asked the Secretary of State for Social Services if he will make a statement on the progress of hip replacement operations under the National Health Service.

In 1978 there were 28,000 such operations in England. By 1985 this had risen to 37,650, an increase of 34 per cent. While the number of operations has increased steadily, so, too, has the demand. We have made it clear to health authorities that hip replacement operations should he regarded as a priority for the development of services in the acute sector. The aim is for 48,000 such operations a year by the year 1990.

Although, clearly, many thousands of elderly people have cause to be grateful to the Government for the number of hip replacement operations, is my right hon. Friend aware that there are special problems for elderly people in retirement areas? There is increasing demand there for hip operations, and the special needs of those people must be met if they are not to become prisoners in their own homes. Will my right hon. Friend say something particularly about the Plymouth and Torbay area health authorities, in which I have a special interest because of my constituents?

I know that my hon. Friend would thank not the Government, but the excellent National Health Service for the success in this area. I cannot give details but I shall write to my hon. Friend about the specifics on the Torbay and Plymouth areas. In my hon. Friend's region, waiting times have been radically reduced from 32 weeks in 1979 to 22 weeks at present, which is only a fraction above the national average and is a major improvement.

Will the Secretary of State issue an instruction to all regional health authorities not to close operating theatres over Christmas, as this would enable a further reduction to be made in the waiting lists?

I am not sure how the hon. Lady's question connects precisely with the specific question on hip operations. Obviously, her remarks about the particular management of regions will be drawn to the attention of the region in question.

Is my right hon. Friend aware that the Norwich district authority proposes to close the Wells cottage hospital to save £150,000? Is he further aware that—

Order. Does the hon. Member's question deal with hip operations?

asked the Secretary of State for Social Services if he is satisfied with the response times of the London ambulance service during April, May and June of 1987; and what action he has taken to ensure that previous levels of performance are maintained.

In general, yes. During the period January—June 1987 the London ambulance service responded to 89 per cent. of accident and emergency calls within 14 minutes and 95 per cent. within 17 minutes. That is an improvement on last year.

Does the Minister agree that the question was about April, May and June? In her letter to me dated 8 September the hon. Lady admitted not only that shifts were not covered but that more than 50 emergency ambulances were single manned during that period. Is it not a fact also that the London ambulance service will have to contribute from its resources and, therefore, from economies 1 per cent. of the pay offer now on the table? Does the hon. Lady agree that the effectiveness of ambulance services is not helped by spreading resources ever more thinly and that the emergency services must be demand-led and not budget-prescribed?

I am sorry if the hon. Gentleman is not satisfied with the figures that I give him. He never is. However, I point out that in the period that I mentioned—the first half of this year—the average response time for emergency calls in this city was just over 10 minutes. Given the traffic conditions in the capital that is absolutely marvellous, and it compares very well with the average response time in Derbyshire—which contains my constituency—where that time is well over 13 minutes.

Is my hon. Friend aware that in my constituency and in many others car parking is so dense and tight that emergency services such as the ambulance service simply cannot get to the people whom they need to collect for serious and emergency operations? Will her Department take a serious interest in this issue to see what can be done to improve matters?

That is a most serious matter. Emergency services are allocated largely on the basis of medical need, and it is a matter of concern if ambulances cannot get through to the people who need them. If my hon. Friend will give me more details, I shall take the matter up with the appropriate authorities.

On a point of order, Mr. Speaker. Owing to the unsatisfactory nature of the Minister's reply, I beg to give notice that I shall seek to raise this matter on the Adjournment at the earliest and most appropriate opportunity.

asked the Secretary of State for Social Services what steps he takes to ensure that the number of available maternity beds is sufficient for comfort and safety during confinement.

It is regional health authorities in England who are responsible for maternity services, and this includes determining the number of maternity beds. I am satisfied that we have plenty of beds. The Health Service in Scotland, which covers the hon. Lady's constituency, is a matter for my right hon. and learned Friend the Secretary of State for Scotland.

Will the Minister agree to conduct a review of existing maternity services both in England and Wales and in Scotland? Many women thoughout Britain would dispute her complacent response to this matter. They know from direct experience that the service is not always satisfactory. Does the Minister agree that it is vital that women should feel confident that the service offered is safe and secure for them and for their babies? Therefore a review would be in order. The Government should consult not only the area health authorities but women's groups.

The hon. Lady asked me about beds. We have plenty of maternity beds throughout the country. Occupancy of maternity beds ranges from 59 per cent. in the Trent regional health authority area, which covers my area, to 70 per cent. in Glasgow. The average maternity bed produces only one baby per week. That does not suggest overcrowding or excessive pressure on resources.

Is my hon. Friend aware that in the West Berkshire district health authority area one of the problems in keeping beds open is the high cost of recruiting labour, which is extremely difficult given the national average rates agreed? Does she have any proposals for breaking the log-jam so that we may recruit the staff that we need to keep the beds open?

For some time it has been our policy to pay to our staff—including midwives—the rates of pay that the review boards recommend. That includes a 9 per cent. pay rise this year. As a simple matter of fact, there has been a large increase in the number of midwives whom we employ, from 20,000 when we took control in 1979 to nearly 23,000 in 1985.

Will the Minister note that if the Northumberland health authority goes ahead with its plan to close down all the maternity beds in Alnwick many babies will be born, not in maternity units, but in ambulances on 40mile journeys to a distant hospital? Will she take careful note of that when the matter eventually comes before her?

If the community health council objects to any major proposal for such a change, the matter will come before Ministers in due course. We treat each proposal on its merits and we try ultimately to base our decision on the interests not only of mothers but of babies.

Will the Minister take steps to improve maternity services so that pregnant women do not have to wait for hours in ante-natal clinics to see a different doctor or midwife on each visit? Will she ensure that extra resources are rapidly provided to regional health authorities when there is a sudden increase in the birth rate, to avoid women being left not knowing in which hospitals their babies will be born? Will she also increase the number of special care baby cots so that all low birth weight babies have a fighting chance of survival?

I could not agree more with the hon. Lady's first sentence. The way in which pregnant women are made to wait is sometimes a disgrace, but that is a matter not of resources, but, frequently, of the need for careful management and treating the individual as a human being rather than just as a patient.

asked the Secretary of State for Social Services if he will give the figures for mental patients (a) living in National Health Service hospitals, (b) living in residential care accommodation and (c) living in the community; and if he will give these figures for those in England and Wales and for the Wandsworth health authority, respectively.

On 31 December 1986 there were 60,279 mentally ill in-patients in hospitals in England, including 807 under the care of the Wandsworth health authority. The number of places in residential care accommodation provided specifically for mentally ill people is 8,267 for England, including 133 provided by the London borough of Wandsworth. We have no comprehensive figures for people living in the community who could be described as in some degree mentally ill, many of whom are being treated by their general practitioners.

Does my hon. Friend agree that there is an imbalance in the mental health budget whereby 90 per cent. of the funds go to the hospital service and only 10 per cent. to care in the community? Does he agree that the satisfactory transfer of patients to the community requires adequate housing, personal income and aftercare as well as adequate co-operation and co-ordination between the Health Service and social services departments? Does he agree that the programme of mental hospital closures should proceed extremely slowly until those prerequisites are met and the mental health budget rebalanced?

There are really three questions there. First, I think that the 90:10 statistic is oversimplified, hearing in mind how many mentally ill people are living in their ordinary homes.

Is the Minister aware of the serious concern of parents of mentally handicapped and mentally ill people with respect to two different needs, in that people in that situation might be better off in hospital until the Secretary of State provides the funding to ensure that the necessary care in the community is available? Does the Minister agree that there is no excuse for closing hospitals before that provision is made?

I have already made my view clear. The aim of health authorities in this area is to improve the pattern of patient care. Hospital closures are incidental. If the hon. Gentleman studies the figures, he will see that there have been very substantial increases in resources for the care of mentally ill people in the community, including, for example a more than doubling of the number of community psychiatric nurses.

Will my hon. Friend take on board the fact that there is widespread concern that people are being let out of hospital when there is not always adequate care available for the community as well as for the patient? Is he aware that a great deal of trouble may be caused when neighbours suddenly find these poor people living next door? I beg my hon. Friend to bear that in mind.

I fully accept that there is concern, and in some cases I share it. That is one reason why at almost every meeting with district or regional health authorities I stress the point that I have emphasised to the House—that discharges need to be properly planned and based on proper provision of alternative facilities.

If that is so, when do the Government intend to implement one of the essential first steps towards ensuring proper care in the community—the Disabled Persons (Services, Consultation and Representation) Act 1986, which has still not been implemented?

The hon. Gentleman knows full well that the primary focus of discussions between my hon. Friend the Minister and the local authority associations relate to sections 5 and 6 of that Act, which are concerned with disabled school leavers. We are very conscious of the importance of section 7, and one of my aims is to get that implemented as soon as possible.

Is my hon. Friend aware that included in the statistics are the children of the Princess Marina hospital? I extend a personal "thank you" to our hon. Friend the Parliamentary Under-Secretary of State for visiting that hospital. Is my hon. Friend aware that those children are in tragic circumstances? May I press him for an early decision that they should remain in hospital?

I shall take careful note of what my hon. Friend said. As he mentioned, our hon. Friend the Parliamentary Under-Secretary of State recently visited that hospital. I wish to take this opportunity to make it clear to him and the House that in my judgment there are still many people who need hospital care. The policy of care in the community is not something to be pursued regardless of the needs of the individual concerned.

Does the Minister accept that his response to the hon. Member for Caernarfon (Mr. Wigley), in which he explained the delay in implementing one section of the Disabled Persons Act, does not excuse the delay in implementing another section? Does he further accept that there is a need for proper funding of bridging arrangements? The transitional period between hospital discharge and patients going into the community is of profound importance, if only because those who suffer from mental illness almost certainly have the additional adversity of poverty, unemployment, homelessness and family break-ups. If the Government continue with their inadequately funded community care policy, will it not simply be seen as a euphemism for community neglect?

On the hon. Gentleman's first point, I did not in any way use my references to sections 5 and 6 as an excuse for not implementing section 7. I said that, quite rightly, a great deal of pressure in the House and elsewhere has been concerned with the provision for disabled school leavers. However, I also said that I attached high priority to implementing section 7. Regional health authorities have substantial resources available, and we look to them to use those resources sensibly to provide for the transitional period, as the hon. Gentleman rightly recommended.

Will my hon. Friend give a firm assurance that he will slow down the closure of psychiatric hospitals until there are sufficient trained and qualified staff to look after the patients when they are in the community, and also that suitable accommodation is available? We do not want them to end up in prisons, as the Select Committee on Social Services found in its inquiry into the prison medical service.

Certainly the answer to the latter part of my hon. Friend's question is yes. I think that, by implication, I have already answered the first part. The slowing down of the programme is not the issue; rather, it is that we will not approve hospital closures until we are satisfied that proper alternative provision is available.

asked the Secretary of State for Social Services if he will make a statement regarding health inequalities in and between regions in England and Wales.

It has always been one of the principal aims of the National Health Service to ensure that services are equally available to all who are in equal need and considerable progress has been made since 1977–78 in ironing out long-standing inequalities in health provision between regions.

The right hon. Gentleman may be interested to know that almost all experts disagree with his view that progress has been made. The reality is that my constituents and others in the northern region stand a much higher chance of ill health and of dying early than do those in the more fortunate regions. Given that background, and given that every Member of Parliament from the North-West has files bulging with cases of failures of social service provision, why did the north-west region recently say that it would accept service reductions from the district health authorities to balance the budget? If the right hon. Gentleman does not wish to comment on that matter now, will he accept my challenge to come to the north-west and debate the failure of the Health Service in that region so that the public can make up its mind on the matter?

I shall correct the misimpression given by the hon. Gentleman about NHS progress in his region as against the country generally. Since 1977–78, the RAWP reallocation, to the advantage of the northern region, has progressed from the point where its resources were 9 per cent. below target to being currently 2 per cent. below target. As opposed to the appalling collapse in the capital programme under the last Labour Government, the region now has the second largest capital receipt programme. Its citizens are benefiting from the RAWP reallocation undertaken by this Government.

Has the time not arrived to reconsider the allocation of resources to the four Thames health regions? Whereas in 1977–78 it could be said that facilities in the four regions were ahead of those in the rest of the country, that is no longer the case, and unless there is an increase in resources for the four Thames health regions, patient care is ultimately bound to suffer?

My hon. Friend will know that I have been a London Member for many years. I am somewhat conscious of what he said when I look at the relative data throughout the country. The RAWP programme ensures that service provision is equalised throughout the country. I recognise what my hon. Friend said to the extent that the RAWP formula is currently under review.

Does the Minister dispute all the evidence that we now have a two-nation divide in health as well as in wealth?

I sometimes wonder whether the hon. Lady and other Opposition Members might consider what they say in regard to the relative comparators between our country and the rest. The hon. Lady may not be aware that health—[Interruption.]The answer will come in proper time. The hon. Lady may not be aware that health inequalities are less significant in the United Kingdom than in most other Western countries, including the United States, Japan and France. That is the reality of the relative lack of inequality. The question related to equality in the provision of services. RAWP is seeking to do precisely that.

Will my right hon. Friend most seriously consider the inequalities that arise specifically in areas where there is a large retired and aged population and where doctors must spend much more time dealing with the elderly? Perhaps hip operations can be dealt with in the private and public sectors to relieve the specific problems that the elderly face in such areas.

My hon. Friend made an important point. I have been particularly conscious of it when I have looked at the concept of the primary health care review. I hope that I shall be able to assist in that direction.

asked the Secretary of State for Social Services if he will make a statement on the Tameside and Glossop general hospital development.

I am pleased to report that, after a delay while additional post-contract work is carried out, the admission of the first patients to phase II of Tameside general hospital is scheduled for the autumn of 1988.

My hon. Friend's statement will be well received in my constituency of High Peak and in the north-west as a whole. The large expansion of the hospital shows the Government's commitment to the Health Service and to the north. None the less, I seek an assurance from my hon. Friend that adequate funds will be made available in future so that the magnificent new facilities can be fully staffed without detriment to other important facilities in the north-west.

I am grateful for my hon. Friend's first remarks. I am glad to know that, even in this place, one can please some of the people some of the time. My hon. Friend will know that the region and the district are currently discussing funding issues. I think I am right in saying that the region has already offered £2·6 million as revenue consequences, but some issues remain to be settled.

rose—

Well—yes—Mr. Favell.

I am entranced by the way in which you receive my question, Mr. Speaker.

Order. Does the hon. Member's question cover Tameside and Glossop general hospital?

It covers the north-west region and the north-west regional health authority.

I am afraid that I could not hear part of my hon. Friend's question, so I can hardly expect that he will be as entranced by the answer as Mr. Speaker was by the question. However, I can at least confirm that Stockport and Tameside are in the north-west region.

asked the Secretary of State for Social Services if he is satisfied with the level of physiotherapy support available from the National Health Service to special schools for handicapped children in Birmingham.

Yes. The provision of physiotherapy services to special schools is the responsibility of the local health authorities in co-operation with the local education authorities. It is for them together to decide on the appropriate level of physiotherapy services.

I am surprised that the Minister is satisfied, given the amount of concern that has been expressed by parents at the Wilson Stuart special school in my constituency. That school caters for children from at least six constituencies. Is the Minister satisfied that the differences between health authorities in the city of Birmingham can lead to the position where the Wilson Stuart school in West Birmingham health authority has 140 handicapped pupils with two physiotherapists and two who are rotational, whereas at Bray's special school, which is covered by South Birmingham health authority, 110 pupils, who have almost the same type of disability, have the services of 4½ full-time physiotherapists? The Minister cannot be satisfied with such discrimination against the pupils from the six constituencies in north Birmingham.

The Wilson Stuart school, which the hon. Gentleman mentioned, was affected by a shortage of paediatric physiotherapists at the end of last year, but is currently up to establishment. The number of physiotherapists who are employed by the Birmingham health authorities has jumped from 268 in 1982 to 302 this year. The biggest increase has been in West Birmingham health authority, which covers the hon. Gentleman's constituency.

Is the Minister aware that my hon. Friend the Member for Birmingham, Perry Barr (Mr. Rooker), has exemplified, by reference to Birmingham, a problem which grievously affects handicapped children all over Britain? Is she further aware that giving the right help in the right place at the right time can make all the difference between enabling a handicapped child to live an independent life and living a life of dependence and preventible disability? Will she consider this problem more urgently and accept that we would like a fuller statement at an early date?

I accept much of what the right hon. Gentleman has rightly said. The number of physiotherapists who are employed in the Health Service has climbed rapidly from about 7,000 when he was a member of the Government to about 11,000 now. Perhaps that will help to answer his question.

asked the Secretary of State for Social Services when he plans to respond to the third report of the Social Services Committee on problems associated with AIDS, HC 182, Session 1986–87.

I expect to respond to the Committee's report before Christmas.

Does my right hon. Friend agree that a programme of anonymised screening represents by far the simplest way of obtaining accurate information about the spread of AIDS through the population? Does he further agree that without that information it is impossible to evaluate the efforts that the Government are making to combat the spread of this appalling disease? Does he agree that such a programme could be introduced at a low cost because blood samples are already routinely collected from large numbers of people?

What I can agree with is that we need better information about the spread of the HIV infection. I know that my hon. Friend served honourably on the Select Committee in the previous Parliament and that the Committee did not share his view on anonymised screening. Having said that, I am, of course, anxious to ensure that we have the best scientific advice, and I am considering the issue. I hope that my hon. Friend will share my desire for better information, not necessarily gained from the route that he seeks to pursue.

Following the Committee's report, have the Government been able to respond positively to the capital needs of London Lighthouse, and if so to what extent?

I know of that particular issue, and my hon. Friend the Minister for Health is actively considering it at the moment. I hope that he will be able to make a statement, which I hope will be helpful, in the not too distant future.

May I confirm to my right hon. Friend that my hon. Friend the Member for Suffolk, South (Mr. Yeo) was in a minority of one in proposing anonymised screening? All other members of the Select Committee felt that it would be entirely irresponsible clinically. However, if a person is found to have a blood sample which is HIV positive, it must be right to do something about that patient.

I appreciate my hon. Friend's comments. As he and hon. Members on both sides of the House will know, my predecessor welcomed unreservedly the advice of the Committee and the help that it gave in this difficult area.

Does the Secretary of State accept the estimate of the Select Committee that 1,200 haemophiliacs are antibody positive as a result of infection at the hands of the NHS? Does he recognise that the Government must bear part of the responsibility for that number because of the failure to make Britain self-sufficient in blood products, which has left us dependent on imports from commercial sources in the United States? Does he agree with the robust statement of the Under-Secretary of State, the hon. Member for Derbyshire, South (Mrs. Currie), that anyone who denies that AIDS can be transmitted by blood products needs his head examined? Therefore, does he accept that, whatever the legal liability, the Government have a moral obligation to help those haemophiliacs and to protect their dependants against mortgage defaults and homelessness?

I can confirm the figures that the hon. Gentleman gave with regard to the 1,200 haemophiliacs. I have received letters from my hon. Friends on this issue. Some of their constituents have suffered from this, and I share their deep sympathy, but the House will be aware that there has never been a general state scheme to compensate those who suffer the unavoidable adverse effects that arise from medical procedures. The Government have tried to provide all NHS facilities to those who suffer illness as a result of the infection. So far we have provided £104,000 to each of the six haemophilia reference centres in England so that they can provide a counselling service. In addition, the DHSS is working closely with the Haemophilia Society. Beyond that, I can say that I will meet representatives of the Haemophilia Society next week.

asked the Secretary of State for Social Services what recent evidence his Department has compiled on the expenditure of elderly households on domestic appliances and other durable goods.

The latest information is for 1985, when the average pensioner household spent more than £230 on durable household goods. This forms the fastest growing area of pensioners' spending and is two thirds higher in real terms than in 1979.

I thank my hon. Friend for his remarks about pensioners' spending. Will he comment on pensioners' incomes which underlie that spending? How do they compare with 1979?

Again, the latest information available is for 1985. Between 1979 and 1985 pensioners' incomes increased in real terms by about 18 per cent., which is roughly twice as fast as incomes in the community as a whole.

The Minister will be aware that one of the most important items of expenditure in any elderly household is the purchase or rental of a television set. Indeed, given the lack of safety on the streets, and the fact that many elderly people are afraid to go out after dark, it could be argued that acquiring a television set is an essential item of expenditure in elderly households. Therefore, to keep as many elderly people as possible living independently in the community, will the DHSS support the proposal for a system of concessionary television licences for pensioners, which would cost the Treasury only £330 million? It gives thousands of millions of pounds in tax cuts to the rich every year.

No doubt many hon. Members will recall the time when pensioners were given vouchers with which to buy cigarettes and other tobacco products. We should concentrate on protecting the real value of the retirement pension rather than embarking on a series of specific grants for items which some pensioners may not want.

Does the Minister not recognise that there is something a little more than ironic about Ministers congratulating themselves on the increase in pensioners' incomes, which stemmed directly from the changes made in state and occupational pensions by the Labour Government in 1975 and which were seriously weakened by the activities of this Government in the Social Security Act 1986? Does he admit that that Act will weaken the standard of living of pensioners?

No. The steady maturing of the SERPS scheme, the reforms which we shall introduce for pensions in 1988, the increase in pensioners' savings and the Government's success in controlling inflation will all contribute to rising standards of living for our pensioners.

asked the Secretary of State for Social Services what is the percentage change in non-emergency ambulance patient miles in Lewisham between 1983 and 1987.

The London ambulance service does not calculate patient mileage statistics by district health authority.

Does the Minister not think that it should begin to collect such statistics, given that there is an increasing percentage of elderly, chronically sick and disabled people in the community, particularly as a result of Government policies on community care, the fact that the dial-a-ride schemes are vastly oversubscribed and given that a walking case is defined as someone who can walk with the help of one other person and who can sit in a vehicle and therefore may not use the ambulance service?

The London ambulance service runs some 1,000 vehicles. Last year it performed 2·3 million patient journeys and covered some 12 million miles. It answers emergencies at the rate of 1,300 every day of the year and the average ambulance journey costs £18. I can give the hon. Member no end of statistics, but I apologise for the fact that I cannot give her exactly the ones that she wants.

asked the Secretary of State for Social Services how much the Government are making available in the current year for grants under section 64 of the Health Services and Public Health Act 1968.

In the current financial year the Department is planning to provide funding of more than £37 million to the voluntary sector, an increase of 82·5 per cent. in real terms since 1978–79. Of that money about £26–3 million is provided under section 64.

I thank my hon. Friend for that excellent reply. Although I know he is aware that the new Chesil counselling centre in Weymouth is doing excellent work, can he confirm that, through section 64, the Government are giving funds to this type of project to support the work to overcome alcoholism and drug abuse?

Section 64 money is principally available for national schemes. I know about the Chesil counselling service, and I know that my hon. Friend is in touch with the county council about that service. We provide about £ ¾ million section 64 money to voluntary bodies concerned with alcohol abuse.

asked the Secretary of State for Social Services if he will make a statement on the proposed increase in retirement pensions.

This matter will be covered in the statement that my right hon. Friend will be making to the House shortly.

asked the Secretary of State for Social Services how many consultant geriatricians there are now compared with 1978.

The number of consultants in geriatric medicine in England has increased from 330 in 1978 to 479 in 1986. That is an increase of nearly 50 per cent. and it demonstrates our commitment to care for the elderly in this country.

I offer my hon. Friend congratulations on such a satisfactory reply. Does she agree that the success of the NHS under this Government means that many people are living much longer than hitherto and that the demand for geriatric services is likely to increase still further in the future?

Yes, I agree. The increasing number of old people in our society and rising life expectancy are a tribute to success in the Health Service. There are more nurses in the geriatric service, more district nurses, more private residential care, more nursing homes, more home helps, more day centres and more people cared for in day hospitals. We expect those increases to continue.

Is the Minister aware that far too many geriatric hospitals are outdated, ancient and inadequate and are totally unsuitable for the people who must live in them? Is the Minister aware that far too many pensioners are in hospitals because there is inadequate care available for them in their homes and that the entire system of care for old people is cracking?

Perhaps the hon. and learned Gentleman is unaware that 1·6 million old people are currently cared for at home by home nurses and that that is a rapid increase on recent years. I take on board the point he makes about the tatty state of some old geriatric hospitals, and I hope that he will support the Government when we make moves to close and replace those hospitals.

asked the Secretary of State for Social Services how many elderly persons were admitted to private residential homes with Department of Health and Social Security financial support during the year ended 31 March.

The information is not available in the exact form requested. Figures for February 1987 show that there were 65,000 people of pension age in private and voluntary residential care homes claiming supplementary benefit help with their fees.

In view of the situation demonstrated by the recent Yorkshire Television programme, "First Tuesday", which looked at the care of the elderly, are the Government satisfied with the impact of their free market ideology on the care of the elderly? Furthermore, does the Minister accept that it is in the best interests of elderly physically or mentally handicapped people to be advertised as chattels in estate agents' descriptions of houses to be sold for the private care of handicapped people?

Recent concern has centred not only on private homes but on local authority homes. We shall look at the report of Lady Wagner's review of residential care, which is expected shortly. Meanwhile, the social services inspectorate is discussing with local authorities the ways in which it can improve its monitoring.

asked the Secretary of State for Social Services if he will make a statement on the Bridlington new community hospital.

I am delighted to say that Bridlington new community hospital was handed over by the contractors to East Yorkshire health authority on 23 October this year, three months ahead of schedule. The hospital cost £16 million and is expected to receive its first patients around Easter.

I am sure my hon. Friend knows how delighted we are at having that hospital in east Yorkshire, but does she not agree that the mere fact that the consultant medical staff are being drawn from Scarborough should not be used as an excuse by those who would like to see East Yorkshire health authority die on the vine and be taken over—if I can be allowed to say it—by Hull health authority?

I shall convey to my colleagues in the regional health authority the views and remarks of my hon. Friend. I thank him for his kind words about that new development.

asked the Prime Minister if she has any plans to put before the House proposals for changes in the constitution or powers of Select Committees.

No, Sir.

Does the Prime Minister agree that the continuing failure to set up departmental Select Committees is undermining the role of this House in holding the Government to account'? To ensure that the Select Committees have a life of their own, independent of Government—indeed, independent of shadow Government—will the right hon. Lady consider putting her personal weight behind the proposal that Members of this House should directly elect the members of the Select Committees?

With regard to the hon. Gentleman's first point, as my right hon. Friend the Leader of the House said last Thursday at business questions, he is working through the usual channels to get the Select Committees going as soon as possible. I cannot add to that point. With regard to the hon. Gentleman's second point, the membership of Select Committees is ultimately for the House to determine. The membership is determined by the House on an amendable motion tabled on behalf of the Committee of Selection. I am not aware of any strong support for changing the present system.

With regard to the powers of Select Committees, does my right hon. Friend not think that the time is now appropriate for the Public Accounts Committee to monitor the nationalised industries, because now there are far fewer nationalised industries that w as the case when they were last considered?

Ultimately, I think that this is a matter for the House itself. The Public Accounts Committee does an extremely good job.

I am sure the Prime Minister is aware that 40 per cent. of Scottish Conservative Back Benchers have stated publicly that they do not want to sit on the Select Committee on Scottish Affairs. Given that that will make it difficult for the Government to have a majority on the Committee, is it not time that the right hon. Lady hit the bullet and allowed a Select Committee on Scottish Affairs that reflected accurately the party situation in Scotland?

As the hon. Gentleman is aware, the point was put to my right hon. Friend the Leader of the House last Thursday. The Committee is being considered along with the others, and my right hon. Friend is working through the usual channels to get the Committee going as soon as possible.

Is my right hon. Friend aware that the reason for the difficulties with the Select Committee on Scottish Affairs is the way in which that Committee has behaved in a partisan manner in the past? Those of us who worked hard to make the Committee effective were disappointed by the way in which it developed.

I note what my hon. Friend says, and I am sure that there is no stauncher representative of Scotland than him.

asked the Prime Minister if she will list her official engagements for Tuesday 27 October.

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

In the light of the BP share issue fiasco, have the Government revised down the amount of money that they expect to raise from selling off our water industry? They estimated that they might raise £8 billion, even though the assets are worth £29 billion; so they were selling it off cheaply anyway. Are they going to raise about £3 billion-£4 billion now, bearing in mind that it will cost between £2 billion to £3 billion to install water meters on a compulsory basis in every home?

With regard to water privatisation, there is a paving Bill before the House that will have to go through the House, and there will be other legislation before that process can be completed.

May I put it to my right hon. Friend that the present crisis in stock markets around the world is primarily an international rather than a national problem, and that it needs an internationally co-operative response? In particular, it needs, first, an early announcement by the Federal Republic of Germany that it intends to reduce its interest rates. Secondly, it needs an early announcement from the President and the Congress of the United States that they intend to put up their taxes. Thirdly, it needs continuing international supervision and control of the new and ever-proliferating financial mechanisms, which, if necessary, will prohibit some of those speculative instruments so that we shall not all he faced by an international financial Frankenstein.

With regard to the several points that my hon. Friend has made, I would agree with him that the matter of the United States' budget deficit needs dealing with. I believe that it is being dealt with by the President and Congress. I agree with my hon. Friend that that is a significant part of the matter. With regard to the co-operation of Germany and, of course, Japan, I point out that the Louvre agreement was reaffirmed by Mr. Baker, Mr. Stoltenberg and Mr. Poehl, and that has had a considerable effect on exchange rates. I also point out that interest rates have been falling, particularly at the long end of the market, as people have gone into gilts and bonds. We have reduced our interest rates recently, as my hon. Friend knows, so we have played our full part in sound financing, for which I have sometimes been criticised, but which has turned out to be the safest thing that we could possibly have done.

It is clear, as the Prime Minister said, that the underwriters of the BP share issue do not consider the sale to be a proper underwriting risk in terms of the prospectus. Does the right hon. Lady agree or disagree with them?

I think, perhaps, that the right hon. Gentleman could not quite hear what I said earlier. He will know that I am restricted as to what I can say—

Why?

For legal reasons. The right hon. Gentleman also knows that the Chancellor is to make a statement. Therefore, I repeat what I said: the underwriters have made representations to the Treasury that the BP issue should be withdrawn. The Chancellor is considering those representations, as he is contractually bound to do under the terms of the underwriting agreement and he will explain the procedures in the statement that he is to make shortly.

The Prime Minister knows very well that there is no legal consideration that forbids her responding, especially when the underwriters have made their position so clear. Indeed, she has an absolute duty under the prospectus to respond. Is she not aware that the absence of a firm decision only prolongs and increases instability? Is not the Prime Minister's refusal to say what the position is a pathetic evasion of responsibility when the underwriters have made their position so clear?

With all due respect, I do not think that the right hon. Gentleman has taken full account of what I said. The Chancellor is contractually bound to consider the representations. Under the terms of the underwriting agreement he must give due and proper consideration. That is what he is doing.

The Prime Minister knows that the underwriters made their representations yesterday. Everybody knows that the Chancellor has an obligation to discuss the matter with them and, in the event of failure to agree, to consult the Bank of England. I ask again, why the delay? Why is the Prime Minister prolonging instability?

The right hon. Gentleman knows that the Chancellor must genuinely go through the procedures. That is what he is doing. The right hon. Gentleman also knows that there is a private notice question from his Front Bench on precisely this matter.

During my right hon. Friend's busy day, did she have a chance this morning to hear Sir Nicholas Goodison, the chairman of the stock exchange, whose motto is "My word is my bond"—[Interruption.]

Order.

The chairman of the stock exchange, whose motto is "My word is my bond", said that the BP issue was fully underwritten and should go ahead. Underwriters have done well for some years, and now is the time for the motto "My word is my bond" to be taken up.

As my hon. Friend is aware, my right hon. Friend the Chancellor must follow the procedures that he is contractually bound to follow. If he were not to follow those he would be the subject of criticism. He is following them and will make his decision and announcement, not today, but in due time.

asked the Prime Minister if she will list her official engagements for Tuesday 27 October.

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

When the Government come to make a decision on the BP flotation, which group will be the most important — the small shareholder or the fat cat underwriter?

I cannot add to what I have already said. The Chancellor will be answering further after Question Time.

Will my right hon. Friend try to find time today to consider the desperate plight of the haemophiliac AIDS victims who are suffering through no fault of their own and who many hon. Members believe deserve very special consideration?

I will, of course, discuss this matter with my hon. Friend the Minister for Health.

Will the Prime Minister say what advice I should give to people in my constituency who have taken her advice and invested in private occupational pension funds? Those constituents are now at risk because of the belief in market forces, to which she has been telling us we should respond. What advice should pension fund holders be given in relation to any BP issue?

In general, the market is just about where it was just before the turn of the year, and very much higher than it has been on previous occasions.

asked the Prime Minister if she will list her official engagements for Tuesday 27 October.

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

Is my right hon. Friend aware that many of my constituents are furious at the persistent attacks on the Government and herself by Commonwealth Prime Ministers, many of whom are leaders of one-party states condemned by Amnesty International? Is it not time that they were told that in future the ruder they get the smaller will be their allocation from our very large overseas aid budget?

I appreciate my hon. Friend's concern, but I think that he will agree, after a moment's reflection, that we must give aid according to where people need it most. That has been, and will continue to be, our policy.

As the Prime Minister's—[HON. MEMBERS: "Reading".] Some of us choose our words carefully.

Nor does the Labour party's performance during the last election or since lead me to listen to it, from any front.

asked the Prime Minister if she will list her official engagements for Tuesday 27 October.

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

Will my right hon. Friend spare some time today to reflect upon the success of the Government's right-to-buy policies, whereby some 1 million families, formerly tenants, now enjoy the security and independence of home ownership? Will she join me in deploring the delay and delaying tactics of some councils in dealing with right-to-buy applications? I have constituents who have waited. for 18 months to two years before their applications have been dealt with, and I believe that Southwark council has some 2,000 applications before it at the moment.

I join my hon. Friend in deploring any delays in allowing tenants to take up their right to buy. My hon. Friend will know that in extreme cases the Department of the Environment can take over from the local authority the entire right-to-buy responsibility for council houses. Therefore, perhaps he would have a word with our right hon. Friend the Secretary of State for the Environment.