asked the Secretary of State for Social Services how many people he estimates have or will come out of long-stay sub-normality hospitals under the care in the community policy in 1984, 1985 and 1986, respectively.

There were 31,500 discharges of people from mental handicap hospitals and units during 1983, the latest year for which figures are available. However, 27,500 of the discharges followed periods in hospital of less than one month. Only 1,800 followed periods of two or more years and, within this figure, 760 patients had been in hospital for over 15 years. Figures for 1984 should be available in September. We cannot yet make estimates for future years.

Will the Minister confirm that in many authorities the funds are not available to provide the full range of community care that is needed by those who have been in hospital for a long time? Will he speak to the Secretary of State for the Environment and ask for a 100 per cent. disregard for such funds, or will the Government continue to penalise local authorities which are trying to provide the services which these people so desperately need?

Many of the services for discharged patients who have been long-term stayers in hospitals are provided by health authorities, which are substantially increasing their spending in this area. Local social service departments throughout the country have increased their spending on social services as a whole by 17 per cent. over and above inflation over the past five years, and many are making good progress. I do not believe that local authorities which are making a proper choice of priorities are inhibited from joining in the care in the community policy.

Is my right hon. and learned Friend aware that there is widespread concern about the many children who continue to be admitted to long-stay sub-normality hospitals?

I share my hon. Friend's concern. I am glad to say that the number of mentally handicapped children in hospital has dropped by 50 per cent. during the Government's period in office, but we would like to see them all out of hospital. That is why we have allocated so much money for that purpose. I hope that all admissions will stop soon.

Will the Minister consider the problem that arises from the effect of tapering on joint funding in the discharge of long-term patients? Will he take into account especially the problems that are faced by Prestwich?

The rules on disregarding joint finance for local government spending purposes have been eased slightly, but the joint finance was always intended to taper after the requisite period. We have given new powers so that health authorities can provide funds without any time limit where it is intended to move long-stay patients out of hospitals.

Will the Minister make himself fully and urgently aware of the compelling case put to the all-party disablement group about children in mental hospitals when Peggy Jay and her colleagues from Exodus came to address the group earlier this month? Is he aware that there are still 450 children in such hospitals and that four more have been added this year? If some regional health authorities can tackle the problem positively, why not all of them?

I agreed with my hon. Friend the Member for Surrey, South-West (Mrs. Bottomley) when I expressed the wish that all admissions could now cease. The fact that only four have taken place this year shows that we are near the end of the problem. The number of children in those long-stay wards dropped by over a half. We have provided money to enable health authorities to get the remainder out. I share the all-party group's aims, and I hope that we shall soon realise them.

Is the Minister aware that MIND on Merseyside has reached an agreement with the health authority by which the health authority will pay £14,000 a year for every person taken out of institutions in that area? If he believes that to be good practice, will he Commend it to other health authorities?

Certainly, I shall. Almost all health authorities now have some variant of those arrangements. It is important that they should all have plans whereby they can obtain the better services required for those patients by paying the correct sum to other health authorities, if they are to take over the obligation, to local authorities or to voluntary bodies, including those such as MIND, which have a good record.

asked the Secretary of State for Social Services what are the criteria for registering private mental health facilities with the National Health Service.

The criteria for registering a private mental nursing home are for the district health authority in whose area the home is located to determine, having regard to the provisions of the Registered Homes Act 1984, the Nursing Homes and Mental Nursing Homes Regulations 1984 and the Mental Health Act 1983.

Is my right hon. and learned Friend satisfied that existing codes of practice are of a sufficiently high standard, without being too strict, and that they can be enforced without new legislation?

Yes, Mr. Speaker, I am. If there is a dispute between a proprietor and a local health authority the matter can be determined on appeal to the registered homes tribunal, which the Government set up under the legislation that I have just set out.

asked the Secretary of State for Social Services what further representations he has received regarding the Green Paper "The Reform of Social Security".

By today some 450 representations have been received about the Government's proposals for the reform of social security.

Is my right hon. Friend aware that of the many welcome aspects of these proposals one of the most important is the arrangement whereby benefit will be withdrawn on a tapering basis in relation to net rather than gross income? Is he further aware that many employers in my constituency have drawn attention to further examples of how the present system acts as a disincentive to people seeking jobs?

I entirely agree with my hon. Friend. That change will mean that we can tackle the unemployment and poverty traps in a way that has not been possible until now.

Many of my constituents are, unfortunately, in receipt of supplementary benefit. When shall I be able to advise these practical people whether they will be better or worse off after the reviews?

The hon. Gentleman will be aware of our proposals in the Green Paper. In the White Paper we shall put forward illustrative figures, but, of course, ultimately he will have to await the uprating in April 1987 to know the exact rates.

Does my right hon. Friend accept that there is no way in which he or anyone else can solve the unemployment or the poverty traps unless tax is brought into the equation? So long as tax and social security are kept separate, there is no way in which the poverty or unemployment traps will be solved.

I am aware of my hon. Friend's interest in this matter. In the Green Paper he will have seen a number of ways in which the two sytems are moving closer together. He will also be aware that in the autumn my right hon. Friend the Chancellor of the Exchequer will be making his personal taxation proposals.

asked the Secretary of State for Social Services if he will make a statement on nurses' pay and the representations made to him on the recent proposals of Her Majesty's Government in response to the review body's recommendations.

Following my right hon. Friend the Prime Minister's announcement on nurses' pay on 6 June, we have received a number of letters. Most have concerned the staging of the award and its funding. Agreement has now been reached with the staff side on all the new salary scales, which were notified to health authorities on 1 July.

Is the Secretary of State aware that anyone interested in the Health Service was appalled by the miserable ministerial speeches made in yesterday's debate? Does he recognise that for every percentage point over 3 per cent. paid to nurses and others there will be a diminution in the standard of service to patients, because of the tight cash limits imposed on the local health authorities? Does he further recognise that even with the 5·6 per cent. increase that is to be given to nurses—those dedicated people—between now and February they will have to suffer a reduction in their standard of living?

I do not agree with anything that the hon. Gentleman has said, including his comments on the outstanding speeches made by my right hon. and learned Friend the Minister for Health and my hon. Friend the Under-Secretary of State for Health and Social Security. Since 1979, nurses' pay has gone up by 23 per cent. above inflation. After the review pay award, their pay will have increased by between 25 and 30 per cent. The Government set up the independent pay review body which the nurses wanted, a desire which the Labour party ignored.

Will my right hon. Friend recognise the unique importance of midwives, even if the pay review does not? Will he ensure that in the final recommendation midwives' pay is related to their contemporaries who remain in nursing or who progress to health visiting?

I am sure that the review body will take that into account. We recognise the great importance of midwives in the Health Service.

Will the right hon. Gentleman confirm that the pay award was, on average, 8·5 per cent., possibly rising to 14 per cent. for some grades, but that in the year 1985–86 nurses will receive an average of 5·6 per cent.? Will he now look at another problem that he has not solved—that of bottle-necks? Is he aware that in hospitals near here there is such a shortage of neonatal nurses that, although there is sufficient cash, the service is run in a way that is hazardous to the health of patients? Is he further aware that there is a shortage of theatre sisters and sister tutors?

I shall examine any specific issue that the hon. Gentleman wishes to draw to my attention. The review body recommendations mean that nurses' pay will increase from between 4·1 and 14·3 per cent., and for professions auxiliary to medicine by up to 16·6 per cent. The award has to be staged, but by the beginning of the new financial year all those changes will be in place. This is an outstanding award for the nurses and it would do the hon. Gentleman more credit if he recognised it.

Why, when the Northampton district area health authority, which is one of the most economic and efficient health authorities in the country, can provide for nurses' pay without a cut in services, do the more profligate authorities seem to have a problem? Is it that the Labour party wants a propaganda weapon with which to beat the Government over the head, when, in fact, the health authorities could do the job properly?

Few health authorities are complaining that they are unable to manage. One or two of those that are complaining are the ones which complain about virtually everything. At the beginning of this year we provided £500 million more cash for health authorities in England. The stage award that we have announced for this year can be afforded out of that.

Has the right hon. Gentleman seen the reported response by Mr. Trevor Clay of the Royal College of Nursing to the speech made by the Under-Secretary of State for Health and Social Security yesterday? If so, what is the Secretary of State's response?

I have seen the letter that Mr. Clay wrote to The Times this morning, if that is what the hon. Gentleman is talking about. If the hon. Gentleman wishes to talk about nurses' pay, he should check with Mr. Clay whether he and the RCN supported the setting up of an independent pay review body. This Government have achieved that. The Labour Government ignored the problem.

Has the Secretary of State seen the Nursing Mirror survey, which reveals that 90 per cent. of all nurses believe that their wards are dangerously understaffed, and shows that trainee nurses are responsible for the manning of wards at night? Is that fair, and how does the Secretary of State justify that? The voice of the profession demands action.

That question is not fair, because the Government have put more money and resources into the Health Service than the Labour Government did. Above all, we have put more money into the Health Service capital building programme. The hon. Gentleman's question reveals that he is unaware that the last Labour Government cut the capital programme.

asked the Secretary of State for Social Services what representations he has received about the provisions for the single homeless in west central Scotland; and if he will make a statement.

Provision for the single homeless is primarily for local authorities to determine. My right hon. Friend the Secretary of State for Social Services has, however, a responsibility to provide temporary places for people without a settled way of life. In west central Scotland, the Department currently runs the Bishopbriggs resettlement unit for this purpose. As my hon. Friend is aware, it is our policy progressively to close these units, in parallel with measures to develop more appropriate alternative provision. In the case of Bishopbriggs, our aim is to close it within the next three years, and a review team chaired by the Department and including representatives of the Scottish Council for the Single Homeless and local housing interests is currently, through a process of consultation, assessing the needs of the single homeless in the area and considering proposals for alternative facilities. My hon. Friend has written to me about the matter, as has the hon. Member for Dundee, East (Mr. Wilson) and one member of the public.

I am grateful to my hon. Friend for that reply. Is he aware that there is considerable concern in west central Scotland about the Department's proposal to close the resettlement unit at Bishopbriggs, which has in the past provided a refuge for single homeless people? Is he prepared to extend the consultation period, and will he give a commitment to retain the unit if the consultations show a pressing need for it?

My hon. Friend knows that we are determined that this shall be part of a programme of ensuring proper alternative provision. In that spirit, I am happy to say that I would be willing to extend the consultation period to the end of this year. The same will apply to the other seven units which we have in mind for relatively early closure.

Will the Minister take an early opportunity to visit the Bishopbriggs resettlement unit and talk to the staff about the excellent work that they have been doing? What voluntary services will take on the work of that unit. when others in the west of Scotland say that at present they could not take on its role? Rather than simply extending the consultation period, will he make it clear that the Bishopbriggs resettlement unit will he kept open?

The purpose of the consultation period—the consultations involve some distinguished people, including the former chairman of the Supplementary Benefits Commission and representatives of the Scottish Council for the Single Homeless—is to establish what the possibilities are for alternative provision. I shall bear in mind the hon. Gentleman's request for me to visit the unit. I am due to visit some resettlement units in the next few months, though I cannot make him an absolute promise to visit that one.

asked the Secretary of State for Social Services what progress is being made in setting up the review committee on the selected list of National Health Services drugs.

We announced details of the advisory committee on NHS drugs on 12 July. The committee's first meeting is to be held on 23 July.

As the doctors do not want a personal appeal system, may we now be assured that the new review committee will get on quickly with the job of reviewing the list, because there seem to be about a dozen drugs which doctors and patients believe should be restored to the list as soon as possible?

I assure my hon. Friend that we shall ask the committee to get on with its task as quickly as possible. I cannot guarantee that it will admit to the list all the drugs to which my hon. Friend referred. There are genuine divisions of clinical opinion, and all of those that have been excluded so far have been excluded on the unanimous opinion of a group of experts who said that there was no scientific or medical need for them.

Is the right hon. and learned Gentleman still prepared to consider specific cases where a medication is seen by the medical profession to be the only one?

There are no drugs seen by the medical profession to be the only available drugs and which have been excluded from the NHS. We still get some individual complaints, but, as I say, the best advice that we could gather was that there was no medical or scientific need for the drugs that are now excluded. However, the new committee will look at individual products, at the request of doctors and manufacturers, and consider whether anything should be restored to the NHS list.

Why does my right hon. and learned Friend think that the BMA refused the appeal machinery offered by the Government? Could it have been because of the minuscule number of complaints about drugs that had been received?

It would not be wise for me to try to speak on behalf of the BMA on all these matters. There was a division of opinion before it was decided to decline the offer that we made. I agree with my hon. Friend that the number of difficulties turned out to be remarkably small and that many doctors no longer perceived a need for the individual appeal mechanism about which we were once talking.

Will my right hon. and learned Friend ensure that the drug Mucodyne is drawn to the attention of the review body at the earliest possible opportunity?

It will be considered by the committee at its first meeting.

asked the Secretary of State for Social Services whether he is yet in a position to formulate a national policy for the prevention of drug misuse.

Prevention is one of the key elements in the Government's overall strategy for dealing with this problem. We set out our policies in the document "Tackling Drug Misuse", which was published last March.

I thank my right hon. Friend for his comments and congratulate him on his efforts in this difficult matter. Will he consider directing more attention towards educating parents and teachers about the problems of drug misuse, so that those problems can be detected at an early stage?

Both aspects are important. We have instituted an advertising campaign, and the Department of Education and Science is also taking action. One of the aims of both campaigns is to give more information to parents and teachers.

Has the Secretary of State had time yet to study the report on this important and vexed question by the Select Committee on Social Services, which was published on 20 June? Will the right hon. Gentleman give us an assurance that, in view of the public disquiet about the escalating problems of drug abuse, he will expedite the Government's response to the report and proceed to implement some of its conclusions?

We shall give urgent attention to that report. I share the concern of the hon. Gentleman and the Select Committee about the problem.

Does my right hon. Friend agree that his task and that of his ministerial colleague in the Home Office with responsibility for warning people about the misuse of drugs is made more difficult by certain books, especially one by Harold Robbins called "Descent from Xanadu" which glamorises drug taking among tycoons? I do not ask my right hon. Friend to read this trash; I simply draw his attention to it.

I am sure that the whole House deplores any publication that seeks to glamorise drug taking.

Has the Secretary of State read his Department's report entitled, "Drug Misuse: Prevalence and Service Provision"? If so, does he agree that he is bound to conclude that there is much more "prevalence" than "service provision" and that fewer than a quarter of the district health authorities have received any help from his Government to set up rehabilitation clinics?

We are rapidly expanding the rehabilitation units. Spending has increased to £11·5 million—almost double. The hon. Gentleman may want to claim that more needs to be done. I agree, but I hope he will recognise the initiatives which the Government have taken to deal with this serious problem.

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

Implementation of the Mental Health Act is continuing satisfactorily.

Is my right hon. and learned Friend aware that people involved in mental health matters are concerned that the Central Council for Education and Training in Social Work is adopting a negative attitude towards the training of approved social workers under the Act? Is he confident that there will be sufficient approved social workers to fulfill the functions of the Act later in the year?

With respect, I think that my hon. Friend's criticisms should be directed not at CCETSW but at WALCO, which is still continuing the ridiculous boycott of the courses that had been arranged for approved mental health workers. I hope that the union will soon end its unhelpful attitude. It is rejecting a policy that had all-party support and preventing the building up of a cadre of professionally trained people.

Does the Mental Health Act 1983 contain provisions covering people serving in prisons? At Strangeways prison 12 prisoners are designated as mentally ill. When I visited the prison last Friday, I heard of one prisoner who was partially sighted and mentally inadequate and on remand on a charge involving about £6. It is costing about £250 a week to keep him in prison.

We are desperately anxious to end this problem of people in prison who are mentally ill and require treatment. I am glad that their numbers are decreasing. This is however, a long-standing problem. New powers have been brought into effect whereby prisoners can be remanded to mental hospitals for reports. That, I hope, has helped to alleviate some of the problems. I am sorry that it has not been used in the case to which the hon. Gentleman referred.

asked the Secretary of State for Social Services what plans he has to seek to reduce the need to receive children into care.

We support the growing emphasis on preventive measures and policies in child care. Indeed, the number of children in local authority care has been decreasing. It is for local authorities to provide services for children in need, whether to keep them with their families or, in the interests of the children, to provide alternative arrangements for their care.

Is the Minister aware that every year 500 children are received into care by local authority social service departments because of homelessness? Will he accept that the policy of selling council houses and cutting back on the construction of new council houses makes this problem far worse, and is likely to increase the number of children taken into care due to homelessness? Does he not think that he ought to give the House a statement on what he intends to do to improve the housing stock of the worst-off people in the country, so that children are not brought into care?

Order. I think that that is well beyond the Minister's responsibilities.

As you say, Mr. Speaker, it is well beyond my responsibilities. I recognise the hon. Gentleman's views about homelessness, because in Islington there is a considerable amount of homelessness. I also recognise that in Islington there are a considerable number of children in care. However, the numbers of children in care have been decreasing nationally. Most children go into care for a range of reasons. Homelessness might be one of the reasons that cause children to go into care.

Despite welcome modifications in the law brought in by my hon. Friend, does he accept that there is still a long way to go to achieve a balance between, on the one hand, of protecting the child who needs protection, and on the other of looking after the interests and rights of the parents?

It is a difficult balance to strike, and social workers have a difficult job in trying to strike that balance. I pay tribute to the work they do. In any case where a child is placed into care, it is the welfare of the child that has to be paramount, and the future of the child that has to be considered above all else.

Does the Minister recognise that children in care are largely the children of the poor, and that high levels of unemployment, his Government's policies of undermining wages councils and planned cuts in benefits—which mean that more families will not be able to make ends meet—will result in more children being split apart from their families and having to be fostered, adopted or put into children's homes? Is this not the very opposite of being the party of the family, in that the Government are providing for the splitting apart of families?

Once again some of the hon. Lady's questions go beyond my departmental responsibilities. The numbers of children in care are reducing. Those who look after children in care have a responsible and difficult job. That is why I hope that the hon. Lady, who has been uncharacteristically silent for some time about problems affecting children's homes in her constituency in the London borough of Southwark, will back me at the meeting of the London borough of Southwark's full council tomorrow in a call for a full investigation of all homes over which doubts have been cast.

asked the Secretary of State for Social Services when he last visited a bed-and-breakfast establishment used for homeless families.

In recent months I have visited a number of board and lodging establishments catering for single people and for families.

Will the Minister come and visit the people who are living in tents opposite the metro station by the Newcastle Haymarket, and will he explain to them the Government's response to the report of the British Association of Social Workers "Housing in social work", which sets out the fact that it costs the Government twice as much to provide bed-and-breakfast accommodation as it would cost the state to provide decent council housing?

I shall happily look at any particular problems in Newcastle that the hon. Gentleman wishes to bring to my attention, but I hope he will understand that the measures we have taken are a sensible use of the social security budget.

Is my hon. Friend aware that on Tyneside alone there are 5,500 empty council houses, a quarter of which have been empty for more than a year? Will he consider telling these hypocritical Labour councils to allow homeless couples homesteading rights on any council houses that are empty?

I take note of the important point that my hon. Friend makes, but, of course, he is taking me into realms beyond my responsibilities.

When will the Minister stop the rip-off imposed on public funds by the owners of these so-called bed-and-breakfast establishments?

I welcome the hon. Gentleman's support for the measures introduced by my right hon. Friend some months ago.

While my hon. Friend is looking at Newcastle, will he also look at the fact that that city has banned the use of Noddy and Babar the Elephant books because of the racist overtones?

I do not know whether that has anything to do with bed and breakfast.

Answer.

Order. I, too, was confused. It may have something to do with bed, but nothing to do with breakfast.

On a more relevant point, is the Minister aware that in a study undertaken by the citizens advice bureaux into board and lodging restrictions affecting young unemployed persons in Stoke it was found that in two thirds of cases return to the parental household was impossible because of divorce, sexual abuse or parental refusal, and that in another one fifth of cases the DHSS was apparently quite unaware of grounds for exemption? Does that not show how utterly unjust these regulations are? When will the Government accept that the real answer to this problem is not to force young people into wandering round the country like nomads, but to restart the housebuilding programme and to provide adequate rented accommodation in the public sector?

As the hon. Gentleman knows, our original proposals established very important exemption categories, and local DHSS officers are under clear instructions to make those exemption categories widely known. The studies that we have had so far, and the feedback from local social security offices, suggests that the regulations now in place are effective and helpful.

asked the Secretary of State for Social Services what representations he has received concerning cuts in ambulance services on Merseyside; and if he will make a statement.

We have received no such representations. The Mersey regional health authority has consulted widely on proposals to reorganise the emergency service provided by the metropolitan ambulance service. The proposals were drawn up following a study on accident and emergency cover in the Mersey metropolitan area.

The Minister will be aware of early-day motion No. 771, which has been supported by 38 hon. Members. I have received representation from the public, patients and NUPE, who are objecting to the reduction of five ambulances in a fleet of 30. Will the Minister have words with the regional health authority, given the possibility of a catastrophe in Liverpool, when lives and limbs could be at stake? Will he make sure that essential services in the city are maintained?

I am, of course, aware of the early-day motion, and I shall pass the hon. Gentleman's comments on to the chairman of the regional health authority, Mr. Don Wilson. However, I understand that the proposals involve no loss of service and no loss of jobs. I also understand that the ambulance service in Merseyside is an expanding service, with an 8 per cent. growth in jobs over the past eight years and a further 10 per cent. growth in the next decade.

asked the Secretary of State for Social Services whether he estimates that the relative financial position of the unemployed will improve in the two years after the implementation of the social security review.

A firm estimate of the effects cannot be made until benefit rates are set within any new structure of social security benefits which may be settled following the current consultation on the Green Paper proposals.

Is not the Minister's answer a cover-up of the truth? Will not the financial position of the unemployed drastically deteriorate after the implementation of the review, as a result of which the unemployed will be impoverished? Is not the Government's message to the unemployed and those who become unemployed that they will be made financially and socially insecure?

All that the hon. Gentleman has done is to convey the impression that he has not even read the Green Paper. One of the major causes of concern has been the position of families with children, whether unemployed or in low-paid work. It is clear from the Green Paper that that is a group to which the Government wish to give greater emphasis.

In any consideration of the effect on the unemployed of the proposals in the social security reviews, is it not wise to take into account the fact that encouraging people who may be discouraged at the moment from taking a job is a positive step in the interests of those who are unemployed?

That is correct, and the effect on both the poverty and unemployment traps, especially the latter, is one of the major advantages of our structural proposals, as is the improved earnings rule for those who have been out of work for a long time.

Is the Minister aware that those who lose service through unemployment will be most disadvantaged by the abolition of SERPS? Does he recall that when the Secretary of State announced that abolition he told the House that it was the result of unexpected and unforeseen developments and that those developments had come to light during the reviews? In the light of the statement in the last few days that these matters were not discussed, and in the light of the Government Actuary's statement that costs were not unforeseen and that what has changed is the Government's willingness to meet the costs, will the Minister now tell us whether his right hon. Friend intends to apologise to the House? [Interruption.] Further, will he tell us the real reason for the abolition?

I am in some difficulty about replying to the hon. Lady, because I heard only about half the question. I can say, however, that it is quite clear from the additional analysis, including work relating to the 1981 census carried out for the review, that the prospective cost of SERPS is significantly greater than was fully appreciated by those who made the decisions at the time.

Will my right hon. Friend bear in mind that many people take low-paid employment out of a sense of pride? They find it enormously difficult to make ends meet.

Yes. Not the least of the failures of our social security system is that we have put many people in low-paid work in the intolerable position of knowing they would be better off out of work. We intend to put a stop to that.

Is the Minister aware that all the cuts, as opposed to the restructuring in the Green Paper, the abolition of SERPS, the requirement on the poorest families to pay at least 20 per cent. of their rates, the removal of mortgage interest payment relief from those on the dole for the first six months, were not recommended by the review committees and imposed only on the personal decision of the Secretary of State? What other decisions, what other cuts, did he impose which were not recommended by his own review committees? Will he now publish all the review committee reports so that we can judge how much he has deviated from his own advisory review committees to impose cuts?

It was made absolutely clear throughout that the Government would be taking decisions and putting forward proposals as Government decisions after taking account of the work of the various teams which were set up. What I would like to know from the hon. Gentleman is when we shall know whether his proposals about mortgage interest are the policies of the Leader of the Oppostion and the Labour Party.

asked the Secretary of State for Social Services if he has yet received the reply of the British Medical Association to his proposals for an appeals procedure on the limited list.

Yes, Sir. The general medical services committee of the British Medical Association has now formally declined our proposals for a local appeal mechanism for the selected list of drugs.

Would support from general practitioners wishing to implement such an appeal system be sufficient for the Minister to implement it for them unilaterally?

It would be very difficult to implement a scheme without the co-operation of the people who originally asked for it. We have gone through the process of having this mechanism asked for by the BMA. We then negotiated with BMA representatives to their satisfaction. Eventually, our proposal was rejected by the conference of local medical committees. As I said earlier to my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight), what has happened is that, in practice, the need for such a mechanism has turned out to be insufficient.

Does my right hon. and learned Friend agree that that is an unacceptable decision by the medical profession? Bearing in mind that he regarded such an appeal mechanism as important for patients when he established the system, will he pursue the proposal, preferably with the help of the medical profession? If that is not possible, will he seek some other way to set up such a mechanism?

The decision was taken on the advice of the conference of local medical committees, a body fairly representative of general practitioners. The history of the matter is that the mechanism was called for before we introduced the selected list system, when there were exaggerated fears about the likely effect on patients. In practice, the need for such a mechanism has diminished and we are getting along well without it, but if the BMA or the medical profession changes its mind we shall, of course, consider the matter again.

Why does the right hon. and learned Gentleman not go straight to the general practitioners themselves? He does not need to have the support of every GP, but if a sufficient number will follow the scheme they will be able to carry out their main purpose of pursuing the best interests of their patients. Why does he not go straight to the GPs and let them work the scheme?

With respect to the hon. Gentleman, who has been a general practitioner, I do not think that a sufficient number of GPs are challenging the decision of their own local medical committees. The present system is working reasonably well, and now that we have set up a new review committee to keep the list up to date it is unlikely that there will be any major difficulties in practice.

asked the Prime Minister if she will list her official engagements for Tuesday 16 July.

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

Does my right bon. Friend agree that, apart from the lunatic fringe on the Opposition Benches, the vast majority of people in this country and in the world will be heartened by her strong and robust words yesterday on the subject of terrorism? Will she re-emphasise those words today and at every opportunity, especially to the justices of this country and to others responsible for sentencing policy, so that not only terrorists but all who are involved in vicious crime are brought to book and receive long sentences?

I am grateful to my hon. Friend. I believe that most people share the views that I put across on the need for maximum co-operation between countries on terrorism and the need for very severe sentences of imprisonment for those convicted of crimes of violence.

What does the Prime Minister intend to do to prevent a repetition of the disastrous effect of the exchange rate on British industry in 1981?

I have no reason to think that the present exchange rate is adverse to British industry. As the right hon. Gentleman knows, when the pound is higher against the dollar we can get raw materials and semi-fabricated components at a lower price. When the pound is lower against the dollar exports become more competitive, but it is not advisable to rely on the exchange rate for competitiveness.

Will the Prime Minister take time out to visit Trinity House and take the Secretary of State for Transport with her—even if he has to be taken or t a lead—and discuss the efforts being made by Trinity House to have lighthouse tender ships built in this country? Is she aware that she is being asked merely to match the offer and to repay the efforts of the shipbuilders on Tyneside who built the Endeavour for the Falklands campaign as well as the Ark Royal, but who for their pains now see ships for Britain being built in Korea? Will she show some compassion? Will she show the kind of woman she is and repay the people who work for us? They are British.

The hon. Gentleman is aware that the gap between the price quoted in Korea and that quoted by British Shipbuilders was too great to be bridged by subsidies under the intervention system. The hon. Gentleman knows that we subsidise the business, but if we are to get business we must be able to match competitiveness and efficiency.

asked the Prime Minister if she will list her official engagements for Tuesday 16 July.

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

Does my right hon. Friend agree that a substantial reduction in interest rates would be much to the advantage of British industry and therefore outweigh any disadvantage to the value of the pound? Will she therefore have a word with the Bank of England and get the British banking system to act in the interests of manufacturing industry in the United Kingdom?

Many interests have to be considered in the determination of interest rates. My hon. Friend is aware that, when the value of the pound went down seriously, that was extremely damaging to the reputation of Britain, to British industry and bad for inflation. My hon. Friend is aware that we shall keep interest rates at whatever level is needed to maintain downward pressure on inflation, but no higher than that.

May I join the Prime Minister in her praise for the performers and contributors to Live Aid? As she said, it was humanity in action. By the same token, is it not inhumanity in action when a Government cut 18 per cent. off an aid budget in real terms in five years, when that same Government reduce the aid budget by 3 per cent. in real terms—£40 million just in this year—and when that Government, despite the emergency in Sudan and Ethiopia during the past two years, have not added one penny to the aid budget, except for the Hercules services, which they are now thinking of withdrawing? With a record such as that, what price the brotherhood of man?

The right hon. Gentleman is comparing the taxpayers' aid with voluntary aid. There has always been a place for voluntary aid. Voluntary services have done a great deal. For example. Christian Aid, Oxfam, War on Want and Save the Children have always been extremely active in this area and the new Live Aid was an extremely welcome addition. As for what we have done for Ethiopia and Sudan, in 1984 we provided £266 million, of which £248 million went to sub-Saharan countries, including £234 million for long-term development. In the year to March 1985 we spent £95 million on famine relief operations in Africa. This year we expect to spend at least £60 million. As the right hon. Gentleman is aware, my right hon. Friend the Minister for Overseas Development is now in Ethiopia and considering the needs for future months, especially the need to keep going with the Hercules.

I am more than prepared to compare Government aid—taxpayers' aid—with the charitable contributions made freely by people in Britain. When I do, I see that in the past year, a year in which the Government took £40 million off aid, the people were prepared to subscribe £67 million in aid—[HON. MEMBERS: "What is wrong with that?"] Well, why do we not have it all together, public and private? I also see that the Government have cut an amount equivalent to 10 times that which has been subscibed in the wake of the Live Aid concert. In any case, is the Prime Minister not ashamed of the fact—[HON. MEMBERS: "No."]—that the only way in which she is prepared to provide short-term aid to the starving is by robbing the hungry of the world as she shuffles round the aid budget? Will she do three things? First, will she reverse this disastrous and cruel cut in aid policy? Secondly, will she make a contribution—[Interruption.] I can understand the irritation, embarrassment and shame of Conservative Members. Secondly, will she make a contribution to the international food and agricultural development fund, which helps poor farmers in Africa? Thirdly, will she give us a guarantee now that the essential Hercules service will continue—and not be withdrawn—for as long at the need for it exists in Ethiopia?

First, as the right hon. Gentleman knows, the majority of general aid is spent on capital long-term projects of the sort that he proposes should take place, that is on the development of food resources in Africa. Secondly, I am extremely proud of the Government's record on aid to Ethiopia and the Sudan. We were the first to respond, and that is what the right hon. Gentleman cannot stand. As he knows, within the aid budget there is always a certain amount both for disaster and famine relief and for contingencies. The right hon. Gentleman is well aware that the Government were the first to respond to the need in Ethiopia, and quick to respond in Sudan. We were the first to respond to the need for transport to take food to its destination. Yesterday, in response to a serious shortage of transport, my right hon. Friend the Minister for Overseas Development announced further assistance of £2 million to help with the purchase of transport.

Will my right hon. Friend seek time this afternoon to drop a congratulatory note to Bob Geldhardt—[Interruption.]

Order. Interruptions take up the time of the House.

Will my right hon. Friend seek time this afternoon to drop a congratulatory note to Bob Geldof—[Interruption.]—and will she thank him for raising £50 million to be sent to Ethiopia? Will she remind him that young people, far from being hooligans on the football terraces, are as compassionate and caring as any people in the world?

Obviously, I sent a letter to Mr. Geldof before the concert congratulating him on the idea. We are all delighted that it had such a magnificent result. We congratulate him not only on the result, but on the leadership that he gave to young people and to humanity everywhere.

asked the Prime Minister if she will list her official engagements for Tuesday 16 July.

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

Will the Prime Minister condemn the monstrous murder in Ilford of Mrs. Kassam, who was eight months pregnant, and her three children in what was almost certainly a racial attack? Does that not highlight the need for tougher laws against racial attacks and harassment, such as I shall introduce tomorrow? Will the Prime Minister give a pledge to introduce such legislation at the earliest opportunity and to end her Government's failure to act in the face of an increase in racial attacks?

I am not yet convinced that we need any changes in the law. It would be premature to embark on legislation before the Home Office has received the Commission for Racial Equality's proposals for amending the Race Relations Act 1976 following its review of that legislation. One wholly and utterly condemns that terrible attack, which had such terrible consequences for the Kassam family.

asked the Prime Minister if she will list her official engagements for Tuesday 16 July.

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

In the light of the optimistic economic forecast made today by the chairman of the British Steel Corporation, will my right hon. Friend comment on the future of Ravenscraig and on the fact that those on the Left who are the most vociferous in howling for its retention were the ones who were prepared to make it the sacrificial baa lamb during the miners' strike?

My hon. Friend is correct. The results announced by the British Steel Corporation are the best for 10 years, although the steel industry lost £180 million because of the miners' strike. But for the effect of the strike on steel, it would have been in profit to the extent of about £40 million. It is an extremely good result. I agree with my hon. Friend about Ravenscraig. The people who work there struggled nobly and successfully to keep it going. Those who are now pleading for more for Ravenscraig are the very people who were anxious to close it during last year's coal strike.

Will the Prime Minister give some thought today and, indeed, every day, to the plight of the long-term unemployed? Will she examine some of the studies that have been made of people who have been without work for a long time, to see the devastating effects of long-term unemployment? Does she sometimes have qualms of conscience about the catastrophic effect of long-term unemployment on families? Is it not the biggest single indictment of her economic policies?

It is because we are so very much aware of the catastrophic effect of long-term unemployment on the morale of people and their families that, in the Budget, my right hon. Friend the Chancellor announced nearly a doubling of the community programme and a substantial increase in jobs so that the long-term unemployed can have a chance of a worthwhile job after their periods of unemployment. Perhaps the hon. Gentleman has seen a document from Europe, published today, which shows that the numbers in employment in Europe are increasing, and that the increase in jobs in Britain during the past year is greater than that in all the other European countries put together.

On a point of order, Mr. Speaker, arising out of questions. Can you ask the Government Whips whether, when they are planting out, they could choose more fertile ground and occasionally water the plants?

I have no responsibility for the Whips.