asked the Secretary of State for Social Services whether he is satisfied with the provision for cervical cancer screening in Islington.

Health authorities are responsible for operating the cervical screening programme within their own districts. I understand that there is concern about the scope of the recall arrangements in Islington. We are taking this up with the authority and I shall write to the hon. Member when the inquiries are completed.

Does the Minister agree that this area of health care is of great importance to women? Does he further agree that until we get proper recall systems throughout the country, and a proper call system for women to be screened for this form of cancer throughout the country, the provision of services will be inadequate? Does he have any intention of providing funds to district health authorities to enable them to make such provision?

I agree that cervical cancer is a major cause of avoidable death. We shall do everything possible to continue to reduce deaths caused by it. We have given advice to all district health authorities, asking them to set up effective recall systems, especially for priority groups of women who are most at risk. We shall take up with Islington the fact that, although it has arrangements, they do not seem to comply with our guidance. I shall write to the hon. Gentleman about that. Call systems require an authority or a practice to have an adequate age-sex register of their patients, but not all of them do. As we make more advances with the computerisation of family practitioner committees, and as better information is available to them, I hope that we shall move towards the introduction of call systems if research shows them to be effective.

Will the Minister confirm that Camden and Islington FPC is not unique in not having a scheme? Will he confirm that more than 25 per cent. of FPC areas have no schemes whatever?

The schemes vary. Good local schemes are much more effective than the national scheme that we replaced. Islington is operating a scheme but it is not of the form that we have recommended and we are asking it why it does not introduce an automatic recall scheme for at-risk groups every five years. We have just reminded authorities again of their duty to have a local recall system. As we advance further with computerisation and get new FPCs going I believe that we shall get them all up to the standards of the best.

Although my right hon. and learned Friend has asked local authorities to examine their recall systems, what powers of enforcement does he have?

We do not use legal powers in this area. We give guidance and instructions and inform authorities of their duty to have a local recall system. I do not find resistance to the idea at local health authority level. We are merely ensuring that we encourage all of them to make progress.

asked the Secretary of State for Social Services if he will make a statement on the current state of his social security reviews.

I am currently considering the work which has been done on pensions, benefits for children and young people, supplementary benefit and housing benefit. I hope to be in a position to announce proposals for change in the course of the next few months.

I fully accept the need for such reviews, but will my right hon. Friend bear in mind that it would be quite wrong if, to obtain some limited savings on administration by streamlining certain areas, he dovetailed various allowances into one level, which meant that those on the highest level no longer received them? Can he assure me that those who get the maximum amount will not be affected, as they are inevitably those who are in the greatest need?

One of the aims of the reviews is to bring help to people in the greatest need. I shall have to ask my hon. Friend to wait and see in regard to the proposals. I shall not make commitments on that or any other benefit.

What is the primary purpose of these reviews? Is it to save money, or to discover whether the services are adequate?

The reviews have a whole range of purposes. One of the first is to see whether we can reduce the complexity of the system, which I think the hon. Gentleman will agree is bad for claimants and expensive to administer. A second purpose is to ensure that we are making best use of available resources and channelling them to the people in most need.

Does my right hon. Friend agree that one of the best ways to alleviate the problem of family poverty is to provide some sort of an allowance for those mothers who stay at home to nceslook after their children? Will he talk to his right hon. Friend the Chancellor of the Exchequer with a view to transferring some of the cash from the married man's allowance to those spouses who are not in employment and who stay at home to look after children?

I hear what my hon. Friend says. I am talking and will talk to my right hon. Friend about the inter-relationship of benefits and taxes.

Will the Minister confirm that among the recommendations of the social security review committees is the abolition of heating additions, and that this could be the last winter that pensioners receive heating allowances, no matter how cold the weather? If, as he has admitted to me in an answer published today, Treasury officials are attending meetings of the social security review committees, how will it be possible for him to resist the Treasury's insatiable demands for public spending cuts?

As to the first part of the hon. Gentleman's question, as I said, I am not making commitments on particular benefits. As to the second part, not just Treasury Ministers or officials, but officials and Ministers from other Departments and people from outside Government are attending. If the House contrasts that with what the Labour Government did in 1978 when they had a review of supplementary benefit carried out entirely by civil servants, it will agree that the way in which we have approached this matter is infinitely superior.

I am grateful for my right hon. Friend's assurance about simplification. In seeking to simplify the system, will he seriously consider the possibility of a simple minimum income support system to replace the current complex supplementary benefit, which acts as a gateway to a plethora of other benefits which, in turn, increase the poverty trap and allow some people to milk the system?

A whole range of proposals have been put forward around that idea. They will be considered.

Does the Secretary of State admit that for two reasons the reviews are of limited value only? The first is the no-cost theme which pervades them all, and the second is that he and his Department persist in introducing changes which will be disadvantageous to claimants on pensions or benefits without waiting for the result of the reviews? I have in mind the proposal contained in the Social Security Bill, through which 44 per cent. of those who receive invalidity benefit will lose out. How can the Secretary of State claim that the reviews are fundamental when he is making such changes all the time?

The hon. Lady must recognise that we cannot stop all change inside the social security system while the reviews take place. The point of the reviews is to have a new look at the whole of social security. It is the first time that it has been done for many years. It is long overdue, and I am surprised that when the Opposition were in government they did not do something of the same kind.

asked the Secretary of State for Social Services if he will make a statement on progress in establishing regional secure psychiatric units.

By the end of 1984 seven permanent regional secure units were open. These will eventually provide a total of 264 places, of which about 120 are now staffed and available. In most units, the places are being brought into use in stages. Seven further permanent units providing in total a further 141 places were completed and undergoing commissioning. These units are expected to admit their first patients in the spring. In addition, two pemanent units providing a total of 128 places are under construction and are expected to be completed during 1985. Four further permanent RSUs, providing over 170 places, are at various planning stages.

Is it not an absolute disgrace and scandal that, over a decade after the Butler committee recommended the establishment of such units as an urgent national priority, regions such as Oxford, North-East Thames and the West Midlands still do not have units despite having received millions of pounds from the Government, and patients from their regions are detained unnecessarily and inappropriately in special hospitals and prisons? Will the Minister ensure that those regions establish units for mentally disordered patients?

The hon. Member has pressed me on this matter for some time and I have considerable sympathy for some of the points that he makes, but, with respect, his complaints are getting out of date. I have announced a programme which at least is achieving substantial success. We shall have 600 places by 1985. Recently I took up the matter of Oxford region at the regional review which I conducted with the chairman and officials of that region. We set them the priority task of coming back with plans to catch up with the rest.

May I assure my right hon. and learned Friend that his statement will receive a wide welcome from those who are interested in these matters. Is he aware that those who are working in the special hospitals are particularly concerned about the commitment of the Government to regional secure units? Will he consider further the possibility that if areas do not wish to have regional secure units in their communities they should be put into existing special hospital grounds?

I agree with my hon. Friend that we should regard regional secure units as part of a range of treatment, ranging from the ordinary psychiatric hospital in the National Health Service, which should deal with many difficult patients who needs secure accommodation, all the way across to the special hospitals which deal with the most difficult patients. We are not laying down a blueprint for every region. They can adopt their own approach. However, all of them must have regional secure units as one part of a range of care, all of which is very important.

asked the Secretary of State for Social Services what representations he has recently received about financial assistance for pensioners for heating purposes.

asked the Secretary of State for Social Services how many representations he has had about problems of lack of heating for elderly people and for families with children as a result of the changes in the heating regulation for supplementary benefit.

In November there were changes to the rules for paying supplementary benefit weekly additions for special needs, including heating additions, to pensioners and others receiving the higher long-term rate of benefit. At the same time we extended age-related heating additions to supplementary pensioner householders aged between 65 and 69 and introduced an enhanced heating addition for those aged 85 or over. Heating additions in respect of children were not affected. Since 18 June, when my right hon. Friend announced the changes, we have received about 1,070 letters, including some 680 from hon. and right hon. Members, about the changes.

Is the Minister aware of the misery that is faced by so many pensioners during this very cold spell who simply do not have enough money to keep their homes adequately heated? They turn off the heating, wrap themselves in blankets and go to bed very early. Instead of cutting £1 from the heating addition given to those elderly pensioners who need that amount to help them more, why do not the Government recognise the problem involved and give the necessary assistance?

It is precisely because of our conern over this problem that we have massively increased heating additions by comparison with the piffling scheme that the last Labour Government left behind. When the hon. Gentleman refers to those elderly pensioners who are most in need, may I remind him that part of the package was an increased heating addition for those aged over 85 which has given to them an extra £2.10 a week.

Will the Minister remind the House of how much last June's change in the regulations saved the Government?

The net saving of the change in the regulations in this respect last June, which covered not only heating additions but all additional requirement payments, was of the order of £60 million.

Is my hon. Friend not aware that the answer he has given means that there are people aged between 70 and 85 who are disadvantaged by the new arrangements, and that it is wholly unacceptable to any side of the House that elderly people in this age group should have suffered cuts in their heating benefits, as Department of Health and Social Security officials have confirmed?

I understand what my hon. Friend says, but I must ask her to bear in mind that the original rationale of this deduction was the full difference between the short and the long term rates of supplementary benefit. That is how it was introduced by the Labour Government. On that basis, the deduction would now be not £1 but £11 for a married couple.

Is my hon. Friend aware that the special supplement that he announced yesterday apparently will not apply to Kent, yet Kent has been hit worst by the weather in the past fortnight? That is met with incredulity by many many people in Kent, because there are many elderly pensioners in my constituency. Is my hon. Friend satisfied with that situation?

Frankly, the exceptionally severe weather payments regulation is a pretty weird and wonderful construction. It is operated as best it can be operated on the basis of objective advice from the met office by the chief adjudication officer and I cannot go beyond that.

Following yesterday's announcement that East Anglia and some parts of southern England are to get special payments, and that the hon. Gentleman's Department is to publicise those payments and invite claims, is he not aware that many other parts of the country are facing serious weather conditions? What steps is his Department taking to draw to the attention of local offices the need for such payments? Would it not be outrageous if claimants throughout Britain were not treated on an equitable basis? Will the hon. Gentleman agree to meet a delegation of Labour Members, especially from Scotland, to discuss the matter?

It cannot be said to be inequitable to operate a regulation on the basis of objective advice from the met office weather stations assessed by the chief adjudication officer. If the hon. Gentleman and some of his hon. Friends wish to meet me or my hon. Friend the Member for Wycombe (Mr. Whitney), or both of us, of course we shall do that.

Is my hon. Friend aware that the Government's excellent record in caring for the elderly is being disproportionately damaged by the withholding of fuel allowance from some categories of the elderly? Will he urge his colleagues to think again on that issue?

I must make it clear that that applies to all additional requirements. Therefore, the effect varies according to what range of additional requirements exist. Some pensioners' heating allowances will have been affected only to the extent of 50p. I must repeat the underlying rationale and emphasis that part of the package was to enable us to extend heating additions automatically to all supplementary pensions to those over 65 and not least to give extra help to those most likely to be most in need, the over-85s.

Is it not a perversion of social justice that a minor cold snap in the south of England can trigger off exceptional payments, when it can cost up to 30 per cent. more to heat a similar type of house in Aberdeen as a matter of general conditions? Should there not be a complete review of the heating additions so that claimants receive the benefits to which they are entitled according to climatic requirements so that, wherever one lives in the United Kingdom, one's house is heated to a reasonable standard?

I understand that the hon. Gentleman had a long talk with my hon. Friend the Member for Wycombe (Mr. Whitney) about those matters last year. The very fact that, as measured under the regulation, the weather now is more severe in the south than in the north illustrates the difficulty of some blanket assumption that it is always more serious in the north. If the hon. Gentleman were to ask me to have a further look at the working of the regulation, that would be very much the kind of point my right hon. Friend the Secretary of State has in mind in the social security review.

Will my hon. Friend give some consideration to concentrating heating allowances during the winter months when they are desperately needed perhaps at the expense of not offering any additional heating benefit during the summer months?

I shall certainly consider that point.

Since the Government have now spent nearly £5 billion on the coal strike, do they still believe that that is a good investment for Britain, when the alternative could be the use of surplus coal stocks by providing every pensioner in Britain with a Christmas fuel allowance bonus of £100 for each of the next five years? Is not the eradication of hypothermia a much better investment for Britain than the present destructive use of our scarce fuel resources?

There have been few things more depressing this year than the Opposition's persistent support for policies which were bound to result in more expensive coal, to the disadvantage of pensioners.

asked the Secretary of State for Social Services if he is satisfied with the present arrangements for dealing with single payment claims by his Department.

We are broadly satisfied with the existing arrangements, given the complexity of the regulations, but one of the aims of the social security reviews to which my right hon. Friend the Secretary of State has referred is to simplify and improve the working of supplementary benefit generally.

Does the Minister accept that, in the main, the people applying for single payments are the most deprived and the most in need of urgent assistance? Does he really expect them to wait for a Government review? Does he agree that urgent action should be taken to ensure that it is made easier for those people to obtain the help that they need immediately, without having to wait?

I am satisfied that the regulations are being applied efficiently and with urgency where appropriate. The appeals system is also working effectively. Nevertheless, we recognise that there is reason for improvement. That is why we have launched the reviews of the social security system which, as my right hon. Friend said, are somewhat overdue.

A few moments ago my hon. Friend the Minister for Social Security described the emergency heating regulations which form part of the single payment regulations as "weird and wonderful". Does my hon. Friend accept that they should be examined with some urgency? In particular, will he investigate the reason for the exclusion from the arrangements announced yesterday of Kent and, in particular, my constituency, which is among the areas worst affected? Will he ensure that the regulations are brought into some discernible relationship with reality?

As my hon. Friend the Minister for Social Security acknowledged, we recognise the complexities of this, but I refer my hon. and learned Friend to the criteria published in the "S Manual", which is available in the Library.

asked the Secretary of State for Social Services what response there hs been to the publication of the first annual report on the National Health Service.

The report has been widely welcomed as a clear description of the developments and achievements of the Health Service in England over the past five years and of some longer-term trends over the past decade.

Does my right hon. and learned Friend agree that the main conclusion to be drawn from the report is that we have significantly expanded the Health Service and that it is safe in our hands? Will he ensure that if the annual report is repeated in future years more emphasis will be given to the performance of the Health Service in the regions, rather than just the national position?

I agree with my hon. Friend. The report focuses attention on the real measure of what is happening in the Health Service—the number of patients treated and the results in patient terms. The report shows that in 1983 alone 300,000 more inpatients were treated in our hospitals, which is a bigger increase than the Labour Government achieved in five years. I agree that future annual reports should show more on progress, perhaps broken down by regions.

I recognise the usefulness of the report, but is not one of its defects the fact that it fails to evaluate whether the people of this country are actually healthier, and merely seeks to determine whether more people have been treated, which is far from the same question?

The health status of this country remains extremely good. I see no evidence that people are getting more ill. There is, however, evidence that the Health Service is providing ever more treatment.

I welcome the annual report. May we hope that future reports will set clear performance targets for each region and assess performance against those targets?

We are devoting a great deal of work to producing a credible means of measuring the performance of authorities. That is now well advanced and the sooner we can put it in place and have a real means of comparing performance in different areas the better it will be for all of us, including the service and the patients.

Does the Minister accept that the whole House would approve that part of the report which describes the advantages of taking elderly people out of hospital and into the community? Will he tell the House now or publish in the Official Report, the impact of rate-capping on that highly desirable exercise?

I am grateful for the hon. Gentleman's support of our policy of care in the community, which reduces the number of unnecessary long-stay hospital patients and provides better facilities elsewhere in the Health Service and in the community. I do not believe that rate-capping need have any impact on that. Rate-capping affects the totality of local authority expenditure. It affects the expenditure of those local councils which are spending excessively across the whole range of their activities. It is thus quite wrong to suggest that its impact need affect desirable community care, which other authorities provide without getting into trouble with rate-capping.

While I warmly welcome the positive step that the Government have taken to increase the number of kidney donor transplants, is my right hon. and learned Friend aware of the great anxiety about the inadequate provision of dialysis? Does he accept that it is wholly unacceptable, given the resources already within the Health Service, that each year several hundred people are condemned to death by the failure to provide a known treatment?

Throughout our period of office we have recognised the need for more renal treatment and have given it a high priority. The figures show that we are increasing the number of patients substantially each year. Now that our new drive is going forward on the transplant programme in particular, the transplant figures are extremely encouraging. Obviously we have further to go. With respect to my hon. Friend, the figures that he quoted in the second part of his question are of an elastic quality, because we depend on a mass of statistics. His emotive language is not justified by facts from hospitals. It is not necessary to dramatise the case in that way or to persuade us of what we already know, which is that there is a need to continue to develop the kidney services.

How does the Minister justify blocking the appointment of general managers whom Conservative health authorities wish to appoint, for example, in the Oxford region and Lambeth, when at the same time he insists on appointing as chairman of the NHS management board a man who, at his press conference, admitted that he knows little about the NHS and always uses private health insurance for his family, and whose immediate background is confined to the Port of London Authority and the National Freight Corporation?

We shall come to questions about the specific issues later. The point is that if we are to improve the service, put more money into it and get better value for money we must, among other things, improve its management. With a good, cost-effective management more patients are treated, whatever resources are available at a given time. It is wrong for the hon. Gentleman to question us, although he is entitled to do so, about what he perceives to be inadequacies in the service, and then to say that Ministers should not take a view about who holds key posts within it. Presumably, the hon. Gentleman prefers jobs for the boys, Buggin's turn, to allow NALGO to dominate the process, or whatever else takes his fancy. The new general manager of the NHS has an excellent track record of management, which is now being put at the service of the NHS and its patients. That is a wholly welcome development.

asked the Secretary of State for Social Services what savings have been achieved through putting ancillary services out to competitive tendering.

asked the Secretary of State for Social Services if he is satisfied at the speed health authorities are dealing with privatisation in the National Health Service; and if he will make a statement.

I am satisfied with the progress being made by most health authorities in drawing up and implementing their programmes for competitive tendering. We have asked health authorities to provide us with up-to-date figures on savings, but information available to us so far suggests that the policy will result in savings of nearly £20 million over the next three years.

I welcome the news that savings are to be made. That is good news for patients, because of the increasing demands on the Health Service. What plans does my right hon. Friend have to extend competitive tendering to other sections of the Health Service?

Our first priority is to ensure that the programme of competitive tendering for domestic services in the Health Service is continued and brought to a conclusion in 1986–87. That is our aim. There are substantial further savings still to be made. As my hon. Friend said, the point of savings is that the money saved goes to patient care. That is what our policy is about, and the House is beginning to see it work.

Is the Secretary of State not worried that at least 40 Conservative Members have direct financial interests in profiteering from the privatisation of these services? Does he not recognise that the code of conduct laid down for local councillors at local level is much more stringent than it is for hon. Members of this House, who can go into the Lobby and vote to line their own pockets?

I am much more concerned that some Labour Members take their line from trade unions such as COHSE and NUPE and apply an entirely uncritical attitude to those policies.

Is my right hon. Friend aware that some health authorities may be including unnecessarily restrictive clauses in their tendering documents, which are designed to ensure that private companies cannot compete and that contracts are awarded to in-house, fully unionised labour?

I shall consider any points that my hon. Friend may wish to raise with me. Of course, in some instances, the in-house organisation will produce a better price and a better service. That is also part of the policy of competitive tendering and it provides savings for the Health Service.

Will the Secretary of State avoid grotesque exaggeration of the savings that may result from privatisation? Will he avoid misleading the House as the Minister for Health did on 23 July last year, when he told me that Merton and Sutton had made estimated savings of £126,000 compared with the in-house tender. That health authority has told me in writing that there was no in-house tender with which to compare the tenders that it had received, as the Minister had said. He said that Medway had saved £357,000 compared with the in-house tender, but that health authority told me that the figure is only £102,000. He said that north Warwickshire had saved £70,000, but the figure is £22,000.

The hon. Gentleman is fighting the battles of yesterday's debates. We have asked health authorities to provide us with up-to-date figures on savings, and I shall ensure that those figures are at the disposal of the House. I hope that the hon. Gentleman will not continue to take the absurd position that there is a monopoly of skill in cleaning and domestic services inside the Health Service, and that he will support this sensible programme, which means that more money will go to patient care.

asked the Secretary of State for Social Services whether he will make additional resources available to improve the health education services; and if he will make a statement.

Since 1979–80 the Government have increased funding of the Health Education Council from £4·5 million in that year to £9·1 million in the current financial year. This is an increase of 39 per cent. in real terms. The council's funding for 1985–86 is currently under consideration.

Despite what the Minister says, when will the Government take health education seriously? The Minister knows that, despite what he said, there is no successful continuing health education service. Will he have new consultations with the British Medical Association, the Health Education Council and health education officers in order to provide a better service? Does he agree that a net saving could be made in the Health Service if we had an efficient health education service?

Uncharacteristically, the hon. Gentleman has ignored my answer and has completely ignored what is happening in health education in the regions and districts. In most regional health authorities, health education is part of the regional strategic plan, and almost every district health authority has a health education officer. Great steps have been made by the Government's preventive policies, and more has been achieved on preventive medicine by this Government than by any other.

Is my hon. Friend aware of the Tesco initiative on food labelling that was announced last week, and does he welcome it? Does he recognise that the need for health education is made even greater if there is to be a proliferation of such initiatives, leading perhaps to extra confusion for the consumer?

Food manufacturers recognise the public concern for greater knowledge about the contents of the food that they eat, and the demand for better food labelling. That is why my right hon. Friend the Minister for Agriculture, Fisheries and Food is consulting the food industry on this important matter, so that he can draw up guidelines which will be easily understood by the consumer and which will not lead to the confusion to which my hon. Friend referred.

asked the Secretary of State for Social Services what increase there has been in the number of inpatients per available bed in the geriatric services.

The number of inpatient cases treated per available bed in NHS hospital geriatric units in England rose from 4·2 in 1978 to 5·8 in 1983.

Does my hon. Friend agree that this is a good sign of the hospital care that has been extended to our elderly people, and can he confirm that sufficient funds will be made available for their care in the community subsequently?

Yes, we are totally committed to the promise in our 1983 election manifesto to make better health and care for the elderly our great priority. That is why, in geriatric care, we have increased the number of nurses by 11 per cent., the number of consultants by 17 per cent. and the number of senior registrars by 43 per cent. since 1979. That is a considerable record by any Health Service standards.

Instead of the Minister playing the numbers game on geriatric care, should he not pay attention to the fact that geriatric hospitals are the worst in the medical service, with antiquated wards and inadequacies in the provision for geriatric patients? Is it not about time that we spent far more money in this sector?

It has been the case, as the hon. Gentleman says, that long-stay geriatric hospitals have often been the part of the National Health Service that has been ignored. My right hon. Friend the Secretary of State for Social Services has referred to that form of hospital care as one of the Cinderella services. That is what we are trying to put right, not only by our massive building schemes for new hospitals and geriatric units, but by the advances that we are making in our care in the community processes, by the increase in domiciliary visits by nurses and those who bring meals on wheels, and by increases in day centres and the other things that make up the new fabric of care for the elderly.

asked the Secretary of State for Social Services what is the total number of beds in hospitals within the National Health Service in England and Wales, the number of pay beds and the number of beds now awailable in private hospitals, excluding nursing homes for the elderly; what percentage of the population are now covered by private health insurance schemes; and if he will make a statement.

In 1983, the latest year for which figures are available, there were on average 343,090 beds available daily in NHS hospitals in England. On 31 December 1983 there were 2,987 authorised pay beds in NHS hospitals in England. At the same date, there were, provisionally, 37,980 beds in the private sector, of which 8,100 were in premises with operating theatres. My right hon. Friend the Secretary of State for Wales will send the hon. Member figures for Wales. We estimate that 8 per cent. of the population is now covered by private medical insurance. We welcome the growth of private medicine because patients should have freedom of choice, and because it adds to the country's health care resources and relieves pressure on the NHS.

Do not these figures and facts make complete nonsense of the statement by Mr. Victor Paige when defending his BUPA attachment? He said that most people now have private health care and that he would have to take some time to understand the Health Service. Cannot the Minister start thinking again about bringing from business people who have not a clue about health care and provision to run the Health Service? Is it not appalling to pay £70,000 a year to a man whose only previous experience is to preside over the diminution of the Port of London Authority, and over Sainsburys, when he thinks that baked beans going in and out of a checkpoint are the same things as patients?

The hon. Gentleman has slightly misquoted Mr. Victor Paige, who was describing the arrangements for managers in industry and was not talking about the generality of the population. Unusually for the hon. Gentleman, he is making trite points in a silly attack on Sainsburys and the rest, when we are talking about the appointment of a powerful manager to head a successful and expanding service. We should be concentrating on what we are producing by the changes that we are making, and on the room for changes. We are treating 12 per cent. more patients each year in our hospitals than was the case in the last year of the Labour Government and no fewer than 45 per cent. more day cases each year than in 1979. The appointment of a general manager is the next step in carrying on improving the Health Service.

Notwithstanding the rather carping attitude of Labour Members, has my right hon. and learned Friend recently noticed evidence that NHS patients are progressively being treated from time to time in private hospitals? Does this not underline the fact that, far from being competitive, there is a strong argument that coexistence between the public and private sectors is to the benefit of all?

I strongly agree with my hon. Friend. We should be interested in whether we are treating the patients properly and getting waiting lists down. That matters far more than who owns the building and who pays the staff. If it is a more cost-effective way of treating patients, we would welcome collaboration between the NHS and the private sector if a health authority finds that it gets more inpatients treated that way.

asked the Secretary of State for Social Services what recent representations he has received about his proposals to limit the range of drugs prescribed under the National Health Service.

I have received representations from a wide range of individuals and organisations on both the principle and the detail of the scheme. Consultations are continuing on the content of the limited list, which will be finalised next month.

Is my right hon. Friend aware that, while there is considerable support for the concept of substituting generic preparations for brand name drugs, the idea of having a limited list whereby certain drugs are not available at all on the National Health Service is quite another matter? Will he set his face resolutely against a system whereby a general practitioner has to consider the means of a patient before considering what prescription to write?

We are not seeking to introduce some kind of two-tier system as has been suggested by some highly misleading advertisements of the Association of the British Pharmaceutical Industry, which I greatly deplore. Let me tell my hon. Friend that my chief medical officer and a team of independent advisers are examining all the drugs that could be on the list. We always made it clear that we would undertake this consultation and that the list was provisional. If we find a branded drug for which there is no adequate alternative, it will remain available for prescription.

asked the Prime Minister if she will list her official engagements for Tuesday 15 January.

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.

Is the Prime Minister aware that the Department of Health and Social Services estimates that in 1984 140,000 homeless people, at a cost of £380 million—an increase of over 600 per cent.—will have used board and lodging accommodation, much of it substandard, lacking in heating, lighting and toilet facilities and representing a serious fire risk? Should not the Government be advocating an increase in the amount of cash available for public sector house building rather than a decrease, so that people can escape from despair, desperation and degradation?

No. I believe chat the Government's housing policy is the right one and that most people wish to own their own homes. Home ownership has gone up 1·7 million since we were in power and in accordance with that wish the majority of house building is taking place in the private sector.

Does my right hon. Friend agree, and will she take time today to consider, that this nation's economy is not a one-commodity economy, and that to consider it as such is simplistic, if not downright hysterical? Does such a view not ignore the fact that under this Government inflation is down, productivity is up and the export of goods and services is ever-increasing?

Yes, I agree with my hon. Friend. Gross domestic product is at its highest ever level, fixed investment across the economy is at its highest ever real level, retail sales are at their highest ever real level—up 4 per cent. in volume in 1984—profits are up 20 per cent. in the first three-quarters of 1984 and non-oil exports are up 12·5 per cent. in volume in the three months to November over a year ago. Britain is still worth investing in.

May I express the wish, with regard to the Prime Minister's last sentence, that many more people agree with her that Britain is worth investing in? Will she accept that on the Opposition side of the House we find the speculation against the pound irresponsible and irrational, but that we also feel that her Government's handling of the current crisis is an epic of bungling indecision that will cost the industries and the households of this country very dear? Will she let this shambles continue, or will she now help the pound by sacking the Chancellor of the Exchequer?

I am not sure whether the right hon. Gentleman means that he would have put interest rates up earlier, not at all, or later. Of course, he will not say—[Interruption.]—because he has not got a clue. The speculation to which he referred has gone on, not only against the pound, but against other currencies. In the last day, record lows against the dollar have been reached by the Swiss franc, the Italian lira, and by the French franc, and the deutschmark also reached a 12-year low. Yesterday, the deutschmark stood at $3·20 in New York. The speculation which the right hon. Gentleman condemns has gone on against all currencies in Europe. We took what we believed to be the right decision because we had to consider exchange rate policy along with several other factors.

The truth is that the Prime Minister did not take the right decision in any calm fashion. She and the Chancellor of the Exchequer were eventually forced to panic into taking some kind of decision. As she has compared our condition with that of Germany and Switzerland, is she saying that she would do what the Germans and Swiss do, and that she would intervene? If so, will she come clean and admit it? Will she stop dodging the question and asking what the policies of others are and, instead, tell the country what it wants to know, which is what she and her Government will do to stop the crisis in currency and interest rates?

I recall recently two occasions when Germany intervened. I emphasise that I recall only two occasions. The intervention was not successful, as I indicated — [Interruption.] Will the right hon. Gentleman listen, as he might then learn a thing or two —[Interruption.]

Order. These are very serious matters. The Prime Minister is seeking to answer the question, and should be heard.

Intervention alone was not successful, because, as I indicated to the right hon. Gentleman, yesterday the deutschmark also reached a 12-year low in New York. No single country has enough reserves to counter large volumes of currency moving round the world. We used the interest rate because we thought it right to do so in the circumstances in the exchange market. I remind the right hon. Gentleman that he predicted doom and gloom in July, when we had to do precisely the same thing. Since July, when he predicted doom and gloom and we eventually managed to get down interest rates, inflation has remained at, or below, 5 per cent., output across the economy has continued to grow, exports have been up in volume and retail sales have been higher in the fourth quarter. What the right hon. Gentleman predicted would happen in July did not happen, and the economy is being properly handled by my right hon. Friend the Chancellor of the Exchequer.

In July I asked the Prime Minister what she would do to give new strength to our economy. Since then we have lost 80,000 jobs and billions of pounds have flowed out of our economy. Will she now answer the question that the whole of Britain is asking? What is she going to do to change her policies in order to bring us strength, to stop the speculation, to bring down interest rates and to give us a secure future? The right hon. Lady has not yet answered that question.

The right hon. Gentleman's points are not right. After the interest rate increased to 12 per cent. in July output across the economy continued to grow. Construction output was up 3 per cent. in the third quarter over the second, exports were 6·5 per cent. up in volume in the three months to November over the previous three months and the doom and gloom that he predicted did not come to pass—[Interruption.] It did not come to pass because my right hon. Friend the Chancellor of the Exchequer took the right decision to contain inflation, and we have been containing public expenditure. That is why the Stock Exchange today is 14 points higher than a month ago, 233 points higher than at the time of the 1983 election, 395 points higher than at the time of the 1979 election and 803 points higher than the lowest point under the Labour Government.

It is a shame to change the subject. Will my right hon. Friend take the opportunity to ask Chancellor Kohl whether he agrees that we are fully entitled to celebrate the end of a war which secured the freedom, not only of Britain but West Germany? Might Chancellor Kohl not agree also that the only aspect we have to regret about our victory on VE day is the fact that the United States did not heed Sir Winston Churchill's advice to shake hands with the Russians as far east as possible?

I know that there is a good deal of feeling that we should have a national celebration of VE day. I understand that feeling and believe that we should celebrate not only victory but peace with freedom and the fact that for some 40 years we have had peace with freedom across Europe. We are considering the form of a national commemoration, which will honour the dead and point to the reconciliation and reconstruction that has been achieved. We shall make an announcement in due course.

Returning to the currency crisis, does the Prime Minister recall that in October 1976, when she was Leader of the Opposition, she said that the drop in the value of pound sterling to $1·66 was due to the lack of confidence of other countries in the Chancellor's policies? Now that the right hon. Lady is in office, does she consider that the current drop in the value of the pound sterling to below $1·12 is a massive international vote of confidence in her Administration's success?

The right hon. Gentleman's question shows that he cannot understand that the strength of the dollar is an entirely new and different phenomenon. Otherwise, the right hon. Gentleman would realise that that currency affects not only sterling but the Swiss franc, the Italian lira, the French franc and the deutschemark, whose value has fallen to record lows. Normally one expects the richest nation in the world to have great outflows of capital to finance other countries. In fact, for some time, the United States has been attracting capital from the rest of the world and has not been putting capital out because of the debts in the rest of the world, because previously the banks overlent and other countries borrowed more than they could repay.

asked the Prime Minister if she will list her official engagements for Tuesday 15 January.

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

Accepting the Prime Minister's preoccupation today with the sterling crisis, will she take time to reconsider the war of attrition against the miners? The right hon. Lady may believe that the miners are misguided, but they are accepting severe privation and showing heroic determination in fighting for their communities and the dignity of work. Does the right hon. Lady recognise that in June, September and October last year real negotiations which almost secured a settlement took place? Why can we not have a resumption of negotiations without preconditions to secure a principled and balanced conclusion to a dispute which is not helping sterling and is damaging the economy?

Some 73,000 members of the National Union of Mineworkers are not on strike. More than 20,000 members of the NUM have returned to work since the beginning of November, including 1,800 so far this week. The only attrition against the miners is being carried out by the leadership of the NUM.

asked the Prime Minister if she will list her official engagements for Tuesday 15 January.

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

Can I take it that the Prime Minister has now overruled the view of the Foreign and Commonwealth Office, expressed to me last week by letter, that any celebration of the 40th anniversary of VE day would be at best nostalgic and at worse anti-German? Will the right hon. Lady ensure that any celebrations are genuinely international in character and involve all our wartime allies?

I believe that we are entitled to national celebrations, and I have said that we shall be bringing forward some proposals. I hope that those will celebrate the victory of freedom over tyranny and that they will also celebrate 40 years of peace with that freedom. It will, therefore, be a celebration with two aspects to it.

In view of the clamour from Opposition Members for increased public spending, may I ask my right hon. Friend to spare a word for those engaged in the wealth-producing private sector? After all, they have borne the brunt of the recession, they need all the help they can get and, contrary to popular belief, the vast majority of them are not engaged in building roads and sewers.

The health of the public sector depends on having a flourishing private sector, and that depends on not putting so many burdens on those in that sector that they cannot make sufficient profits to re-invest and extend their activities. I absolutely agree with my hon. Friend.

On a point of order, Mr. Speaker—

Does it arise directly out of questions?

It does, Mr. Speaker. In answering questions, the Prime Minister spent seven minutes answering two questions.—[HON. MEMBERS: "Three".] Before the Christmas recess, when a Minister of State at the Home Office purported to answer a question by taking eight minutes, you ruled, on a point of order raised by me, that you would exhort Ministers in future to restrict the length of time they took in purporting to answer questions. The Prime Minister, in her attempt to answer questions, clearly infringed that ruling that you gave before the Christmas recess. I ask for your guidance for future reference.

The whole house knows that I should like to see shorter supplementary questions, which I think would lead to shorter answers from the Front Benches. In fairness to the Prime Minister, she was answering a very important question put on three occasions by the Leader of the Opposition. As a general principle, however, I agree with the hon. Gentleman that shorter questions would be beneficial.

On a point of order, Mr. Speaker—

Does it, too, arise directly out of questions?

Yes, Mr. Speaker. Two of the three hon. Members who asked questions this afternoon did not, in their preliminary phraseology, refer to the Prime Minister's business today. Is it not the requirement that such a reference should be part of the phrasing of questions, and would it not have been right for you to have drawn the attention of the hon. Members concerned to that fact?

The hon. Gentleman is entirely right, but I suppose that that preliminary phrase takes up that little bit of extra time. The whole House knows what we are about when we have these open questions.