asked the Secretary of State for Social Services whether his Department has studied the effect of the current level of dental charges upon patients seeking dental treatment.

We continue to monitor on a regular basis the demand for dental treatment. The number of patients coming forward for dental treatment continues to increase.

Has the Secretary of State studied closely the statistics from the Dental Estimates Board showing that the current level of charges is a serious disincentive for people seeking dental treatment? Is he aware that the number of fillings has dropped by about 5 million, with commensurate falls elsewhere? Is he further aware that the associations within the dental profession take a serious view of that? Will he seek an early meeting with the General Dental Practitioners Association and give some assurances?

I have studied what has been said and I think that the hon. Gentleman has misinterpreted the figures. Courses of treatment have increased from 28·5 million in 1979 to 32 million now. It is certainly true that the number of fillings has gone down, but surely that is good, because it is a sign of better dental health rather than less treatment.

What safeguards has my right hon. Friend introduced to ensure that less well off and deprived people obtain effective dental treatment?

There are a whole series of exemptions from dental charges, including those under 18, those under 19 and in full-time education, expectant mothers, those who have a baby under the age of one and 'those who receive supplementary benefit or family income supplement. In total, about 46 per cent. of chargeable courses of treatment are provided free.

Is the Secretary of State aware of the opinion held by the British Medical Association and other professional bodies that the prohibitive cost of dental treatment is deterring some people from seeking treatment? Will he ask those bodies for that evidence, consider it carefully and take action if necessary?

There is no such evidence. The evidence clearly shows that courses of treatment have increased. That is clear from all the figures, including the latest figures for the period from January to December 1986 which show an increase of 3 per cent. in courses of treatment. The evidence is there and I suggest that the hon. Gentleman considers it.

asked the Secretary of State for Social Services what is the annual cost of merit award payments to National Health Service consultants; and if he has any plans to review the system.

The actual amounts paid out in distinction awards are not collected centrally since the award holder is paid pro rata to his sessional commitments to the National Health Service. The current value of awards recommended by the Doctors and Dentists Review Body for Great Britain is £56·8 million, of which it is estimated that some £47 million will be paid. We have no plans at present to review the system.

Does my right hon. Friend agree that with more than 6,000 merit awards now being paid annually and with the top award being worth more than £27,000, thus virtually doubling a consultant's pay, it is in the interests of the public, the patients and the profession that more information should be readily available? It is time for people to know the by whom, the to whom, the how and the why of merit awards. That would end the secrecy and suspicion.

I understand entirely what my hon. Friend is saying about the issue of confidentiality, which has been a long established rule, not only in the medical profession, but in the Civil Service. Consultants can inspect the record of merit awards, but I shall bear in mind what my hon. Friend has said.

Does my right hon. Friend agree that although consultants are often the leaders of medical teams, those teams depend upon the nursing arrangements for their effectiveness? As consultants are already extremely well rewarded, is it not time that merit awards were extended to senior nurses?

I certainly agree with the first part of what my hon. Friend has said. One of the reasons why the Government have set up the independent Pay Review Body for Nurses is to allow distinctions and differentials that seek to reward the merit and long service of particular nurses. I shall bear my hon. Friends comments in mind.

Is the Secretary of State not perfectly well aware that the merit award scheme has long been total nonsense? We need to know who awards them, who sets them and, above all, why. Why does the Secretary of State not tackle what is in grave danger of becoming an abuse?

With respect, I do not think that the scheme is in grave danger of becoming an abuse. It is a long established system, as it was under the Labour Government of which I believe the hon. Lady was a member. An incentive to maintain a high level of distinction is provided by a rising scale of awards. I cannot believe that anybody could frankly or sensibly contest that proposition.

Does my right hon. Friend agree that when consultants are overtly critical of the National Health Service, and often manipulate their patient lists to exert pressure, we are entitled to know what they are getting from the NHS at the same time as they are demanding more and more resources from the NHS?

I hear what my hon. Friend says, and in one or two respects I have some sympathy with him, but two thirds of consultants do not receive any merit awards.

Is the Secretary of State aware that merit awards are a secretive and elitist system which represents a serious distortion of NHS expenditure? Is he further aware that the same amount of money could be used to fund an extra 1,750 consultants to meet the consultant shortage, an extra 3,500 junior hospital doctors so that operations would no longer have to be cancelled due to the lack of doctors, or an extra 20,000 nurses so that awards would no longer have to be closed due to the lack of nurses? Why do the Government always favour tiny rich minorities at the expense of the general good?

I knew that the hon. Gentleman would somehow work some of his well developed conspiracy theories into this. If he feels so strongly about the system, why did he do nothing about it when he was a member of the Labour Government?

asked the Secretary of State for Social Services how many responses he has had from local authorities to his consultation document on housing benefit; and if he will make a statement.

We have had a number of initial queries and reactions on specific aspects of the detailed proposals issued in the form of draft regulations. Formal comments representing local authority views are submitted by the local authority associations. We have asked for their full responses by 6 March.

Does the Minister recall that his Department's last attempt to make changes in the housing benefit scheme resulted in what was described as

"the worst administrative fiasco in the history of the welfare state"?

It is precisely to give local authorities time to consider the draft regulations and be prepared that we are consulting now. They will thus have the best part of a full year to prepare themselves before the regulations are in place.

My hon. and learned Friend will be aware of the grotesque scandal of Left-wing local authorities which always have to put up the rates but never seem able to collect rents. Where those rents include an element of housing benefit, and knowing that at some stage the Government will have to bail out those lunatic authorities, will my hon. and learned Friend take action to withhold that Government benefit and keep it for later purposes?

One aspect of the reforms that we are introducing is to enable local authorities to monitor the amount that they are spending, particularly on housing benefit, and provide incentives for them to do so.

Can the Minister confirm that among the proposals that he has put to authorities is a proposal that the time limits which force people under 26 in board and lodgings to move every few weeks should be abolished? Can he explain why they are needed in 1987 if they will not be needed in 1988?

The new system of income support combined with housing benefit could provide a good framework which would overcome the present difficulties, but part of the system is the careful monitoring of the amount that housing authorities spend on housing benefit and the level of rents which they are prepared to support.

Has the Minister initiated contact with the local authorities and urged them to have rents registered where private landlords are overcharging in the knowledge that the tenants receive housing benefit and thus have no personal interest in registering a fair rent?

Part of the changes will give local authorities greater opportunities to monitor and control the amount of housing benefit which they are prepared to pay if they think that rents in any sector are excessive.

asked the Secretary of State for Social Services what information and training is available to his Department's staff on the properties of chemical weapons and protective measures.

Health authorities have responsibility to ensure that plans are laid to deal with major incidents arising within their boundaries. This includes any involving toxic chemicals. Specialised advice is available from the National Poisons Information Service on a 24-hour basis. Guidance on handling and transportation of chemical casualties was sent to chief ambulance officers last year.

I thank my hon. Friend for that reply, but is she satisfied that the degree of co-operation between local authorities and her Department is adequate to ensure sufficient protection for the general public in the event of a chemical escape or attack?

My hon. Friend will know that studies are under way led by my right hon. Friend the Home Secretary. Health authorities are being advised that further guidance will be considered in the light of those studies.

asked the Secretary of State for Social Services in what circumstances minors may be invited to give written consent to an abortion and to a general anaesthetic for such abortion, without parental knowledge; and whether he will make a statement.

Written consent may be given in the circumstances described if, in the judgment of the doctor concerned, it is in the patient's best medical interest and she has sufficient maturity and understanding to appreciate what is involved.

Dose my hon. Friend think that that squares with our principles of the defence of the family, family responsibility, parental responsibility and protection of the child?

I hope my hon. Friend will accept that those very points are emphasised both in the current guidance from the Department and in the guidance issued by the General Medical Council. It would be a rash person who would want an absolute rule in these circumstances with no room for judgment, especially as the risk would be that a young person might end up receiving no advice.

Is it not the case that parental approval must be obtained for a tonsil or adenoid operation on a minor, or even for the removal of a verruca? Does the Minister not feel that the removal of a child is even more important? How on earth can parents look after their children properly if they do not know the kind of ordeal that they have suffered?

As I have said, the guidance issued by the Department and by the General Medical Council clearly shows the normal desirability of ensuring that parents are involved. I am advised that in circumstances where in the clinical judgment of the doctor it is appropriate to proceed otherwise that would cover the use of an anaesthetic.

asked the Secretary of State for Social Services if he will intervene in the dispute within the South-East Thames regional health authority regarding the location for new radiotherapy equipment; and if he will make a statement.

The location for new radiotherapy equipment in South East Thames is the responsibility primarily of the regional and the district health authorities. I am aware of the region's proposal, which has been the subject of full public consultation. If the regional health authority intends to proceed with the proposal and the relevant local community health councils continue to object, the matter will be referred to Ministers. I understand that the regional health authority will be considering the proposal at its meeting on 19 March.

After four years, has not the time come for my hon. Friend to take action to provide the service that must be provided for patients who have been waiting for four years for the service to commence? Is it not time that the Government took an initiative?

I entirely accept my hon. Friend's point. He will know that £10 million is proposed to be spent to improve cancer therapy for patients in Kent and Sussex. We await the view of the regional health authority. If the community health council still objects, the matter will come to Ministers for a decision.

Is my hon. Friend aware that the regional health authority's proposal allows, among other things, for a concentration of skilled staff, which I believe to be extremely important? Will she assure us that before she overturns the regional health authority's intentions she will consider the effects very carefully?

We are taking into account all the results of the consultation procedure. It is our view that whatever decisions are taken will be in the interests of all the people covered by that particular regional health authority.

asked the Secretary of State for Social Services if he has any plans to extend the availability of industrial disablement benefit for occupational deafness.

We have no immediate plans to do so, but the Industrial Injuries Advisory Council is keeping the occupational deafness provisions under review and is expected to report further later this year. We will consider the matter then.

While I am grateful for the fact that the council is to report, is the Minister aware that many hundreds of my constituents who suffer from loss of hearing as a result of industrial noise find it difficult to understand how can win a claim against their employer for industrial deafness and they find that they do not qualify for industrial injury benefit? Is that not perverse? Surely the Minister would want that position to be corrected.

I am aware of the particular problem in the hon. Gentleman's constituency, and not least the problems that he has raised in relation to the glass industry. With regard to his specific point, however, there are different criteria governing the awards of industrial disability benefit and of damages in common law. One particular difference is the question of negligence. However, I understand the hon. Gentleman's point.

Is the Minister aware that the exclusion from benefit applied to people who suffer from occupational deafness applies to no other disability? Does he recognise that the two reasons for this outrageous discrimination are, first, the shortage of audiologists to carry out the necessary testing and, secondly, the lack of political will? Will he do something about those two points please?

The right hon. Gentleman probably knows more about this matter than anyone in the House, and I take his point very seriously. It is perfectly true that there is a shortage of audiological resources within the National Health Service. The provision of funding for such resources is the direct responsibility of individual health authorities. I am certainly aware of the right hon. Gentleman's point and I am sympathetic to it.

I am sure that none of us would want people to suffer deafness through their industrial occupation, especially in the furniture trade, in which I worked for 20 years. Will my hon. Friend ensure, however, that industrialists are not made to pay the penalty for people playing very loud music and using personal stereos which affect their hearing in later years?

I take my hon. Friend's point. We are concerned about occupational deafness. That is why we have extended the scheme on two or three occasions and why we keep it constantly under review.

Have not claimants faced a minefield when making claims relating to occupational deafness? I am blaming, not just the present Government, but successive Governments who have failed to deal with this ongoing problem. For example, in the shipbuilding and ship repair industry there are men in their 70s who have not been able to resolve this problem. Is it not time that something positive was done?

Part of the problem is the point raised by the right hon. Member for Stoke-on-Trent, South (Mr. Ashley) concerning the number of audiological technicians available. As I pointed out, we have two or three times extended the scope of the scheme in an endeavour to meet the points that the hon. Gentleman has made.

asked the Secretary of State for Social Services what financial provision he is making for community care in 1987–88; and if he will make a statement.

It is not possible to identify all community care expenditure with precision, but National Health Service expenditure on community health services in 1984–85 was £856 million, representing a real increase of nearly 30 per cent. since 1978–79. It is likely to have increased further since then, and to rise again in 1987–88, following the increased allocations to regional health authorities which have been announced. Sir Roy Griffiths has been asked to review the way in which public funds are used to support community care policy.

Will the Minister recognise that there is considerable concern that unless sufficient financial resources are made available for community care this policy will not work? Will he also recognise that organisations such as Rescare and families of people in institutions such as Calderstones and Brockhall in Lancashire are concerned about the way in which the policy is working?

I am aware of the concerns expressed by Rescare, with which my noble Friend the Under-Secretary of State has had meetings. I am also aware of the concern, which we share, to ensure that the large sums of money being expended on community care are well spent. The Roy Griffiths exercise is designed to help us improve our capacity to ensure that.

The principle of a locally based community care fund, with resources from local authorities and health authorities and an independent manager who would procure services from a variety of public and private agencies and then match services to individual needs, would seem to have much to recommend it. Will my hon. Friend examine that proposal carefully?

I respect the source from which that suggestion comes, in view of my hon. Friend's long-standing interest in this sector. It is very much the kind of suggestion that Sir Roy Griffiths will be able to examine.

In view of the importance of community care, when does the Minister expect those eligible to be released from long-stay mental hospitals will be evacuated, given the rate at which funds are being provided?

The hon. Gentleman has a persistent tendency to ask me questions which he knows no Minister in his right mind would answer. [Interruption.] I am now subject to universal advice not to answer. As the hon. Gentleman knows, Government policy is that people should not be removed from mental illness, mental handicap or other institutions without proper provision being made in the community. It is our persistent endeavour to ensure that that should not happen.

In view of the emphasis recently placed by my right hon. Friend the Secretary of State on the importance of community care in the treatment of AIDS, will my hon. Friend allocate additional funds for this part of the treatment? Will he further confirm the reports in The Times this morning that an additional and separate amount of £10 million is to be allocated to research seeking a cure for AIDS?

It is for health authorities to determine how to use their allocations, including the extra AIDS allocations to three of the Thames regions announced last week. The point about community care is that further work is needed. As my hon. Friend will know, we are convening a conference towards the end of next month with the voluntary organisations, the churches and professional bodies to look at community care for AIDS cases. On the latter point, I cannot confirm any particular figure. We are discussing these matters, but we are considering initiating a different way of fostering research into AIDS.

Is the Minister aware that the Audit Commission report on community care last month roundly condemned his policies as a £6 billion misallocation of public funds? What action is he therefore taking to stop his perverse anti-community care policy of flooding the private sector with public supplementary benefit money for residential care, while at the same time stopping or reducing community care by squeezing local authority social service budgets? Is he aware that there has been a 25 per cent. cut in mental illness and mental handicap hospital beds since 1979 and that many thousands of these people are now utterly neglected in the community?

I do not accept the hon. Gentleman's description, either of the Audit Commission report or of those Government policies which have significantly extended choice to many people who could not otherwise have afforded it. So far as his figures on beds are concerned, I must ask the hon. Gentleman to stop using those figures in this irresponsible way. He knows perfectly well that he is including in those figures, among other things, the beds that used to be occupied by the children in long-stay mental handicap hospitals who have been got out into better care in the community, and that is a policy which all of us support.

asked the Secretary of State for Social Services if he will make a statement about the intended role of community health councils and the experience of their activities in practice.

Community health councils are independent statutory bodies with a duty to represent the interests in the Health Service of the public in their districts. Within this broad framework CHCs decide for themselves how to go about their tasks, and we have no plans to change this system.

I thank my hon. Friend for her reply. Will she accept from me that, given the operational role of the health authorities and the strategic role of the regions, some CHCs are struggling to find a role for themselves and resort to casting around to find things to complain about?

I am sure that my hon. Friend would join me in deploring any suggestion that the CHCs were looking for something to do or would even dream of opposing for opposing's sake. In many parts of the country the CHCs have proved themselves to be extremely useful and valuable. We have no plans at the moment to abolish them or change them in any way.

Is it not the case that community health councils were set up originally as watchdogs for the patients and that as a result of gross underfunding they have neither the bark nor bite any more?

No, I would not agree with that. The CHCs spend a substantial amount of money, about £35,000 per CHC—a total of nearly £7 million—just for the role that has been identified. As I said a moment ago, in many cases they have proved their worth.

Is my hon. Friend aware that, far from looking for something to do, the community health council in my constituency is quite rightly criticising the Trent regional health authority for trying to shut down rural maternity units? Will she make sure that that is not a policy that is supported by her Department?

When a community health council objects to a major change, as proposed by the regional health authority and the district health authority, the matter must come to Ministers for consideration. I assure my hon. Friend that we give the closest consideration to each individual case.

Given that community health councils are closer to patients and their needs than either district or regional health authorities, can the Minister say why so little notice is taken of them by the health authorities at district or regional level?

As a former chairman of a health authority before I came to this House, I disagree with the premise behind the hon. Gentleman's question.

asked the Secretary of State for Social Services when last the Minister for Health met Mr. Trevor Clay, the general secretary of the Royal College of Nursing; and what subjects were discussed.

I last met the general secretary of the Royal College of Nursing on 19 January as part of a series of informal meetings with the general secretaries of the professional nursing organisations. A very wide range of issues relating to the nursing profession were discussed.

Now that the Minister has had a chance to study "Project 2000" from the United Kingdom Central Council for Nursing, Midwifery and Health Visitors, what action is he going to take, and when? In view of the shortage now occurring—in England last year 27,000 nurses left but only 22,000 trainee places were provided, making a shortfall of 5,000—will he, before ever again giving the figure of 73,000 more nurses in the NHS under his Government's regime, take out the untrained auxiliaries who are now counted in the total, and will he also deduct the difference between the 374½-hour week and the 40-hour week?

The hon. Gentleman will know that we normally seek to give these figures as whole-time equivalents, which is the most realistic way to do it. On his main point, as he knows, I, as well as all the other Health Ministers, received "Project 2000" from the United Kingdom Central Council last week. I undertook as a matter of urgency to seek to produce a document around the end of this month on the basis of which we would consult health authorities and others about the proposals with a view to setting a deadline for consultation to finish about the end of July. I think the council recognises that that is a speedy time scale which illustrates the importance we attach to the issue.

As my hon. Friend seeks to ensure that the net intake of nurses remains adequate for the purposes of the National Health Service, to what extent is consideration being given to stepping up the recruitment of those whose family responsibilities may well be reaching a conclusion and who would welcome the opportunity of being reabsorbed into the National Health Service?

That is precisely one of the courses that we are urging health authorities to consider. As my hon. Friend will know, we have also set up, with the Equal Opportunities Commission, a special study known in the trade as managing the career break, which is designed to see how we can build up procedures which make it easier for people to come back to nursing in future.

Does the Minister accept, and did he say to the general secretary of the Royal College, that nursing in London is in crisis? Of four district authorities, Riverside has over 600 vacancies, Bloomsbury and Paddington have 200 and 300 respectively, and my own authority, Lewisham and North Southwark, has over 300. Urgent action is needed. Agency nurses are not enough. What will the Minister do this year to make sure that there are enough nursing staff in London hospitals?

The problem varies from one authority to another. We are urgently seeking better information with a view to judging what action can be taken by district health authorities. It will not, I think, be the same in all cases.

I welcome warmly the action that the Government have taken in support of the nursing profession. Nevertheless, does my hon. Friend accept that there is a severe problem of nurse wastage in the London area? Does he further accept that a contributory factor may well be the differential housing and transport costs for young nurses in London? Will he consider this again?

My hon. Friend will be aware that the pay review body is in operation, as it were, at this very moment. I have no doubt that this is one of the points to which its attention is being and will be drawn.

Will the Minister take the opportunity to talk to Trevor Clay about the position in south Manchester, where the occupational health physician reported that there has been a massive increase in nervous debility caused by stress because of the staffing crisis for nurses?

I am not aware of the study to which the hon. Member has referred, but I shall ask to see it.

asked the Secretary of State for Social Services if he will make a ministerial visit to Hong Kong and Singapore to observe Government policies on smoking.

I am prepared to make that sacrifice.

In view of my right hon. Friend's heavy commitments, perhaps it would be just as well if he did not leave us again too soon. Is he aware that since 1973 there has been a complete ban on advertising tobacco products in Singapore, and that the Hong Kong Government are preparing legislation for a complete ban on all tobacco products? Since well over 1,000 people per week are dying prematurely from smoking-related diseases, does he think that we may have something to learn from policies in Hong Kong and Singapore on advertising, promotion, education and pricing of products? If my right hon. Friend cannot visit those countries, perhaps he could ask his officials to study their policies to see whether we have something to learn from them.

I understand my hon. Friend's concern. In fact, the United Kingdom has a favourable record in comparison with Hong Kong. On the reduction of smoking, the percentage reduction here is as good as, if not better than, those in Hong Kong and Singapore. Certainly the United Kingdom has stronger and more varied health warnings on cigarettes and has stronger and more comprehensive restrictions on advertising. Clearly I shall consider any other lessons from both Hong Kong and Singapore.

Does the Secretary of State realise that there was great disappointment throughout the nation about the agreement reached by his hon. Friend the Minister for Sport—

Order. That has nothing to do with Singapore and Hong Kong, has it?

Yes, it has. On the arrangements for tobacco promotion, does the Secretary of State agree that the example set by Hong Kong and Singapore should be followed and that it is not satisfactory to wait for another few years before proper preventive medicine is practised by banning advertising here of tobacco and sport?

No, I do not think that. In the United Kingdom we have followed a voluntary policy. It is a subject that has been dealt with in public areas, for example, by those responsible for management in response to public calls. I do not find that the case for making advertising in all areas illegal is one that has yet been made out.

asked the Secretary of State for Social Services when he intends to introduce regulations to uprate the level of £35 a week of occupational pension above which unemployment benefit starts to be abated, as defined in section 5(1) of the Social Security (No. 2) Act 1980; and if he will make a statement.

We have no present plans to change the existing threshold. Future changes will be considered in the light of other competing demands for social security funds.

Is the Minister aware that it is now six years since that level was set and that since then some hundreds of thousands of workers, men of 60 and over, including not least those Talbot car workers in Coventry who have asked me to raise the matter, have paid national insurance, yet now, on the point of retirement, because they have an occupational pension, are denied unemployment benefit? Why does not the Minister, if he will not abolish that regulation, at least uprate the figure by inflation to the £47 it ought to be today instead of £35? Why is it that if a millionaire has £100,000 of investment income unemployment benefit is not affected, but if a worker has £35.10p occupational pension that affects his unemployment benefit?

The principle of the offset is one that previous Labour Governments twice tried to introduce, although unsuccessfully. The offset seeks to reflect the fact that occupational pensions form a retirement income, and a retirement income is not wholly consistent with people being non-retired and available for work.

Will my hon. Friend be very cautious about proceeding along the road indicated by the hon. Member for Coventry, South-East (Mr. Nellist)? Does he agree that, as this country moves closer towards the four-pension household as being the norm, the aim should be to reduce dependence on benefits rather than increase it?

I agree with my hon. Friend. I am always cautious about following advice from the hon. Member for Coventry, South-East (Mr. Nellist).

asked the Secretary of State for Social Services what recent representations he has received about establishing improved salaries for speech therapists.

There have been numerous representations about this subject, which is a matter for Whitley council negotiations.

The Minister will know that in the National Health Service there is a serious shortfall in the level of salaries paid to speech therapists as compared with those paid to other graduate professionals. The Minister should know that that shortfall can amount to as much as 70 per cent. The Minister will agree, I think, that the level of responsibility in no way justifies that differential. How can he justify that kind of situation?

The hon. Gentleman will, I am sure, accept that I, too, very much value the important work of speech therapists within the Health Service, and indeed elsewhere. He will also be aware that the speech therapists, at their own request, were not included in the review body provisions when they were set up. It remains the case, therefore, that these are matters for negotiation within the Whitley council.

When will the Minister realise that the efforts of people such as speech therapists, who are making cases for equal pay for work of equal value, are seriously impaired by the cumbersome and obstructive nature of the procedure? When will he ask his right hon. Friend to simplify the procedure so that people such as these can claim equal pay, and women attracted into speech therapy may find it a rewarding profession in a monetary way as well as in every other way?

I shall draw my right hon. Friend's attention to what the hon. Lady has said, but she will understand that I would not wish to comment further on these cases as I understand that appeals have been lodged with the employment appeals tribunal.

asked the Secretary of State for Social Services if he has any plans to reintroduce the role of matron into hospitals; and if he will make a statement.

Health authorities are free to use the title matron if they wish to do so.

Is my hon. Friend aware that there is a certain amount of concern that record spending on the National Health Service at the moment is not necessarily coming through in terms of record patient care? Bearing in mind the unique tradition of the old matron in terms of understanding consultants, doctors and nurses—all her staff— and patients, as well as her ability to control supplies very carefully, will my hon. Friend reconsider reintroducing this invaluable post into our hospitals?

The role of matron in different institutions varies quite widely, but I accept my hon. Friend's point that it is important for there to be clear-cut lines of managerial responsibility. That is what we think we are achieving at the moment.

Where would the matron stand in the pecking order, with the proliferation of general managers now being appointed in every hospital throughout the country?

Where a matron stood in the pecking order would depend on precisely what responsibilities she was asked to fulfil. I hope the hon. Lady will recognise that quite a number of nurses have become general managers at both district and unit level. That is something that we are anxious to see.

asked the Prime Minister when Her Majesty's Government intend to implement in full the Disabled Persons (Services Consultation and Representation) Act which was given Royal Assent on 8 July 1986.

It is hoped that sections 4, 8, 9 and 10 can be brought into operation by next April and section 11 during the course of 1987. However, the provisions of the Act, which have significant resource implications, can be brought into effect only as and when these resources can be provided.

How can the Prime Minister justify her Government's failure to introduce a single order or to set aside an extra penny for the implementation of this Act? Does she accept that people will not take lightly a decision to set aside the clearly expressed will of the House, to treat it with contempt and to do so in the knowledge that the needs of disabled persons and those who care for them are being sacrificed on the high altar of pre-election tax cuts?

During the passage of the Bill we consistently made it clear that it would be wrong to impose extra financial burdens on local and health authorities until sufficient resources were available. That remains the position. The Labour Government — [Interruption] —faced a similar difficulty after they had passed the Chronically Sick and Disabled Persons Act 1970. When a Labour Government later came in they took no steps to provide local authorities with the resources to put the Act into effect. The hon. Gentleman says that we have not provided money. May I point out to him that increased spending on benefits for the long-term sick and disabled has gone up by about 75 per cent., allowing for inflation, to nearly £6 billion.

Referring to the way in which my right hon. Friend the Minister of Agriculture, Fisheries and Food was dealt with by The Times this morning—

Order. The hon. Gentleman should look at the Order Paper.

Does the right hon. Lady not recall the Minister of State saying last July that he wanted to bring the provisions of this Act into effect in time to benefit disabled young people leaving full-time education in the summer of 1987, that is by the autumn of 1986? Given the fact that absolutely nothing relevant to this Act has been allocated in any of the rate support grant settlements, will the Prime Minister now tell us where she thinks that the extra money to implement those sections of the Act relating to school leavers is supposed to come from? In her refusal so far to honour her Government's commitments, is she not being mean and evasive with the disabled?

I have indicated the sections that we hope can be brought into operation by next April, with section 11 during the course of 1987. I have also indicated that, although we would all wish to do more, a former Labour Government — [Interruption] Of course, hon. Members do not like to hear this reply because it is true. A former Labour Goverment who passed the Chronically Sick and Disabled Persons Act were also in a similar position. The last Labour Government did not, in five years of government—[interruption]—

Order. This is a rare definitive question on the Order Paper and I think that the whole House wants to hear the answer.

The last Labour Government, during five years in office, did not take steps to provide local authorities with resources to put the Act into effect. If the right hon. Gentleman wishes me to give him the whole excellent record of this Government in giving extra help to the disabled I shall do so. We increased spending on benefits for the long-term sick and disabled by 75 per cent., after allowing for inflation, to nearly £6 billion. We have increased the real value of the mobility allowance and the new severe disablement allowance. The Opposition hate to hear that because it is true and shows us in a much better light than them.

The sum of which we speak in relation to sections 5 and 6 of that Act and the disabled school leavers amounts, by the best calculations, to no more than £50 million. The right hon. Lady's lectures about the availability of resources comes ill from a Prime Minister who is allegedly contemplating a give-away of £3 billion in the Budget. While all the voluntary organisations concerned with the disabled welcome any progress made under any Government, why does the right hon. Lady not heed the view that they express about this Act when they say that if the Government do not move now the future of those young people leaving school in 1988 and 1989 will be seriously and adversely affected? That is not the voice of congratulation: it is the voice of justified suspicion. Why does the Prime Minister not listen to it and do her duty by the disabled, instead of dodging?

We do not need any lectures from a former Labour supporter of the last Labour Government, who did not begin to do anything like as well for the disabled as we have done. The right hon. Gentleman's second point was about helping people into jobs. As far as the disabled are concerned—[Interruption.]

Order.

—we have extended help through the Manpower Services Commission which has meant that last year over 77,000 people were placed in work or on the community programme. That is all help for the disabled.

asked the Prime Minister if she will list her official engagements for Tuesday 10 February.

This morning I had meetings with ministerial colleagues and others, and attended the memorial service for the first Earl of Stockton. 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.

Is my right hon. Friend aware of the strong public feeling that court sentences are too often so lenient that they do not deter and thus offer no protection whatever to the public? Since guidelines laid down even by the Lord Chief Justice and the Lord Chancellor on this matter have consistently been ignored by judges, will my right hon. Friend find time in her busy day to consider the possibility of supporting a suggestion that inadequate sentences be referred to an appeal court?

I am well aware of strong feelings about certain sentences. In general, the guidelines laid down by the Lord Chief Justice have been followed. However, there appear to be some cases where that is not so, and they have given rise to great concern. As my hon. Friend is aware, clause 29 of the Criminal Justice Bill would give a power to the Attorney-General to refer a particular sentence to the Court of Appeal, with the leave of that court, for it to say, not what the sentence should have been in the specific case—so it would not affect the case my hon. Friend has in mind — but to give a guideline about what would be an appropriate sentence for such a case in future. Of course, that would be argued in open court and people could hear the arguments. The guideline would then have more effect. Such a clause will help public opinion and help to give a clear indication by the Court of Appeal about a proper sentence.

As the National Farmers Union conference this morning called for the resignation of the Minister of Agriclture, Fisheries and Food, will the right hon. Lady see to it? Does she recognise that his statement yesterday, taken together with the Secretary of State for the Environment's recent Green Paper abolishing structure plans, amounts to a free-for-all for development in the countryside? Will this not simply accelerate the north-south drift and turn our farmers from stewards of our land into speculators in it?

If the right hon. Gentleman has read the draft circular for consultation, he will know that what he says is nonsense. There is no question of removing planning controls on agricultural land. There is nothing in the proposals to reduce the protection given to the green belt, national parks or other areas of good countryside. What we have said is that it no longer makes sense to apply reservations on agricultural grounds to less good land that is being proposed for development. Each planning application will continue to be considered on its merits according to the usual planning considerations.

My right hon. Friend will be aware of the visit this week to Britain of Maulawi Younes Khales, leader of the Hezb-i-Islami of Afghanistan. Will my right hon. Friend therefore take time today to reassert Her Majesty's Government's support for the right to self-determination for the people of Afghanistan, free of outside interference?

We believe wholeheartedly, as my hon. Friend says, in self-determination for the people of Afghanistan, and that the occupying forces of the Soviet Union should be withdrawn completely.

asked the Prime Minister if she will list her official engagements for Tuesday 10 February 1987.

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

As this morning the National Farmers Union—[Interruption.]

Order. The hon. Gentleman has a right to ask his question, as has any hon. Member.

I am most grateful to you, Sir. May I assure you that the chiacking will not silence me. We will start again. As this morning the National Farmers Union passed a vote of no confidence in the right hon. Lady's Minister of Agriculture — a matter quite without precedent—and, indeed, demanded his resignation, and in view of the consternation that he is causing among his parliamentary colleagues and fellow Ministers, does the Prime Minister retain any confidence in him?

Yes, complete confidence. My right hon. Friend has done a great deal to try to modify the common agricultural policy. Whatever votes were passed by the NFU this morning, in agriculture, food supply and demand must be brought more closely into balance, and surpluses eliminated. New surpluses must not build up through the intervention system. That matter will have to be dealt with in the interests of taxpayers, and consumers—all who purchase goods.

asked the Prime Minister if she will list her official engagements for Tuesday 10 February.

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

Has my right hon. Friend studied the detailed account of the events leading up to the cancellation by the BBC of Ian Curteis's play on the Falklands war? Does my right hon. Friend agree that the actions of the leading BBC officials in trying to enforce changes in the script, just because the play appeared to be pro-British, pro-Government and pro-Prime Minister, are disgraceful? Should not the BBC hand over the script to ITV so that it can produce the play to commemorate the successful defence of freedom?

I am grateful for what my hon. Friend says. I am sure that the people concerned will take careful note of his comments.

Mr. Rooker.

Where is the morality—

Order. Question No. 5.

asked the Prime Minister if she will list her official engagements for Tuesday 10 February.

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

I repeat: where is the morality in the British Government allowing Iranian arms dealers to organise their arms purchases from London when there are British citizens in Iranian gaols who have not been charged or brought to trial?

As the hon. Gentleman is aware, the only powers that Governments have are to prevent exports of such arms from London without an export licence. There has been no such export licence. I am afraid that if the hon. Gentleman wants us to take powers to find out what goes on in every office we shall totally reject that.

On a point of order, Mr. Speaker.

Order. I will take the hon. Gentleman's point of order later.