asked the Secretary of State for Social Services if he is satisfied that local authorities now have sufficient resources and facilities for dealing with the unified housing benefits scheme.

Local authorities have statutory responsibility for administering the housing benefits scheme and it is up to individual authorities to decide what resources of staff, accommodation, computer equipment and so on they need. We are satisfied that the arrangements for subsidising local authorities' administration costs adequately reimburse authorities for all reasonable costs arising from the new scheme and that there is no reason why authorities should not have the resources and facilities that they need.

As the right hon. Gentleman has said in reply to previous questions that his Department undertakes no monitoring, how can he be satisfied that councils have sufficient resources to do the job, especially when one remembers the financial restraints that have been imposed on them? Is the right hon. Gentleman aware that when the changes were brought into effect many councils had insufficient resources to do the job and that many people will suffer hardship because councils are not able to do the work as speedily as they would wish?

I do not accept that. Our arrangements for reimbursing local authorities on housing benefit are entirely fair to them. The hon. Gentleman made a good point about checking. We shall look at that to see whether we can get a better system to check on what local authorities are spending.

Has my right hon. Friend seen reports in various organs of the press suggesting that there is to be a cut in the resources available for housing benefit? As an inquiry into the future of the scheme is taking place, will my right hon. Friend take the opportunity to confirm that there will be no movement one way or the other in the provision of housing benefits at least until the inquiry has been completed?

The story to which my hon. Friend referred appeared in The Guardian on Saturday and it is wrong. No decision has been taken on housing benefit and I am well aware of the importance of waiting until the independent committee under Mr. Rowe has made its report.

When the scheme was introduced, about 2 million people were an average of 75p a week worse off. Is the right hon. Gentleman aware that there is considerable anxiety in all parts of the House about the possibility of housing benefit being cut further? When is he likely to be able to make a statement on the subject?

The hon. Gentleman knows that public expenditure is being reviewed and he will have to await the completion of that review. The importance of the review process is well recognised, as is the importance of what the hon. Gentleman said.

Is my right hon. Friend aware that we warmly welcome his reply to my hon. Friend the Member for Brentwood and Ongar (Mr. McCrindle) that no changes will be made until he has received the report of the inquiry? However, can my right hon. Friend assure me that even when he has received the report there will be no question of placing further burdens on pensioners or retired people?

I shall not enter into commitments on decisions that have not been taken. I said that The Guardian story was wrong. That is a fact. My hon. Friend will have to await the completion of the public expenditure discussions that are currently taking place.

In view of the rumours about a public expenditure cuts package, will the Secretary of State categorically deny that the Government are seriously considering further chopping back housing benefit at any stage, reducing unemployment benefit and taxing or means-testing child benefit? Do not those pre-emptive decisions clearly reveal the right hon. Gentleman's reviews to be meaningless charades?

The hon. Gentleman has used a pre-prepared supplementary question and has taken absolutely no account of what I have already said. He must be even more foolish than I thought if he thinks that I will give a commitment that at no stage in the future will we study the benefits currently under review. The review process is intended to highlight how we can better provide aid for those in need.

asked the Secretary of State for Social Services what recent representations he has received about community provision for patients discharged from mental illness hospitals.

A number of hon. Members and organisations concerned with mental health have written to Ministers on this question.

Is the right hon. Gentleman aware that there is widespread concern about what happens to the mentally ill when they are discharged into the community? Is he further aware that local authority social services departments simply do not have sufficient money to provide adequate support? Will he study that problem in the light of what the Government are doing to weaken further the resources of local authorities?

I do not accept the last part of the hon. Gentleman's question, but I certainly accept what he said about the importance of community care. I believe that both parties are committed to that policy, which clearly has financial consequences. We have never regarded community care as a cheap option. It has consequences for personal social services. The hon. Gentleman is wrong to suggest that personal social services spending has been reduced — indeed, during the past five years it has increased by 18 per cent. in real terms.

I welcome my right hon. Friend's emphasis on the importance of community care. Will he stress the importance of closing the very large Victorian-built mental hospitals, which are almost impossible to modernise? However devoted the staff, it cannot be in the interests of patients for them to remain in such hospitals.

I agree with my hon. Friend. There is a clear need for hospitals and for the continuation of hospital care. However, no one wants to continue unsatisfactory and inadequate treatment in those surroundings.

As the right hon. Gentleman has said that he will study the problem and take into account the concern expressed, will he especially consider the position of local authorities and the effect that the potential rate-capping programme will have on the encouragement of joint funding projects? Are not those projects of exactly the sort that are relevant to the community care programmes?

The hon. Gentleman is in error to suggest that restrictions on local authority spending fall upon specific projects—they fall upon general spending. Joint financing is continuing to develop.

Is it not true that buildings and services for the care of patients previously in institutions are simply not developing? Is that not for two reasons: first, that regional health authorities are not handing over the necessary finance; and, secondly, that social services departments cannot take up additional spending commitments because of rate penalties?

The fault in the hon. Lady's supplementary question is the suggestion that joint finance is in some way not being taken up. This year, allocation of joint finance money is about £100 million, and there is no evidence that that is not being taken up by local authorities. In addition, the personal social services budget has increased, as has the money made available for care in the community. Obviously, we regard this matter as a priority. I hope that there will be as much agreement as possible between both sides of the House on the importance of this matter.

asked the Secretary of State for Social Services whether his officials have had any meetings with the British Medical Association to discuss civil defence planning.

asked the Secretary of State for Social Services whether he is preparing a new circular on civil defence to replace HDC(77)1.

A preliminary draft to replace circular HDC(77)1, which contains the existing guidance to health authorities on civil defence planning, was sent to the British Medical Association on 30 July 1984 with an offer of meetings wth officials to facilitate the association's internal discussions. We are awaiting a further response.

I thank my hon. Friend. Would he care to enlarge on that answer and explain what he aims to achieve in those discussions?

We hope to have the active co-operation of both the BMA and the Royal College of Nursing in planning for the care of casualties after a conventional or, indeed, a nuclear attack on this country.

I am sure my hon. Friend is aware that a number of area health authorities are anxious to get their hands on the documents. Will he do all that he possibly can to expedite the matter by putting pressure on the bodies currently being consulted?

I appreciate my hon. Friend's interest as chairman of the National Council for Civil Defence. We shall circulate the draft guidance to local health authorities for consultation as soon as we are in a position to do so, but at a meeting last October I pledged, with the then Minister of State, Home Office, now my right hon. Friend the Secretary of State for Northern Ireland, that we would give the BMA and the Royal College of Nursing a first look.

Do the Government now accept the assumptions as to the likely number of casualties arising from a nuclear attack which are contained in the BMA's historic report on the medical effects of nuclear war, a report which concluded that the entire National Health Service could not cope with the dropping of a single 1 megaton bomb on a British city?

At its own request, the BMA is constructively considering its advice to us on these issues. We are awaiting that advice and hope to have it shortly.

On the point raised by my hon. Friend the Member for Edinburgh, East (Mr. Strang), as a World Health Organisation study recently revealed that no health service in the world could deal with the casualties arising from a single 1 megaton nuclear bomb, and as most experts believe that a nuclear exchange would be in the range of 200 megaton, is not medical expenditure on civil defence at best a cruel deception and at worst a sick joke? If that is not so, how do the Government justify spending £20 million on building deep shelters for regional and central Government personnel while in "Protect and Survive" they tell the rest of us to whitewash our windows and wrap jackets around our heads?

I do not agree with the hon. Gentleman's comments. They are a classic case of the kind of remark made before the event which prefaces the kind of complaint that will be made after the event if we have not taken the necessary precautions. It is incumbent on the Government of this country to take every reasonable precaution to deal with the aftermath of both conventional and nuclear attack, exactly as the Labour Government did in 1977.

asked the Secretary of State for Social Services what help he is able to give to the voluntary aid societies for medical training to meet their civil defence role.

asked the Secretary of State for Social Services what training aids and publications are available from his Department for medical training of voluntary aid societies personnel in their civil defence role.

Under the provisions of section 64 of the Health Services and Public Health Act 1968, grants of £10,000 per year are being made towards the administrative costs in respect of their civil defence role of both the British Red Cross Society and the Order of St. John. There is no question of the volunteer members of these organisations being involved in the provision of definitive medical treatment. The training aids and publications on first aid produced by the voluntary aid societies themselves provide all that is required to supplement the high standard of practical training that they give.

As many first aid posts are the responsibility of area health authorities or boards, does my hon. Friend agree that training funds might be forthcoming from his Department as well as from the Home Office?

At present my right hon. Friend the Secretary of State does not have the statutory power to make such funds available. None the less, there is close co-operation between the voluntary aid societies and district and regional health authorities, and considerable help is given with training at that level.

Is there not a need for paramedical guidance for civil defence volunteers to enable them to deal not only with the problems of radiation sickness but with long-term problems such as the shortage of drugs, equipment and expertise?

It is just such issues that will be addressed in the circular that was the subject of the previous question.

Has the Secretary of State considered issuing suicide pills to the emergency services, as the Government's own studies show that, after a nuclear attack, there will be millions of untended dying?

No, Sir.

Will the Minister take on Mr. MacGregor to give advice on the treatment of victims, as he seems to be an expert in putting a plastic bag over his head?

No, Mr. Speaker. As always, I look to my right hon. Friend the Secretary of State to take the lead on such important issues.

asked the Secretary of State for the Social Services how many people injured on the airport building site on the Falklands have been treated at National Health Service hospitals.

None.

How long can a situation last in which those who have burns and other complex injuries find that their nearest hospital is 8,000 miles away in the northern hemisphere?

That is not the case. A general practitioner and nursing staff are available in the Falklands to deal with people who have injuries. The more serious cases are brought back to this country. No one has had to attend an NHS hospital. So far as I am aware, no one has been short of the necessary treatment. To all those taking an objective view of the situation, that is the most important thing.

asked the Secretary of State for Social Services if he will make a statement about the future of the Dreadnought seamen's hospital in Greenwich.

Greenwich health authority will discuss at its meeting on 13 November the issue of a consultation document which proposes transferring the Dreadnought's services for seafarers from Greenwich to St. Thomas's hospital and absorbing services for local patients in other hospitals in Greenwich.

Is the Minister aware that, according to the Price Waterhouse report published in February, such a transfer could well mean that the services that are specially provided for seamen by the seamen's hospital would become more expensive?

I look forward to seeing that document if the proposal goes ahead in due course and comes before Ministers to be resolved. Greenwich is acting on the basis that it could save £700,000 for its own patient services by the proposed change, and the maritime board is anxious that the seamen's hospital should be moved to a new specialised unit in St. Thomas's.

asked the Secretary of State for Social Services whether he will take steps to improve the service available to those claimants who do not receive their supplementary benefit Girocheques on time.

In general, the system of payment of supplementary benefit by Girocheque works well. We recognise, however, that there are problems from time to time, as occurred recently following the derailment of a train carrying mail to the hon. and learned Member's constituency. As he knows, steps have been taken locally to improve arrangements for dealing with such contingencies.

Is the Minister not aware that the only arrangement that could do any good in the long run would be to make good the cuts in staffing at DHSS offices in my constituency and elsewhere? Is he aware that there will inevitably be even greater delays after 26 November when there is to be an increase in supplementary benefit which cannot conceivably be implemented in Leicester because of the mammoth task that awaits a thoroughly depleted staff?

I shall answer the hon. and learned Gentleman's second point first. Our understanding is that in general the uprating will be carried out on time, thanks to the loyal work of staff throughout the system who are working despite the problems at Newcastle. If the hon. and learned Gentleman is worried about what will happen in Leicester, he should talk to the strikers in Newcastle and ask them what they propose to do about the situation.

The Minister should talk to them.

It is no use Labour Members running away from the fact that one of the objectives of the strikers in Newcastle is to prevent the uprating being paid on time.

Is my hon. Friend aware that his Department is paying out large sums of money to meet mortgage interest payments that are due from striking miners, that that money is being suborned to pay other bills, and that mortgage interest is not being paid? Is he satisfied with that?

We are aware of my hon. Friend's point and are not satisfied with it. We are considering what our stance should be in the light of the evidence that is emerging.

Is the Minister aware that there is evidence of claimants doing without essentials in the days before a Girocheque arrives? Is that problem not greatly exacerbated when cheques do not arrive? Is it possible to give a post office that pays out claimants the authority to make emergency payments?

I do not think that it would be practicable for the Post Office to act in that way. Post offices tend to close at mid-day on Saturday. That does not help. We hope to be able to improve our home telephone service, which we are studying. Social services departments have power to make emergency payments without reference to us.

As a result of the strike at Newcastle offices, delays are also being experienced at post offices and, as a result, pensioners are having to queue outside in the cold. With the onset of winter, will my hon. Friend please consider setting up some form of distribution centre so that pensioners do not have to queue outside in bad weather?

I acknowledge the problem that my hon. Friend has raised. He will know that the Post Office has already taken action to ameliorate the problem that is considering further action. We shall do anything that we can to help.

Does the Minister agree that although it is good for him to recommend to my hon. and learned Friend the Member for Leicester, West (Mr. Janner) that he talks to the strikers in Newcastle, it would be much better if he and the Secretary of State talked to those strikers and recognised that, in this dispute, as in others, the Government are spending vast sums of public money to achieve a small gain that will now not be recovered for several hundred years? Does he recognise that the wholly arbitrary cuts in staff numbers in the Civil Service, the DHSS and elsewhere have led directly to the problem that my hon. and learned Friend identified? Will he assure us that, in the current review, an opportunity will be taken to improve rather than to worsen the service?

I do not accept that any policies which the Government have adopted on staffing, which have been matched by cuts in work load, have contributed to the problem to which the hon. and learned Member for Leicester, West (Mr. Janner) drew attention. With regard to Newcastle, Ministers and management in the Department have made it clear throughout the dispute that we are willing to talk. The problem is that we have been faced with unions which have been unwilling to talk constructively with us.

asked the Secretary of State for Social Services whether he is satisfied with the level and quality of health service provision in Greater London.

Health authorities in London face the difficult challenge of adjusting their services to match the movement of population in recent years. Some districts, particularly in inner London, need to reorganise acute provision to free resources for development of local services for the elderly, the mentally ill, the mentally handicapped and to improve primary care.

Is that not a way of saying that, in London, we must make serious health service cuts? Did not hospital waiting lists in London increase between September last year and March this year? During the past two years the four Thames regions have suffered cuts and are to suffer more in the next two years to the tune of more than £22 million. Is not the Minister being complacent about the situation in London?

The hon. Gentleman has skilfully selected his dates and figures. Spending in the Thames regions has more than kept pace with inflation since we have been in office, although regions are planning some reductions in inner London districts. The problem is that the population has moved away. There is a clear surplus of acute beds in inner London as reports to the Labour Government and to us have shown. We must move resources to where the population is—in the suburbs and home counties—and develop services of which inner London is short. London has 15 per cent. of the country's population and gets 20 per cent. of health spending. It does not always spend that money in the best interests of its inhabitants. There must be much change to get the type of service that we require.

Does my right hon. and learned Friend agree that there is scope for making more funds available for direct health care by contracting out ancillary services, as Bromley health authority does with its catering service?

Bromley authority has made spectacular savings on its catering service, all of which are devoted to patient care. Hammersmith hospital is saving more than £500,000 on changes to its ancillary services, all of which is available for patient care. I wish that the hon. Member for Newham, North-West (Mr. Banks) would put pressure on his political friends to stop them choosing to spend money on keeping up the cost of cleaning and instead to spend it on developing patient care.

Will the Minister call for papers from his Department to show the large number of Departments that are being consulted either about closing or transferring in the London region and take his personal time to examine them? Does he recognise that much of the savings envisaged for 1984–85 will cause double the amount of expenditure during the following five years?

At our request all the regions are drawing up strategies for the next 10 years. I should have thought that that was invaluable for knowing where we were going and for making well-judged decisions for future health services in London. The disputed cases will eventually come to Ministers for a decision. We shall not approve those which fail to make financial sense. Most important, we shall not approve any which do not result in an improved service to patients either through the facilities of a more modern unit or by releasing resources whose value can be better realised elsewhere.

I take comfort from my right hon. and learned Friend's response to the question in so far as he relates the moving of resources from inner London areas to suburban areas. Will he confirm that he will give kind approval to those schemes which involve certain health services and voluntary and community services?

I am grateful for my hon. Friend's comments. It makes sense to plan for the future of health services on the basis of where the population now live rather than to retain surplus provision of acute accommodation where the population used to live—in the teeming slums of inner London, before we began to make happy progress clearing them. The voluntary and community services must also be involved. We need to improve joint planning for the future between health authorities, local authorities and voluntary and community bodies.

Does the Minister accept that people living in Greater London who want an operation are sick to death of him talking about plans for the future? They want plans for the present, to reduce hospital waiting lists in Greater London. Will he confirm what my hon. Friend the Member for Newham, North-West (Mr. Banks) said, which is that hospital waiting lists have increased during the last six months for which there are records? Does he accept that in the Bloomsbury health district the number of people awaiting operations has increased by 2,000 during that period so that 12,000 people are waiting? Does he accept that in Hackney there are now 1,100 people who have been waiting for urgent operations for more than a month? Despite that, he still proposes to shift resources from those areas and thus cause an extension of hospital waiting lists.

As I said the hon. Member for Newham, North-West was doing, the hon. Gentleman is making a careful selection of dates for his figures. Throughout the country the underlying trend is that the number of people on hospital waiting lists is steadily decreasing and the numbers of those being treated in hospital is increasing. The hon. Gentleman's comments about how authorities cope with these problems in Greater London must be set alongside the needs of other parts of the country where people are also on waiting lists and where services are provided from far lower resources per head than is the case in inner London.

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

Implementation of the Mental Health Act is continuing in a satisfactory manner. Sections 35, 36 and 38 of the Act, which provide for remands by criminal courts to hospital for assessment and interim hospital orders, were implemented on 1 October 1984.

Regarding sections 35, 36 and 38 of the Act, will my right hon. and learned Friend tell the House how many representations he received from regional health authorities and the nature of the responses to the consultative document which his Department circulated in March?

We consulted all the regional health authorities on the proposal to increase the powers available to the courts when dealing with offenders who might be mentally ill. Nine of the health authorities were in favour of our going ahead, but the other five had reservations, especially about their ability to provide the service in their regions and its resource implications. Ministers were anxious to get on with that part of the Act because we believe that the mentally ill should be treated in hospital wherever possible and we do not wish the courts to have to send sick people to prison. Therefore, we brought the proposals into effect and the courts must accept that the ability to provide the service will vary across the country. However, all regions must continue to try to provide the facilities required.

asked the Secretary of State for Social Services whether he is satisfied that the operation of five-day hospital beds is fair to people who live alone.

The use of five-day wards, and indeed of other types of short-stay wards including day beds, can lead to an increase in the number of patients treated. However, such patients need careful selection, taking account not only of the probable length of stay but of the availability of adequate care afterwards.

Does the Minister accept that on the evidence of a leaflet prepared for five-day hospital stay patients at Charing Cross hospital they are being told that if they cannot make their own transport arrangements and provide food for themselves at weekends they can go to the end of the list? Does that not mean that many of the most deprived people in society are being ruled out of obtaining access to five-day beds at a time when, as in Hammersmith, there are reductions in the number of home helps, meals on wheels services and health visitors? Will that not be exacerbated by rate-capping and by constant pressure from the Government to reduce the provision of the services that would make the use of five-day beds reasonable for the worse off?

The hon. Gentleman suggests that the use of five-day beds is not being helped by the way in which clinical practice is carried out. I have not seen the leaflet to which he referred and he did not send it to me beforehand. All I can say is that all guidance that goes from my Department to clinicians stresses that they must consult general practitioners and primary health teams before they decide whether a patient is suitable for five-day or shorter treatment in hospitals.

Does my hon. Friend agree that better utilisation of five-day beds for patients who live alone and others could take place if hospital waiting lists were computerised? Will he take this opportunity to confirm to the House his Department's commitment at least to carrying out a pilot study on the computerisation of hospital waiting lists, and to confirm that the West Midlands regional health authority has instructions from his Department to carry out such a pilot study?

I am thoroughly in favour of such a pilot study. We have offered some money to the West Midlands regional health authority so that it can carry out a valuable study of the bed bank idea, which my hon. Friend has to a large extent pioneered. Somewhat surprisingly for a regional health authority, having been offered money, it is going rather slowly with the project. I wish that the authority would get on with it.

Does the Minister accept that one problem with five-day hospital beds is the occasional need for emergency readmission? What guidelines has he given to clinicians to cope with that problem?

Clinicians have every opportunity to enable them to allow emergency readmission. About 50 per cent. of all patients in NHS hospitals come in immediately on emergency admission procedures, and I have no evidence to suggest that anyone who needs emergency treatment is not so treated immediately.

asked the Secretary of State for Social Services what is the total number of medical and non-medical staff employed in the National Health Service at the last available date.

There were 819,100 whole time equivalent medical and non-medical directly employed staff in the NHS in England at 31 March, the latest date for which a total figure is available.

Does my right hon. Friend agree that increasing the proportion of medical and non-medical staff in a useful way of ensuring that the maximum share of Health Service resources is devoted to patient care? Will he take whatever steps he can to ensure that the ratio continues to increase?

Yes, Sir, and for the past 12 months that has taken place. Although there has been a reduction in support staff, there has been an increase of about 1,200 in the number of doctors employed in the National Health Service.

In this connection, can my right hon. Friend give us any information about the progress in the implementation of the Griffiths staffing report? Can he confirm that although some junior appointments have been made, key posts have not yet been filled?

Many key posts are being filled, and the key posts at regional level are being filled now. We shall then go on to general managers at the district and unit levels. What we are waiting for—I hope that we can make an announcement on it reasonably soon—is the appointment of a general manager at the centre of the DHSS.

asked the Secretary of State for Social Services what representations he has received from the British Medical Association about the prescription of oral contraceptives to girls below the age of 16 years; what reply he has sent; and if he will make a statement.

The British Medical Association has drawn my attention to its policy statement in support of our current guidance on family planning services for young people. In reply I said we would consider this guidance again when the outcome of the legal action of which it is currently the subject is known.

Is my right hon. and learned Friend aware of the widespread public concern over the right of doctors to prescribe oral contraceptives to girls under 16 at a time when it is vital to strengthen the family unit?

I am aware of widespread concern and widely differing views. The guidance from the BMA, our Department and the General Medical Council stresses the need to try to involve parents wherever possible, and doctors often succeed in doing so. At present we say that if they cannot, what happens next should depend on what the doctor judges to be best in the interests of the girl. Mrs. Gillick claims that this is illegal and we have undertaken to review the whole question again once we have received the final decision of the court.

Bearing in mind the cost and necessity, if possible, to involve parents, does the right hon. and learned Gentleman accept that the primary consideration is the confidential aspect between patient and doctor?

A number of important issues are raised, such as the confidentiality of the relationship between a 15-year-old and a doctor, the ability of a 15-year-old to give valid consent to treatment and whether she is sufficiently mature to give such consent. Obviously we shall have to bear all these matters in mind when we review this policy.

asked the Secretary of State for Social Services what is the total number of people on the waiting list for National Health Service operations and how many usable beds are temporarily out of use.

On 31 March 1984 there were 666,327 people awaiting admission to surgical specialties in NHS hospitals in England. Information on numbers of beds temporarily out of use is not collected routinely.

Should not the Minister be able to give more accurate and up-to-date information on this scandalous waste of resources?

For someone who could not remember the number of his question, that is ripe. We give very up-do-date and accurate information to the House, which shows that a record number of inpatients, outpatients and day patients are being treated by the NHS.

asked the Secretary of State for Social Services if he will make a statement on the financing of the National Health Service.

Between 1978–79 and 1983–84 we doubled expenditure on the Health Service. Spending will increase this year by £1 billion to a record £16½ billion. These extra resources together with greater efficiency stemming from our management initiatives will enable the NHS to expand and build upon the substantial gains we have already made. Since we took office provision has increased to the extent that hospitals in England alone treated 900,000 more inpatient and day cases and had 2½ million more outpatient attendances in 1983 than in 1978.

Will the Government consider a change in current NHS policy so that cervical cytology can be provided by general practitioners to women under the age of 35? In addition, will they give extra financial resources to Coventry city council to enable workplace screening for breast cancer to take place for women under 35?

I congratulate the hon. Gentleman on his wisdom in moving away from the substance of his original question, the reply to which reveals how much more we are spending and how many more patients we are treating than did the Labour Government. We take screening for cervical cancer extremely seriously and at present there is nothing at all to prevent a general practitioner from providing a screen for a younger woman. We do not provide a special additional item-of-service fee for that, but concentrate that fee on priority groups — older women and those who have had a number of pregnancies. We expect GPs to provide a wide range of services to their patients but do not expect to provide a special item-of-service fee for every item.

When he is making financing decisions, will my right hon. and learned Friend tell regional health authorities to get away from the idea that all babies must be born in district general hospitals, and that they should put proper support behind rural maternity units?

There is often a conflict between the medical opinion of consultants, who, rightly or wrongly feel that it is safer for a mother to have her baby in a large district general hospital, and the preference of would-be parents for local, much-loved traditional hospitals. Often, the conflicts come to Ministers for decisions, and we have to decide each one on its merits, weighing up the respective claims on both sides.

asked the Prime Minister if she will list her official engagements for Tuesday 23 October.

This morning I had meetings with ministerial colleagues and others. I was present at Victoria to meet President Mitterrand on his arrival for a state visit. In addition to my duties in the House I shall be having further meetings later today. This evening I hope to attend a state banquet in honour of President Mitterrand at Buckingham Palace.

When will the Prime Minister stop sacrificing the poor and the aged on the altar of her Government's dinosaurian economic policies? [Interruption.]

Order. I appeal to the House to allow the hon. Gentleman to finish his question. Such interruptions take time out of Question Time.

Has the right hon. Lady just one grain of compassion for those old people who are threatened with death through hypothermia this winter? If she has, will she review her Government's policy of increasing the heating allowance but cutting the real value of that allowance, so that far more people suffer as a direct result of her Government's half-baked policies?

As the hon. Gentleman has just heard in social security and health questions, in the Health Service more day patients and inpatients are being treated than ever before, while the retirement pension has gone up in real terms, as have supplementary benefit and benefits for the sick and disabled. As to the hon. Gentleman's specific point about heating, the sum now spent on heating is £400 million. The amount has gone up by far more than inflation and is far greater than it was during the time of the last Labour Government.

Bearing in mind that, of the three questions put to members of the National Association of Colliery Overmen, Deputies and Shotfirers' in the September ballot, question three on the crossing of picket lines has been conceded in full, question two on conciliation procedures has been fully met and question one on pit closures is covered by the offer by the Coal Board to give full weight to the independent arbitration procedure, what possible grounds are there for NACODS entering its members on a full-scale strike?

I agree with my hon. and learned Friend. The strike by the NACODS members will do great damage to jobs and the economy. NACODS is negotiating with the Advisory, Conciliation and Arbitration Service and the NCB and it is to be hoped that those negotiations will result in a settlement acceptable to NACODS and the NCB.

I congratulate the right hon. Lady on her escape from injury in the horror at Brighton. I also express our warm wish that her injured colleagues will continue to make a good recovery.

I thank the right hon. Gentleman for the kind words at the beginning of his question. I shall pass on his good wishes to those who are still in hospital. I am sure that they will be very pleased with what the right hon. Gentleman said.

"in the light of the changed circumstances the Board will revise the March 6 proposals and re-examine those proposals for individual areas, taking account of the changes that have occurred in the needs of the market and the loss of output resulting from the dispute".

I read what the Prime Minister said in the letter that she was kind enough to send to me last Friday, and I have listened to her again this afternoon. It appears that she does not yet comprehend the need—as Mr. MacGregor has previously said—to be specific.

I am sure that the right hon. Gentleman has been through the National Coal Board proposals of 6 March. They were proposals to bring the capacity of the whole industry into line with the continuing demand for coal in the most cost-effective way possible. Because of the length of time that the strike had taken, in July the National Coal Board made the undertaking that I have mentioned. There was no hit-list in the 6 March proposals. [Interruption.] Will the right hon. Gentleman tell me in what paragraph of those proposals that hit-list appeared? [Interruption.] Those proposals were to bring the capacity of the whole industry into line with the continuing demand for coal in the most cost-effective way possible. The colliery review procedures are as they have always been.

I regret having to come back, but this is obviously a central issue, and the Government's reluctance to be constructively involved in promoting a settlement is still causing problems. So much has changed as a consequence of the dispute that speeches that the Prime Minister could have made seven months ago are now no longer relevant. Further, the proposition of March this year for the cutback of 4 million tonnes and the announcement on 23 March by the NCB of the loss of 20,000 jobs directly constitute a hit list. Until the right hon. Lady realises that this is the case it is difficult to see how progress can be made.

No, Sir. I repeat that the proposals of 6 March were to bring capacity into line with demand in the most cost-effective way. All the proposals for colliery closures go through the colliery review procedures, as they have since 1973. Since 1973 it has been accepted that heavy losses at pits were grounds for making closures. The procedures have not changed; the only proposed change in procedures is an improvement which ACAS proposed and the NCB accepted.

asked the Prime Minister if she will list her official engagements for Tuesday 23 October.

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

Still on the miners' dispute, will my right hon. Friend continue to ram home the fact that, in terms of wages, investment, redundancy payments and closure procedures, the miners are getting a better deal under this Government than under any previous Administration, Labour or Conservative, and guaranteed work?

My hon. Friend is absolutely right. On pay the offer to the miners exceeds anything that was ever offered to them under the Labour Government. It means that they would be 25 per cent. above the level of average male industrial earnings compared with 18 per cent. under Labour. Investment has exceeded all expectations. It is £650 million more than was expected under "Plan for Coal". The colliery review procedure remains as it is. There is a guarantee that no one shall be compulsorily redundant. I should like to give one example of voluntary redundancy pay. At the age of 49, someone who had been in the coal industry for many years would have got about £1,700 redundancy pay under Labour and would get £33,000 under the Conservative Government.

Will the Prime Minister discuss with President Mitterrand the French Government's newly announced policy of offering every school leaver a place in higher education, a place in industrial training or a job? As both France and Germany can do that, why cannot the right hon. Lady do the same instead of offering our teenagers places on the dole queue?

As the right hon. Gentleman is well aware, every school leaver of the age of 16 was guaranteed a place on the youth training scheme by Christmas if he left school the previous summer. In fact, that was fully met and, indeed, there were spare places. That guarantee will be fully met again this year. Therefore, young people can have the option either of staying on in education until the age of 18 or going into the YTS, with a number of them still going into work. We really hope to reach the position where it is not an option to be unemployed. Young people can already stay on in education.

asked the Prime Minister if she will list her official engagements for Tuesday 23 October.

I refer my hon. Friend to the reply that I gove some moments ago.

Will my right hon. Friend take time today to deplore publicly the long-running strike at the Department of Health and Social Security computer centre in Newcastle? Is that not an example of how strikes inspired by Left-wing militancy hit hardest the pensioners in all right hon. and hon. Members' constituencies? Is it not one further example of how strikes of this nature hit the most vulnerable members of our community?

That strike appears to be designed to prevent the uprating of pensions due in November and to prevent the uprating of child benefit. It is therefore deliberately aimed at both the old and young in our community in a disgraceful way.

asked the Prime Minister if she will list her official engagements for Tuesday 23 October.

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

Is not the Chancellor of the Exchequer's statement at the weekend that unemployment is not an economic problem but only a human or social one the most humiliating confession of failure? Does the Prime Minister stand by that confession? If she does, how does she square that with her endorsement at her party conference of the 1944 employment White Paper, which puts the battle for jobs at the heart of economic policy?

Unemployment is both an economic and social problem, of course. One cannot possibly argue against that. If the hon. Gentleman were fully familiar with the 1944 White Paper on employment I am sure he would agree that it has a great deal in common with the policies that the Government are pursuing — [Interruption.] I have a copy in my handbag. He must know the White Paper. It is indeed very old. — [Interruption.] It points out right at the beginning:

"But the success of the policy outlined in this Paper will ultimately depend on the understanding and support of the community as a whole — and especially on the efforts of employers and workers in industry; for without a rising standard of industrial efficiency we cannot achieve a high level of employment combined with a rising standard of living."