asked the Secretary of State for Social Services what advice he has received as to the compulsory wearing of seat belts from the Medical Commission on Accident Prevention.

None recently, but the president of the Medical Commission on Accident Prevention wrote to my right hon. Friend on 6 July 1979 expressing dismay at the loss of the Road Traffic (Seat Belts) Bill with the dissolution of Parliament earlier in that year.

In considering this or any other advice that he may receive from the commission, will my hon. Friend agree that this is pre-eminently an area in which progress should be made by precept and example and not by legislation?

On 99 issues out of 100, I agree with my hon. Friend's perception of what the Tory Party stands for, but this is the hundreth issue, and I have to agree that compulsion is fitting. It is worth noting that in the Division on the Bill introduced by the hon. Member for Glasgow, Kelvingrove (Mr. Carmichael) in July 1979, of those Conservatives who voted, a majority voted for the Bill.

One of the claims of the supporters of the compulsory use of seat belts is the alleged cost of the accidents and the hospital treatment. Will the Minister refer to the written question which the Secretary of State answered last week, showing that 20 times as much money is expended on accidents and illness arising from smoking, drinking and various other causes? Perhaps the pessimists will bear that in mind.

No simple solution is available in the case of the illnesses associated with the activities mentioned by the hon. Gentleman, whereas seat belts have been tried and tested and found to be successful in other countries.

Does the Minister agree that no other single practical measure that can be taken would have such an effect on the reduction of loss of life and serious injury on the road? Does he also agree that there is something illogical about the attitude of those people who proclaim the merits of seat belts yet will not support the single practical measure that can be taken to ensure a high rate of wear of seat belts?

I have made clear my own position. It is worth adding that my hon. Friend the Minister for Health and my right hon. Friend the Secretary of State would also, in a free vote, vote for a Bill providing for the compulsory use of seat belts.

May I say how warmly I welcome the statement made by the Minister, and the further statement on behalf of his colleagues? Is the Minister aware that not only the Medical Commission on Accident Prevention but the Royal College of Surgeons, the Royal College of General Practitioners, the Royal Society for the Prevention of Accidents, the Automobile Association and many other organisations deeply regret the position taken by the Secretary of State for Transport? Will the Secretary of State for Social Services use his good offices to ensure a more flexible attitude when the issue is debated in the House of Lords on a motion by Lord Nugent?

I welcome the right hon. Gentleman's support for the existence of a second Chamber.

Is my hon. Friend aware that precept, example and the expenditure of a considerable amount of public money on exhortation have not solved the problem, and that all the evidence that is given to hon. Members, to the medical profession, to the ambulance services and to the police, leads inexorably in the direction that compulsion is absolutely essential?

I endorse what my hon. Friend has just said.

asked the Secretary of State for Social Services whether he will seek to place the onus on National Health Service practitioners to advise patients whether or not they are receiving treatment under the National Health Service, rather than the onus being on the patient to find out what sort of treatment he is receiving, as at present.

The ethical onus is already on the practitioner. It is a fundamental part of good professional conduct that when a patient seeks treatment he knows the basis on which it is being given.

Should not something more than an ethical onus be placed on the practitioner? Is not my hon. Friend aware that the present situation is very unfair to many patients, particularly those seeking emergency treatment?

I am aware that recently one of my hon. Friend's constituents had a special problem in an emergency. The present system has been working reasonably well for a long time. However, I undertake to look into the matter again with the General Dental Council and the British Dental Association.

When will the regulations proposed by the DHSS, which concern patients who receive treatment from National Health Service practitioners, but who are not entitled to free treatment—such as those visiting from abroad—come into effect? It should be borne in mind that the tourist season is upon us.

I expect the regulations to come in in October.

asked the Secretary of State for Social Services how many patients are awaiting transfer from each of the special hospitals; and when he expects the transfers to take place.

On 1 April 1981, 31 patients in Broadmoor, 129 in Rampton, 43 in Moss Side and four in Park Lane hospital were awaiting transfer. These transfers will take place as soon as the appropriate health authority can make a suitable hospital bed available.

Is the right hon. Gentleman aware that he and his predecessors have been saying that for the past seven years? Is it not a continuing disgrace and scandal that many patients have to wait a long time in those hospitals, particularly when many are probably being detained illegally and are certainly being denied proper medical care and treatment? Will the right hon. Gentleman ensure that the NHS lives up to its responsibilities?

I share the hon. Gentleman's concern, but it is only right to put on the record what has been achieved. In the first quarter of this year 61 patients were transferred, compared with 38 in the same quarter of last year. Since last November—when the Rampton report appeared—90 patients have been transferred. There is a marked increase in the rate at which special hospital patients are being recommended for transfer. The number of patients who have been waiting for more than two years has fallen from 66 in January 1980 to 45 in April 1981. That is a reduction of almost one third. I am satisfied that the health authorities are doing their best. More patients are being recommended for transfer. I intend to keep a close watch to ensure that the intention which the hon. Gentleman and I share—that those who should not be in special hospitals are transferred to National Health Service hospitals—becomes a reality.

Whether transfers are made to NHS hospitals or back to the community, does the Secretary of State agree—particularly in cases that involve criminal offences—that continuing surveillance should be the order of the day? It would then be possible to reassure those communities that surround NHS hospitals to which patients had been transferred. In addition, such surveillance would be in the interest of the patient.

I understand my hon. Friend's concern. It is essential that there should be secure accommodation for patients who are regarded as a danger to the community. That is why the Government have maintained and are getting ahead with a policy that will give each region a regional secure unit, to which patients for whom such treatment and care is appropriate can be transferred.

Although there has been an advance in the number of patients transferred, is there not a time lag? Is the Secretary of State satisfied that local authorities will have sufficient money to help in the provision of halfway houses, in the form of hostels? In several counties, suitable hostel accommodation is lacking and existing accommodation is being closed.

One must be realistic when discussing the transfer of patients from special hospitals. The vast majority of patients will need psychiatric care in NHS hospitals. The subsequent transfer to hostels—if appropriate—is a different question.

Is my right hon. Friend aware that another special hospital, namely, Perivale maternity hospital in my constituency, is in difficulties? It is strongly rumoured that there is a danger of closure less than a year after confirmation that it had a strong future. Will my right hon. Friend confirm that?

Order. The hon. Gentleman should put that question on the Order Paper.

asked the Secretary of State for Social Services if he will make a statement on the provision of training facilities in the National Health Service.

Responsibility for the professional training of most NHS staff is vested in statutory or other independent outside bodies. Advice on other training is provided by the National Training Council for the NHS and the five national staff committees.

Will not NHS training facilities be used by the private sector? For example, the promoters of the Yorkshire clinic, which is being built near Bingley, will almost certainly draw NHS-trained staff from Airedale general hospital, in my constituency. What will the right hon. Gentleman do about private sector promoters and those consultants who put greed before need, in placing private profit before the duty of service towards NHS patients?

I must make it clear that I disagree with the hon. Gentleman's view about the private sector. We welcome the growth of the private sector, because it adds to the total of health care resources available to the people of this country. In addition, it relieves pressure on the NHS. However, the private sector could and should make a greater contribution to the training of health care staff, particularly nurses. My hon. Friend the Minister for Health has been having discussions with the joint liaison committee for independent health care on how the private sector's contribution to staff training might be increased.

In view of the bottleneck caused by the private sector's drainage of specialised nurses, such as trained theatre nurses and those qualified in renal dialysis, will the right hon. Gentleman put special money into crash courses to repair the damage done? Given the unemployment problem, will he discuss with the Secretary of State for Employment the problem of training in the professions supplementary to medicine, particularly chiropody, in which many school leavers could do a useful job?

I am not sure that I would want to be operated on in a theatre in which staff had been through a crash course. As I said, we want the private sector to make a better contribution. I welcome the fact that the Wellington Foundation has established a lectureship in nursing at the Chelsea college of the University of London. I am glad to say that that will make a considerable contribution towards allaying the anxieties expressed by the hon. Gentleman.

Will the Secretary of State confirm that, to date, the private sector has made no contribution to the training of medical and nursing staff?

I absolutely deny that. I direct the hon. Gentleman's attention to the excellent relationship that has existed for many years between the Roehampton school of nursing and the Royal Masonic hospital, where nurses have done much training. In addition, medical training can often be greatly enhanced if a consultant can use some of the less common cases found in some private hospitals for teaching his students.

asked the Secretary of State for Social Services what further consideration he has given to encouraging more mothers with babies at risk to attend antenatal clinics.

I share the hon. Lady's concern over this. We have drawn the attention of the health authorities to the Government's paper Cmnd. 8084, and we are having discussions with the appropriate Royal colleges.

Although I thank the Minister for that reply, may I remind him that pregnant women in socioeconomic groups four and five are most at risk? Is he aware that an urgent effort needs to be made to attract such women to antenatal care? That cannot be done without additional resources. The Minister has refused them. Will he reconsider his decision?

I entirely accept what the hon. Lady has said. At present, 11 out of the 14 regions are actively taking steps to improve the service. We are particularly anxious that the antenatal service should be made as human as possible. I am having discussions with the Royal College of Obstetricians, the Maternity Alliance and other bodies about this.

Is the hon. Gentleman aware that about the only non-controversial provision in the Employment Act 1980 is that which provides that mothers shall have a reasonable amount of paid time off work for antenatal care? Is the hon. Gentleman further aware that very little is being done, because employees do not know their rights and employers do not grant them? What does he propose to do?

I am aware of that. I am also aware that one of the Select Committee's recommendations was that unions should be more involved in the various aspects of pregnant women at work and leaving work.

asked the Secretary of State for Social Services what steps he is taking to overcome the problem of elderly persons who should be in geriatric units or old persons' homes who are occupying instead acute beds in hospitals.

I am concerned that all elderly hospital patients should receive the care most appropriate to their needs, and that scarce resources should not be wasted by unnecessarily prolonged stays in any type of bed. The recently published White Paper on elderly people, "Growing Older", stresses that all hospital departments concerned need to develop admission and treatment procedures geared to as early a discharge as home circumstances and community support permit.

As hospital bed occupancy now costs about £100 a day, would it not be cheaper to build more old people's homes? Is my hon. Friend aware that, for every elderly person occupying an acute hospital bed, solely because he has nowhere else to go, someone is being denied treatment or surgery? It is two years since I asked the same question. Nothing was done then and I hope that my hon. Friend will do better.

I will do my best to satisfy my hon. Friend. The economics that she has outlined are correct. Care in the community is cheaper than care in hospital and is what many elderly people want. For that reason we have developed joint funding, which enables the transfer of NHS money to social service departments to enable that transfer to take place. Two-fifths of the total expenditure on joint funding has been devoted to services for elderly people.

Is not the Minister's reply either naive or cynical? He knows that the provisions in his White Paper provide no funds to carry out what the Government are imposing on local authorities. Is he aware that cuts are being made in residential provision, and money spent on day centres, transport to day centres, home helps, telephones and aids and adaptations? Is he not aware that in those circumstances it is cynical and misleading for him to suggest that it is likely that more geriatric patients will be moved from acute beds in hospitals to beds in residential or community care?

The hon. Gentleman is misinformed. Local authorities have maintained spending on personal social services. Current spending in 1979–80 on personal services was 4·4 per cent. higher in real terms than in 1978–79. Present indications are that spending in 1980–81 will be at about the same level.

On comparative costs, what is the average cost now of placing an elderly person in a welfare home or in an acute bed in a hospital ward? Is the Minister aware that the Secretary of State for the Environment's harrying of local authorities that are trying to improve community care will mean that more and more elderly people will find themselves in more expensive hospital care? How can he possibly justify such a crackpot policy?

I have given the right hon. Gentleman the figures about the growth in spending on personal social services.

On a point of order, Mr. Speaker. I asked the Minister——

Order. The Minister is answering.

That problem has been raised by many hon. Members. The National Health Service is developing a programme of building nursing homes to overcome the problem that has been identified of transition of responsibility from hospital to social service departments.

Will the Minister tell me what is the average cost of placing an elderly person in a welfare home and the average cost of placing the same person in an acute bed in a hospital ward? That is the question I asked?

If the right hon Gentleman will table that question, I will give him accurate figures. I said earlier that the economics were as expressed by my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight)—namely, that the costs of treatment in the community are less than the costs of treatment in an acute hospital.

Will my hon. Friend take this opportunity to praise those who work in geriatric units on behalf of the community? In spite of what has been said, they do a good job in difficult and distressing circumstances. Is he aware that many of those workers are young people and the good community job they do is not always recognised?

I endorse what my hon. Friend has said. Going round hospitals, I have noted the active approach being adopted by many geriatricians to the treatment and rehabilitation of elderly hospital patients, as a result of which they can return to the community much earlier than would otherwise be the case.

asked the Secretary of State for Social Services if he will make a statement on the application of the European Economic Community draft directive on proprietary medicinal products and the question of parallel importing to United Kingdom circumstances.

I refer the hon. Member to the sixteenth report from the Select Committee on European Legislation. I subscribe to the view that a directive may be necessary, but not in its present form.

In view of the opposition of the British pharmacists, does the Minister envisage any positive gain from the directive to the National Health Service?

In theory the extension of parallel importing should exercise a downward pressure on prices but in reality, because the pharmaceutical price-regulating scheme which applies to purchases of drugs by the National Health Service applies only where £200,000 a year and above is spent on the drug in question, it is unlikely that parallel imports would come within the purview of that scheme. The question whether we can benefit from cheaper drugs sold through pharmacists will depend on how far one can squeeze something extra out of the pharmacists. All experience suggests that any difference between the home price and the parallel imported price would be absorbed by the manufacturer and the importer.

If the Minister is not convinced that there will be a saving to the NHS from that sort of change, will he not look at generic prescribing to see whether he cannot do something positive about the drugs bill inside the Service?

I remain quite unconvinced that it would be to the advantage of patients that the doctors' freedom to prescribe should be circumscribed in the way suggested by the hon. Lady.

asked the Secretary of State for Social Services if he will make a statement on nurses' pay.

Negotiation of nurses' pay is the responsibility of the Nurses and Midwives Whitley Council. I understand that the council has had some preliminary discussions about a 1981 settlement but has not yet begun any detailed negotiations.

Is the right hon. Gentleman not aware that, as the Government have made it quite clear that they will impose a limit of 6 per cent. on nurses' pay and the inflation rate is substantially greater than that, the Government are calling for a substantial reduction in the standard of living of those people? Does he adhere to the view expressed by his hon. Friend the Minister for Health in the Official Report on 15 March 1979 when the said that nurses are a special case deserving of the same kind of treatment as firemen, policemen and the rest? Is this yet another instance of the Tory Government clobbering the most deserving section in the community?

The hon. Gentleman, who is sponsored by a union that represents nurses, should know that the Government's record on nurses' pay is outstanding in that the cost of nurses' pay to the National Health Service in the two years since the election has increased by about 50 per cent. That is not a bad record. My hon. Friend the Minister for Health has followed up what he said before the election by the letter that he wrote to the management and staff sides of the Nurses and Midwives Whitley Council making proposals to get away from what has sometimes been called the four-year ratchet. Although we have had replies from the management side, we have not yet heard from the staff side.

Is my right hon. Friend aware that the number of additional nurses in the National Health Service over the past two years amounts to over 8,000—one of whom is the daughter of the hon. Member for Cambridge (Mr. Rhodes James)? Is he aware that there is considerable concern in the profession that the differences of opportunity among nurses, doctors and consultants and the administrative staff represent a real problem—one to which I hope my right hon. Friend will give his attention?

The overwhelming majority of the additional staff recruited by the National Health Service in the past two years are engaged in the direct clinical care of patients. There are about 9,000 additional nurses. We have embarked upon reforms which will significantly reduce the burden on management and overheads in the Service.

Although I am not sponsored by a union representing nurses, may I ask whether it is true that the Government regard nurses as no less important than soldiers and policemen, and will ensure that they are paid accordingly?

The Government made specific, direct and explicit commitments in their manifesto about the pay of the Armed Forces and the police. We also made it clear that we wished, as the hon. Member for Fife, Central (Mr. Hamilton) has reminded us, to find a better way of settling nurses' pay which does not have the effect, as happened under successive Governments—the right hon. Gentleman's Government were as guilty as any—of nurses' pay falling behind over four years and an inquiry being necessary so that they could catch up. That is not a satisfactory way of settling the pay of what, I agree, is an important group in our community.

Can the Secretary of State give the House a good reason for the recent increases in failures in nursing exams? Will he tell the nurses that that has nothing to do with economies in the NHS?

Since the question of the standards for passing exams is a matter entirely for the professional bodies involved, working under the General Nursing Council, the hon. Gentleman's suggestion is unworthy of him. I can give the hon. Gentleman the good news that there has been a significant improvement in the wastage rate of nurses during training. More nurses are staying on, completing their training and coming into service. That is good news.

On a point of order, Mr. Speaker. In view of the unsatisfactory nature of the Under-Secretary of State's replies, I beg to give notice that I shall seek to raise the matter on the Adjournment.

asked the Secretary of State for Social Services what has been the percentage increase of National Health Service patients being treated under contractual arrangements with the private sector since January 1981; and in what specialties.

The information requested is not yet available. The latest available figures show that, in England in 1979, there were 24,600 in-patient treatments and 176,000 out-patient attendances under contractual arrangements with institutions outside the NHS. The comparable figures for 1978 were 23,300 and 191,600.

Does the hon. Gentleman agree that encouraging health authorities to take the private sector into account in planning for the future is a subtle way of undermining the NHS? Does he also agree that, as there can be no guarantees that the private sector provision would be available to NHS patients in changed economic circumstances, the whole move in the recent DHSS circular is designed to turn the NHS into a second-rate service and to force people into the private sector?

That is absolute rubbish. The contractual arrangements between the NHS and the private sector have existed ever since the NHS was formed in 1948. If local health authorities wish to use the private sector in the interests of NHS patients they should be free to do so.

Contrary to what the hon. Member for Thurrock (Dr. McDonald) has said, do not the figures that my hon. Friend has given show the value of co-operation between the NHS and the private sector? Will he confirm that the growth of the private sector is helping to relieve pressure on the NHS and to retain staff in medicine and in nursing?

My hon. Friend is right. We see the private sector as an integral part of the health resources available to this country and we are anxious that the NHS should be free to make use of it if it wishes. To do otherwise would be wasteful and would ultimately penalise NHS patients.

Will the Under-Secretary confirm that the Government have recently made it possible for the first time for business men to obtain money from the NHS in order to provide or maintain private hospitals and then to make a profit out of contracts with the NHS?

I should like further details of the transaction that the hon. Gentleman has outlined, so that I can respond to his remarks.

Will my hon. Friend tell us how many trade union members enjoy the advantages of BUPA and the like following negotiations by their leaders?

I should very much like to give those figures, but the trade unions seem rather coy about releasing them.

Is it not a fact that general surgery gets the pickings from the private sector in the NHS and that tonsilectomies, appendicectomies and prostate gland operations are the major sources of income? As those services are being given to patients from outside the NHS, does it not mean that those people are jumping the queue and that NHS patients are having to wait longer?

In the hope that, if the hon. Lady will not listen to what I say, she will listen to what Barbara Castle said——

I am asking you.

The hon. Lady may prefer to accept it from Mrs. Castle who said:

"I believe that it would be intolerable in a democratic society to prevent people buying private medical care if they felt that it was an essential part of their personal interest."—[Official Report, Standing Committee D, 18 May 1976; c. 38.]

asked the Secretary of State for Social Services what is his estimate of the number of male midwives who have completed their training who are unemployed 12 months after they qualified.

We do not know for certain, but 13 men have qualified as midwives since May 1978. Four were from overseas and have returned overseas, one is working as a midwife, one is working in health education, and we believe that the other seven are working as nurses.

Does the hon. Gentleman agree that, from the Prime Minister down, it is regularly said in the House by Ministers that we should spend money wisely? But the Government are spending money unwisely as far as male midwives are concerned. When will the hon. Gentleman change his policy on discrimation against males? He supports up to the hilt the organisations that are dead against male midwives. When will he be honest about it and support the money that is being spent in this direction?

It appears that the hon. Gentleman has some special anxiety about this matter and the Sex Discrimination Act 1975. I strongly share his view——

What are you going to do about it?

We are about to publish a report on the attitudes of the public and the profession and no doubt the hon. Gentleman will make his views known at that time. We shall be discussing with the professions what action to take.

asked the Secretary of State for Social Services if he will make a statement about arrangements for the payments of child benefit.

asked the Secretary of State for Social Services whether he has now reached a decision on the periods applicable to the payment of benefits.

I am still considering comments received on the proposals in Cmnd. 8106, but I hope to announce the Government's decisions very shortly.

Cannot the right hon. Gentleman make a statement now guaranteeing that all those who want to draw child benefit weekly will be able to do so? If he cannot, will he give advice to those on supplementary benefit about how they could bridge the four-week gap that will exist if the benefit is to be paid four weekly in arrears?

The hon. Gentleman is a student of these matters and he knows that the proposals in Cmnd. 8106 provide that those on supplementary benefit will have the option to retain weekly payment. However, I am still considering the many comments raised on the point that the hon. Gentleman has put to me and I shall be announcing my decision shortly.

Does my right hon. Friend agree that we should be aiming at widening choice for those in receipt of benefits and that the subject should not be mixed up with the future financial viability of post offices, which is a separate topic and which should be dealt with separately?

With the best will in the world, I have to say to my hon. Friend that these questions are inevitably linked and I am having to consider them together. While attaching considerable importance to the question of choice, the Government must also have regard to the viability of the sub-post office network, about which we have made some firm commitments. That will certainly be one of the factors that I shall have very much in mind in any announcement that I make.

Is not the right hon. Gentleman aware that over the past year or so the number choosing to take benefits weekly has gone up by about one-third, which suggests that there is real need in this area? Did not the Government pledge their support for the principle of freedom in social security and is not the hon. Member for Bromsgrove and Redditch (Mr. Miller) right in saying that choice is the paramount consideration, because people could deal with their own problems in their own way if the Government, with their repressive legislation, would get off their backs?

The points made by the hon. Gentleman are in my mind, but I cannot accept that, for all time and for all purposes, there should never be any change in the administrative arrangements concerning the payments of social security benefits. That does not make sense, particularly if the system lands the taxpayer generally—and many of those concerned here are taxpayers—with extra and unnecessary costs. We have to hold a balance between what is fair to the taxpayer and what is fair to mothers with children.

Is my right hon. Friend aware that I support the idea of choice? Can he say how long it would take to make arrangements for people to receive child benefit monthly?

That can happen now.

As the hon. Lady says, anyone who wishes to draw child benefit monthly is free to do so. A surprising number already does so. The new choice that we want to offer, not only to mothers receiving child benefit but to pensioners, is the option to have their benefits paid into their bank account by the modern cash transmission method of automated credit transfer. I hope to be able to offer that option to beneficiaries during the next couple of years.

The Secretary of State has already said that if he were to deny mothers the opportunity, if they want it, to draw their supplementary benefit weekly, he would be denying them freedom of choice. Is he not aware that the Select Committee of which my hon. Friend the Member for Wolverhampton, North-East (Mrs. Short) is the chairman strongly recommended that this choice should remain for women who felt that they needed to receive the payment every week?

That is one of the factors that I have in mind.

asked the Secretary of State for Social Services what further representations he has received on the questions asked of claimants for supplementary benefit who are single parents concerning their personal and private circumstances by visiting officers of his Department; and what changes he intends to make in the procedure in the light of those representations.

In all, my right hon. Friend has received 25 letters, including 18 from hon. Members. There have also been 26 questions in the House from nine hon. Members. The hon. Member will be aware that I have arranged for these procedures to be examined. I hope to make an announcement shortly on the outcome of that examination.

I am grateful for that reply. Will the Minister accept, however, that some of the questions asked were unacceptable in a non-police State?

I accept that there was grave concern. I must, however, draw attention to the fact that these questions are asked only in cases where the mother wishes the Department to take legal action for the financial support of the child by its alleged father. In such legal proceedings, the Department would be erring in its duty if it did not present the case fully. I can, perhaps, reassure the hon. Gentleman by saying that in the 90,000 cases where supplementary benefit is paid, involving illegitimate children, only 714 cases were taken under section 19 procedures of the Supplementary Benefits Act 1976.

Is the hon. Lady aware that the first part of her answer pleased hon. Members? We were, however, rather disappointed with the second part. These questions are surely quite monstrous. If the legal profession desires to pursue these prurient matters, it should not be encouraged by the Department of Health and Social Security. I wish the hon. Lady every success in getting these questions changed or withdrawn.

We were reviewing procedures long before The Sunday Times article appeared. The same questions have been asked, in one form or another, over the last two decades. It is right that where there is a father he shall remain, as the Act says, responsible for the maintenance of the child.

asked the Secretary of State for Social Services how many contracts for the use of National Health Service services by private establishments have been entered in the North-East Thames regional health authority.

asked the Secretary of State for Social Services how many contracts for the use of National Health Service services by private establishments have been entered into in the West Yorkshire regional health authority.

The information is not available centrally, but the hon. Member may like to seek it from the health authority concerned.

Will the Minister say what steps his Department takes to vet the financial propriety of some of the dubious American companies seeking to enter into these arrangements with the NHS with a view to making profits as parasites on the NHS?

The arrangements to which the hon. Gentleman refers were enshrined in the National Health Service Act 1977. It is for local health authorities to satisfy themselves about the propriety of the companies concerned.

asked the Secretary of State for Social Services if, having regard to the case of Paul Hardman of 4 Landsbury Avenue, Parr, St. Helens, whose parents received one document which contained incomplete paragraphs, other relevant documents which were incomplete, and others which were hardly legible, he will ensure that his Department always provides clear and conclusive information to the parents of vaccine damaged children upon request.

In dealing with vaccine damage payment claims every effort is made to obtain and provide all available information, but in some cases relevant documents have unfortunately been destroyed.

Is the Minister aware that until the father of this boy saw his Member of Parliament about the Department's refusal or inability to supply the necessary information that parent was unable to gather any information on which to base an appeal? On taking the matter up with the Department, I was only able to get some information but not all of it. Will the Secretary of State and the Under-Secretary take steps to ensure that the medical officer of health, who was in a position to give the necessary evidence on behalf of Paul Hardman, is brought forward?

The hon. Gentleman has acted commendably in taking up this constituency case. Both my right hon. Friend and I have gone through the file in some detail. The suggestion that the hon. Gentleman has made is a matter for the tribunal and not for Ministers.

asked the Prime Minister if she will list her official engagements for 5 May.

This morning I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall be having further meetings later today.

Two years ago yesterday, the Prime Minister quoted St. Francis and talked about bringing faith, hope and harmony to this country. Can the right hon. Lady deny, having brought about the highest level of unemployment since 1934, the biggest jump in unemployment in one year since 1930, the biggest fall in total output in one year since 1931 and the biggest collapse in industrial production in one year since 1921, that she heads the most hated Tory Government this country has known for at least two generations?

I can most certainly deny that. Most people in this country realise that the steps that have been taken were necessary to put industry in a healthy condition to compete. If the Government had not had the courage to take such steps long-term unemployment in this country would have been much worse.

Will my right hon. Friend make clear to the Heads of any friendly Governments, especially the Prime Minister of the Irish Republic and the President of the United States, that they have a direct interest in the defeat of terrorism anywhere in democracies? Does she agree that these Heads of Government should be seen to be helping us and helping her in the stand that she takes against terrorism in Northern Ireland?

I am grateful for what my right hon. Friend says. The Government's job always is to protect the law-abiding, and to defeat terrorism. To grant political status would be to give a licence to kill. That is why this Government will never grant political status, no matter what the extent of any hunger strike.

Arising from the NATO Ministers' meeting at the weekend, may I ask the right hon. Lady to give her active personal support to the resumption of talks between the Soviet Union and the United States on a reduction in the horrific stockpiles of nuclear weapons in the world?

That has been the policy of the Government since the NATO meeting that first enunciated the policy, that there should be talks with the Soviet Union on the reduction of theatre nuclear weapons. It would greatly assist matters if the Soviet Union were to stop positioning an extra SS20 every five days.

In view of the lobby at present assembling at the House, will my right hon. Friend confirm that, if private flows are taken into account, this country ranks second only to the United States in its contribution to developing countries?

That is so. Private flows of capital from this country to developing countries amount to just over £4 billion. Added to official flows of £1 billion a year, this means that our total GNP proportion is 2·8 per cent., a very good record and second in the world.

asked the Prime Minister, if she will list her official engagements for Tuesday 5 May.

I refer the hon. Gentleman to the reply which I gave some moments ago.

Is the Prime Minister aware that unemployment in the Cumnock area is now 17 per cent.? Does she know that a carpet factoy is now threatening closure, but, despite that, the Secretary of State for Scotland refused to meet the local authorities in Ayrshire to discuss unemployment? Will she either instruct him so to do, or get someone to do the job who is prepared to do it properly?

Most departmental Ministers see that one of their Ministers receives deputations. As the hon. Gentleman knows, I received him when he had a complaint about a closure. There was a happy ending on that occasion, because the closure did not take place.

When the Prime Minister answers questions about terrorism from persons or statesmen throughout the world, will she make clear repeatedly that this country is a democracy and that there cannot be political prisoners in a democracy because in democratic countries people do not go to prison not for their political beliefs but for the crimes that they have committed?

I wholly agree with my hon. Friend. In a democracy people can pursue their objectives by peaceful means. Only those people who reject democracy pursue their objectives by terrorist means. Terrorism is a crime and always will be a crime.

Is the Prime Minister aware that her firmness and determination, steadily supported by Her Majesty's Opposition, have laid a firm foundation for the restoration of public confidence in Northern Ireland?

I am grateful to the hon. Member. I believe that we have the support of virtually the whole House in the action and the stand that we have taken.

The whole country's affairs have been darkened by the events that have taken place in Northern Ireland, about which we must all be concerned. In my view—and, I believe, in the view of the vast majority of hon. Members certainly on the Labour side of the House—the central question concerns conceding political status. That cannot be done without the Government giving sure aid to the recruitment of terrorists. If political status were conceded, it would greatly increase the numbers who would be encouraged to join. That, in turn, would mean a great increase in the number of innocent people who would be killed. We believe that matters in Northern Ireland, as elsewhere in the country, should be settled democratically, and not at the point of a gun.

I am grateful to the right hon. Gentleman. As I said, to concede political status would be to grant a licence to kill innocent men, women and children, and that is why we shall never concede that status.

Does the Prime Minister realise that the Ulster people will not respond to the vicious propaganda of the Irish Republican Army, and that that is due, in part, to the strong and unequivocal attitude adopted by the Government and by the House? Will the Government take action to win the propaganda battle? Is she aware that foreign television crews in Northern Ireland are putting out the wrong version of what is happening there, and paying youths to throw stones and other missiles at the security forces and then televising scenes which are being shown in their own countries?

What has been said in the House today, and the unity with which the House has approached the problem in its determination to stamp out terrorism, will help the case of the Government, the parliamentary system and democracy throughout the world.

Is the Prime Minister aware that one of the difficulties in Ireland is that there has always been too much "me too-ism" in the House of Commons on the subject? Is she aware of the widespread impression overseas—notably on the part of the New York Times, until recently a stout ally of this country's policy on Northern Ireland—that the death of Mr. Sands whom you, Mr. Speaker, have already described this afternoon as a fellow Member of Parliament will be due to the right hon. Lady's intransigence?

Shame.

Is the Prime Minister further aware that by appearing hard and unfeeling or "firm and determined" she has spectacularly illuminated for growing bodies of opinion in neighbouring and allied countries, whose comments are flowing in hourly, her Government's moral bankruptcy and the colossal and criminal incompetence of Conservative Governments at all times in their dealings on Ireland?

Her Majesty's Government are on the side of protecting the law-abiding and innocent citizen and we shall continue in our efforts to stamp out terrorism. Mr. Sands was a convicted criminal. He chose to take his own life. It was a choice that his organisation did not allow to many of its victims.

asked the Prime Minister if she will list her official engagements for Tuesday 5 May.

I refer my hon. Friend to the reply which I gave some moments ago.

Is my right hon. Friend aware of the widespread and continuing support in the country for the firm stand taken by the Government on Civil Service pay? However, will she consider one problem that arises from Civil Service inaction, namely, the repayment of VAT? What advice would she give to constituents such as Mr. Brader of Little Grimsby in my constituency, who is owed £37,000—soon it will be £40,000—and who is in danger of going out of business? That would result in 15 to 20 jobs being lost in my constituency. As my right hon. Friend will recall, land drainage is an important part of Lincolnshire life.

I am grateful to my hon. Friend for raising the matter. About 500,000 claims for repayment of value added tax are pending, and this is an example of how those on strike in the Civil Service are deliberately harming many small businesses. I have been in touch with the Treasury, the Customs and Excise and the Inland Revenue, and we are making the following arrangements. The Inland Revenue will not press the collection of PAYE when a company is in difficulties because it is awaiting a value added tax repayment. I hope that that will be a constructive and helpful step. Moreover, it will certify to repay the banks of those traders when a value added tax repayment is due. I hope that those two steps will assist traders who find themselves in difficulties as a result of the actions of the Civil Service. I hope that the Civil Service will soon desist, because if business is not prosperous we certainly cannot have a well-paid. Civil Service.

Coming to problems rather nearer home, will the Prime Minister reconsider her remarks made soon after the Brixton problems when she said that unemployment was not a primary cause of the trouble? Is it not a mistake in any case for a Minister of the Crown to pre-empt an inquiry in deciding, before the inquiry takes place, what is or is not a cause of the trouble? Is the right hon. Lady aware that there is still a problem in South-East London, where unemployment is rising faster than in most parts of the country, and that the majority of that fast-rising unemployment is among young blacks?

No, Sir. Unemployment is certainly a problem. I do not believe that it was the prime cause of the Brixton riots.

In view of the distasteful and disgraceful possibility that His Royal Highness the Prince of Wales had his telephone tapped in Australia when speaking to Her Majesty the Queen and to his fiancée, Lady Diana, will the Prime Minister now consider, during her busy day, whether to introduce a Bill of Rights, such as many hon. Members have wanted for years, to protect other Heads of State when visiting this country?

I do not know whether those stories about publication of telephone conversations are true. If they are, they are totally despicable, and I believe that the whole House would condemn any organisation which went ahead and published those conversations. A Bill of Rights is, however, a very much larger question.

The Prime Minister said that she was making arrangements for prosperous businesses and others to receive VAT repayments. What arrangements do the Government intend to make to enable recipients of supplementary benefit, invalidity payments, pensions and so on to obtain those benefits from DHSS offices which are affected by the strike? Will she now make strong efforts to ensure that the dispute is settled or, alternatively, that those who are in need receive the money to which they are entitled?

I hope that the Civil Service will not withhold benefits from anyone who is in need of them. If it does so, that too would be totally and utterly despicable and it would be a great reflection upon the Civil Service.