c. 754–5.]

On receipt of that answer I turned my attention to the Health and Safety Executive. First, I contacted the department in the West Midlands. I raised the issue of the acupuncturist and Section 3 of the Health and Safety at Work, etc. Act 1974. The reply that I received from the Health and Safety Executive of the West Midlands stated:

"The proposition that the Health and Safety at Work Act might be used to control the work of a person offering professional advice or treatment is a difficult one. On the plain words of Section 3(2) of the Act it would appear that a self-employed practitioner has a duty under the Act to conduct his undertaking in such a way as to ensure, so far as is reasonably practicable, that other persons are not thereby exposed to risks to their health and safety. This duty would appear to extend across the whole field of medical treatment and service as well as consultancies of all sorts. You will appreciate, therefore, that the issue is one of considerable importance.

The proposition has not been tested in law so that there is, as yet, no authoritative interpretation of the Section. The Health and Safety Executive is, however, actively considering its implications and I will bring your interest to the notice of the persons concerned at my Headquarters."

I have referred the content of my correspondence to the Health and Safety Executive at national level, but as yet I have not received a reply to my representations.

I say emphatically that this predicament must be resolved. The public cannot be so blatantly exposed to such health and safety risks. I know that there is a measure of disagreement about the practice of acupuncture. Members of the public have written to me to say that acupuncture treatment has helped them. A number of people in the Birmingham area have done that. I do not wish to disagree with them. I cannot adjudicate on the subject. Some people have said the opposite, and some are dubious. It is like many other issues that become controversial. I am not a medical man and I do not set myself up as an authority. I am merely concerned with the health and safety of my constituents and the public at large.

In the West Midlands there is one medically trained person, a doctor, who specialises in acupuncture. He is in full-time National Health Service general practice. He informs me in correspondence that he is against any form of registration of non-medically qualified acupuncturists. He seems to think that it will give them a standing of respectability within the profession that they have not earned and do not deserve. He says that the Medical Acupuncture Society, the local medical committee and the local branch of the British Medical Association take the same view. I can understand why my hon. Friend's Department takes that view. It is perhaps to be expected when the profession as a whole seems opposed to the registration of acupuncturists.

It is clear that to deal with the individual acupuncturist is a complicated exercise. Obviously, there is a great deal of resistance to registration within the medical profession. However, in my view, there is no reason why we cannot insist on clean and disease-free premises. The seriousness of the outbreak in the Birmingham area has led the county authority to include a section on the control of acupuncture in the West Midlands County Council Bill.

As I understand it, the Bill has already been deposited in Parliament. I have read the section relating to acupuncture, and the clauses seek to establish that there will be no practice of acupuncture in a district unless the practitioner is registered by the district council. Under the terms of the Bill, the district council may make byelaws for the purpose of securing the cleanliness of premises that are required to be registered as well as the instruments, materials, towels and other items. It concerns itself with the cleanliness of the persons employed in regard to themselves and their clothing. Appropriate penalties for non-adherence are included in the Bill.

The Bill is to be welcomed. It is positive and clear and meets a genuine need. No doubt the West Midlands County Council has included the acupuncture provisions in the Bill because of the seriousness of the situation in the West Midlands and Birmingham area. Nevertheless, the Bill contains 189 clauses covering a multiplicity of other subjects. It is primarily an exercise of consolidation. The tortuous journey through this place and the waylaying in another place constitute major hazards for any Bill, and certainly one with 189 clauses. The House will recall that the previous West Midlands Bill never got off the ground. It was a consolidation measure and parts of it were found acceptable and other parts were found to be unacceptable. On balance, it appeared that too many parts were unacceptable and the Bill was lost. In fact, it never got on its way.

Except for one local authority, I understand that authorities do not have bye-laws requiring the premises used by acupuncturists to be registered. There seems to be a great need for some urgent and positive Government action to deal with the problem. I raise that especially with my hon. Friend and his Department.

The area medical officer in Birmingham, in correspondence that I have had with him, states:

"There is no doubt that there is a rising reservoir of viral hepatitis B in this country The current incidence of acupuncture, tattooing and ear piercing only contributes to the bank of carriers. It is now accepted that hepatitis B is probably responsible for a very much larger proportion of chronic liver diseases than is generally regarded."

Perhaps the Government should investigate what I call the needle men—the acupuncturists, the tattooists and the ear piercers—and determine standards of hygiene and safety. Certainly—this is the most important matter in my contribution—there should be some control over non-qualified acupuncturists and some check on how many there are in the country at large. The Government ought to legislate in the interests of the health and safety of the public and not leave it to local authorities to decide whether to do something about the problem.

As I have pointed out, it is not easy for local authorities to acquire the byelaws that they need. Even those which have acknowledged the seriousness of the problem and want to do something about it face difficulties in getting the appropriate byelaws and powers through this House, I revert to the point about the differences between the Departments or the difficulty of one Department enforcing legislation which has been in operation since 1974. The existing legislation—Section 3 of the Health and Safety at Work, etc. Act 1974—must be activated and, where necessary, the premises of acupuncturists must be brought up to standard.

Order. I apologise fot interrupting the hon. Gentleman. It is only to let him know, in case he is under a misapprehension, that this debate must finish at quarter to two.

Thank you, Mr. Speaker.

If it is difficult to license practitioners, it seems that in the short term it will be easier, where there is legislation, to license the practice—the premises. I appeal for serious consideration to be given to activating this part of the Health and Safety at Work, etc. Act. I realise that this comes under the jurisdiction of another Department, but my hon. Friend's Department is concerned when people who attend acupuncturists' premises are exposed to risk. I submit that it is vital to tackle the control of the disease by reducing the opportunity for spreading it. The control of premises would be helpful in that connection. It would have a salutary effect on lay practitioners of acupuncture and would encourage a safe practice. Unnecessary exposure to this potentially dangerous disease is unacceptable, and it must be curtailed to protect the public.

I hope that the Department will take the outbreak in Birmingham—not yet concluded, because of the chain of silent carriers of the virus—as a warning and will take steps to introduce appropriate and effective legislation to deal with this serious problem. I ask my hon. Friend not to wait for further outbreaks before something is done. This is an urgent matter which requires urgent attention. I ask him to heed the warning and to act in the interests of the safety and health of many of our citizens before it is too late.

I am grateful to my hon. Friend the Member for Birmingham, Yardley (Mr. Tierney) for having raised this subject of considerable public importance. Indeed, he has given me the opportunity to dispel what seems to be a lingering misconception.

I know that my hon. Friend will be the first to accept that registration of a profession or of those who practise it provides no guarantee that it will be practised properly. I know that the analogy is not exact, but even the registration of motor vehicles does not ensure that their owners will keep them clean. The licensing of drivers, after they have been tested, may keep off the roads people who do not know how to drive. However, it does not prevent someone who has passed the test from driving recklessly.

My hon. Friend referered to the serious outbreak of hepatitis in the city of Birmingham. I am deeply concerned, as is my Department, that there should have been such a grievous outbreak of the disease in that city. Between May and October this year 36 cases of hepatitis, which were attributed to the practice of acupuncture, were reported in Birmingham. It is both understandable and proper that my hon. Friend, who represents a constituency from which some at least of these cases were reported, should have expressed his concern in this debate.

My hon. Friend expressed his concern previously and promptly when he put down a Question for written answer in July. There was concern in my Department then, as there has been on other occasions before and since, when techniques involving the piercing of the skin have caused hepatitis. Yet, as was said in reply to my hon. Friend's Question and to one from the hon. Member for New Forest (Mr. McNair-Wilson), I do not believe that the introduction of legislation to seek to compel the registration of acupuncturists will by itself remove the risk. It is not only acupuncture, unhygienically practised, which can cause or spread hepatitis. So, too, can ear piercing or tattooing. I hope that this will be as widely noted as it deserves to be, not least among young people. After all, hepatitis can be a most grievous condition. Unfortunately, even in the best regulated institutions, there are rare instances of infection notwithstanding the best preventive endeavours of those in charge. That does not mean that we should ignore the threat of hepatitis from unhygienic acupuncture, ear piercing and tattooing. We have to consider how best the threat can be countered and reduced.

I believe that legal powers already exist to provide for the inspection of premises and, where necessary, the prosecution of those who practise their professions in a manner which is a threat to health. Section 3(2) of the Health and Safety at Work, etc. Act 1974 imposes on an employer the obligation

"to conduct his undertaking in such a way as to ensure, so far as is reasonably practicable, that he and other persons (not being his employees) who may be affected thereby are not thereby exposed to risks to their health of safety."

The same obligation is imposed by the same section of the Health and Safety at Work, etc. Act on the self-employed. Failure to comply with this legal requirement can lead to prosecution.

I am firmly of the opinion that if local and health authorities, which are themselves equally subject to the Act, Co-operate with the Health and Safety Executive, the Act can be invoked to curb the activities of anyone who by the careless practice of his profession, occupation or craft, threatens the health of people using his services. My advice is that the Health and Safety at Work, etc. Act can be as effectively used to enforce hygiene in ear piercing and tattooing as it can be to ensure the sterilisation of the needles used in acupuncture.

The Government are prepared to consider whether general empowering legislation is desirable to enable local authorities to control the hygiene of acupuncture, ear piercing and tattooing establishments. However—my hon. Friend will no doubt take careful note of this point—we believe that there are remedies in the law as it stands. Nevertheless, everything said by my hon. Friend will be carefully considered by my Department.

The Health and Safety at Work etc, Act is, of course, of wide application and the inspectorate of the Health and Safety Executive is nessarily limited. In consequence, some local authorities may consider that other powers are needed to control the premises of people whose skills, carelessly performed, may lead to outbreaks of hepatitis. If a local authority comes to this view, it can seek powers to enable it to license the premises about which it is concerned. It can then impose conditions upon the licensing of such premises.

I am informed that some local authorities already have powers to control tattoo parlours. The West Midlands County Council, no doubt because of the very serious—and, I hope, not to be repeated—outbreak of hepatitis in Birmingham to which I have already referred, is seeking powers to require district councils to register acupuncturists and their premises and to make byelaws for the purpose of securing the cleanliness of such premises and of the persons employed in them. The Bill seeking these powers has already been presented to Parliament. My strong advice is, therefore, that high standards of hygiene should be required of and enforced upon anyone who offers services for which he charges and which may threaten the health of his clients or customers.

I am deeply aware that there are many people, including hon. Members of this House, who believe that acupuncture, if properly practised, has much to offer in the treatment of the sick. I shall not, therefore, limit my reply to this debate to my hon. Friend's concern about the uncontrolled practice of acupuncture as a threat to public health.

There are those who wish to see acupuncturists become State registered. Indeed, this is sought by the British Acupuncture Association and possibly also by other organiastions of acupuncturists. They believe that registration would give recognition to acupuncture as a medical therapy in its own right and permit its practice within the National Health Service by other than the comparatively few doctors who are now its practitioners. They believe also that it would enable the public who seek acupuncture treatment to distinguish between those who are qualified to provide it and those who are not. In this respect, what the proponents of acupuncture want and what my hon. Friend wants tend to coincide.

There are, however, difficulties, in registering the members of any therapeutic profession. These have been explained on a number of occasions in the past. This happened, for example, when my hon. Friend, the Member for Wood Green (Mrs. Butler), introduced a Private Member's Bill for the registration of osteopaths and also when Lord Ferrier, in another place, sought the registration and recognition of chiropractors.

We have a tradition in this country of self-regulating professions. It is initially for the professions to determine what is involved in the exercise of their professions, what training and qualifications their members require and what are the ethics and standards of practice demanded of them.

rose—

I am in some difficulty because of the time.

I am not sure whether the right Minister is present. Perhaps we should have both Ministers here, one from the Department of Health and Social Services and another from the Department of Employment. I do not wish to become involved in the long argument about the medical people themselves. I hope that my hon. Friend will make a bit of a noise about the fact that existing law on the registration of premises is not being activated.

My hon. Friend can be assured that my Department has the closest possible rapport with the Department of Employment. I am in some difficulty about the time.

I was referring to the question of ethics and the standard of practice. Under the National Health Service Acts, the paramedical professions must practise therapies which are

"based on a systematic body of knowledge, which may or may not be wholly scientific in character, which is compatible with the body of knowledge for the time being attributed to and acknowledged to be the basis of contemporary medical practice".

That is not a quotation from the National Health Service Acts. It is a quotation from guidelines published by the Council for Professions Supplementary to Medicine in its annual report for 1976–77. The council intends to follow these guidelines in considering applications to extend the provision of the Professions Supplementary to Medicine Act 1960 to new professions. There is nothing to prevent acupuncturists from applying to the council for an extension of the Act's priorities to cover acupuncture. Indeed, I am told that the procedures necessary for making such an application have been explained in writing and at meetings with my Department to the British Acupuncture Association.

The Council for Professions Supplementary to Medicine is a statutory body. It is not controlled in any way by my right hon. Friend, and appeal from its decision is to the Privy Council. I cannot say how acupuncturists would fare if they applied to have the Professions Supplementary to Medicine Act extended to cover their profession. I do not and nor does my Department make value judgments about the comparative efficacies of different methods of treatment. We quite properly leave such judgments to be made by the medical profession as a whole. This is demonstrated in the way that its profession exercises individual clinical judgments. The Royal Colleges and their speciality organisations speak on behalf of the profession. We look to the Council for Professions Supplementary to Medicine on the basis of applications made to the council to determine to what professions to extend the application of the Act. It is for the council to create the machinery for the State registration of the members of professions whose members accept that their work is supplementary to medicine.

The law does not exclude the offering of new therapies which the medical profession has not yet generally adopted or recognised. Nor does the law exclude the introduction to this country of forms of treatment which are exotic but very old, as is the case of acupuncture. The law permits practitioners of such therapies to offer them under the common law. Meanwhile, our traditions permit the spread of new ideas or the removal of old ones. Their acceptance or rejection depends ultimately, of course, on the people at large and by Parliament as their representatives.

I am sorry that I have not been able to give as comprehensive a reply as I should have liked, but I am mindful of the importance of the claims of hon. Members who have later debates. My Department will remain in contact with my hon. Friend about the other points that he raised in his speech.

For the past few weeks there has been a steady trickle of news stories, leading articles and articles in the British Press, notably in The Times, the Daily Telegraph, The Guardian, the Observer and The Sunday Times, about the boat people—the refugees from Vietnam who seek to leave that country. This has been caused for two basic reasons.

In the last few weeks there has been an upsurge in the number of those who have been trying to leave. In the first fortnight of October about 600 people reached Thailand from Vietnam.

I have seen one of the United Nations refugee camps where these people live in harsh conditions waiting, they hope, for onward passages to France, Australia or the United States. Some of the experiences of these men, women and children who set to sea in their small craft were very harrowing indeed. I talked to some of those involved. I talked to a Cambodian family who set forth from their country in a rowing boat which was no larger than some of those which are to be found on the Serpentine. For seven nights this family of nine rowed and laid up in the inlets of the country in the daytime. Finally, they had reached a haven.

In the whole of October, just under 900 boat refugees reached Thailand. In November, the Thais, who had been frightened by the influx, decided to impose rather harsher rules than hitherto, and the tide flowed down to Australia. In the first nine days of December, it seemed that some 2,000 refugees from Vietnam were making this extraordinary journey, comparable with the journey of Captain Bligh, across open seas to reach the haven which they hoped to find in Australia.

We do not know how many altogether have set out. It seems that over the past two years about 12,000 have found some sort of haven in the refugee camps of Thailand, Malaysia and Australia. It has been suggested by the former deputy leader of the Opposition to President Thieu in South Vietnam, who himself became a refugee from the Communists after co-operating with the Communist regime, that no fewer than 100,000 have set out and that some 90,000 have perished en route. Mr. Ian Ward, of the Daily Telegraph, who has made a substantial study of the problem, estimates that only one in six of those who set out finally makes it, which suggests that in the last couple of years about 72,000 Vietnamese have either perished or been caught and imprisoned.

But added publicity has been given to the plight of these poor unfortunate human beings by the fact that, as the number of those fleeing increases, so the number of places to which they can go is reduced. Malaysia used to offer some sort of haven and has now shut its coastline. Thailand has had a noble record in the past, but the Thais, frightened by the increase in the number coming in, frightened that some of those posing as refugees will be a security threat to their own country, and frightened that the refugees will put a substantial financial burden on the Thai Government itself—not a rich Government by any means—have raised barriers.

The Philippines has raised barriers. Japan has raised barriers. Singapore has raised barriers. Australia has had a noble record in the past, but the recent surge of some 2,000 refugees towards its shores has made even the present Australian Government doubtful whether they can continue an open coast policy.

Added to that is the problem that many masters of merchant ships, on seeing the refugees in their small pathetic craft, turn away and do not pick them up according to the law of the sea, because they are uncertain about whether they will ever be able to unload the refugees when they next reach port.

What can be done? Curiously, no one likes to be seen to be doing good in this matter, because people fear that if they are seen to be too hospitable, a swarm of new refugees will follow. It is suggested by those who study the situation closely that the number of those who wish to leave Vietnam, especially South Vietnam, could run into hundreds of thousands.

Some people are doing good. The Americans, who, immediately after the Vietnam debacle, took in about 140,000 Vietnamese refugees, are now issuing 15,000 extra visas. The French are taking about 1,000 a month. We have taken about 150. But I do not suggest that this country is necessarily the right place for the resettlement of these refugees. They are often fisher folk, and it would seem pointless to bring them half-way round the world and to settle them in Birmingham, Beckenham or Belfast.

What we need is international co-operation and some degree of consultation—inevitably, I believe, under the leadership of the Americans—to find satisfactory homes for these boat people. I think that the lead must come from America. America is a wealthy country, the Americans have a strong humanitarian instinct, and, of course, the recent history of Vietnam, in which they have been heavily involved, gives them an additional moral obligation. But the whole burden ought not to fall upon their shoulders. In my view, they have to carry too much of the burden now, and I feel that America's allies should be willing to co-operate with her in trying to find some place to which these refugees can go.

However, as the world is beset by so many problems, it is becoming increasingly difficult to find places to which the refugees can go. There is the possibility of some resettlement in Central America. One notes that there have been conversations between the Brazilians and the Japanese about the movement of an additional 1 million Japanese to Brazil. One is inclined to wonder whether it might be possible for a substantial number of Vietnamese to take the place of some of those Japanese settlers in Brazil, one of the few countries where there is substantial space left.

The Vietnamese represent only part of the Indo-Chinese refugee problem. A far bigger problem is posed by the Cambodians and Laotians. It is not for me to set forth this afternoon the reasons why these people try to flee from their homelands. We know that many from Vietnam flee because they fear that their families will be broken up, that they will be sent away from their homes to new economic areas, and that if it is relatively easy at present to get away, the situation will deteriorate quite rapidly in the future.

That applies with additional force in Cambodia, but the number of Cambodian refugees is now very small—perhaps two or three a day crossing the border into Thailand. The reason why the number is so small is that the final solution "really seems to have worked there, and most of those who had the ability and the drive to get away from that tryrannical, horrendous regime have either already flown or already been killed. There is now a substantial killing zone along the Cambodian-Thai frontier that makes it almost impossible for the average person to get across.

The problem from Laos is more difficult. There again, substantial numbers are faced with the break-up of their families by postings to new economic areas. There is a substantial food problem. It is suggested that in order to ward off starvation, Laos, with a population of only 3 million, will need to have 300,000 tons of rice imported this year. Two thousand refugees a month are now crossing from Laos into Thailand. It is feared by the Thais that that number could increase very rapidly, so they have sharply increased the restrictions on the number of refugees coming across the frontier.

I am delighted that in the course of the last few days the Government have been able to announce a quite substantial increase in the support that we are giving to the refugees in Thailand. It seemed to me last year that it was a disgrace that we were making no contribution at all to the United Nations' special programme for refugees in Thailand. The amount then went from nought to £250,000. Now, I am happy to say, it is £750,000. But there is a basic problem in Thailand. I have talked to the local commissioner for refugees, and it is perfectly plain that at least 50,000 of the 90,000 Laotian and Cambodian refugees who are now in the camps there cannot possibly move to the West and make a go of it. They will have to stay on the spot in Thailand or move to some other tropical area, and no other tropical area seems readily available. The Thais are obviously concerned about the number flowing in. They are concerned that they will be an economic burden to them. What is needed is a substantial international programme, again led by the United States but with ourselves and France participating strongly, to make possible the permanent resettlement of these refugees within Thailand. This is not an idea that is popular with the Thai people. It will, therefore, mean international co-operation as well as international money to get over the psychological resistance and the psychological problems of the Thai people.

I hope that as well as making our contribution, which I am delighted to say has recently been increased, Her Majesty's Government will be able and anxious to co-operate in any future international discussions that are held in order to find a permanent home for these unfortunate refugees. This problem, at Christmas time, ought to be a blot on the conscience of the world.

I am grateful to the hon. Member for Beckenham (Mr. Goodhart) for raising this afternoon the whole question of aid to Indo-Chinese refugees. The predicament of these refugees, who felt it necessary to flee from their own countries and to seek refuge elsewhere, is a matter of concern to the Government and to many individual people in this country.

I think that the hon. Member has been right to draw attention to the scale of the problem, because, although we read about it in our newspapers, very frequently the scale of the problem escapes many people in this country.

The collapse of the non-Communist regimes in South Vietnam, Laos and Cambodia in 1975 resulted in large numbers of Vietnamese, Laotians and Cambodians leaving their countries. When the United Nations High Commissioner for Refugees estimated the numbers that were involved in this in September 1977, he felt that there were some 88,000 Indo-Chinese refugees in Thailand, made up of 73,000 Laotians, 14,000 Cambodians and 1,000 Vietnamese.

The scale of this problem, as the hon. Member pointed out, is a matter of great concern to everybody. I believe that it is tragic, so long after the dramatic changes that took place in Indo-China in 1975, that there are still so many who are willing to incur the great risks involved to their persons and families in leaving their countries in a search for the basic elements of a civilised life elsewhere.

The flow of people leaving the countries of Vietnam, Laos and Kampuchea has continued, and most seek refuge, as the hon. Member said, in Thailand, facing an uncertain future of life in refugee camps. A smaller number set out in perilous conditions in small boats hoping to be picked up by passing ships or to find landfall and refuge in neighbouring countries.

The hon. Member referred in some detail to the problems of the boat people. I agreed with what he said. The only point that I would make in addition about the boat people is that I welcome the fact that the General Council of British Shipping, at the request of the Government, some time ago reminded British ships' masters of our own legislation, which requires them to rescue anyone who is in distress at sea, and was assured that this would be adhered to where it was within their power to do so. We know of a number of cases in which British masters, despite the uncertainty of the position, to which the hon. Member rightly referred, have gone out of their way to assist refugees and to make sure that they came to safety.

The problem, though, as the hon. Member stated, is an international one which requires international solutions. Many Governments and international and voluntary agencies are making efforts to assist in relieving the problem. Great tribute is due to them. In the international field the principal rôle has rested with the United Nations High Commissioner for Refugees, who since 1975 has been conducting programmes for the provision of material assistance and resettlement, both within and outside Indo-China. During 1975 and 1976 the High Commissioner, in co-operation with Governments and other agencies, assisted in the resettlement in other countries of more than 54,000 people. During that period the British Government contributed over £2 million in humanitarian relief for Indo-China generally, through the United Nations High Commissioner for Refugees and other international and voluntary agencies.

But there are still large numbers of refugees in Thailand, and more continue to arrive. The latest information that I have is that there are about 90,000 people still in camps. Other refugees in smaller numbers—we shall probably never know how many set out from the shores of their countries—are stranded in other countries in Asia without permanent homes or means of support.

This year the United Nations High Commissioner for Refugees made a new appeal for funds to enable him to continue to implement a programme of humanitarian assistance in 1977 for Indo-Chinese displaced persons in Thailand and other Asian countries. As the House will be aware and as the hon. Member rightly mentioned, last year we gave £250,000 to the High Commissioner for this purpose. I am obviously glad that the hon. Member has so warmly welcomed the fact that we have since decided, subject only to the minor reservation of the need for parliamentary approval, to increase that amount to £750,000. That is what has happened so far.

The financial resources for the United Nations High Commissioner for Refugees' special programme come not from the United Nations regular budget but from the voluntary contributions of member States. The United Kingdom has regularly supported the High Commissioner's programmes. We have always held that financial burdens should not be left to a few countries and that those countries which have not already done so should now make every effort to contribute to the High Commissioner's fund. If the High Commissioner were to approach us with a further programme for the region, we would certainly be prepared to see how best we could assist in that further programme.

We also contribute to the regular programme of the United Nations High Commissioner for Refugees, part of which covers activities concerning the Indo-China refugees. Last year for the regular programme we pledged £350,000 and this year, subject to further parliamentary approval, we have pledged a further £350,000 for the 1977 programme and £400,000 for the 1978 programme.

I should like to take this opportunity to pay tribute to Prince Sadruddin Aga Khan, who has been United Nations High Commissioner for Refugees since 1966. The Secretary-General of the United Nations announced last month that he had accepted the request of Prince Sadruddin to be released from his responsibility as High Commissioner at the end of this year. I should like to express the deep appreciation of the Government of the dedicated and energetic manner in which he has discharged his responsibilities over the past 10 years. It is in no small way due to his personal efforts that the Government place such confidence in the United Nations High Commissioner for Refugees as one of the most effective international agencie: in the humanitarian field.

The work of the voluntary agencies amongst refugees in Thailand should not be overlooked. It is greatly appreciated by the Government. Indeed, we regard it as essential that it should exist to complement the considerable efforts of the High Commissioner to which I have already referred.

As far as I am aware, the Government have received no request for grant from British voluntary agencies for assistance to refugees in Thailand. We consider that our official aid to this assistance should be directed through the international agencies of the United Nations, but we would be prepared to look at other requests for assistance. I say that having the voluntary agencies particularly in mind.

I am delighted to hear the Minister say that. May I pay particular tribute to the work of the Save the Children Fund teams in Thailand? I bad an opportunity to see some of the work they were doing at Ubon and with the Laotians and Cambodians which was of absolutely outstanding quality.

I am grateful to the hon. Gentleman for the tribute he has paid. I am aware of the work that the Save the Children Fund and many other voluntary agencies are doing. I am sure that they will welcome the fact that their work is appreciated. I wanted to make it quite clear that we should be prepared, in the context of the work that they are doing with refugees in Indo-China, to consider requests for assistance.

I think that there is general agreement that we are dealing with a tragic situation, a situation which is a blot on humanity and which requires international effort to bring it to a successful resolution. The Government are playing their part in that international effort and I hope that the House will agree that our successive grants of United Kingdom aid make a worthwhile contribution to the relief of the problem and give tangible effect to the trust and support we have for the work of the United Nations High Commissioner for Refugees and his staff and to the concern felt in this country about the humanitarian problems in South-East Asia.

It is against that background that I once again say that the House is grateful to the hon. Member for taking this opportunity to raise the serious question of Indo China refugees in the House.

I raise again the subject of the restoration of the cuts in educational spending in the county of Avon, because of the widespread disgust and concern among parents and teachers' within the county. I and my right hon. and hon. Friends who are Members of Parliament for Bristol have received many representations, and many of these have been sent on to the Department of Education and Science.

This is why I believe that at this stage it is important to raise this matter once again. There is a great need to restore the cuts in educational spending in Avon. The cuts that were imposed by the local education authority were much too severe and went far and away beyond the restraint on spending recommended by the Government.

It is maintained that as a direct result of the cuts 290 teachers and more than 300 ancillary workers are unemployed and that pupils are inadequately supervised during lunch hours. The teacher-pupil ratios in sixth forms have been cut, contrary to the recommendations made by the Government. No rising fives are being taught in schools in the county of Avon. Reductions in supply teachers have meant that whole classes have had to be sent home.

Whatever complaints have been made to the Avon education authority over the period since the cuts were initiated, the Avon Tories have simply blamed my right hon. Friend the Secretary of State for the severity of the cuts when they themselves are really guilty of what has been done. The cuts that have been made gravely affect the children, their parents and their teachers and will have a lasting effect on our education service in both the short term and the long term. Unfortunately, the damage of education cuts is not as dramatic as something like a power cut, but the results are just as damaging.

The reason for the great problem in Avon stems from the fact that the education budget in 1973 was inadequate. At the meeting of the education committee on 25th January, when cuts of £2,043,500 were finally approved, Dr. Glendinning

"referred to the inadequate budget of 1973 and the £900,000 taken out of that budget in error as being the prime cause of today's troubles. The size of the education budget had been kept below what could reasonably have been expected."

So the source of the trouble and the reasons for our present predicament are that the base situation in 1973 was far too low.

The exclusion of the rising fives from infant schools has provoked more anger among parents than anything else that has been done, and in my view it is probably the most undesirable action that has been taken, because I believe that this policy will seriously affect the ability of some children to profit from their education throughout the whole of their school lives. This is the main concern which has been expressed in many of the letters I have received and which I have passed to the Department.

In addition, schools are not being redecorated or repaired. It is impossible even to get things like windows replaced, or minor works undertaken.

Avon has also cut the provision for the purchase of new books by 50 per cent. I have heard of some schools—one of them is in the constituency of my right hon. Friend the Chief Whip, whom I am delighted to see present for this debate—which have asked parents to contribute 50p a year for a school library and to send along computer paper and card cut-offs to supplement their stock of materials. These are the things that have curtailed the ability of children to get on with the job. There are grave disadvantages in later life for all the children who are faced with this situation.

My hon. Friend the Under-Secretary of State, who will reply to the debate, has been most helpful. In reply to a Question on 28th November, she held out some hope for the future. In that reply my hon. Friend told me that the rate support grant for 1978–79, unlike that of 1977–78, was intended to enable local authorities to continue to admit, or resume the admission of, rising fives in primary schools.

That is widely welcomed, but when I circulated that reply to parents they asked "Will Avon take any notice of the Government? What will happen to make Avon change its mind?" In 1976. 6,000 rising fives were admitted to schools, but in 1977 the number was only 1,500. My constituents are quite right in thinking that there is a need for the Department of Education to say something to Avon about this.

I had a letter from one of my constituents in Downend, which arrived only this morning, which welcomed the reply given by the Under-Secretary of State. The letter states:

"Will Avon indeed change their policy in time to benefit my daughter and children of similar age who would normally be starting school after Easter instead of five months later in September?"

In doing this, how much money will be spent? I have an instance of a school in Timsbury, where the saving is extremely minimal. The county council makes a capitation payment of £7.10 for each child for which it is responsible.

In the case of Timsbury, 17 children were kept out of school for one term. The saving, I assume, would be one-third of the capitation payment—£2.33 per child—making a total of £40.23 for the 17 children. We have gone to all the trouble just to save £40.23. To my mind, the damage that it will cause for these children in later life does not make it at all worth while.

There is also the problem of the cutback in ancillary workers. Many of them are members of my union, the Transport and General Workers Union. The director of education wrote to primary school heads in Avon telling them that they had to achieve a given reduction in hours worked by ancillary and clerical assistants. He gave them nine days to sort this out, and there was no question of the unions being consulted beforehand. It was done in a high-handed manner, and it is hardly surprising that there has been a great deal of resentment about it.

In the school at which my son is a pupil, the Christchurch School at Han-ham, there has been a problem where the hours of the clerical secretary and the assistant have been cut to make up a total of 32–5 per week. Although great diligence has been exercised in making sure that one or the other of the two is in attendance so that if a child needs attention someone is at hand, it means that on Tuesday afternoons the headmaster not only has to answer the telephone and attend to secretarial matters but has to look after any child who has been sick during that period. As a parent, I find that far from helpful.

With regard to ancillary workers, I have an instance from the Sir Bernard Lovell Comprehensive School in my constituency, where the cleaners have always worked on Saturday mornings as well as after school. When a new wing was built about 18 months ago, it was reasonably supposed that the cleaning hours would be increased. But that was not so. The new wing comprises 16 new classrooms, two offices, four toilets and cloakroom space. But 12 cleaning hours were removed when this additional building came into use. Without these hours, the carpet in the school is never shampooed, because the only time it can be done is on Saturday mornings. There are numerous instances where ancillary workers are not able to undertake the jobs that they have done in the past to maintain this sort of thing. It is all left to Avon. There are some instances of two firms turning up to do the same job. That is the inefficient way in which Avon is organising things.

Only last week, at the Sir Bernard Lovell School, one firm came to mend a hole in the roof of the deputy head's office and a day or two later another firm came along to do exactly the same job. These are the repair jobs which in the past were carried out by the caretaker and ancillary workers, but these jobs are now not being done because Avon has lost the confidence of those people by the penny-pinching way in which it has cut down their hours.

Another thing which has happened is the cut-back in supply teachers. It was thought that Avon would be economising, but the only thing on which it has economised is the good will of the teachers. By cutting back in this way Avon has got the teachers in such a belligerent mood that they are not prepared to cover absent colleagues, which is what they have done in the past. Despite advice from the unions, Avon went ahead with these so-called economy measures. As a result, Avon has been forced to employ far more supply teachers than it has ever done in the past. I understand that the additional cost to the authority is in the region of £450,000 and that the bulk of it has been spent since September 1977.

In simple terms, penny-pinching Avon has cost the ratepayer money. The rise in the cost of supply teachers since the imposition of Avon's restrictions is an indication of the great reliance that the authority hithero placed on the good will of the teachers who covered for their colleagues.

This week I received a communication from the National Association of Schoolmasters Union of Women Teachers which claims that, as a result of the cutback in supply teachers, 16,721 pupil days have been lost, and that on occasions when supply teachers were not available classes, and sometimes the whole school, have had to be sent home.

Representatives of the Avon Campaign Against Cuts in Education saw the Secretary of State in October. They were most impressed. On its behalf, the campaign has asked me to tell the Secretary of State of its deep concern about the problems that I have outlined today.

The chairman of the education committee said on 25th May this year:

"We cut to the bone last year. This year we are cutting into the bone. Next year we shall be amputated."

With that kind of talk, my constituents and others are naturally gravely concerned about what is happening. Obviously, as things get better economically they want to see the improvement projected into Avon with regard to the severe cuts that they have experienced.

My colleagues who are Labour members of the local authorities are sickened by the severity of the cuts, which are being blamed on the Secretary of State. We certainly feel that there is a need for the Government's position to be made clear at this stage. The Avon education service has been mismanaged. In the past I have had to raise the problem of how the chief education officer departed from us in mysterious circumstances. It has been a far from happy experience since Avon took over the education of our children. The effects of those actions will be felt well into the future, and the future of many of our children will be sacrificed.

Those employed in the education service in Avon have suffered from uncertainty, the threat of redundancy and the frustration caused by undermanning and by not being given suitable conditions of work. I recognise that, because of the economic situation a year ago, the cuts had to be made, but Avon's cuts were too severe and it got its education priorities all wrong. I hope that, in the light of the better economic climate in which we now find ourselves, talks can take place to review the situation to stop the great damage which is being done to the children of Avon.

Order. Mr. Speaker has asked me to remind the House that this is a half-hour Adournment debate and that it ends at 2.44 p.m.

I am grateful to my hon. Friend the Member for Kingswood (Mr. Walker) for raising this matter. I am aware from the many strong representations made by my hon. Friend to my right hon. Friend the Secretary of State that there is very great concern in Avon about the level of expenditure by the local authority on education. My hon. Friend has accurately described the situation in which the education service in the county has been subjected to economy measures of increased severity over the last few years.

I believe that the county council has made savings on education, as on other services, in every year since 1974–75. In the current year, I believe that the difference between the estimated cost of continuing existing policies and the expenditure limit set by the council amounts to just over £2 million, or about 2 per cent. of the total planned expenditure on education.

I believe that the economy measures that the county has introduced fall into three categories. These are, first, those which can be brought about without major changes in policy, or by the continuation of existing economies. Savings are made under this head on administration costs, the school meals service, student support and energy conservation.

The second category entails significant policy changes but does not affect staffing levels. The school meals service, again, is affected, as is the library service, school transport, adult education, swimming lessons for schoolchildren and so on. In particular, capitation allowances, from which schools buy the majority of their books and teaching materials are being held at 1976–77 levels in cash terms.

Finally, there are those economies which involve both policy changes and changes in staffing levels. Here my hon. Friend referred to the effective loss of supply teachers, peripatetic teachers, and so on in services in school. Other measures include reductions in staffing ratios for pupils aged over 16 who are not studying for A-levels and, as my hon. Friend mentioned, restrictions on the admission of rising fives to the infant classes of primary schools. This is of great concern to my hon. Friend—as it is to me—and to many parents, particularly those in the areas of authorities which have adopted policies similar to those folowed by Avon.

My hon. Friend asked me to highlight how the policies of Avon are set against the background of central Government policy. I must remind him that the 197778 rate support grant circular was expressed, as always, in national terms, and the advice and figures given relate inevitably to the average for the country and cannot be applied readily to every local authority. But the corollary of that is, as we always say in the circular, that what the circular means for particular services will be for the authorities to determine in the light of their own circumstances and priorities. We therefore set the background of national policy, and authorities must, in the circumstances in which they find themselves, make their own decisions, for which they must take responsibility in the light of the advice which we give.

The circular for that year sought, as my hon. Friend has indicated, to give local education authorities a clear idea of the main consequences of the settlement in terms of national priorities, putting emphasis on the need to maintain staffing ratios in schools, to begin the expansion of in-service training and to continue with the development of nursery education.

Rate support grant is a block grant available to authorities for their expenditure as a whole, and it is not earmarked in any way, even for the education service as a service, let alone for particular priorities within that service. So, again, I must repeat that it is for each authority to decide, taking account of its priorities and our guidance, how to allocate its resources. It is for that reason that debates of this sort are all the more important, because they show how much local concern is being expressed about decisions taken locally, and they spell out the background to those decisions.

So far we have been talking about decisions already taken by Avon and in the process of implementation during 1977–78. Yesterday, the Government's rate support grant proposals for 1978–79 were approved by the House. I shall now consider how the settlement affecting the next financial year may bear upon Avon and its provision of education.

As with most authorities, Avon began to consider next year's budget long before the information was available about the rate support grant settlement or, indeed, about its own level of spending in the current year against the background of the policies to which I have referred. It would appear that, in deciding that there should be a provisional target to save £263,000 in education next year, the local authority took the figures contained in this year's public expenditure White Paper and assumed that the national reduction in local authority expenditure between 1977–78 and 1978–79 envisaged in that document would apply pro rata to each individual local authority. As my hon. Friend knows, and as I have emphasised in discussing the advice we give, these national priorities cannot be simply apportioned in that way.

Apart from that, however, the figures in the White Paper require a certain amount of examination. As we indicated in Circular 3/77, while overall planned expenditure on the education service was expected to fall by about 1·5 per cent. between 1977–78 and 1978–79, the main burden of the economies was meant to fall on the schools meals service. I do not know how Avon considers that the saving should be made, but if it bases its savings on the White Paper it should be aware that that document actually envisaged a slight increase nationally in expenditure on education in schools and colleges.

Since the White Paper was published in February, the Government have made additional resources available for 1978–79 to help the education of the young unemployed, to increase the number of children eligible for free school meals, to provide more discretionary awards for further education students, to expand the urban programme and to allow for the employment of additional teachers to help the disadvantaged. These resources are on top of the provision in the White Paper, which already assumed a certain slight increase in education spending, the maintenance of school staffing standards nationally, a modest increase in provision for the under-fives and further development of induction and in-service training schemes for teachers.

The White Paper took as its figures for 1977–78 those embodied in the rate support grant settlement for that year. There are now indications that local authorities' actual expenditure on education in 1977–78 will be somewhat below the settlement level.

Against that background of what was expected and what we are looking to for this year, perhaps I may say a little about the rate support grant settlement for next year. It should make it possible for local authorities, if they so choose, to spend a little more on education than we estimate them to be spending in 1977–78. The Government attach importance to the maintenance of staffing standards, the expansion of in-service training and continued help for the disadvantaged, especially for the under-fives or for young people faced with the prospect of unemployment. But, taking the country as a whole, the settlement provides a basis for maintaining standards and for restoring expenditure in some parts of the education service which have suffered most from economies over the last year or two.

As my right hon. Friend the Secretary of State for the Environment told the House yesterday, the great majority of authorities will be able under this settlement to maintain their standard of services. If authorities decide to make further cuts, the decision must be seen as entirely and solely theirs, because we do not believe that there is anything in this settlement which requires them to do so.

I understand that the resources co-ordination committee of the county council met yesterday and decided to recommend to the full council that the proposed savings targets of £263,000 should be reduced by £250,000. I also understand that this recommendation will be discussed by the county council in January. The main point that I should like to make is that when that discussion takes place the local authority should have available to it all the relevant information on next year's settlement, a better picture of the financial effects of its decisions this year and our views on the main implications of the settlement for the coming year, expressed in national terms.

I hope that the authority will want to look at its committee's recommendations not only against the background that we have discussed today but in the light of the representations made throughout the last year, by my hon. Friend in particular but also by many of his constituents and those of others of our hon. Friends in the area of the Avon authority.

The Government are trying to give assistance to local authorities to enable them to maintain and improve the standards of education in their areas. Nevertheless, my hon. Friend knows that we cannot take responsibility for the decisions that they are free to make and that they choose to make in the light of their own views of their priorities. For those decisions they must be responsible to their local electorate.

I wish to raise a matter of considerable public importance brought about by the issuing at the beginning of October this year of a discussion document on the future of Mendip Hospital, Wells, a 600-bed, old-established hospital which handles long-stay elderly and mentally infirm patients. I do so because there is a need for a great deal more information locally, and there is still a great lack of knowledge and understanding nationally about our mental health services. Indeed, there is still a need to awaken the public concience about how we as a community should be treating our mentally ill.

The way in which the discussion document was handled has caused much criticism and ill-feeling locally. I do not intend to dwell on the hard things that have been said, some of them by me, although I believe them to be fully justified. I shall make one or two general observations.

There is a need to take extra-special precautions in making proposals for the future care of the mentally ill everywhere. Public attitudes have not caught up with the new concepts of community-oriented care, and there are still substantial doubts about these concepts among highly qualified medical staff. Psychiatric and geriatric medicine are not popular options among the keenest and most able career-minded nurses and doctors. Those who are dedicating themselves to this challenge—we are extremely grateful to those who do—must therefore be kept in as high a state of morale as possible, and questions affecting their personal careers, conditions of work, the localities in which they work, their housing and so on must be handled with care and sensitivity.

People who serve on area health authorities are not generally in the public eye. To be fair to our Somerset Area Health Authority, it was unanimous on the way to handle the document. That is what I have been told by the chairman. However, area health authorities must beware of appearing to be too remote and insensitive to what local people are thinking. They are large employers. In the Mendip Hospital the authority employs about 600 people, and it is therefore, about the largest employer in the city of Wells. These authorities must remember that they are not directly elected bodies. It is still very much an open question among Members on both sides of the House whether such bodies should be elected or should be made in some way more accountable to the public.

I hope, therefore, that the Somerset Area Health Authority and the other two health authorities involved in the proposals will listen very carefully to all the comments that will be made on the discussion document. I hope they will regard this consultation as the beginning of a long discussion and a prelude to a further and more informed document about mental health care in Somerset and the surrounding area. It would be totally wrong for comments on the first document to be the basis of any final decision.

What strikes me about the document at first sight is that, because of the special circumstances of the three-sector catchment area from which patients come to the Mendip Hospital, this cannot be a one-off decision. How can a fair assessment of the demand for long-stay beds be made for the Wells part of Somerset when one can read in paragraph 4, on page 7 of the document, that

"Both Avon and Wiltshire Area Health Authorities have declared their intention of becoming independent of the services of Mendip Hospital but have at present no firm plans for achieving this."?

This should not be, and cannot be, the basis for a one-off decision. A fair assessment can be obtained only by looking at the much broader picture of health care in the three areas. It will be extremely difficult to gain a picture of the likely requirements for mental illness beds in a vacuum. How do the plans for hospital services in Avon. Wiltshire and Somerset tie in with the Resource Allocation Working Party plans for each, for example? That is an important consideration which will have to be taken into account.

We should be extremely sceptical about basing plans entirely on having so many beds for such and such a population. The sizes of patient catchment areas are much more flexible and extended than they were a few years ago. It is not necessarily such a drawback as it was to travel 30 or 40 miles for treatment by a specialist at a certain hospital.

I wish to ask the Minister one question to which I do not expect he can give an immediate reply. It is relevant to the document and the understanding of what is behind it. How are all the costs of treatment and accommodation of the Avon and Bath sector patients debited? Does Somerset bear a major part of other areas' bills? That is an important question which is not answered in the document.

I turn now to the future concept of specialist psychiatric treatment of acute patients in district general hospitals in order to give those patients a pattern of living which more closely resembles normal life and which integrates them with that of shorter-care patients. This is desirable and a matter of great importance. Though it may be somewhat Utopian in present circumstances, we should be looking towards that end. However, there are certain reservations about this in the medical world and the subject requires much study and attention.

I wish to draw the Minister's attention to an article which appeared in the British Medical Journal of 1st May 1972. In the interests of time I shall not quote from it, but it indicates some of the perils of developing a two-tier system of the district general hospitals for acute psychiatric patients and for the long-stay hospitals nearby. Those difficulties should be examined in respect of each area health authority and taken into account when considering the document.

Yet the document bases its present strategy on this and states that the Mendip Hospital may have no rôle to play in the treatment of acute patients. That is a further important matter to be considered. In regard to long-stay patients, there is great scepticism among staff and nurses that bed needs are declining in this area in the way suggested in the document.

I wish to illustrate an area of concern which might suggest that there is substantial under-provision in regard to certain long-stay patients throughout the country. I wish to draw attention to an article in The Guardian of 5th December in which the Lord Harris of Greenwich, Minister of State, Home Office, was reported as saying:

"There are now hundreds of mentally disordered people in prison who should be receiving treatment in a psychiatric hospital."

Does this indicate a serious under-provision of beds in the psychiatric hospitals? If that is so, it is disturbing and is relevant to the figures showing likely needs of lone-stay patients in psychiatric hospitals in the area.

Nobody I have met among the staff in the Mendip Hospital is other than acutely conscious of the need for constant pressure to find better and more humane ways of caring for and treating the mentally ill. The modern concept of getting away from the large institutionalised hospital atmosphere, must be handled realistically and at a pace that matches the provision of alternative services of high quality. Above all, the approach must be flexible, otherwise the desire to move forward in this difficult field towards more community care will be frustrated. That would be a most unfortunate development when all are trying to treat mentally ill people in as humane a climate as possible.

I congratulate the hon. Member for Wells (Mr. Boscawen) on securing this opportunity to debate this important matter. I know that he takes a particular interest in health and social services matters, and on this occasion that interest is heightened because of the important contribution the Mendip Hospital, Wells, makes to the level of employment available in the hon. Gentleman's constituency.

The hon. Gentleman has spoken both of the possibility of the eventual closure of the Mendip Hospital and also of the way in which news of this possibility reached his constituents, many of whom are employed at the hospital. It may be helpful and perhaps reassuring to the hon. Gentleman if I set out what action has so far been taken by the Somerset Area Health Authority, which is responsible for the management of the Mendip Hospital, Wells. I would like to lay particular stress on the precise status of the discussions which have taken place and the papers which have been issued for consultation.

The Somerset Area Health Authority at its meeting on 30th September considered a document which examined the future of the Mendip Hospital and the authority resolved that this document should be issued as a discussion paper to all interested organisations and bodies. I would stress here that the authority has not taken a decision to seek the closure of the Mendip Hospital, although such consideration of the needs of the population of Somerset for services for the treatment of mental Iliness that has so far taken place has indicated that it might be open to the authority to take such a decision in 15 years' time.

I cannot, of course, predict what will then be the procedures laid down by the Government of the day when hospital closures are proposed, but at present the procedures are as follows. In general, the initiation of these procedures rests with the appropriate area health authority. If the area health authority decided that a closure or change of use of a hospital was necessary, it would have to institute formal consultations. The procedures require the authority to prepare a consultative document covering such matters as the reasons for its proposals; an evaluation of the possibilities of using the facilities for other purposes, for the disposal of the site; implications for the staff; the relationship between the closure or change of use and other developments and plans; and the transport facilities for those patients who might be affected by the proposals contained in the document. The AHA would invite comments from a wide range of bodies. Those hon. Members whose constituents were affected would also be informed of the proposals.

The area health authority would then seek the community health council's views on the comments it received and on its own observations on those comments. The authority would then review its original proposals in the light of the comments received, and unless there was strong local opposition, it could then implement its original proposals provided that the community health council agreed. The regional health authority and my Department would be informed of the decision.

However, if the community health council objects to the area authority's proposals, it is required to submit to the authority a constructive and detailed counter-proposal, having full regard to the factors, including restraints on resources, which led the authority to make its original proposal. The matter must then be referred to the regional health authority and if the regional health authority is unable to accept the views of the council and wishes to proceed with the closure or change of use, it falls to my right hon. Friend the Secretary of State to act as an arbiter. However, we have not yet reached this stage and, as I have mentioned earlier, we are not likely to do so until the 1990s.

The hon. Gentleman has spoken of the manner in which news that the future of the Mendip Hospital was under consideration reached his constituents. It is clear that, despite the authority's best intentions, the chain of distribution of the discussion document was such that copies of it reached different people at different times over the period of about a week beginning on 6th October and that some staff interests first learned of the documents' existence in the local Press on 7th October. I very much regret that this happened and that all interests did not receive the discussion document at one and the same time. The hon. Gentleman will know that I attach particular importance to the standards of industrial relations existing in the National Health Service.

Comments on the document have been invited by 31st January 1978, so those bodies and organisations which have been consulted have ample time to formulate their views and put them forward for consideration. I urge everyone to act through these bodies and organisations. The community health councils have been set up to represent the public view and three of these councils have been invited to comment. Staff bodies, too, have been consulted, and the document has been sent to the Somerset area, West Somerset district and Wells sector joint staff consultative committees as well as those trade unions and professional organisations with members employed at Mendip Hospital, but not represented on the committees. Additionally, adjoining area health authorities have been given the opportunity to comment, as have the local authorities concerned and the professional advisory committees.

Therefore, the area health authority has consulted widely and will take full account of the views presented before deciding what further action to take. No doubt, any proposals that may emerge in due course will also become the subject of consultation.

As the hon. Gentleman pointed out, the Mendip Hospital, Wells, is concerned with the treatment of mental illness. Like many other such hospitals its history stretches back well into the nineteenth century. Our concept and understanding of the needs of the mentally ill has very much changed in the intervening 120 to 130 years. At times the population of the hospital has been as high as 1,000. Today in keeping with the national trend, it is reducing and currently is around 600.

I shall now set out our policy for the provision of services for the treatment of mental illness. I want to make it clear that the Government's policy is not directed towards closing large mental illness hospitals as an aim in itself. Rather, they will be replaced over the next 20 to 30 years by a new pattern of local psychiatric services. This is described in our White Paper "Better Services for the Mentally Ill". Some mental illness hospitals will continue to provide a service for longer than others, and this will depend on local circumstances and the rate of development of alternative facilities. But we look to all regional health authorities to develop a strategy which will, over the next 20 years or so, give people everywhere the benefits of the new pattern of service. The authorities will, of course, do this mainly by redeploying those irreplaceable human resources—doctors and nurses and others—who are today serving the public, in Somerset as elsewhere, and largely in the old patterns of services. But, of course, we do not want to see under-provision for patients who need longterm stay.

The new pattern of psychiatric services will comprise a network of locally based facilities to provide treatment and care according to the varying requirements of those who are mentally ill. It enables the services for these patients to respond effectively to differences of need, and enables people with mental illness to be treated close to their home while maintaining links with family, friends and colleagues. Past experience clearly shows that lengthy periods spent in mental hospitals isolated from family and friends has made a return to normal life in the community much more difficult—has, indeed, made it impossible in some cases.

The psychiatric unit at the local general hospital will be the centre of specialist psychiatric treatment of mental illness for adults, including the elderly, from its health district. It will provide facilities for treatment on both a day and in-patient basis, and act as the base from which specialist therapeutic teams can provide advice and consultation outside the hospital.

Although the emphasis in future will increasingly be on the provision of treatment in a community or day-hospital setting, hospital in-patient treatment will continue to play an important role. Some people whose mental illnesses can, in the main, be successfully managed in the community, with out-patient or day-patient care, will need to be admitted for short spells to hospital for the treatment of acute episodes, or for more detailed diagnosis and testing. Better treatment and a new awareness of the harm that can be done by long in-patient stays have led psychiatrists to reduce in-patient treatment even if they are still working in distant mental illness hospitals—hence the falling need for beds which the Somerset AHA reports. But how much better if the patient in the community and his doctor remain only a mile apart, not 25 miles!

But I do not want to give the impression that psychiatric units in general hospitals can provide treatment for all the groups of patients hitherto catered for by mental illness hospitals. In the new pattern of locally based services other inpatient facilities are also needed. It is our policy that small units in local hospitals should provide in-patient and day-patient care for elderly severely mentally infirm patients who do not really need all the facilities of our psychiatric hospitals.

At the same time, we recognise the need to provide longer-term in-patient accommodation in each district for those small numbers of younger patients whose mental illnesses do not respond to modern treatment. In the White Paper we suggest that these people may be best cared for in hospital hostels, associated with but not necessarily part of the main general hospital complex. Regional secure units will also be needed for patients requiring security, though of a degree less than that provided by special hospitals.

Finally, there is a need to develop a high degree of awareness and knowledge about the treatment of mental illness amongst those working in the community—general practitioners, community nurses and social workers—as well as in the community at large, as the hon. Gentleman rightly said. This will ensure that a far greater proportion of mentally disordered people can be treated in the comfort, privacy and security of their own homes. Progress is being made in this direction, too—introduction of the community psychiatric nursing service is valuable also—but we still have a long way to go before a genuinely community-oriented psychiatric service is functioning effectively in every health district in the country.

I must emphasise, therefore, that we would not contemplate agreeing to the closure of a mental illness hospital, if matters do eventually reach the stage of such a proposal coming to the Department, until we were satisfied that adequate alternative facilities offering a high standard of psychiatric care were available in all the districts served by the mental hospital. This will cost money—units will have to be built or adapted to provide the in-patient, day-hospital, daycare and residential accommodation needed, with planning and joint financing between health and local authorities.

Once the new pattern of services is established, I am confident that we shall have a vastly improved psychiatric service which, once established, will cost no more to run than the services which are being replaced—and they will be better, more human in scale, more flexible and closer to the patients' home. They will provide facilities to enable people to be returned to more normal living, where before we could only shut most of them away out of sight.

As I and my colleagues have made clear—in speeches and in reply to Questions in the House—we are determined to make sufficient resources available to enable health authorities to provide these services. The consultative document on priorities for health and personal social services and "The Way Forward" both make it clear that our policy is to devote an increased proportion of NHS capital and revenue expenditure to improve facilities for the mentally ill. The changes will take time and will require careful planning and full local consultation, especially over the crucial transition period, and Somerset Area Health Authority's action in issuing its own consultation document is to be warmly commended.

Many districts already have psychiatric units in general hospitals--six more were opened last year—and nearly 30 per cent. of all psychiatric admissions in England are now to psychiatric units. But even so, many of the older mental illness hospitals will for some years continue to provide accommodation for the so-called "old long-stay" patients—those patients who have been in hospital for many years and for whom no other accommodation is available. Many of these patients could be better accommodated in facilities in the community, like residential homes, group homes or approved boarding houses, so the rate of progress towards the replacement of the older hospitals will depend to a considerable extent on the build-up of this type of accommodation.

The provision of adequate levels of community facilities, particularly local authority accommodation, is quite crucial to the development of the new pattern of services for the mentally ill. There are two related needs—for social care and for rehabilitation. Various forms of residential accommodation are needed to cater for different degrees of dependency and for various lengths of stay. Day centres need to be provided with a variety of facilities within a single establishment which can be used flexibly to give effective help to each individual.

I know that some doctors and nurses working in services for the mentally ill, and other health and local authority staff involved, feel uncertain about their future at the moment, and may fear upheaval during the change to the new pattern of mental illness services. This is one of the reasons why the Secretary of State set up his working group, which is currently looking at mental hospitals' problems of management and organisation within the psychiatric services. But I want to reassure those who are uncertain about their future in the psychiatric services that we shall continue to need more staff, not fewer, as the White Paper guidelines on staffing make clear.

I certainly do not want to underestimate the enormous contribution being made by staff working within the limitations imposed by the traditional pattern of mental illness services. They have risen splendidly to the challenge of new techniques, changing work loads and often inadequate and unsuitable facilities. I know that many psychiatric hospitals are continuing to provide an excellent service in very difficult circumstances and that their staff will continue to do so and will respond to the challenge of the transition to the new pattern of services in the same way.

As I have already said, it is not for me, at this point of time, to make any suggestion as to what is the best strategy for the future of the mental illness services in the hon. Gentleman's constituency or in Somerset. It is for everybody who is concerned to discuss this discussion document. This is not something that is being done in a tremendous last-minute hurry. What the discussion document proposes as a possibility is that this hospital should be closed in 1991 or thereafter. May I express the hope that the discussions are constructive and fruitful, and that the local mental illness services build on the strength they have to achieve new strengths?

I have mentioned briefly that we have the NHS planning system under which the regional health authorities produce strategic plans having regard to overall national policies. This is a new development in the history of the National Health Service and I am confident that it will enable us to make better progress in future.

The South Western Regional Health Authority supports the national policy on services for the mentally ill. Its strategic plan covering the 10-year period up to 1986 makes this clear. Its aims include the establishment of health district-based psychiatric services, including day-hospital provision both at the district general hospitals and in community hospitals. As the hon. Gentleman will know, it is intended to develop the Priory Hospital site in Wells as a community hospital and the area health authority will be planning this.

The hon. Gentleman asked me a specific question about the allocation of the costs of the Mendip Hospital between the three health authorities concerned. I cannot give him information at the moment but I shall write to him with the details.

To summarise, therefore, I can do no more than emphasise that no decisions have been taken on the future of the Mendip Hospital, Wells. It is too early a stage in the consultation process for ministerial involvement, which may even not be necessary at all, and that is why I have purposely avoided any detailed comment this afternoon. I would not, however, wish to close without recording that discussions currently taking place in no way are intended to suggest that the staff at Mendip Hospital are doing other than the best possible job that their surroundings permit. I also recognise that if a large hospital in a predominantly rural community has to close the effect on that community's employment is very significant. It is for this, if for no other reason that consultations on future plans must be particularly thorough.

My purpose is to ask my hon. Friend the Under-Secretary of State for Industry for information concerning the activities of the National Enterprise Board in the North-West of England, with particular emphasis on the creation of employment on Merseyside. I emphasise that this is not the wider debate about total Government aid to the area but the comparatively narrow debate about how we can use the NEB to support and create employment on Merseyside.

My inquiries will be on two aspects of the NEB's activities in the North-West. The first aspect concerns the opportunities created by and for the new North-West Regional Board of the NEB. Secondly, I shall ask for information on the Government's actions and progress on the recommendations of the NEB in its special report for the North-East and North-West of June 1977.

I trust that I shall not embarrass my hon. Friend if I say that I want to thank him for being present to answer the debate at what, I understand, are considerable personal inconveniences to himself. I understand—I think that the phrase is "from a reliable source"—that at 6 o'clock this morning my hon. Friend was watching the mail flow past in his constituency of Nuneaton. He was watching his constituents moving the Christmas mail. At 9 o'clock he went underground—not for the first time and not for the last—and spent three hours down a coal mine. My hon. Friend surfaced to come back to London specifically for this debate, and he will be back in Nuneaton again this evening. I think that he could have avoided this debate if he had chosen to do so. I am most grateful that he chose not to take that course, because, before he became a Minister, he gave his support to Merseyside and has continued that support since.

I have no need in this debate, or at any other time, to remind my hon. Friend of the industrial, economic and employment situation on Merseyside, because he knows it already. Indeed, he and his colleagues ought to take some credit for the investment and new opportunities which are coming along on Merseyside.

All too often we hear the bad side of investment and unemployment, but in recent months there has been major investment on Merseyside. I think that it will be useful to list some of that investment. On 18th November the Merseyside Development Office gave information about major investment in the Merseyside area.

Pilkington at St. Helens has invested £70 million for a new float glass plant. Tate and Lyle has invested £10 million for a factory development at Knowsley as part of its diversification plan. Rock-ware Glass has invested £10 million to increase warehousing and to develop glass container technology at St. Helens. Kodak at Kirkby has invested £8 million for the provision of new production facilities for synthetic chemicals.

Ford is investing £8 million to back new production targets at Halewood by spending £3 million immediately and a further £5 million over the next 12 months.

Unilever has an investment of £.6: million at Kirkby for buildings for processing, packing and freezing at Birds Eye Limited. Cadbury Typhoo is investing £5 million at its Moreton plant in the Wirral.

The Mersey Docks and Harbour Company is to invest £2 million following its announcement of a £5 million prat for 1976. Hughes and Ellison Limited is to invest £11 million on new works at Liverpool. Massey-Ferguson is to invest £750,000 at its Knowsley factory. Synthetic Resins Limited is to invest £500,000 on new warehousing and distribution facilities at Speke, Liverpool.

Those are only some of the investments that have been made on Merseyside, but they total £1221 million.

I wish that our successes were given as much publicity as our occasional failures. We have to live with the fact that Merseyside in general and Liverpool in particular are news. Events which take place in other areas, because they are not necessarily news, do not get the publicity that Merseyside attracts. Anything bad seems to be front page news, locally and nationally, and anything good all too often gets two column inches on the back pages.

The investment figures that I have given are proof that manufacturers have more faith in Merseyside than is sometimes assumed. Of course, we need more investment—lots more. We need not only the big ones, but the small ones. In this regard, the £500,000 investment by Synthetic Resins Limited is particularly significant.

I understand—I ask my hon. Friend to confirm this—that the new North-West Regional Board of the National Enterprise Board, whose membership was announced in Liverpool on Wednesday, will be able to initiate and to approve investment schemes up to £500,000 without constant reference back to London before making a decision. When North-West Members of Parliament met Mr. Leslie Murphy on Tuesday, that was how they understood the situation. I now ask my hon. Friend to confirm that and to tell us about any other ideas that he has on the rôle of the North-West Regional Board of the NEB.

In particular, I hope that my hon. Friend will encourage the NEB to give at least as much attention to service industries as it has given to manufacturing industries. We shall not solve the unemployment problem on Merseyside unless we help profitable, viable service industries as well as manufacturing industries.

I give two examples. The Royal Insurance Company, which has its headquarters on Merseyside, is a viable, profitable, major, first-class employer with great invisible export earnings, tremendous growth potential and an international reputation. Littlewoods, with its pools, mail order and general stores, is Liverpool-based and has Liverpool headquarters. It is a major employer and it is viable and profitable.

If any of these concerns were to install a computer they would have different Government aid and support from that of a manufacturing firm who put in a capstan lathe—if there are such things these days. The contrast between the service industries and manufacturing industries is considerable in this respect. They seem to receive much less Government interest and support than comparative manufacturing industries.

I ask my hon. Friend to appreciate the needs and opportunities of commercial services and to encourage the National Enterprise Board, locally and nationally, to do the same.

I turn to the NEB recommendations contained in the report of June 1977 entitled "Investment Potential in the North-East and North-West of England". This report was personally commissioned by the Prime Minister after the setbacks in the Plessey Telecommunications Centre in March 1977.

It is necessary to concentrate attention in this debate on the recommendations for the North-West, although the recommendations for the North-East would have support from the North-West. There are 15 recommendations. I shall not discuss them all. Some of them are for the North-East and Merseyside, some for the North-East and some for Merseyside. They are all worthy of support.

I shall concentrate on the major items. The first recommendation is:

"The Government should consider a widening of the differential in regional assistance which the Special Development Areas enjoy compared with other areas."

There are already differences in aid. Development programmes are changing and progress is being made.

Recommendation No. 3 is:

"The NEB should intensify its efforts to stimulate the growth of smaller manufacturing companies in the Northern and North West Regions by providing finance for expansion and modernisation."

This is one rôle for which the NEB is entirely suited.

Recommendation No. 5 is:

"The Government should devote a larger proportion of the resources available for advance factories to the provision of nursery factories in Merseyside and the North East."

I like the phrase "nursery factories", because it gives an idea of something being started and being able to continue.

I shall take three recommendations from the North-East section which are also viable for the North-West and Merseyside. Recommendation No. 6 refers to the need to stimulate the tourist industry in the North-East, and it would be equally applicable to the North-West. Liverpool is a tourist centre for the people visiting the Lancashire fells, the Lake District and North Wales. It should not be neglected, particularly since we are at the hub of the best road and motorway network in the United Kingdom.

Recommendation No. 7 points to the opportunities for major offshore contracting companies to be helped and expanded. If that is viable for the North Sea, I hope that it is equally viable in the not-too-distant future for the Celtic Sea. Coastguard defence vessels could be manufactured on Merseyside. I urge the Minister to ask his hon. Friends not to forget Cammell Laird and Western Ship Repairers in that respect. We were hoping that one of the Polish ship orders would be placed on Merseyside.

The specific Merseyside proposals include recommendation No. 10 entitled.

"Measures of particular relevance to Merseyside."

That recommendation is:

"To stimulate office employment on Merseyside special arrangements should be made between the Liverpool Corporation, a developer, and the Department of Industry to build a speculative office block in Liverpool to attract office employment from outside the Assisted Areas."

This supports my pleas for help for services and commercial activities.

Recommendation No. 11 states:

"The measures already announced by the Government to provide resources for the inner areas of large cities should be used to stimulate the construction industry on Merseyside and the need for further measures of a similar nature should be kept under review."

The Minister already knows of the South Dock scheme which is a pilot scheme and an important centre of focus.

There is a proposal for a new police headquarters in the recommendations for office development. I hope that the proposal will not exclude the provision of a sub-police station in my constituency. Mine is an urban area, although within it there are some large farms. It covers 20 square miles, with not a police station within it, and we want something on the ground where people need that support.

Recommendation No. 15 is

"The Department of Industry should initiate a study to identify industries which might be attracted to the port area of Merseyside."

What developments have there been in this regard?

No one will deny that Merseyside has problems. But we have great achievements. We are part of the North-West, and we do not suggest in the slightest that we should solve our problems of industry and employment in isolation from the North-West or any other part of the United Kingdom. I am asking for information on the narrow question of the rôle of the National Enterprise Board in the North-West. We have received a tremendous amount of Government aid. That is on the record and is much appreciated. I want my hon. Friend to fill in the details and to tell us how he proposes to encourage the activities of the National Enterprise Board especially in the North-West and on Merseyside.

I am grateful to my hon. Friend the Member for Liverpool, West Derby (Mr. Ogden) for his kind personal remarks, and I am grateful to him also for raising what consider to be an important topic even at this late stage before we adjourn for the recess, because he gives me the opportunity to offer some detailed replies to the points which he has so rightly raised on behalf of his constituents. I admire the way in which my hon. Friend has so assiduously made representations on behalf of his constituents both today and on earlier occasions.

Merseyside has traditionally suffered from high rates of unemployment, much higher than the national average. The main objective of the Government's regional policy is to reduce unemployment in areas such as Merseyside. It is designed to attract new industry and to strengthen local firms.

It was because of our concern for Merseyside that we designated it a special development area in August 1974. This means that firms setting up or expanding there qualify for all the regional assistance at the highest rates within Great Britain. In fact, Merseyside is among those places which are given the highest priority in the steering of new investment. I assure my hon. Friend of that. We estimate that Merseyside received some £302 million of regional financial assistance over the five years 1972–73 to 1976–77.

Before I touch upon the National Enterprise Board specifically, I shall refer to one or two other matters. My hon. Friend will know already that, under the Hardman decisions on the dispersal of Government work from London, announced by the Government in July 1974, the North-West Region will receive over 4,000 posts. In fact, it will do best among the English regions. The bulk of these dispersals—nearly 3,000 posts—will go to Merseyside. In addition, Mersey side is scheduled to receive another 2,500 or so Government jobs, through Government decisions on top of Hardman, consisting mainly of the Inland Revenue at Bootle and the Land Registry at North Wirral.

My hon. Friend referred to advance factories, and nursery factories in particular. I can tell him that the Government's advance factory programme has been given a new impetus on Merseyside in the past three years, with the building of nearly 1 million sq. ft. offering the potential for some 4,000 jobs. Much of this is in the inner city. Already factories have been let at Sandon Way and Birkenhead, for example, and more schemes are to follow at Grain Street and King Edward Street, as well as further afield at Knowsley, Speke Netherton, Bronborough and elsewhere.

I refer my hon. Friend also to the selective assistance which Merseyside has received. The Government's measures include various national schemes introduced under Section 8 of the Industry Act to promote investment in certain key sectors of industry and under the accelerated projects scheme and its successor, the selective investment scheme. Up to 14th October, offers of assistance totalling some £2 million had been made in respect of projects on Merseyside, estimated to cost £20 million.

Those are just a few examples of assistance which the Government have given to Merseyside. Of course, in company with my hon. Friend, I recognise that there is still much to be done. The Manpower Services Commission has introduced a wide range of measures with the Government designed specifically to alleviate the increased unemployment brought by the present economic recession. I refer to projects such as the job creation and work experience programmes, the youth employment subsidy, the job release scheme, the temporary employment subsidy and the small firms employment subsidy. Merseyside, in fact, has seen that these measures benefit some 35,000 persons, many of them young people.

If I may refer to the temporary employment subsidy figures by themselves, 14,000 workers in Merseyside have benefited. There is no doubt that without TES many more redundancies would by now have occurred.

Before I refer more specifically to the NEB's role, I want to say how pleased I was with the success of the recent conference in Liverpool on small firms in inner cities. I am sure that my hon. Friend recognised some of the conclusions which emanated from it. What I think it showed was a wide determination on the part of local industry to help in the revival of the inner city areas of Merseyside.

Turning to the NEB itself, I am sure my hon. Friend knows that under its guidelines, which have the force of law, the NEB has a well-defined responsibility towards areas of high unemployment, particularly in the North and North-West. But the NEB cannot create jobs out of nothing. It can invest in companies only where it sees the prospect of an adequate:return within a reasonable period.

My right hon. Friend the Secretary of State has discussed this regional responsibility several times with the NEB's new chairman, and I can assure the House and particularly my hon. Friend that the NEB is fully aware of the importance that the Government attach to it.

I turn now to the report to which my hon. Friend referred. He knows that that was a detailed examination of the problems of Merseyside made earlier this year at the Prime Minister's request in the context of the very disturbing Plessey factory closures on Merseyside and in the North-East. The NEB's report was published in June. A copy of it was placed in the Library. I am bound to say that almost all of its recommendations have been accepted and acted upon by those to whom they were addressed.

The report recommended, for example, that there should be a widening of the differential in regional selective financial assistance in favour of the special development areas. I am pleased to tell my hon. Friend that the Government have accepted this and have also increased the maximum rent-free period on Government factories to five years.

My hon. Friend will recognise that, also arising from the NEB Report, the Government have commissioned PA Management Consultants to identify types of businesses most likely to prosper close to the port of Liverpool. The consultants will want to consider how we might best attract these to the area. They started working in November and hope to report in the spring. Their emphasis will be particularly on creating jobs in inner Liverpool. This, of course, is perfectly consistent with the Government's policy to check the decline in many of our inner city areas.

In Liverpool, partnerships have been established between the Government and the relevant local authorities. I am again glad to tell my hon. Friend that a Bill to give inner city local authorities more power to assist industry had its First Reading on Wednesday. The Government's counselling service for small firms, my fellow Under-Secretary of State for Industry has already announced, following an initial pilot scheme, will be introduced to the whole of the North-West, including Merseyside, next February.

In addition to this, recent Government initiatives to help the inner cities will bring a substantial commitment of central Government resources to Merseyside over the next few years. Some £11 million-worth of capital projects was approved in July 1977 in a programme of construction works for the inner areas of Liverpool. These works included housing improvements, advance factory units, new school buildings and a social services centre.

The proposals, which I believe my hon. Friend mentioned, for an offshore contracting company and a speculative office block are still under consideration, but we hope that the practical and legal difficulties associated with the latter can be overcome.

My hon. Friend made a passing reference to shipbuilding. Of course the Government recognise the contribution made, for example, by Cammell Laird to a viable British shipbuilding industry. Indeed, up to July 1977 loans totalling £21 million and grants totalling £2·5 million had been made available to this company.

There are various schemes of assistance to shipbuilding and, in addition, the Ministry of Defence is always willing to assist in the promotion of sales of all defence equipment overseas. The NEB's report also recommended that the Government should consider a relaxation of the eligibility rules for selective assistance under Section 7 of the Industry Act which at present apply to locally based service industries in the special development areas. The Government feel, however, that locally based service industries depend on local demand, and this would not be increased by giving aid to them.

Of course, I entirely agree with my hon. Friend that the continued existence of locally based service industries is important to the Merseyside economy. Until now, the NEB's resources have been focused on the needs of manufacturing industry, but I assure my hon. Friend that there is nothing to prevent the NEB from investing in service industry where it sees opportunities which meet the requirements of its investment policy.

My hon. Friend has also referred to what the NEB's report said about the need to stimulate the tourist industry. As a development area, Merseyside has already benefited from Section 4 of the Development of Tourism Act 1969, which empowers tourist boards to provide financial assistance to tourist projects, and applications, which are a matter for English Tourist Board, can certainly be considered.

Let me emphasise that only three of the 14 recommendations made by the NEB in its report have not been accepted by the Government, and in each case the rejection has been for sound reasons. I think the House will agree that the Government's response has been a positive one.

As regards the new boards, I think my hon. Friend will understand that the NEB's first problem was the need to secure greater and more direct involvement of local people in the tasks of identifying and appraising potential beneficiaries of NEB finance. A number of hon. Members have made suggestions as to possible candidates for membership of the boards. I know that the NEB has found these suggestions most helpful and has considered them all carefully.

The two new boards will have an active, not merely a passive, say in the NEB's affairs. With the support of the existing NEB regional offices, whose directors will be full members of the new boards, they will seek out opportunities wherever they may be found for NEB investment within their region. They will decide, drawing on the collective experience of management, trade union and financial matters for which they have been selected, whether the NEB should go ahead with proposals to invest in companies in the region. For larger investments, those greater than £1/2 million, they will advise the NEB's main board. They will advise the main board on regional investment matters generally. I hope that that will clarify my hon. Friend's doubts about the NEB's own possible local initiatives.

The second major problem which the NEB is facing in the areas of high unemployment is that of making NEB finance as attractive as possible to industry, to encourage firms to develop in the areas most in need of jobs, such as Merseyside. This task is closely linked with the Department of Industry's work in providing selective financial assistance to firms in the region, and one of the NEB's initiatives is to seek ways of further strengthening the already strong ties between its own regional offices and my Department.

The NEB is, therefore, exploring the scope for investment packages comprising financial assistance from my Department and equity or loans on commercial terms from the NEB. It will be for the regional offices of the Department and the NEB to make the availability of finance in this form widely known. I very much hope—I think my hon. Friend will be able to help in this—that firms on Merseyside and elsewhere in the North and North-West will contact my Department or the NEB to see what help they can secure.

The object of all these measures is to increase the NEB's investment activity in the regions to as high a level as possible. The NEB's regional investment has never been subject to a budgetary ceiling. I make that point particularly in view of what my hon. Friend said. The only limit is the NEB's own financial provision. I am sure that the NEB will be delighted, as I shall be, if we see investment in Merseyside taking up a very much larger part of the total budget in future years.

But I should make one point clear, in view of what my hon. Friend has asked about a more detailed perspective on the part of the NEB. The NEB, in forming a bridge between the public and the private sectors, depends very largely on the good will of the commercial world. It has no special powers, no powers of compulsory purchase, and it is not in the business of investing in companies which lack long-term profitability. It cannot invent jobs. Therefore, to make a real impact, of the sort that all of us would like to see, the NEB needs willing customers for the investment capital which it can make available.

It is not enough for companies merely to hope that the NEB will come along and discover them. The NEB will do its best, but primarily it is for management on Merseyside—I hope that my hon. Friend can provide a degree of assistance in this matter—or on Tyneside or throughout the North and North-West, to contact the regional offices either of the NEB or of my Department to see whether there is any way in which we can help.

I again apologise to my hon. Friend for going through a number of the points on which he asked for a detailed reply. I hope that I have been able to assure him and to give him the information which he sought on the points that he raised. I thank him for giving me the opportunity of giving this information, which I hope will be of use to his constituents. In the same spirit in which he raised the points on behalf of constituents, I hope that he will be able to help the NEB to make a much bigger success of its regional investment activity, particularly on Merseyside.

I am grateful for the opportunity of this debate to urge the full implementation of the Shackleton Report. I am also grateful for the presence of my right hon. Friend the Member for Knutsford (Mr. Davies), who, as Shadow Foreign Secretary, will be able to say a few words.

I draw the attention of the Government to Early-Day Motion 136 on the Falkland Islands, which, among other things, urges the Government

"to declare unequivocally that this free and democratic British community will not be forced into dependence upon a foreign power for its international communications and economic viability."

That admirable motion, tabled by my hon. Friend the Member for Essex, South-East (Sir B. Braine), has been signed by no fewer than 180 hon. Members of all parties in the House, although not many are present today.

If one were to search for a perfection of proportional representation, there would be none better than that of one M.P. standing behind every 10 Falkland Islanders. But Britain's vital interests cannot be over-represented. Indeed, until yesterday I believed that they would be strongly represented in the current negotiations with the Argentine Republic in New York.

I must draw the attention of the House to an article which appeared in Tuesdays Herald Tribune and Monday's New York Times, which said:

"Any agreement that the Falkland Islanders rejected would not even be submitted to the House of Commons for approval, the Foreign Office says, but the islanders would be under enormous pressure to go along with any deal placed before them."

I believe that these leaks and rumours demand some sort of Government denial, otherwise what has been said in this House about the rights and wishes of the islanders being protected seems to be somewhat uncertain.

Today, we have had an announcement in The Times of what has happened in the joint talks. It seems that the British and the Argentine Governments have agreed to form two joint working parties on the issues of sovereignty and economic development. I do not want to go into the issue of sovereignty, but I do not see how we can have an effective working party on a matter which should be a subject for a judicial decision. A working party seems to be a bit of a nonsense. The subject of that working party, I would have thought, should be one for The Hague court.

With regard to the second working party, I would have thought that there was grave danger of burying the Shackle-ton Report before it is implemented. Lord Shackleton spent four months finding out what the developments were. I suggest that a further working party on economic development would only support what Lord Shackleton, recalling the 20 earlier reports, said in his report. When asked to define the Falkland Islands, he said:

"The Falkland Islands is a piece of land entirely surrounded by advice".

There is far too much of that already.

What is at stake is not only the moral position of this country regarding the 1,900 islanders and the fellow subjects who remain there but the considerable British interests in maintaining our claim to the development of the Antarctic region. Any such development could be best advanced by successful negotiations with the Argentine Republic, but such negotiations could take place only on the basis of the Falkland Islands remaining British; and in any advance that is the key.

How important that region is or may be is best summed up by an article in the Financial Times in September 1977 which said:

"Antarctica has some 90 per cent. of the earth's usable fresh water; has the world's largest reserves of protein in the form of fish, krill and other marine life; some of the biggest deposits of coal and iron ore on earth; very large quantities of oil and natural gas; and possibly big quantities of plutonium, copper, nickel, gold, cobalt and other rare metals. In 1975 a U.S. Oil Survey talked about 9 times more oil than in the North Sea."

Of course, such developments must be several years, if not decades, away.

There are those who would oppose that development. There is an Antarctic treaty which plays down development, but it expires in 1991. The hazards and problems are enormous with the ice, the cold and the mountainous seas. But already the United States and the USSR are spending scores of millions of dollars on researching the region, and research in world politics runs very close to the threat of development. Already the Germans and Japanese are experimenting on a big scale with krill fishing in the area.

How crazy it would be to throw away the key to what, in effect, could become a new subcontinent for human endeavour. Unless we see the Falkland Islands in this light as part of a chain of British islands—Ascension, St. Helena, Tristan da Cunha, Prince Edward Island, the South Orkneys and other Commonwealth remote island possessions circumscribing the Antarctic—we shall fail in our national duty to a once forward-looking people whose perspectives in trade and commerce are still global.

This is why immediate implementation of the Shackleton Report is so important and why it should not be shuffled off before substantive negotiations are resumed with the Argentine in February. If the Government do not now agree to expand the airfield, our negotiations with the Argentine will be sterile, unsuccessful and humiliating.

Lord Shackleton's report is a wholly admirable and immensely thorough and detailed document. I quote these examples. Item—the road between Goose Green and Stanley. Item—grasslands: the sheep population could well be pushed up from 600,000 to over 2 million sheep. Item—the seaweed industry, which could have finished alginate products worth £2,000 a ton. Item—clarification of offshore oil, mining, and sea fishing rights.

But the main and most important item is the question of communication. Lord Shackleton felt so strongly about this that he sent the Government an interim report on airfield expansion. Personally, I do not think he has gone far enough. The nodal point of economic development and of political independence for the Falklands is an airfield which can take planes, and large planes, without their touching down on Argentine territory.

Unless this critical question of the airfield is faced and the airfield is paid for entirely by British money, there is the danger that the Falklands will become an Argentine colony, grant-aided by Britain. It may be the will of certain officials in the Foreign Office that the Argentine should control all air movements, build jetties and subsidise air fares between the islands and the South American mainland. It is not, I believe, the wish of this House.

The history of the airfield is not a happy one. In 1969 a 2,300-metre field could have been completed for £1 million. Today, some £4 million at least has already been spent to bring the field up to 1,250 metres. Unfortunately, the real need is to build a field which would have to be nearer 3,000 metres than the 2,200 or thereabouts recommended by Lord Shackleton.

At the moment, a fully-laden VC10 would need 2,530 metres to take off and a BAC 111 would need 1,798 metres. Heavier air transport to move machinery, alginates or sheep—for which there might be contracts with the Middle East, as there are with sheep from Patagonia in the Southern Argentine—would need a runway of the higher order. These, of course, are technical matters. The fact is that the 2,300 metres recommended by Lord Shackleton is an absolute minimum, and this would need considerable expenditure.

One of the troubles is that the airfield was, strangely, built on peat, which meant the removal of 40 feet of overburden before rock was struck, but I am informed that much of the needed extension could be built on sand, which is a more manageable and infinitely cheaper and easier method of operation.

The total cost of Lord Shackleton's recommendations, omitting a major airfield development, is about £7 million over the next five years, but to this would be added a considerable sum for immediately expanding the runway. That might run into a further £7 million or £8 million, making a total of £15 million or more. Is that such a gigantic sum, seen against our annual expenditure of £230 million in overseas aid, some of which, like the £10 million to Mozambique, is very questionable? Is it so huge when one considers the economic and strategic implications of Antartica?

After all, as a trading nation our position in the South Atlantic is not unimportant in time of war. Long before anyone thought about the exploitation of Antarctica, in the 1914 and 1939 conflicts we fought two decisive and successful major naval battles based on the Falklands. Who knows? Perhaps under some international treaty we may be asked to play a part in policing as well as developing the Antarctic region. That is not impossible.

As for economic considerations, there are the obvious possibilities of oil, coal and fishing, as well as underwater development. In the past this country has played a leading part in the development of the oceans—in new designs for ships, as hydrologists, and in submarine design. Sea water covers—and, I hope, will continue to cover—three-quarters of the earth's surface. The Falklands could be a laboratory for the development of new technologies to give work to British industry and shipyards which now depend on huge Government subsidies for the production of shins which are more easily mass-produced elsewhere. For a seafaring people there could be no better challenge.

I am all for collaboration with the Argentine Republic. I have a high regard for Dr. Martinez de Hoz, the present most efficient director of the Argentine economy. There is much that we could achieve together. There is much that we have done in the past to assist the Argentine both in its ancient struggle for political freedom—British names still ring through its history—and in its economic development. I hope that we can see a return to that sort of relationship, but it can be based only on the Falklands remaining British, and the Falklands will remain British only if we can re-establish full air communications with this outpost of our national interests. For this we need a full implementation of Lord Shackleton's report.

We must be grateful to my right hon. Friend the Member for Stafford and Stone (Mr. Fraser) for raising the whole question of the Falkland Islands, as we were grateful last Session to my hon. Friend the Member for Shoreham (Mr Luce) for raising it in an Adjournment debate.

My right hon. Friend rightly concentrated upon the economic issues, on the economic importance, not only to the Falkland Islanders but to us of not abandoning them or disregarding their basic economic interests simple because of a relatively pettifogging attitude in favour of our own economy.

My right hon. Friend also touched on the geo-strategic issues. They are very important.

However, I should like to say a few words on the sovereignty issue. We welcome the repeated assurances by the Minister of State that there will never be any question of putting before the House any proposal for a variation of the status of the Falkland Islands without the full support and acceptance of the Falkland Islanders. However, we should not find it a very happy matter if that acceptance were extorted by such economic pressures being put on the Falkland Islanders as to make abandonment of their sovereignty almost a prerequisite of their economic survival. That would be very unsatisfactory. To judge from discussions I had in Ottawa earlier this year, at the time of the Commonwealth Parliamentary Conference, with the representative of the Falkland Islanders, there is in theory no need to discuss the issue of sovereignty at all. The islanders have already made it abundantly clear that they wish never to be anything but British. I understand that for reasons of convenience it may be necessary for these matters to be discussed, although that view has been clearly established.

The danger of introducing the question of sovereignty into the discussion is that it has the risk of becoming a bargaining counter. If there were any temptation to use that bargaining counter in a way prejudicial to the clearly stated wishes of the islanders, we would resent and reject it.

When we consider the Falkland Islands and other former imperial territories, such as Belize and Gibraltar, we must not forget the debt we owe them, which is of a purely moral character. We have a great debt of honour to those outlying residual parts of our former empire. We must not regard them as expendable, but as nations we honour, love and respect.

I hope that the Minister will be able to assist on the economic issues so effectively put to the House by my right hon. Friend, and will have in mind the deeper issues of sovereignty about which I am so concerned.

On 8th December, the anniversary of the battle of the Falklands Islands, I was able to stand at the Cenotaph as a member of the all-party Falkland Islands Group in this House alongside representatives of the Falkland Islands. It was a symbolic moment for many Members of this House, notably for the right hon. Member for Stafford and Stone (Mr. Fraser).

My only purpose in joining this debate is to confirm what my hon. Friend the Minister already knows—namely, the concern that has been expressed on this subject across the party divide. I was grateful that the right hon. Gentleman mentioned our desire to maintain the best possible relationships with the people and Government of Argentina—but not at any price. I hope that that situation will continue.

I am grateful to the right hon. Member for Stafford and Stone (Mr. Fraser) for giving me this opportunity--at greater length than the Government have been able to do previously—to explain the attitude of the Ministry of Overseas Development towards the Falkland Islands and in particular the Shackleton Report. I know that this subject is rightly a matter on which strong feelings are held in this House. The right hon. Gentleman was right to draw the attention of the House to the number of hon. Members on both sides of the House who have signed an Early-Day Motion on this subject.

My hon. Friend the Member for Liverpool, West Derby (Mr. Ogden) was able to emphasise the all-party concern on this subject. Perhaps as a result of these strong feelings certain misunderstandings have arisen, and I shall do my best to put them right this afternoon and try to allay some of the fears.

I recognise the wider political problems mentioned by the right hon. Member for Knutsford (Mr. Davies) and I appreciate his concern, but those problems fall within the area of responsibility of my right hon. Friend the Secretary of State for Foreign and Commonwealth Affairs. I shall ensure that he fully understands the concern expressed in the House this afternoon. However, it would be wrong of me now to seek to intrude into the subject matter of this Adjournment debate other matters relating to the work of the Ministry of Overseas Development.

First, I should like to state emphatically that the present Government, as their predecessors, have always recognised that the remaining dependencies have a special call upon the aid programme. Political considerations apart—and I am not going to trespass on the territory of my right hon. Friend the Secretary of State for Foreign and Commonwealth Affairs—this has meant that the Ministry of Overseas Development has given a high priority to considering the economic and social needs of the 1,950 inhabitants of the Falkland Islands. The commissioning of the report from Lord Shackleton and his team and the seriousness with which we have followed up the report's suggestions give abundant evidence of our concern with and involvement in their problems.

There is one general point which I must make. When the Ministry and the Falkland Islands Government consider aid—because, needless to say, British aid is not imposed on the Falkland Islands but is provided at the request of, and after discussion with, the Falkland Islands Government—we have to consider the amount of aid which the Falkland Islands can absorb without putting strains on its economy. The islands have hitherto been self-supporting, in the sense that the United Kingdom has not provided them with financial means to balance the budget. They and we wish this to remain so. We therefore have to consider aid which will not place an intolerable burden of recurrent costs on a small community mainly engaged in the wool and sheep industry.

Nor do we wish to flood the islands with expatriates. We have already a very extensive programme, for a country of this size, of technical co-operation and we also supplement the salaries of 44 expatriate officers working in the islands. The Ministry of Overseas Development pays for a large expert team working on the improvement of grasslands, an essential task in an economy based on sheep, but this sort of work is not the kind which produces instant dramatic results, or anything like the publicity which it really merits, both within and outside the Falkland Islands. We have funded a number of visiting experts to advise on subjects, ranging from education to fire fighting, and we shall, of course, continue to respond to similar requests from the Falkland Islands Government as and when they come forward.

Since the publication of the Shackleton Report, our programme of technical co-operation and other aid in the Falkland Islands has in no way ignored Lord Shackleton's recommendations—quite the opposite is the case. I would like to mention some of the things which we have financed which are directly in line with what the report recommends. The report rightly stresses the importance of internal transport to the islanders. We have financed a study of these problems, taking into account both road, sea and air transport. Its recommendations should be ready very soon, and the Falkland Islands Government and ourselves will be able to study them early in the new year.

Another major point made in the report was the importance of improving the education system in the islands. As a result of a subsequent visit by one of the Ministry's education advisers, a project for a new boarding school in Port Stanley has been drawn up, and we are prepared to provide finance for its building. We are also financing the expansion of the important Grasslands Trials Unit, which I have already mentioned, and we have sent an expert out to the islands to demonstrate sheepskin processing. We shall also be prepared, at the right time—the report suggests that this would be after the reports of the grassland trials unit have been received—to finance a study of mutton freezing.

If and when the Falkland Islands want it, we would be prepared to advise on diversification of agriculture, on fisheries and on knitwear production. We have already provided advice on the Islands' fiscal and taxation problems, and this is being studied by the Falkland Islands Government. At their request, we are also recruiting a development officer. All these activities, none of them bringing about revolutionary and dramatic changes, are precisely the kind of things which are needed in a small community with limited manpower resources.

The Shackleton Report, of course, made other recommendations of a far more wide-ranging sort. In particular, the report suggested that there could be large-scale exploitation of three industries in or around the islands, namely, oil, fisheries and tourism. The Government's attitude to these suggestions has been consistent, ever since the late Anthony Crosland made his statement to the House last February. If the industries are to be exploited, it will be for the commercial sector, and certainly not for the Ministry of Overseas Development, to provide the considerable capital sums needed. I do not think that there would be major disagreement with that assertion, but it will not be possible for such large-scale exploitation to take place outside a general framework of economic co-operation with Argentina. I am sure that the right hon. Gentleman's remarks relating to Argentina will probably bear out that assertion—

The Ministry of Overseas Development is not responsible for the political aspects but, as I have already said, it has to take into account the simple facts of geography in relation to the neighbours of the Falkland Islands.

It is for these reasons that we are not prepared to support, at this juncture, a further expansion of the new airstrip which has recently opened. The airstrip is perfectly capable of handling the present traffic requirements of the Falkland Islands. The case for enlarging it would have to be based on the much wider traffic which might be generated by large-scale industrial or other developments such as those I have just mentioned.

I hope that I have been able to convince hon. Members that the Ministry of Overseas Development takes the subject of development in the Falkland Islands very seriously. It has not only carefully considered the recommendations of the Shackleton Report, but has acted on a number of them and is prepared to act on more. It will be prepared to respond to any practical suggestions put forward by the Falkland Islands Government. But we must always have regard to the interests of the present inhabitants of the islands. We do not wish, by imposing aid on them for which they have not asked, to saddle them with a financial burden which they will find it difficult to carry.

As I said at the beginning, I am grateful to the right hon. Member for Stafford and Stone for the initiative that he took in raising this debate. I am grateful on behalf of the Ministry of Overseas Development to have the opportunity to elaborate at greater length than there has been the opportunity to do before on some of the less dramatic less headline-catching and less publicised features of our relations with the Falkland Islands.

I am sure that the House will recognise from many of the things that I have been able to list today, which are very important to the small island economy, that my Department is taking seriously the recommendation of Lord Shackleton and the future interests of the 1,950 people within the Falkland Islands. Once again, I thank the right hon. Gentleman for raising the debate. I can assure him that the serious problems that he has raised will continue to receive the serious attention of my Department.