asked the Secretary of State for Social Services if he has yet completed his consultations on the Griffiths report.

asked the Secretary of State for Social Services if he will make a statement on the implementation of the Griffiths report.

I have now completed formal consultation and the report was debated in the House last Friday. I shall be reaching final conclusions on how to carry forward the report's recommendations, in particular on the establishment of the general management function in the Health Service. I hope to issue guidance to health authorities in the next few weeks.

Does my right hon. Friend agree that, notwithstanding the fact that the Conservatives have doubled expenditure on the National Health Service since coming to office in 1979, it is vital that we get value for money and that that is what the Griffiths report is all about? Will he confirm that during his consultations he had direct talks with nurses at the hospital level, because they see waste and inefficient management at first hand? Will he confirm that that could be a great deal more useful to him than relying on the views of the NHS establishment, which may well have a vested interest in maintaining the status quo?

We have had consultations with all the professional bodies, including the Royal College of Nursing. In the main, most of those whom we have consulted have supported the broad thrust of the Griffiths report. I agree that basically we are trying to secure the best possible value from the increasing amount of money that the Government spend on the Health Service.

Will my right hon. Friend draw aside the curtain slightly and let the House know when and at what rate he anticipates general managers being introduced into the Health Service?

As I said in the debate on Friday, We expect that to be done in a phased manner and we shall set that out in the guidance that is given to health authorities in the next few weeks.

Will the right hon. Gentleman give the House an assurance that he will not be influenced by a document written by the hon. Member for Norfolk, North (Mr. Howell), produced by a tuppenny-ha'penny outfit called Aims of Industry, in which he argues that, because patients spend a shorter time in hospital, we do not need as many members of staff, when he ought to understand that the fact that people spend a shorter time in hospital means that they get much more intensive treatment?

I always listen carefully to my hon. Friend the Member for Norfolk, North (Mr. Howell). I have pointed out consistently on this subject that the best way of making comparisons on efficiency is in terms of patients treated. Over the past five years the number of patients treated in NHS hospitals has risen by 500,000 a year.

Has the Secretary of State yet had time to reflect on the calls from both sides of the House on Friday for flexibility in the implementation of the Griffiths report? Does he now feel that it would be inadvisable to force general management functions on those parts of the Health Service which both sides of the House believe to be functioning well under the present consensus arrangements?

As I said on Friday, we support the concept of flexibility. We do not support the idea of having pilot or experimental areas, as was one once put forward, I think, by the Liberal and SDP parties. As I say, we will be setting out the plans in the guidance.

Although the Select Committee received memoranda of evidence, and, indeed, oral evidence, from many quarters, it did not receive direct evidence from many of the health authorities. Is my right hon. Friend able to say whether the regional and district health authorities in the main welcome the thrust of the Griffiths report?

Yes, as a generalisation, I think that the health authorities have welcomed the thrust of the Griffiths report, and certainly the direct talks that I have had with the regional health authority chairmen fully confirm this. Virtually all the district health authorities have also put in their proposals.

In the light of the widespread concern at local level among those who work in the Health Service that national pay agreements will be replaced by district pay agreements, will the Secretary of State take this early opportunity of agreeing with Griffiths that local pay negotiations and local pay agreements are not practicable?

I have nothing to add on pay arrangements to the statements that I have already made.

Has the Secretary of State yet made a decision on whether he will make what is regarded as the most important appointment of all, namely, that of a chief executive in overall charge of the National Health Service?

We have advertised for a general manager, which is, I think, rather different in concept from the chief executive which has been proposed from time to time. That advertisement was placed some weeks ago. We are therefore in the process of seeking names for recruitment, and I will tell the House immediately I am in a position to make an announcement.

In view of the rising tide of criticism of and scepticism about the Griffiths report, will the right hon. Gentleman give a committment that this fresh upheaval will not be imposed nationwide on the National Health Service either until the sixth evaluation studies already made are published, or until genuine experiments are carried out in specific areas to test the advisability of these changes, especially at unit level, where the recipe for conflict is greatest?

No, I do not agree with almost anything that the hon. Gentleman has said. [Horn. MEMBERS: "It must be right, then."] The rising tide of dissatisfaction to which the hon. Gentleman refers is not borne out by the evidence. I made it absolutely clear in response to the hon. Gentleman, who is still, surprisingly, on the Front Bench, that the health authorities are perfectly free to publish that evidence. There is nothing on our part to stand in the way of that. As to experiments and trial and error, I think that it would be absurd to approach the problems of general management inside the Health Service in that way. I think that that would be absurd and counter-productive, and we certainly do not intend to do it.

asked the Secretary of State for Social Services what are now his intentions regarding amendments to the Council for Professions Supplementary to Medicine, in particular as applied to chiropody.

We continue to have discussions with the Council and with bodies representing both registered and unregistered practitioners on the question of protection of professional titles, including chiropodist. However, the response to our previous consultation document showed that there is no clear consensus or common ground on the subject between the professions concerned. We have no intention of legislating at the moment.

Will the Minister reconsider that answer in the light of the situation regarding chiropody and take steps to ensure that the general public are aware of the chiropodist who has the full four years' training and is therefore qualified to treat the patient, and the unqualified people who are treating at present without the right to do so?

I entirely share the hon. Member's concern that members of the public should know exactly the qualifications of the people with whom they are dealing, and then make their choice of a suitable practitioner. However, all attempts to reach agreement on this have led to professional rivalries and disagreements, and we certainly must not put out of practice many unregistered chiropodists who at present give every satisfaction to their patients.

Is my right hon. Friend aware of the widespread mistrust and lack of confidence in the Council for Professions Supplementary to Medicine of the alternative medical professions, and is this not itself a good reason why the Government should now embark upon their own fair and impending inquiry into alternative medicine?

I always encourage practitioners of alternative medicine to make application to the council to seek registration, or whatever they require for their profession. The problem is that the council deals with contentious subjects, over which it is impossible to achieve professional agreement.

asked the Secretary of State for Social Services if he will make a statement on the further progress of implementation of the Mental Health Act 1983.

Implementation of the Mental Health Act is continuing in a satisfactory manner.

In view of the need to have sufficient approved social workers by 21 October for the purposes of the Act, will my right hon. and learned Friend say something about the outcome of the working party, comprising NALGO, the local authorities and his Department, to resolve the dispute on this matter?

I agree that it is important to have approved social workers, as the House decided when it passed the Act. It is unfortunate that NALGO is trying to encourage its members not to go on courses. I find it impossible to understand NALGO's objection. I believe that it thinks it is elitist for certain social workers to be described as approved social workers. I hope that the working party overcomes its difficulty and that we achieve the full working of the Act, as Parliament intended, by the due date.

asked the Secretary of State for Social Services what is the extent to which the increase in money made available for personal social services expenditure reflects the increase in number of the elderly.

The Government do not earmark any particular sum to be spent on different parts of the personal social services. Demographic and similar pressures, including the rising numbers of the elderly, are however reflected in the indicative planning figure used for block grant distribution.

I am grateful to my hon. Friend for that answer. It is obvious that the rising number of elderly people present an increasing problem to his Department. May I draw my hon. Friend's attention to an excellent scheme in Stockport, where the elderly are fostered in private homes rather than being taken into council homes, which saves a great deal of money for councils? Would he like to commend that scheme to other authorities?

That is a very entrepreuneurial and farsighted scheme by the local counc—[Laughter.] It is all very well for Opposition Members to laugh, but providing such forms of care in an informal and domestic atmosphere may be much better for elderly people than providing expensive accommodation.

Will the Minister consider exempting from penalty the results of joint finance, which encourage some experimental schemes for helping the rising number of elderly people in the community?

I am happy to say that the enforcement of penalties on local authorities is not one of my responsibilities.

Since the number of those over 85 years old is likely to increase by about 50 per cent. in the next 15 years, what long-term planning is being done? Will my hon. Friend take particular note of the problems that that will create for certain health authorities such as mine, where so many elderly people live?

I am well aware of my hon. Friend's longstanding interest in this matter and of the fact that his constituency contains a rapidly aging sector. The Government are undertaking longer-term strategic action in a number of ways, including the development of new policy plans, examining expenditure and, especially, looking at ways of encouraging local authorities to become more efficient in what they are doing, to save more money and to involve themselves in the greater provision of care for the elderly.

Does my hon. Friend recall that in a recent Adjournment debate he replied to me about Alzheimer's disease? This is now funded by the Manpower Services Commission. What funds will be available after those funds dry up?

I well remember the Adjournment debate to which my hon. Friend refers. My Department already centrally grants the Alzheimer's Disease Society to help it with its central administrative costs. Otherwise, the help comes from individual health authorities which make grants-in-aid.

How will the Government ensure that already hard-pressed social services departments properly inspect and supervise the enormous growth in private old folks' homes — a business which is booming at the taxpayers' expense? Even though the registration fees for old folks' homes are to be raised, is the Minister satisfied that the registration fees will bring in enough money to provide the resources needed for supervision? Will the increased registration fees go towards inspection and supervision and not into the general coffers?

My right hon. and learned Friend the Minister for Health has already announced an increase in the registration fee to be charged by local authorities. That should be more than adequate to cover the cost of the increased amount of time spent by social workers—quite rightly—in examining private homes and ensuring that they are well run—as most of them are, as we know from our constituencies.

asked the Secretary of State for Social Services if he will make a statement on the progress of the under-fives initiative.

This initiative was launched by my right hon. Friend in October with 80 projects to be managed by 14 major voluntary bodies working in the child care field. Almost all of these schemes are now under way. A further 22 projects run by small local groups are receiving support through the National Council for Voluntary Child Care Organisations as the Department's agent. A sum of £648,000 was paid during the financial year 1983-84.

Does the Minister agree that that is a small sum of money, which works out at about five second-class stamps per child? Is he aware that many of those who originally intended to take up the scheme had to drop out because sufficient funding was not available? Will he confirm that provision for the under-fives is seriously under threat as more and more urban aid programmes come to an end and local authorities, because of rate-capping, cannot take responsibility for them?

I am surprised at the churlish attitude adopted by the hon. Gentleman towards this very welcome scheme. It has been welcomed by the voluntary organisations. I should have thought that the hon. Gentleman and his hon. Friends would welcome it, as it is aimed at exactly those groups — such as ethnic minorities, one-parent families and parents on low incomes — about whom they tell us they are so concerned.

Is it not a fact that more under-fives are in nursery schools, playgroups or other facilities provided by my hon. Friend's Department than ever before?

Two per cent.

Yes—more than ever before.

It is not enough.

It is more than any Labour Government ever did. Is it not essential to do everything possible for the under-fives, especially those in deprived areas?

Yes, my hon. Friend is right. A record number of under-fives are receiving one sort of care or another under provisions from both my Department and the Department of Education and Science. We need to do everything possible to develop new modes of care, especially informal modes. That is why the Select Committee's report is so interesting-it certainly does not suggest any great growth in institutional care.

Is the Minister aware that, although he may be giving £2 million to the voluntary sector, some of his ministerial colleagues are taking money from that sector? Is he aware that with the abolition of the GLC will go its provision of £3 million a year for the under-fives? Because of rate penalties, services must be cut.

It is not at all cosmetic. The under-fives initiative, which has been so widely welcomed, involves the expenditure of £2 million a year for three years. On the hon. Lady's point about the GLC and other councils that may be abolished, my right hon. Friend the Secretary of State for the Environment has made proper provision for the handling of the interests of voluntary bodies.

asked the Secretary of State for Social Services if he is satisfied with the level of invalidity benefit for those disabled unemployed who have undertaken rehabilitation courses.

Invalidity benefit ceases when people start employment rehabilitation courses. Employment rehabilitation allowances are paid by the Manpower Services Commission to persons attending these courses.

Does my hon. Friend realise that, despite the generally held view that when a person finishes his rehabilitation course he can be reinstituted to long-term invalidity benefit, certain appeals tribunals are interpreting regulation 7(1)(a) of the 1983 requirement regulations to the effect that a person loses long-term invalidity benefit? Does my hon. Friend accept that it is a great blow to a person who, having finished his rehabilitation course, finds that he cannot work and, in consequence, has smaller means than before he began the course?

The point to remember about invalidity benefit is that the primary condition for receiving it is being incapable of work. From what my hon. Friend has said, I would guess that a tribunal found his constituent capable of work. I shall happily study the matter if my hon. Friend cares to write to me, but I cannot overturn the judgment of an appeals tribunal.

Is it not outrageous, with regard to the cut in invalidity benefit, that a Government who gave in a single day £1·5 billion in tax relief to the richest 5 per cent. of taxpayers should at the same time have cut the living standards of more than 600,000 long-term sick and disabled people? Is the hon. Gentleman aware that the excuse given does not apply to large numbers of people who are below the tax threshold? When will the cut inflicted on them be restored?

First, a large number of those affected by the abatement of invalidity benefit will have it made good by supplementary benefit; that is to say, we take care of those least well off. Secondly, we have said time and again that the abatement will be restored when invalidity benefit is brought into taxation.

asked the Secretary of State for Social Services whether he is satisfied with the operation of family practitioner committees.

I am not satisfied with the current performance of all family practitioner committees. We must raise the performance of all of them to the level that the best already achieve. We intend, through provisions in the Health and Social Security Bill, to improve their effectiveness to enable them to make a greater contribution to the planning and development of the family practitioner services.

Is my right hon. and learned Friend aware that there is a great deal of concern about the way in which family practitioner committees deal with complaints? Does he not think that the system is far too bureaucratic? Is he satisfied that the changes which he proposes will lead to an improvement in this respect?

I agree that complaints should not be handled in a bureaucratic manner and that the family practitioner committees should hold the balance between the interests of the patient and the legitimate interests of the professional concerned. We propose shortly to issue a leaflet entitled "How to Complain about Family Practitioner Services", which will describe the procedures in plain English to the ordinary layman. We also intend to hold the new FPCs to account for their performance, and that will involve them giving more information about the number of complaints they receive and how they deal with them. I hope that we shall be able to bring the performance of all FPCs up to the level of the best in the handling of complaints and other matters.

How many inspectors who are currently monitoring general practitioners' drug-prescribing habits are reporting to FPCs and to his Department?

I shall have to inform my hon. Friend by letter of the exact figure. We are looking at the work of those inspectors as an important part of our policy of trying to make general practitioners more aware of the necessity to prescribe generic drugs where they are the most effective and cost-effective form of treatment.

Does the Minister accept that many of the positive proposals that he has for FPCs are not likely to be achieved so long as manual recording systems continue to be used? When does he expect every FPC to go over to a computerised system, and can he guarantee that all the committees' computerised systems will be compatible with the computerised systems of the district health authorities to which they relate?

I am happy to agree with the hon. Gentleman in his premise. We have commissioned a report, which is to hand, from a firm of consultants, Arthur Andersen and Co., on the whole question of the computerisation of the records and administration of FPCs. We hope that the systems will be compatible with one another, and I agree with the hon. Gentleman about the importance of ensuring that they facilitate collaboration with the DHAs.

asked the Secretary of State for Social Services what is the cost to his Department arising from the consequences of smoking.

The information available relates only to the cost to the National Health Service. It is estimated that the annual cost to the NHS in England and Wales of diseases attributable to smoking is about £170 million at current prices.

Does my hon. Friend agree that the real cost to his Department of smoking and smoking-related disease is much higher than that and includes such items as the lifelong support of handicapped people whose handicap can be attributed to heavy smoking by their mothers during pregnancy, and the support of widows and children whose husbands and fathers have been killed by smoking? Does he further agree that the enormity of the cost is an overwhelming argument for stronger action to discourage smoking?

My hon. Friend is right to say that we cannot accurately judge the cost to my Department, or to the Government as a whole, of smoking cigarettes. It is clear that the list of problems which he outlined is not complete—for example, the 50 million days a year lost by people at their places of work —but Government action in the last four or five years has resulted in a considerable reduction both in the number of people who smoke cigarettes and in the number of cigarettes smoked.

In the light of the enormous economic and social costs to the country of smoking, is it not unacceptable and intolerable that night after night on our television screens we see sporting and other events that are sponsored by the cigarette companies? When will the Minister take action on that?

I do not want to get too deeply drawn into that issue, because it is a matter for my hon. Friend the Minister with responsibilities for sport and not one of my ministerial responsibilities. However, I shall hazard one remark—[Interruption.]—if I can make it heard—

Order.

—over the raucous noise that is coming from the Opposition Benches. There is no clear and unequivocable evidence to show whether advertising does or does not increase the smoking of cigarettes by children or anyone else.

Does my hon. Friend agree that the Exchequer benefits to the extent of £4,500 million from the tax on cigarettes? Would he care to speculate on the way in which that revenue would be raised by my right hon. Friend the Chancellor of the Exchequer if everyone stopped smoking? Will he give us some idea of how that would be done?

I do not know how my right hon. Friend the Chancellor of the Exchequer would raise the lost revenue, but that is not a matter for me. However, my hon. Friend's figures are exactly right, as I believe he knows. We have a National Health Service as opposed to a national sickness service and one of the duties of the NHS is to draw to the public's attention the considerable health risks that they face if they smoke.

Will the Minister do a little homework and examine the figures? Will he first examine the work of Sir George Godber, a previous Chief Medical Officer at the Department of Health? Secondly, will he examine the report of the Royal College of Physicians? Thirdly, will he read a book entitled "Smoke Rings", which was written by Mr. Peter Taylor? He will find in "Smoke Rings" that the contention that children in Glasgow are persuaded to adopt certain smoking habits as a result of watching snooker is fully justified?

The evidence about the effect of advertising is not incontrovertible. For example, for the past 10 years the advertising of cigarettes has been banned in Norway yet the decline in smoking in that country has been much less than in Britain over the same period.

asked the Secretary of State for Social Services if he will indicate the percentage of patients with appointments at National Health Service hospitals who failed to turn up and were thus listed as not having attended for the last 12 months period for which figures are available; and if he will make a statement.

We do not collect this information at present, but the health services information steering group has recommended in its first report that the number of failed appointments should be recorded in future. Measures to encourage patients to keep their appointments are for local decisions by health authorities.

Is my hon. Friend aware that doctors and consultants practising in the Wessex area who are known personally to me have brought this issue to my attention and that one of them described it as a scandal? It is extremely irritating to the medical people concerned and enormously expensive for the entire Health Service. Does my hon. Friend accept that this is so, and does he accept also that his Department, if it is considering ways of cutting costs, should be giving close and serious consideration to this problem?

We must address ourselves to this problem. There are about 36 million outpatient appointments in any one year in the Health Service. Unfortunately, delays sometimes occur. The picture seems to be patchy. I am bound to say that sometimes the blame lies with the rather poor organisation of some hospitals. On other occasions patients fail to turn up on time for appointments, or fail to turn up at all. I wish that more consumers of the service would heed the advice of the Consumers Association that it is extremely important that they turn up on time.

Is the Minister aware that for many outpatients a hospital appointment means the loss of half a day's pay plus the cost of travel to the hospital? Should he not take that into account and arrange in special cases for some adequate compensation to be paid for those on benefit and for those who are at work but who cannot earn enough to live on?

This is why it is critically important to have a good and direct management system within the NHS to ensure that arrangements for patient appointments are good and that the doctors and nurses deliver to the consumer the care that is required at the time of the appointment. It is up to us to deliver those goods. That is why the recommendations of the Griffiths report are so important.

Is my hon. Friend aware—I refer to my experience in recent months — that the variation in hospital practice is very wide? Where that practice is good, it is so much better than the worst that more steps could profitably be taken to generalise the best practice rather than leave it to the haphazard administration of individual hospitals.

Just before Christmas that point was made by my hon. Friend the Member for Beaconsfield (Mr. Smith) in a similar question. It is right that the best organised outpatients departments are extremely good and provide a model for other parts of the service. We need better information. That is why the Körner committee's recommendations will be adopted and why we intend to do all we can to disseminate good practice in the service.

Does the hon. Gentleman agree that, at any given time, the number of people who do not turn up for their appointments is small compared to the number of Members of Parliament who fail to keep their appointments and turn up for work, as was shown by the voting figures last week, when under one third of Members of Parliament turned up to vote?

The force of the hon. Gentleman's question would be much stronger if he were supported by more of his hon. Friends.

asked the Secretary of State for Social Services if he is satisfied with the progress being made by regional and district health authorities in contracting out ancillary services.

Reports are now being received from the regional health authorities. They summarise programmes for putting out to competition tender domestic, catering and laundry services. These reports are being studied and we shall decide what action to take in the light of them.

Is my right hon. Friend not a little worried at some of those reports? Is he not frightened that some of those reports might show a lack of anxiety on the part of some regional and district health authorities in putting forward genuine proposals for contracting out ancillary services? When my right hon. Friend studies those reports, will he show firmness of touch in ensuring that those authorities that are not serious about privatisation are made to be serious?

I accept my hon. Friend's statement. The reports we have seen so far show that the health authorities are taking the exercise extremely seriously. I do not perceive the type of difficulties put forward by my hon. Friend.

Given that once a service is removed from the NHS it is probably financially impossible to bring it back, will the Secretary of State enable the health authorities to insist on a bond against bankruptcy by a private concern?

Some contracting organisations already provide that facility, but I do not believe it is necessary for me to lay that down as a stipulation.

What studies have been made by my right hon. Friend's Department, or any health authority, on the savings that could be made and the greater and more efficient service that could be provided if individual hospitals were contracted out to the private sector?

We have not made studies of that type. Studies have been made inside the Health Service showing that substantial savings can be made if we contract out some of the ancillary services. That is the reason why the competitive tendering programme is going foward.

Does the Secretary of State accept that the proportion of services contracted out fell every year since 1979? It is only since the right hon. Gentleman started fiddling the rules at the behest of Conservative Members, who are hired consultants of the privatising companies, that the proportion of services contracted out has increased. Why will the right hon. Gentleman not publish all the representations he has received from Conservative Members in favour of contracting out, so that we know exactly what has been said to him, by whom and for how much?

I believe that, on reflection, the hon. Gentleman will accept that the statements he has just made do not in any way represent the true position. The allegation that we are in some way fiddling the rules, as the hon. Gentleman said, is entirely untrue and without foundation. The answer to the only basic point that the hon. Gentleman put is that over that period other contracted-out services, such as building maintenance and equipment maintenance, have increased substantially. I cannot understand why the hon. Gentleman, if he finds that savings can be made in the ancillary services and resources can then go to patient care, does not support that policy of common sense.

Will my right hon. Friend confirm that in-house tenders have been highly successful in securing jobs and that tendering has led to a great deal of economy?

Indeed, and not just in the Health Service, but in other areas as well, one of which is the Ministry of Defence, with its health responsibilities. All those instances have shown that we can provide better value. That is what we are trying to do, and that is the sensible way to run a health service.

asked the Secretary of State for Social Services if he will make a statement on the further steps he intends to take to curb the profits of the pharmaceutical industry.

I have nothing to add to the statement that I gave to the House on 8 December 1983 when I announced measures that we expect will save the National Health Service about £100 million on the drugs bill in a full year.

Is the Minister aware that because of his constant pussy-footing around the problem drug companies are still making, and are likely to make, extortionate and indefensible profits at the expense of the National Health Service? Will he give an assurance that he will use the same energy on the scheme to get at the drug companies' profits that he and his colleagues put into the Bill to charge foreign visitors for their health care, which is an absolute disaster?

With respect to the hon. Gentleman, he was asking the same type of supplementary question before our package in December. Since then we have announced proposals to save the Health Service £65 million in 1984–85 and £100 million in a full year. If he meets people from the pharmaceutical industry he will find that the steps we have taken to contain sales promotion costs are having a marked effect on the companies. We believe that it is in the interests of the Health Service to stop excessive sales promotions being financed by the National Health Service.

No one would wish to defend excessive profits, but is not the hon. Member for Fife, Central (Mr. Hamilton) out of date in what he says? Are not the drug companies in this country experiencing falling profits on prescription drugs? Taking into account the possibility that they could take their research and manufacturing facilities to other European countries, do we not have to take a rather more balanced view than that expressed by the hon. Gentleman.

I entirely agree with my hon. Friend. We must strike the right balance between the interests of the National Health Service as a customer and the interests of the industry, which is a major employer and a major source of export earnings and inward investment. The revision that we carried out to the scheme that we inherited from the Labour Government has made substantial savings for the taxpayer, which is a considerable advance.

Is the Minister aware that some of these profits are made out of faults and misleading advertisements, which do not explain clearly the adverse effects of and the damage that can be caused by some drugs? When can we have some action on that gross dereliction of duty on the part of the drug companies?

There are strict rules in force about the advertising of drugs. There is also a voluntary code drawn up by the Association of British Pharmaceutical Industries, which is acted upon by its members. I take as serious a view as the right hon. Gentleman about misleading advertisements, and our Department and the industry ensure that we stop them.

Does my right hon. and learned Friend agree that while profiteering should be curbed, if one were to adopt the attitude that it is immoral to make any profit out of drugs research would decline, which would be a real cost to the National Health Service and to the earnings potential of an industry which is valuable to this country and to sick people?

I agree. The pharmaceutical industry is one of the most successful research-based manufacturing industries in this country. The advances made by the industry have been of enormous benefit to patients throughout the world. We must protect that, while ensuring that we do not pay excessive prices for drugs through the National Health Service.

How does the Minister defend that in the light of an answer from his Department to the hon. Member for Brent, South (Mr. Pavitt) which compared the costs of 12 brand names as against 12 generic drugs, and which showed that there would have been tremendous saving to the National Health Service bill?

The doctor decides whether to prescribe a branded or generic drug. He should prescribe a generic drug unless he believes that there is some definite therapeutic value to be derived from the branded drug. We are reinforcing that advice to doctors and will be following it with further training and education. All attempts to change to generic substitution, as some people called it, led to great confusion and difficulty for the profession, and would have led to considerable confusion about liability in those cases where things 'went wrong.

Will my right hon. and learned Friend reiterate that without profits there would be no research and without research there would be no new drugs?

I certainly reiterate that point. I give the House the example of the pharmaceutical industries of eastern Europe, where I assume that they operate without making any profit and where, so far as I am aware, they have made no worthwhile advances in living memory in the interests of their own or anyone else's patients.

Is the right hon. and learned Gentleman aware that drug companies' profits from the National Health Service, even after his December announcement, are likely to be about £250 million this year, which is grossly excessive, and that, from certain drugs, Glaxo and ICI are still allowed to make profits of about 30 per cent. from the National Health Service as a result of private deals with the Department of Health and Social Security? Is that not a scandal, when 2,000 people will die this year because of the alleged lack of public money available to buy the kidney machines that they need to stay alive?

Whatever profit is made will be based on a drugs bill that is £100 million less in a year than it would have been had we left undisturbed the arrangements that we inherited from a Labour Government. The deals that the hon. Gentleman described are those made between our officials and the pharmaceutical industry following the rules laid down by the PPRS. Those perfectly proper rules have been tightened up so that a drug company cannot have a target profit of 30 per cent., as the hon. Gentleman claims.

asked the Prime Minister if she will list her official engagements for Tuesday 8 May.

This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House I shall be having further meetings later today. This evening I hope to have an audience of Her Majesty the Queen.

Will my right hon. Friend take this opportunity to congratulate the National Coal Board on winning a contract to sell coke to the United States of America worth 1,000 jobs? Will my right hon. Friend confirm that those jobs depend upon the coke being delivered?

Yes, I believe that the National Coal Board is to be congratulated on securing a contract that will amount to about 400,000 tonnes of coal from a Durham mine. My hon. Friend is absolutely right to say that that contract will depend upon the first delivery of coke made from the coal being made by the end of May. It is worth reminding people that sales, rather than strikes, save jobs.

Does the Prime Minister think that the money spent by the DHSS in supporting the families of striking mine workers, the money spent by the CEGB to generate electricity from oil, the money spent by local authorities on policing the dispute, or indeed the money that the dispute is costing the NCB—far in excess of that required to keep open the pits that the NCB wants to close—is money well spent?

I believe that it is right to spend money to enable those who wish to go to their place of work to do so. That is what has happened, and it will continue. As the previous question noted, jobs are waiting for those who work in the coal industry, if they wish to go to work and dig the coal to secure the contracts.

asked the Prime Minister if she will list her official engagements for Tuesday 8 May.

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

Is the Prime Minister aware that her comments on Sunday about the Government's signals intelligence were deeply damaging, because they drew further attention to the operation of GCHQ, and that what she said was deeply unconvincing as a reason for not having a full inquiry into the Libyan affair? Will the right hon. Lady give more mature consideration to holding a full inquiry into that affair?

GCHQ was not mentioned on Sunday. The point that I was seeking to make in my interview was the danger of commenting on specific intelligence. The incident took place in the House and was reported and commented upon. It is fully in the public domain and there is nothing fresh to say.

Will my right hon. Friend remind the House, on the day when Her Majesty the Queen opens the Thames barrier, that a Conservative GLC under Lord Plummer gave the go-ahead for the scheme? Secondly, will my right hon. Friend remind the House that more than three quarters of the finance has come from the Government, which makes nonsense of the claim that if there were no GLC there would be no Thames barrier?

The decision to go ahead with the Thames barrier was taken in 1974. It was felt to be important that a barrier should be built. I am afraid that the work has taken much longer than we expected and the cost has risen, but my hon. Friend is right to say that 75 per cent. of the money came from Government sources —the taxpayer— through the Ministry of Agriculture, Fisheries and Food.

asked the Prime Minister if she will list her official engagements for Tuesday 8 May.

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

Does the Prime Minister recognise that, given the background of mass unemployment, the cost of closing pits is greater than that of keeping them open? Will she bear in mind the social consequences of destroying thousands of jobs in areas in which the majority of school leavers have no hope of permanent work? Is she aware that, in Scotland and elsewhere, miners who have been treated as industrial gipsies are not prepared to see themselves and their children thrown on the scrap heap of mass unemployment?

The taxpayer already pays about £1x00B7;3 billion a year in subsidies to the NCB. That means that many taxpayers are finding nearly £1 per week with which to subsidise coal. Some other taxpayers have had to learn that they will continue to have jobs only if they produce goods that please the customer. The NCB will have a good future only if it is able to have high volume, low-cost coal that can be sold not only in Britain but in the export markets. Exports are there, if people will work to produce them.

May I congratulate my right hon. Friend on her courageous initiative in inviting the Prime Minister of South Africa to Britain? [Interruption]. Will she suggest to her more vociferous critics that they should examine—[Interruption].—some of the actions taken by some of the self-styled colonels, generals and comrades north of the Limpopo, which have been catalogued by Amnesty International in its most recent report, and compare them with some of the remarkable things done recently in South Africa, despite apartheid, such as the Pace school in Soweto?

The Prime Minister of South Africa is visiting Bonn, Lisbon and Berne. I thought it right to invite him to this country in order to discuss matters concerning southern Africa with him. Many changes are taking place in southern Africa, and I hope that interview will be useful. We do not, of curse, approve of the system of apartheid and will repeat that point again.

The Prime Minister said that "of course" she would condemn apartheid when she spoke to Prime Minister Botha. What has happened in recent years to make her think that Botha will not again tell her—as he has always done— to keep her nose out of South Africa affairs?

I doubt whether Mr. Botha would do it in quite the language that the right hon. Gentleman has used—[Interruption.] He will naturally say that the internal affairs of a country are for that country. He is very well aware that we adhere to the Security Council resolutions, that we do not export arms to South Africa, and that we adhere, as a Government, to the Gleneagles agreement. Internal affairs are a matter for the internal Government, but it is quite possible for other Governments to hold opinions on those affairs, and to express them.

With critics like the right hon. Lady, Mr. Botha does not really need any friends. Since the phrase that I employed earlier is frequently repeated by Mr. Botha, what earthly advantage can result for British people, or for the advance of human rights in South Africa, from accommodating Botha in this country as a result of the Prime Minister's invitation? Why is she allowing herself to be used for no other purpose than to support the South African Government's propaganda effort to prop up apartheid in its own country and its aggression against other countries?

We talk to many countries whose policies we disapprove of, and, indeed, Opposition Members urge us to do so. I remind the right hon. Gentleman that during the Labour Government a Labour Foreign Secretary visited South Africa.

Has my right hon. Friend had an opportunity to read Mr. Arthur Scargill's claim that the coal stocks at power stations will last for only eight weeks? Does she recall that he made almost the same claim three months ago, on 6 February? Will she assure the House about the position of coal stocks?

I was aware of both those facts. I assure the House that there are sufficient coal stocks at the power stations for many months to come.

asked the Prime Minister if she will list her official engagements for Tuesday 8 May.

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

Is the Prime Minister aware that the decision to deport Mrs. Begum, who is 20 years old, and her little girl to Bangladesh shows incredible pitilessness and will reduce considerably the United Kingdom's reputation in Asia? Will she institute a thoroughgoing inquiry into immigration adjudication procedures?

No, Sir. Many procedures must be followed before such a decision is taken. Immigration rules are made to be kept, and there are ample occasions for an appeal. I would not criticise the decision of my right hon. Friend the Secretary of State.

Does my right hon. Friend accept that her defence of British interests in Europe and the attack on the Government by the leaders of the SDP-Liberal alliance—the Tweedledoc and Tweedledee of British politics—for the abandonment of the national veto in Europe means that she is on the right track?

Yes, Sir.

I trust that the Prime Minister does not take joy from what she sees in my constituency of Mansfield. The miners there are as much against her policies and those of Mr. MacGregor as any miners. They are involved in an internal union affair. Will she use her great office to bring some of those people round the table to talk. as they soon must do?

asked the Prime Minister if she will list her official engagements for Tuesday 8 May.

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

When the Prime Minister meets the Prime Minister of South Africa, will she ask him why he did not lift a finger to release the 16 British citizens taken hostage in Angola by UNITA, one of whom was a constituent of mine?

The hon. Gentleman knows of the agreement to release those who have been detained, and we hope that they will be released shortly.

Is my right hon. Friend aware of the deep concern in the farming community about the future of farming in the next few years, especially among dairy farmers, who are worried that they do not yet have the full details of the milk quota scheme, which is to be allocated on an individual farm basis? Will she take an early opportunity to reaffirm her firm support for our farming community in the tremendous job it does now and intends to do?

I accept that our farming industry, as is the case in all Western industrialised countries, must have support if it is to be prosperous. I accept its fantastic record on both productivity and investment, and acknowledge its great success in helping us with our balance of payments by increasing our food supplies. I recognise that farmers, especially dairy farmers, are having a difficult time because we must reduce the surpluses in Europe. The farming community recognises that and is fully prepared to co-operate. However, it is anxious to know the details of how the quotas, which it has had, will be put into effect. We are awaiting further details from the Commissioners about that and will do our best to speed them up.

asked the Prime Minister if she will list her official engagements for 8 May.

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

Is my right hon. Friend aware that some of my constituents—parents with children at school—find that, as a result of the latest strike action by teachers, they cannot send their children to school because headmasters and headmistresses have advised them that the lack of lunchtime facilities means that the children should not attend? Is it not extremely sad that parents, and, worse still, children, should be in that position, and will she join me in regretting this latest example of public sector action that is disadvantaging the weakest members of society?

I agree with my hon. Friend, and I think it quite wrong for teachers to take action that harms the education of their pupils. It could damage them for life, and I am glad that many teachers would not dream of going on strike or refusing to carry out their duties in that way.