asked the Secretary of State for Social Services how many patients are currently awaiting admission to National Health Service hospitals in Great Britain.

asked the Secretary of State for Social Services how many patients are currently awaiting admission to National Health Service hospitals in Great Britain.

Information in the form requested is not available as each country keeps statistics in a different form. The figure for England at 30th September 1977 was 591,096, for Scotland at 31st March 1977 53,974, and for Wales at 31st December 1977 35,143. In all cases, the latest available figure is given.

Has the Minister seen the article in The Sunday Times of 2nd July headed

"Twenty heart patients die waiting for operations"?

I have seen the newspaper report. I have asked for a letter from the Liverpool area health authority. I shall consider the matter when I have received that letter. I do not take action on Press reports.

Is the Minister aware that as recently as the end of last month admissions to 36 hospitals were affected by industrial action? Does he agree that this does not help the Health Service at a time when it is already over-administered and under-financed?

If the Health Service is over-administered, it is because the hon. Member for Carshalton (Mr. Forman) and his hon. Friends ensured that it would be over-administered. If the Health Service is under-financed, it is more financed than it would be if the hon. Member and his hon. Friends were in office.

Is my right hon. Friend aware that many people are waiting for heart operations in Liverpool and that the facilities and resources there are nowhere near sufficient to meet the demand in the north-west as a whole? Is he aware that patients have died while they have been on the waiting list—not 20, as reported, but 10? Is he further aware that this is not a new development? Does he agree that it is scandalous when a regional health authority has to be rescued by a private, parasitic medical service? Will he now give a clear and specific assurance that no further patients will die in Merseyside while they are waiting for heart operations and that he will provide the necessary resources?

I am waiting for a report from the Liverpool area health authority. None of the alleged deaths was reported at the time that it occurred. I am aware that the north-west of the country is under-funded compared with the national average, although that is not necessarily so in the Merseyside area. I am aware of the concern in Liverpool. I shall pay attention to the problem and let my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) have an answer after I have considered the problem in detail.

Is the Minister aware that since 26th June there have been no routine orthopaedic admissions to the Royal United Hospital in Bath? Is he aware that 1,500 cases are on the waiting list at that hospital? Does he know that a constituent of mine has been waiting for 18 months in great pain and has been told that the delay is due to a shortage of nurses? Is the Minister further aware that there has been a drastic cut-back in the recruiting of orthopaedic nurses to that hospital in the past few years?

The hon. Member has not previously drawn my attention to the problems that he has just mentioned. I shall certainly look into the problem now that he has raised the matter. I am not complacent. There is a serious problem involving orthopaedic admissions nationwide. That is because there has been tremendous progress in medical techniques in the past few years. That has been accompanied by an increase in the number of referrals. It takes at least 15 years to train a consultant to perform these operations, and there is bound to be a gap between promise and achievement.

Does my right hon. Friend agree that it is not just a question of the absolute numbers awaiting admission to hospital but a question of the discrepancies between hospitals which are often not far apart? What steps is he taking to ensure that general practitioners and patients are informed about hospital waiting lists so that they choose the hospital with the shortest list, even if it is further from their home?

I agree with what my hon. Friend says about waiting lists. The management of waiting lists is one of the problems. The National Health Service has not been good at that in the past. We are ensuring that all general practitioners are circulated with waiting lists for particular specialties at all the hospitals in their areas. They might then break past habits and refer patients to the place where they are likely to receive rapid treatment instead of following the past pattern of selecting a favourite consultant and referring patients to him, irrespective of the length of the waiting list.

asked the Secretary of State for Social Services what plans he has to extend the coverage of the mobility allowance.

In reviewing their public expenditure programme, the Government keep constantly in mind all claims for extending the scope of this important new allowance. As the hon. Gentleman will appreciate, every claim for improvement in the scheme must be weighed both against other proposals for adding to the Government's present level of help for disabled people and all other proposals for increases in public expenditure.

Does the Minister recall that less than a year ago he was writing that it would be neither consistent nor fair to let people keep the trike beyond the age limit set for the mobility allowance? Now that he has changed his mind on the trike, surely there is an unanswerable case for him to change his mind on the mobility allowance as well and let people keep it beyond retirement age.

Right hon. and hon. Members on both sides of the House have welcomed my recent decision about invalid tricycles. We are very mindful of the strong pressures to continue the mobility allowance beyond retirement age. The resurce implications of such a move are very serious. We shall build on what we have achieved so far, as soon as we can. The hon. Member should bear in mind that we are in process of quintupling public expenditure on outdoor mobility for the disabled.

I congratulate my hon. Friend on his tremendous efforts to improve mobility, and in view of the hon. Gentleman's observations on aid for the elderly will my hon. Friend do two things? Will he persuade local authorities to improve their schemes of free travel for the elderly? Will he do his best to improve access to buses and trains, which sometimes causes immense problems in mobility?

I am very active in reminding public transport operators of the importance of providing access for disabled people. I am sure that local author- ities will note with care my hon. Friend's first point. They have powers under section 2 of the Chronically Sick and Disabled Persons Act to assist disabled people in getting to and from facilities provided outside the home. Both points are very important, and I am certain that those who can help have noted that carefully.

Not all the points raised about the mobility allowance are meant to decry the benefit of what has already been achieved. However, will the hon. Gentleman consider the case of people who are able to walk but who are not necessarily mobile and who would benefit very greatly from some small help they might get which fell short of the present level of mobility allowance? That would enable these people to be independent, which is what they are striving most to be.

This is a very important point. It shows that there is pressure from more than one direction for increassing public expenditure in this area. Blind people argue very strongly that they should receive outdoor mobility help under this scheme. People suffering from epilepsy and agoraphobia feel strongly that they should receive outdoor mobility y help. There is much more to be done in this area. We shall move forward as quickly as resources will allow. I hope, however, that no one will underestimate what has been achieved in very difficult circumstances.

Will my hon. Friend consider extending the coverage of the mobility allowance to blind people who, although able to walk, incur many expenses that sighted people do not? They often have to pay for home decorating, and often they have to have taxis when other people could use public transport. Frequently they have to pay for a gardener. I think that the mobility allowance should be extended to that.

I shall keep very much in mind what my hon. Friend said. I hope shortly to be greeting the national organisations which represent blind people. I have no doubt that they will be echoing the point that my hon. Friend has made. We shall improve the present scheme as soon as resources allow.

asked the Secretary of State for the Social Services what is the present position in respect of ministerial consideration of the unused facilities at the health centre in Hazel Road, Knottingley.

I will be writing to my hon. Friend shortly about this matter. Knottingley is not classified as a designated area requiring additional doctors, nor am I aware of any failure to provide general medical services for patients living on the Warwick estate. Knottingley health clinic is being fully used for community health services, although a branch surgery could be accommodated if a general practitioner wished to practise from there. I have no power to direct general medical practitioners to practise in a particular locality.

If a qualified doctor shows an interest in holding surgeries on these premises, which have not been used for that purpose in the 10 years since they were built, will my right hon. Friend encourage the Wakefield area health authority, which owns the building, to be flexible and generous in offering the doctors terms to practise there?

I note my hon. Friend's interesting suggestion. I shall certainly consider what flexibility I can urge upon the Wakefield area health authority in the solution of these matters.

asked the Secretary of State for Social Services if he is satisfied that the advice given to him as a result of the ballot of consultants on the proposed new pay contract represents the real position, in the light of the evidence sent to him by the hon. Member for Brent, South; what representations he has received from the whole-time Consultants Association; and if he will make a statement.

After receiving a number of representations, including a letter from the chairman of the National Health Service Consultants Association, my right hon. Friend wrote to the British Medical Association seeking an assurance that virtually full coverage of the doctors eligible to vote has been achieved. On the basis of the association's reply, I am satisfied that this was so.

Does my right hon. Friend accept that this proposed contract is not only about consultants' salaries but can affect the whole character of the National Health Service? As the whole-time consultants see it as a charter for private practice, will my right hon. Friend ensure that before the Government take any decision they will have either separate monitoring to satisfy the doubts of the whole-time consultants that the coverage has been complete or monitoring of whatever the BMA does in this connection?

Two-thirds of those eligible to vote did so. Of those voting, 70 per cent. were in favour of accepting the new proposals—subject to pricing—including just over 50 per cent. of all NHS contract-holders. The BMA has said that it may hold a second ballot when the new contract has been priced if it feels that the profession should again be consulted.

There is considerable anxiety among some consultants about the pension arrangements, which are a very complicated matter. Were these covered in the contract to which the Question refers?

No, they were not. I shall refer this point to my right hon. Friend the Secretary of State.

Is my right hon. Friend aware that the position that he describes does not apply exactly in respect of some whole-time consultants who feel that since some consultants are not members of the BMA they were not involved in the ballot? Would it not have been better for the ballot to have been conducted by the Department and not the BMA?

The ballot was conducted by the Electoral Reform Society on behalf of the BMA. Every step was taken to ensure that it was correctly conducted. Obviously, a minority did not get ballot papers, but I think that the fact that over 50 per cent. of the total membership voted in favour is an indication that the coverage was pretty thorough.

Will the right hon. Gentleman dissociate himself from the criticisms levelled at the contract by the hon. Member for Brent, South (Mr. Pavitt)? Is it not a fact that the Government have accepted the terms of the contract and that, now that the consultants have voted in favour of it, as soon as it is priced it will be implemented and the Government will operate it according to the terms of the contract?

There is the possibility of a further ballot after pricing, so a final decision has not yet been taken.

asked the Secretary of State for Social Services if he will make a statement about progress in his talks with local authorities about boarding-out allowance for foster-children.

I have little to add to the replies I gave to my hon. Friend on 11th April and to my hon. Friend the Member for Eton and Slough (Miss Lestor) on 27th June. I understand that detailed proposals are being prepared for consideration by the relevant committees of the local authority associations in the autumn.

I thank my right hon. Friend for that reply. Does he not agree that his policy of trying to lead the local authorities gently along this path is not making much progress? Would it not be better for him to give them a good, sharp kick up the backside to persuade them to implement national minimum standards of support, including financial support, for foster-parents?

I note that my hon. Friend is impatient. He has given a very strong lead in this matter and has made a considerable contribution. I have no power to direct local authorities. All I can do is to give them a lead, and I did that by accepting my hon. Friend's suggestion that the rates of boarding-out allowances should be published in Hansard.

Has the Minister considered, within the context of these talks, an extra boarding-out allowance for children who are disabled or handicapped in any way?

I note the hon. Lady's claim for extra public expenditure, which is contrary to the policy of her party.

Is the case of privately fostered children also being considered? Is my right hon. Friend aware that the foster-parents of such children, in the event of the natural parents defaulting on their payments, may be denied practically all assistance from public funds? I have an example of a child in my constituency who is being denied assistance in this way and who is not even being permitted to have free school meals.

Fostering has not been regarded as part of this exercise, but if my hon. Friend will put down a Question on the subject I shall give him the information he seeks.

I welcome the news of the terms due in October. Is the Minister aware of the unease felt by many foster-parents, as evidenced by their trip to the House of Commons, about the inequalities in the regions? Will he take a positive attitude to ensure that there will be no further delays?

The last time we discussed this subject, the hon. Member raised the question of fostering. It is outside the terms of the Question. If he will put down a Question about fostering, I shall endeavour to deal with it.

asked the Secretary of State for Social Services whether he is satisfied with the provision of accident and emergency services in Mid-Sussex; and whether the new nucleus hospital in Haywards Heath will include such services.

Is the Minister aware that both the local community health council and the medical executive committee are unanimously opposed to the phasing out of accident and emergency services at Cuckfield hospital? Does he think that only one accident and emergency unit will be sufficient in a health district which will have a population of 400,000 by the mid-1980s and which will be growing rapidly due to the expansion of Gatwick airport? Will the Minister therefore seriously reconsider this decision?

The health authorities concerned in the region are planning on the basis that Cuckfield hospital will cease to provide a full accident emergency department, but this will be subject to normal consultative procedures, so that the organisation to which the hon. Gentleman has referred will have an opportunity to make its point then. For the longer-term future, the regional health authority will be considering whether to include an accident and emergency department in later phases at Haywards Heath when it comes to decide on the functional content of further development in the light of population predictions at that time.

asked the Secretary of State for Social Services whether he remains satisfied with the consultation procedures of area health authorities in the light of the approval by the Hampshire area health authority, including the appointed members, of fluoridation of drinking water, though consultation indicated that the county council and 10 out of 12 district councils were opposed to the proposal.

Yes, Sir. The decision to seek the introduction of fluoridation of water supplies rests with the area health authorities as part of their statutory responsibility for preventive health in their areas. I am satisfied that Hampshire area health authority—teaching—took its decision after adequate consultation and after consideration of the evidence on the safety and efficacy of fluoridation in preventing dental decay in the community.

What is the point of providing for a democratic consultation process if when it produces a clear and decisive result, the area health authority immediately goes totally in the opposite direction?

Not only the views but also the reasons given for them have to be assessed, and also weight has to be given to those reasons. The Hampshire area health authority did this before taking its decision.

Is it not clear that there is no pressure at all from the people of Hampshire to have fluoride added to their drinking water? Who has the final decision in this matter? Is it the Secretary of State for Social Services, the Secretary of State for the Environment or the health authority? Who has the final decision?

The area health authority has the final decision in these matters, although, of course, it has to operate through the local water authority. It is not true, as my hon. Friend says, that there is no desire for fluoridation in Hampshire. For example, the Winchester community health council carried out a survey of public opinion which showed a large body of support in favour of fluoridation. That was the only community health council in the area which carried out such a survey.

Whatever one's views on fluoridation—one recognises that children are perhaps less articulate at the age of 3 than are adults at the age of 60—is the Minister aware that the information given by my hon. Friend the Member for Basingstoke (Mr. Mitchell) is factually correct and that the confidence of the general public in any remaining democracy within the Health Service is shattered when there is apparently a total dereliction of duty in the consultation process by the area health authority?

No, Sir. What the hon. Gentleman has to explain is that, although local councillors on local councils might be opposed to it, local councillors on area health authorities are in favour of it.

Is the Minister concerned that the procedure which we are discussing was set up in the National Health Service Reorganisation Act 1973, put through the House by the right hon. Member for Leeds, North-East (Sir K. Joseph), and does he agree that these decisions would have been better taken by elected representatives in the House of Commons than by appointed members of area health authorities?

That would have been a very useful suggestion if my hon. Friend had been a Member of the House in 1973 and been able to put it forward. Incidentally, it was not only the right hon. Member for Leeds, North-East (Sir K. Joseph) who put through that Act; it was the entire Conservative Government at the time.

asked the Secretary of State for Social Services what proposals he has received for the maintenance and improvement of acute hospital facilities in Hemel Hempstead.

Proposals for maintenance and minor improvements are the concern of health authorities and do not come to my Department for approval. Proposals for major improvement of acute hospital facilities would await a decision on the provision of acute hospital services for the north-west district of Hertfordshire by the health authorities before being submitted to my Department.

Given that the chairman of the Conservative Party, Lord Thorneycroft, said in my constituency last Saturday that there was little hope of any incoming Conservative Government immediately making money available for a new hospital at Hemel Hempstead, can my right hon. Friend say exactly what the cash position is? Can he also confirm that we are talking about the development and maintenance of acute services in the area and not their destruction?

I am appalled at the irresponsible remarks of Lord Thorneycroft. I have visited Hemel Hempstead and have no hesitation in saying that it needs decent hospital facilities to serve it. The Health Service will make capital money available for any reasonable solution to the hospital problems of the north-west Hertfordshire district and Hemel Hempstead in particular.

Does the Minister accept that there is great anxiety among people in Hemel Hempstead that their acute services are to be moved to St. Albans? This will cause great hardship for people who have to travel that distance, which is not easy.

The acute anxiety which exists in Hemel Hempstead has been exacerbated by the intervention of Lord Thorneycroft. I urge the inhabitants of Hemel Hempstead to pay no attention whatever to Lord Thorneycroft, because if the Labour Party remains responsible for government Hemel Hempstead will have new hospital facilities, and money is available for them. The hon. Gentleman knows a lot more than I do about what is going on in Hemel Hempstead. He says—it is totally wrong—that the hospital facilities are to move to St. Albans.

asked the Secretary of State for Social Services how many persons are in receipt of mobility allowance and attendance allowance in Birmingham and the West Midlands.

The latest information available for the West Midlands region, which includes Birmingham, is that 6,439 people are currently receiving the mobility allowance and 27,035 the attendance allowance.

I thank my hon. Friend for that information, and I pay tribute to his work in bringing these figures up, but will he take it that even in the past few days I have had constituents coming to see me who have only just found out about the mobility allowance? Moreover, I have another constituent—I do not want other hon. Members to be in the same position—who has fought on for three years because she did not know about the attendance allowance, yet this constituent, Mrs. Simkins, was in touch with every statutory authority that one could think of and no one pointed it out to her, with the result that she lost three years' attendance allowance.

My hon. Friend raises an important matter. I am very anxious to increase the take-up of all the new benefits. The additional help which this Government have made available for the dis- abled is wasted if people do not know of it and therefore do not claim. We have used press advertisements and press statements. We have been in touch with organisations of disabled people. The Attendance Allowance Board has been in touch with directors of social services and general practitioners. I shall do everything I possibly can to draw further attention to these new benefits, and I hope that every hon. Member on both sides of the House will do what he or she can to increase public knowledge of all that has been done for the disabled and of what is now available for them.

Is the Minister aware that in my Birmingham constituency there are several mothers who have sons or daughters on kidney machines who are to lose their attendance allowance later this week? This is causing great hardship and distress. What will the Minister do to alleviate it?

The hon. Gentleman has no basis for the statement at the beginning of his supplementary question. There is a case now with the national insurance commissioner. We are not yet aware of the outcome of his consideration of that case, and we shall look with great interest at the outcome. It is the case of a constituent of my hon. Friend the Member for Derby, North (Mr. Whitehead). The hon. Gentleman can be well assured that we are giving anxious consideration to the matter and that we shall make a statement as soon as we know the outcome of the national insurance commissioner's consideration and decision.

The House is well aware of the Minister's efforts to increase the take-up rate of these benefits, but has he read the document "Second-class Disabled", published by the Equal Rights for Disabled Women Campaign, which shows clearly and dramatically that there are many women who are receiving both mobility allowance and attendance allowance but who cannot get the invalidity allowance, not because they do not know that it exists but because of the way in which the Act has been drafted and is now being interpreted by my hon. Friend's civil servants throughout the country?

My hon. Friend is referring to the housewife's non-contributory invalidity pension. As he says, there are disabled housewives who receive both the attendance allowance and the mobility allowance but who have not sustained their claims to the HNCIP. I must emphasise that decisions are taken by the independent adjudicating authorities. I have been told by women's organisations that there is a strong case for amending the law. There will be resource implications there. Any decision in a particular case is for the independent adjudicating bodies. I am glad that my hon. Friends make their point about resources. There is no case whatever for hon. Members to ask us to cut public expenditure and then ask for more and more for their own constituents.

Can the Minister explain why, in the case of the HNCIP, there are many more successful appeals after first refusal than in the case of any other benefit? Does it not strike him as an indication that there is something wrong in the way in which the benefit is first considered, and ought he not to look again at the rules about incapacity to do housework?

The hon. Lady will remember that I consulted hon. Members on both sides about the new benefit before it was introduced. It has been put to me that there is a case for looking carefully at the number of successful appeals that there have been. I shall take great interest now in all appeals and look at the claim form for this benefit to see whether there is any further action which I should take.

asked the Secretary of State for Social Services if he is satisfied with the overall efficiency of his Department; and what proposals he has for its improvement.

Yes, Sir; but we are constantly seeking to improve it and would welcome any constructive suggestions from the hon. Member.

I am most grateful for that. Has the Minister listened today to the points made by, for example, his hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) and my hon. Friend the Member for Wells (Mr. Boscawen) and been alarmed at the evidence of deteriora- tion in the standard of the Health Service? If the Minister wants a suggestion from me, may I put one to him now? Will he take a stand against the militant trade unionism and the activities of COHSE and NUPE, which are simultaneously destroying confidence in the Health Service and reducing standards in it? Perhaps he would like to start by openly condemning the strike at the Charing Cross Hospital, where attempts are being made to deprive patients of food.

I was wrong to ask for any helpful suggestions from the hon. Gentleman. In fact, my right hon. Friend has been conducting detailed discussions with both the medical profession and the trade unions to reach an understanding within the Health Service which will be helpful to both patients and themselves. What the hon. Gentleman has said has given no help whatsoever to that.

Does my right hon. Friend believe that it contributes to the work and efficiency of his Department and the Health Service if multinational drug companies are still permitted to run bogus trials of their drugs in order to induce doctors to prescribe them for their patients? Is not this extremely wasteful of resources, and is it not high time that my right hon. Friend stepped in to stop it before British companies are forced to engage in the same practices?

I cannot comment on the specific point which my hon. Friend raises, but my right hon. Friend has paid particular attention to the drug industry and to the number of prescriptions issued by the medical profession. I shall certainly draw that matter to his attention.

May I take up the Minister's invitation and make a serious suggestion to him? Will he substantially improve the monitoring by his Department of expenditure by area health authorities, which is quite inadequate at present, and will he encourage greater use of private contractors for cleaning and ancillary services, thereby releasing a great deal of public money for such things as kidney machines and so forth?

On the latter point there is a Question later on the Order Paper, and I shall not be drawn now, though I appreciate what the hon. Gentleman was attempting to do. As for the first point, there is close monitoring of public expenditure through the area health authorities. There is great difficulty in this field, and a lot of the problems lie at the door of the previous Conservative Government who implemented the reforms.

Would it not make good management sense and also lead to good mental health care if the medium secure unit in the north-west, an area with which my right hon. Friend is associated, was opened? May we, therefore, have an assurance that either the Secretary of State or one of his ministerial colleagues will give consideration to the possibility of conciliation in this matter, which certainly should not conflict with NUPE?

I take that point. I have visited the unit to which my hon. Friend refers. We should certainly like to see that unit operating, and we are looking at means to try to achieve that end.

May I also make a constructive suggestion, turning the Minister's attention to the press department of the DHSS? Is he aware that the Department has in the past few days put out two releases of speeches by the Minister with responsibility for the disabled, of whom we are very fond, in which he has appeared to claim the credit for the introduction of the behind-the-ear hearing aid, which was introduced by the last Conservative Government, and has claimed the credit for the exemption from vehicle excise duty, which was forced on him by the Opposition?

The last matter was not forced on my hon. Friend by the Opposition. It is this Government who will implement the vehicle excise duty exemption. The right hon. Gentleman knows that. On the first point, my hon. Friend the Minister was drawing attention to the fact that we passed the half-million mark in hearing aids, which I regard as very creditable.

asked the Secretary of State for Social Services what timetable has been suggested to voluntary organisations and others for their response to the consultative document on the elderly.

We have asked for comments by the end of October 1978. This is so that we can press on with preparation of a White Paper, which we plan to publish next year. But we are prepared to be flexible if any organisation has particular difficulty in meeting this deadline.

I congratulate my right hon. Friend on the issue of the consultative document, but does he agree that in any consultation about the problems of the elderly the most important people to consult are the elderly themselves? Is it not a bit daft that the document should cost 95p a time, and could my right hon. Friend make arrangements for those of the 8 million pensioners who want to know what may be proposed for them to obtain copies without charge? Further, does my right hon. Friend accept that, although within 20 years poverty in old age may be abolished, there is need to divert resources with urgent priority to the present generaton of pensioners who will never benefit from those long-term proposals?

On the second point, my hon. Friend will be aware of the measures which the Government have taken even this year to improve the lot of the pensioner and of what has been done over the past few years, for which, I think, the Government can take great credit. As for distribution, the Government have taken steps to see that these documents are available free of charge in centres which old people attend. We distributed many to leading organisations representing retired people, and we hope that that will meet the need.

Does the right hon. Gentleman accept that the use of the phrase "tomorrow's pensioners" in the consultative document is very misleading, because that is 20 years ahead? It is today's pensioners who matter. Is it not a fact that this coming winter millions of today's pensioners will have to choose between keeping warm and having sufficient to eat?

When we put the uprating order through the House only recently, that meant that in the past four years this Government have increased pensions in real terms by over 21 per cent.—the largest increase for pensioners in modern times—along with heating allowances and other provisions. Of course more needs to be done, but we need more public expenditure for it. Perhaps the hon. Member will pay some attention to that.

asked the Secretary of State for Social Services what progress has been made in the campaign to reduce wastage of drugs in hospitals.

Many hospitals have now established drugs and therapueutics committees whose tasks include the more economic use of drugs. Representatives of these committees met recently to discuss how best to fulfil these functions. The announcement on prescribing which the chairman of council of the BMA and my right hon. Friend issued jointly in April should have stimulated all doctors to seek ways of applying its principles to their particular fields of practice.

Is it not a fact that the amount of money spent on drugs in the Health Service is still rising steeply and that the most recently available figure is £87 million per annum? Is the right hon. Gentleman expecting that, as a result of the measures which he has just mentioned, that figure will be cut as substantially as those working in the NHS say that it could be?

I will have to have notice in order to give the hon. Lady the exact figure, but certainly the expenditure on drugs in the Health Service is higher than we should like. We expect that the measures announced will lead to economies.

Why did my right hon. Friend reject the advice in the drugs therapeutic bulletin that I sent him, which would not only have saved wastage on drugs but would probably have cut the excess profits of drug companies by about £50 million to £60 million?

I would draw my hon. Friend's attention to the fact that the pharmaceutical price regulating scheme mechanism limits the profits which companies can make on drugs.

asked the Secretary of State for Social Services if he is satisfied with the provision of reciprocal health services in EEC countries for the children of self-employed persons.

We have consistently pressed for amending EEC regulations to provide this cover and they are at present under consideration within the Council of Ministers. Self-employed persons and their families are covered for immediate treatment, under bilateral agreements, when visiting Denmark and the Federal Republic of Germany.

Is it not nonsense that the children of employed people are covered for medical treatment when travelling throughout the Common Market but that the children of the self-employed are not necessarily so covered? Why have not the Government done more to put right this ridiculous anomaly?

The Government have done a great deal, but we have to operate within the framework of the Treaty of Rome, and at present the exising regulations in article 51 make it clear that they apply only to employed people. It is solely as a result of this Government's efforts in Brussels that we have got as far as we have in trying to cater for the needs of self-employed people and their families.

Is my hon. Friend aware that while 14 Questions have been answered this afternoon I have made a careful count of the number of times that the Opposition have asked for increased expenditure and that the total is 10? Does he feel as sick as I do about the organised hypocrisy of a party which does that and at the same time votes for a reduction in public expenditure of £500 million?

I entirely agree with my hon. Friend.

asked the Prime Minister if he will list his public engagements for Tuesday 11th July.

In addition to my duties in this House, I shall be holding meetings with ministerial colleagues and others. This evening, I hope to have an audience of Her Majesty the Queen.

During the Prime Minister's undoubtedly busy day, will he pause to reflect that during the stewardship of this Labour Government consumer prices have risen by a staggering 91·1 per cent.—the worst of seven major OECD countries—and that food prices have risen by an enormous 99·8 per cent., the next but one to bottom in the same league table? Will he make abundantly clear to the people of this country the basis upon which the inflation figures that his Government will be putting out in the next few months are calculated, so that there can be no more misleading nonsense of the type of the Chancellor's 8·4 per cent. claim in October 1974?

I have explained to the House on many occasions, but I will continue to do so, that when the Government came into office we were faced with higher inflation than exists today. It was going up and would have continued to go up because of the indexing of wages which had been agreed under the previous Government. We have reversed that and the level of inflation is now lower than it was when we came to power. As for food prices, I wish that the hon. Member had been in the House when the previous Administration took us into the Common Market. Perhaps then he would have pressed upon his leader the necessity for negotiating a better deal than he got on the common agricultural policy.

Will my right hon. Friend try to find a couple of hours this afternoon to pop up to Hatfield and hear how delighted the aircraft workers are at the Government's decision to go ahead with the HS146 and how determined they are to make the aeroplane a commercial success, for the benefit both of British Aerospace and of the country as a whole?

I know that my hon. Friend, in representing the aircraft workers, has made substantial representations on this matter to British Aerospace. It was British Aerospace's commercial decision, which it asked us to ratify, and we were very pleased to do so. It seems to me that there will be a good future for this plane. British Aerospace is being asked to make a commercial return on the substantial sums which are being invested. I am glad that it will provide employment for several thousand people.

Has the Prime Minister had time to consider today the latest evidence published yesterday on the people's attitude to further nationalisation? Is he aware that it showed that 80 per cent. of the people do not want any schemes of further nationalisation and that even the majority of those in the Labour Party take the same view? Why, then, do he and his party keep their commitments to extensive schemes of further nationalisation, both of whole industries and of major companies?

Yes, Sir, I always look at all polls in the newspapers—though I do not necessarily believe all their conclusions, the right hon. Lady will be relieved to hear. As for the particular poll to which the right hon. Lady refers, I am not unaware of the feelings expressed in this matter. That is why I believe that organisations such as the National Enterprise Board have a considerable role to play. I am very glad, because it will combine private and public enterprise and private and public funds. That is why I am glad to hear that the Conservative Party seems to be seeing sense now and, according to its latest document, or the latest speech, I understand, does not propose to abolish the NEB. That will come as a considerable relief to many hundreds of thousands of workers.

As usual, the Prime Minister has inadvertently omitted to answer the question. Why do he and his party still stick to extensive commitments to further nationalisation of whole industries and of companies? Is his last reply the correct one—that for him nationalisation is never off the agenda?

When I gave the reply that nationalisation was never off the agenda, I was thinking of what the previous Government had to do in nationalising Rolls-Royce. When they are driven to nationalisation, it shows that even they must at times face the realities of the situation. We shall continue to do so as we face the problems of these industries, whether we handle them through the National Enterprise Beard or through public ownership. I dare say, if the Opposition ever came to power again and were faced with another situation like Govan Shipbuilders or Rolls-Royce, that they would overcome their prejudices and nationalise once more, as they did last time.

asked the Prime Minister if he will list his official engagements for 11th July.

I refer my hon. Friend to the reply which I have just given to the hon. Member for Hereford (Mr. Shepherd).

Does my right hon. Friend accept that, although the Opposition seem to have nothing better to do than to stoop to personal abuse, he should instead give an assurance that he will concentrate upon policy and spend some time today outlining the Opposition's policy for increasing council house rents, increasing prescription, dental and optical charges, and imposing charges for people visiting the doctor and having to stay in hospital? The Leader of the Opposition's disgraceful suggestion—

Order. I made it clear the other day that the Prime Minister—or any other Minister—cannot be questioned about statements made by those on the other side of the House but only about those things for which he is responsible.

I have noticed that the Opposition apparently will wish to keep public expenditure constant if they ever come to power. If that is so, in view of the large increase in the number of elderly people and the Opposition's proposals for additional defence expenditure, I do not see any escape from the alternative that they would have to charge very heavily for operations or for stays in hospital or for visits to the doctor. They must reconcile these things at some time.

When the Prime Minister meets his Cabinet colleagues today, will he find time to discuss the many things that are happening in Britain's 200-mile economic zone? Is it not about time that he set up a ministry of marine affairs that will look after our fishing, our oil, our shipping and our mineral extraction? Is he aware that at present the Danes and the French are making away with our fish, the East Europeans are making away with our shipping, and the Germans, the Americans and the Italians are making away with our oil while we are nonstarters in the race for the extraction of minerals?

As the hon. Member knows, I have considered setting up a ministry of marine affairs. It does not seem that these functions, which are so different, would be best reconciled through such a ministry, although there is a Minister who co-ordinates all these matters. The fishing problem was raised at Bremen at the weekend and I said that we were looking for a just solution to this problem. The Chancellor of the Federal Republic said that he hoped to achieve a solution during the period of the German Presidency—that is, between now and the end of December.

asked the Prime Minister whether he will publish his official engagements for 11th July.

I refer the hon. Member to the reply which I gave earlier today to the hon. Member for Hereford (Mr. Shepherd).

Will the Prime Minister bear in mind that today is exactly six months since the east coast floods and five months since the Government announced the criteria for paying the victims? Is he aware that no one, whether domestic, industrial or agricultural, has received a penny of any compensation or relief? Will he now set up a national disaster fund, which he might administer himself, so that people can get flood damage relief instead of promises?

I regret to hear what the hon. Gentleman says about no payment of compcation. I will ask the Secretary of Statetor the Environment to look into it. understand that so far only four applications have been received from local authorities. It is not clear why this should be so, and we are waiting to see whether there will be further claims or whether local authorities are not claiming because they do not expect the expenditure to exceed a penny rate.

Has my right hon. Friend in his busy day managed to read the stories about Bremen by economics correspondents in The Times and The Guardian today, apparently based on Treasury briefing? Will he say whether his own attitude towards the Bremen results is as hostile as is apparently that of the Treasury mandarins?

I do not have to take any responsibility, thank goodness, for what appears in the press. I noticed there there was a change in attitude, but I think that on the whole they reinterpret what they themselves have said originally, rather than ascribing any difference in attitude to me.

asked the Prime Minister if he will dismiss the Secretary of State for Employment.

No.

It is a bit late in the day to make changes. Will the Prime Minister explain why every Conservative Government since the war have left office with more people employed than when they came in and why every Labour Government since the war, without exception, have left office with fewer people in employment than when they came in?

It is pretty generally understood that the level of unemployment is related to the world recession. That is why the Government have endeavoured to use measures that would help industry, through such devices as the temporary employment subsidy—against the wishes of the Opposition. It is also the case that there are more people in employment today, as distinct from more people unemployed, than there were in 1973. As to how we leave office, that will not be for a long time yet, so I do not think that the hon. Gentleman needs to worry. His memory is singularly short if he does not remember that when the last Conservative Government left office there was a three-day working week in operation.

Does my right hon. Friend accept that it is a reasonable statistical estimate that if all the proposals which the Opposition have supported in the House had been carried out there would be a million more people unemployed at present? Would he care to comment on that?

I certainly agree with my hon. Friend that if the policies advocated by the Opposition were put into effect there would be a substantial increase in unemployment. I do not think that they deny that.

Rubbish.

It must be clear that the removal of grants and subsidies, which is the Opposition's policy, would lead to the collapse of a number of firms in the depths of the recession. Therefore, we believe that we should continue with these policies until the world economy picks up again.

When the Prime Minister was in Bremen last week, did he notice the figures which showed that Germany's unemployment was at a four-year low in June? Does not that emphasise the tragic contrast between four years of private enterprise recovery from the oil crisis in Germany and four years of Socialist slump in Britain? Is it not because of that contrast that the German wolfhound bit the Prime Minister so hard last week?

On the contrary. It was not like a sheepdog but it was nearly as nice. Germany, like other countries, has suffered from an increase in unemployment to a considerable extent. There are now a number of countries, I regret to say, whose unemployment levels are higher than that of the United Kingdom.

Name them.

If the hon. Gentleman will table a Question, I will give him an answer. [HON. MEMBERS: "Oh."] It is no use hon. Gentlemen shouting "Oh". Everyone knows that this is true. There are, I am glad to say, other countries which we must try to emulate. What is certainly true is that this Government, through their measures to contain unemployment, have done much better than a number of other countries. I shudder to think what would happen if the Opposition came back to power and reversed those policies.

While I agree that the unemployment figures are far too high, particularly in the northern region, may I ask my right hon. Friend whether he agrees that today's inflation figures are extremely encouraging, not only in terms of what happens to inflation this year and next year but in terms of what happens to unemployment this year and next year?

It is true that the wholesale price figures published yesterday show that there is likely to be a considerable steadiness in the inflation rate between now and the end of the year, which is as far ahead as I have always wanted to prophesy because so much depends on the next wage round. [Interruption.] Hon. Members opposite need not affect any surprise about this. So much depends on what happens in the next wage round and upon matters such as the strength of sterling, which is pretty stable at the moment, and similar issues. The lower the rate of inflation—this is what I have said 150 times and will say another 150 times—the more prospects we have of more competitive jobs and, therefore, of more employment.