To ask the Secretary of State for Social Services if he will arrange to meet the chairman of Torbay health authority to discuss health services in Torbay.

I am hoping to visit Devon later this year, but details have not yet been finalised.

When my hon. Friend goes to Torbay, will she congratulate the chairman of Torbay health authority, which has one of the highest bed occupancies in the country? The average length of in-patient stay is one of the shortest, and the cost is among the lowest in Britain. Will my hon. Friend also explain to the chairman how he is supposed to manage to run the health authority when the increase in funding this year has been 6.8 per cent., whereas the national wage increase has already been agreed at 8.4 per cent.? The authority cannot make ends meet.

I understand that Torbay has one of the highest growth rates in allocation of money in the region. I note my hon. Friend's comments and will bear them in mind. However, I would say that the authority is showing other health authorities how to make ends meet. Results are what matter. I note with interest, for example, that the waiting time for hip joint replacement operations is 22 weeks in Torbay and six weeks in Newton Abbot.

On her way to Torbay, I wonder whether my hon. Friend will—

Order. I think not today.

To ask the Secretary of State for Social Services when he last met the chairman of the North West regional health authority; what matters were discussed; and if he will make a statement.

My right hon. Friend last met Sir John Page during a visit to the regional health authority headquarters in Manchester on 30 October 1987. He was told of the progress being made in improving patient services within the region.

Is the Minister aware that, if that visit had taken place just before Christmas, they could have discussed—or indeed witnessed—engineers coming in to cut off the oxygen supply to the incubators for premature babies at St. Mary's hospital ., and that, if it had taken place last week, they could have discussed with nurses why they were forced to strike? Do not those conditions show that the National Health Service is in the throes of a terminal disease for which the Government are not offering a remedy?

I am even more aware that, had my right hon. Friend the Secretary of State visited Manchester in the week before Christmas, he would have been able to point to the substantial additional funds that I had just made available to the North West regional health authority.

Has my right hon. Friend seen the excellent report from Sir John Page, which landed on our desks today, in which he points out the many savings being made in the region—particularly in purchasing policy — the vast increase in building of which my hon. Friend saw an example a few months ago, and the vast increase in patient care? That does not mean that we do not want more in Lancaster, we do. Nevertheless, it is doing very nicely.

I have not yet had the pleasure of seeing the report to which my hon. Friend referred, but I remember with pleasure my visit to her area to open some large new hospital facilities there.

When the meeting took place, was the crisis in the Salford area health authority discussed? Was there a discussion of the four wards that will have to close? Was it mentioned that the health authority must find £2 million per year into the 1990s, and that the money that has been allocated on a one-yearly basis is entirely unsatisfactory? What is the Minister going to do about the crisis in the inner cities—not least in Salford?

Among other things, we are seeking to improve the quality of primary care services in the inner cities, and that is an important part of the mix as a whole. With regard to my right hon. Friend's visit, of course the concerns that were expressed then were taken into account when we made substantial money available this year and an extra £700 million for the hospital and community health services, including those in the north-west, next year.

To ask the Secretary of State for Social Services what measures he intends to make health promotion and the prevention of ill health a central function of general medical practice.

Our plans are set out in the recently published White Paper "Promoting Better Health". Major changes are to be made in the system of payment to doctors to encourage them to provide a range of health promotion and preventive activities; for example, the introduction of incentive payments for reaching target levels of population cover for vaccination, immunisation and cancer screening and new payments for arranging and providing regular health promotion sessions for patients. The family doctors' contract with the National Health Service will be amended to make health promotion and the prevention of disease a specific part of their terms of service.

I thank my right hon. Friend for his reply, but I am sure that people in Sheffield would appreciate more detail. Will he give more details?

I appreciate my hon. Friend's comment. The first negotiating meeting with the General Medical Services Committee will take place this week on 14 January. We will discuss details with the profession. We hope to provide incentives for doctors to reach targets, as I have said, and we will pay a fee to encourage doctors to provide an initial clinical assessment for patients registering for the first time with an NHS doctor. We will also introduce sessional fees for doctors who run health promotion clinics. In addition, we will seek to negotiate the payment of the basic practice allowances depending on a doctor carrying out health promotion and prevention of ill-health activities.

While I welcome the Minister's statement about screening, will he accept that restricting free eye-testing will hinder detection, as optometrists detect what ophthalmologists diagnose, and that it will cost the Health Service more in the long run to end the free eye test?

I do not accept that any of our evidence suggests that in the long run charges deter people from seeking treatment. I hope the hon. Gentleman recognises what we are seeking to achieve in addition to the very substantial increases in moneys going into primary health care. That will enable us to increase resources, especially for inner city and rural areas.

As regular check-ups are so much a part of private medicine, may I assume from the words "health promotion" that my right hon. Friend is now extending that service to the National Health Service so that the "fit person" medical will become part and parcel of the health of this country?

My hon. Friend is right. We are trying to ensure that we are as concerned with the promotion of good health as with simply eradicating sickness. To that extent, my hon. Friend will watch with interest, as I will, our negotiations with the medical profession to see that contracts reflect that.

Is it not a fact that among the many causes of ill health have been the increases in unemployment, increases in homelessness and the abolition of nutritional standards for school meals? Is it not absolute hypocrisy for the Government to say that they are concerned about preventive medicine when they have allowed all those things to grow under their jurisdiction? Is it not the simple truth that the Government are making the country sick?

Most rational people who try to approach the health of the nation with a sense of rationality and balance will understand the political hypocrisy behind that question. Happily, the reality is that, under most Governments since the second world war, our nation has over the past 40-plus years seen a pattern of health improvement. We are now trying to supplement that by adding to the promotion of good health and the prevention of ill-health.

Did my right hon. Friend carry out, before issuing his White Paper on primary health care, as accurate as possible an assessment of the extra loading that will fall on family practitioner committees if they are to have to process the immense number of item-of-service claims? What financial provision will be made to enable them to fulfil their function?

My hon. Friend has made an excellent point. Within the White Paper, which is aimed at promoting health, we are seeking to add to the responsibilities of the family practitioner committees. To that extent we are committed to giving, through negotiation, additional resources to those committees that will allow them to carry out increased duties.

To ask the Secretary of State for Social Services what is his policy towards contracting out the care of National Health Service patients to the private health sector on a commercial basis.

In 1986, private hospitals provided care for over 41,000 NHS cases. This demonstrates the value of partnership between the sectors, and we encourage such local arrangements.

Will the Minister confirm that the contracts for the sale of hospital land to American companies based in Britain are going ahead? Will those contracts contain a clause about contracting-out services?

I am in some difficulty as I am not sure to which particular contracts the hon. Gentleman refers, but if he tells me I shall give him more information on them.

Is my hon. Friend aware that, with the exception of Belgium, Britain has the lowest contribution from the private health sector as a percentage of gross national product of any other country? Will he and my right hon. Friend the Secretary of State have words with our right hon. Friend the Chancellor of the Exchequer to see what can be done to encourage the private sector to make a greater effort in the health services, thereby releasing funds for our National Health Service?

I am sure that my right hon. Friend will take note of the points that have been made. It is vital to harness all available resources for the provision of health care. Some hon. Members insist that health care must be entirely publicly funded. That is a dogmatic and narrow-minded approach to a most important problem.

Does the Minister recall that in November her department released £250,000 to the west midlands on the express condition that it should be spent on private operations? Is she aware that, on inquiry, the west midlands authority discovered that private hospitals were charging £400 more for a hysterectomy and £700 more for a hip replacement than was being charged in its own hospitals? In the meantime, Wolverhampton has suspended all hip operations for the financial year. As it is clear from that experience that the NHS gives better value for money, why does the Minister leave its operating theatres empty while filling the pockets of commercial medicine?

I take exception to the hon. Gentleman's synthetic indignation. The west midlands experience shows that it is important, right from the start, properly to negotiate cost-effective terms with the private sector, or indeed with anybody else. Our view is that the only question that matters is whether it helps the patient, as we expect cost effectiveness in all services.

To ask the Secretary of State for Social Services what recognition the new system of income-related benefits will give to the needs of families on low incomes.

Lower-paid working families will receive more help through family credit, which we expect to be received by over twice the number presently receiving family income supplement, at an extra cost of around £200 million; and we shall be spending around £100 million extra on families in income support, which replaces supplementary benefit.

I am reassured by my hon. Friend's reply and I applaud the principle that the greatest help should be given to those in greatest need. Can he give actual figures of the families who will be receiving family credit in future, and can he say how those who are in need and are entitled to claim will be informed and encouraged to claim that entitlement?

The total number of families should be about 470,000 compared with 200.000 who are receiving FIS today. We will launch a promotional campaign, on which we are spending £3 million.

Would the £50 or £60 that a child has saved in a building society out of weekly pocket money be taken into account for the assessment of supplementary benefit for the parents?

The new rules refer to the resources of adults and exclude them from income support at £6,000, as opposed to £3,000 at present.

Does my hon. Friend agree that we will be spending more on low-income families as a result of our social security reviews than has been the case until recently, and more than we would be spending if benefits such as child benefit had been index related?

Yes. Even allowing for the changes in housing benefit, the extra money going to families is of the order of £200 million. That is nearly double the amo0unt that would be required to uprate child benefits.

Is the Minister aware that, under proposed changes in legislation, an unemployed head of the household who decides to undertake full-time education to increase his employment opportunities will lose out on benefits, including housing benefit, which will be counter-productive to any scheme to encourage people to undertake training?

The provision for education is a separate matter from income support, which is there for those who are available for work. The two are different maintenance systems.

To ask the Secretary of State for Social Services how many in-patient cases were treated in East Anglia in 1986 and 1978.

There were 195,628 in-patient cases treated in 1978 and 253,124 cases in 1986. This is an increase of 29–4 per cent. over the period.

Will my right hon. Friend congratulate the RHA and the districts, in particular the Great Yarmouth and Waveney district, on achieving that impressive improvement? Will he confirm that the same success could be recorded for out-patients and day case treatment?

Yes, indeed. The increase in out-patients was just under one quarter and in day cases no less than one half. That is a striking achievement and I am happy to pay tribute to the RHA and my hon. Friend's district health authority.

Is not the result in East Anglia even more commendable when one reflects that the figures on which its funding is based are some five years old, whereas Huntingdonshire and, to some extent, Cambridgeshire are the fastest growing areas in the country? If that rather ludicrous state of affairs is the case, are not some areas that are not so fast-growing doing very well indeed?

My hon. Friend will be aware that the increase that I announced just before Christmas for next year for the East Anglian regional health authority is among the highest in the country and reflects the rise in population. We are always anxious to ensure that our method for distributing money reflects such factors in as up-to-date a way as possible.

To ask the Secretary of State for Social Services what is the percentage change in expenditure on hospital and community health services in real terms, respectively, using the National Health Service pay and prices deflator, in the four Thames regional health authorities in total, between 1981–82 and the most recent year for which figures are available.

Between 1981–82 and 1986–87 gross revenue expenditure in the four Thames regions rose by 29–4 per cent. Compared with the rise in general inflation, this represents a real terms increase of 1–2 per cent. National Health Service pay and price inflation was comparatively high across this period. Compared with that measure Thames regions' expenditure dropped by some 2.8 per cent., although this was more than offset by increased efficiency. Taking this into account, the purchasing power of the Thames regions rose in real terms by 2 per cent., and, most important, the numbers of cases treated in all specialties rose between 1982 and 1986 by 8.7 per cent. in Greater London.

I am grateful for those figures, but if we look at them carefully do they not confirm that the most crucial part of the answer is that, as we have suspected for a long time, over the last five years in the south-east of England and the Thames regions there has been a cut in real terms in expenditure in the Health Service? Will the Secretary of State confirm that the Health Service is in such difficulties in the south-east, putting aside efficiency improvements and the rest, because the double effect of RAWP on inner London and south-east of England health districts means that they have suffered most from cuts? The consequences that we now see, in bed closures and the like, are the result of those figures, which have hit this part of Britain worse than any other.

First, let me remind the hon. Gentleman that, as I said, there has been a real terms increase. He will want to look at the figures with care, and I explained them with care. Secondly, he will not want to deny what his right hon. Friend the Member for Plymouth, Devonport (Dr. Owen) did when he was involved in government, which was agreed by all parts of the House, when the RAWP process was introduced in 1977. Like the hon. Gentleman, I represent a London area constituency, so I am conscious of the Thames regions' position on RAWP. The reality for 10 years has been that, despite the increase to which I referred, and despite the happy increase in patient activity, London's population has fallen and its relative overprovision, as seen by the then Labour Government, has produced a pattern of acute bed reductions, which has continued ever since that period on roughly the same basis. But—this is the curcial point for hon. Members who represent London areas — in 1993, at the end of the strategic planning period, London will still have more beds per head of population than the national average.

Will the Minister consider urging one of those Thames authorities, namely, South East Thames—in the interests of efficiency and of increasing its income, on which expenditure depends—urgently to start realising the income from the numerous empty properties throughout the region for which it has no further use?

I bow to my hon. Friend's distinguished past and detailed knowledge of these matters. As she will know, in the new Health and Medicines Bill we are specifically encouraging the generation of income from health authorities' resources. I shall draw the attention of the region and the area to her remarks.

Is it the Government's policy to starve the National Health Service of resources to bring about a crisis so that they can introduce new proposals for other methods of funding and thus undermine the principles of the NHS?

Such political partisan nonsense does the House and the country no service at all. The resources that have gone into the National Health Service over the past eight years have been immense. The essence of the question related to the nature of patients served.

I have listened carefully to my right hon. Friend's remarks and, as he will recall, I have raised this matter with him in the past. However, is it not clear that if, as is alleged, 1,400 fewer beds are available in the Thames regions this year than were available last year, there is at least the implication of a threat of a reduction in patient care in constituencies in those areas? Does that not mean that we should at least speed up the review of RAWP, which, I remind my right hon. Friend, his predecessor promised in October 1986?

Like me, my hon. Friend represents a Thames region health authority area. However, he will know from the facts that I have given him that the long-term pattern of acute bed decline since the introduction of RAWP in 1977 has proceeded apace since then without a reduction in patient activity—indeed, quite the reverse. The RAWP review is very near completion and, like my hon. Friend, I look forward to the advice that will be given in it.

The Minister claims that patients are in a happy position. If that is so, can he explain why Whipps Cross hospital in my constituency is now on red alert, which means that patients cannot get routine surgery? That is a scandal, and the state of red alert is likely to persist throughout the winter, which is certainly not a happy state of affairs for that hospital's patients.

Unlike the hon. Gentleman, I was in this House in the winter of 1978–79 and I shall never forget what happened in London hospitals during that winter. Having said that, I again remind the hon. Gentleman that no one denies the constant and growing needs in the Health Service. The question is how we can fulfil those needs and create good patient care.

Will my right hon. Friend consider the example of Mayday hospital in Croydon, which is in a Thames region? Whatever Opposition Members say, that hospital has had a magnificent record of treating patients over the years. It treated about 27,500 in-patients in 1986 and thousands more day patients. In short, every year more and more patients are treated in that hospital, which my right hon. Friend knows so well.

My hon. Friend is absolutely right. He knows Mayday hospital in his constituency very well. As a good constituency Member of Parliament, he is well aware of the reality of increased patient activity, which is what all of us in the House should be concerned about.

To ask the Secretary of State for Social Services what assistance is given by his Department to local authorities for establishing day nurseries; and if he has any plans to increase it.

The answers are none and no, Sir. My right hon. Friend has no power to make specific grants to local authorities to provide day nurseries. Day nurseries are provided by local authorities in the light of their own priorities and resources and their views on the needs of local children.

The Prime Minister has tried to make great public relations play of her concern about child abuse, but in my shire — Nottinghamshire — there are only about 550 day nursery places for an under-five population of 30,000 children. When will the Government start to put their money where the Prime Minister's mouth is and allow Nottinghamshire county council to give a day-care place to every child who needs it?

I can confirm that the number of day nursery places provided by Nottinghamshire county council in 1986 was 555. In fact, it was Nottinghamshire county council that cut the number of places from 585 in 1984. However, the total number of day nursery places provided in that county council area has risen from 1,013 to 1,057 because the local authority is now relying far more heavily on private nursery places. If we bear in mind that Nottinghamshire county council has spent more on day nurseries in real terms and that their day nurseries are cheaper on average, that means that Nottinghamshire thinks that the private sector provides value for money in child care. I commend that attitude to the House.

Does the Minister recall that although the population of children under five between 1981 and 1985 increased by 141,000, only 500 extra places were made available? In view of the genuine concern about family poverty, which the hon. Lady should not dismiss, and the national debate reflecting people's concern about child welfare, is it not a matter of great urgency that local authorities—not just Nottinghamshire—are forced into making a choice between, for example, providing library facilities or day-care facilities? In view, also, of the great tragedies that have been discussed, especially in recent weeks, does the Minister accept that the Government have a responsibility, including a responsibility to improve vital resources?

We have some old-fashioned views on that on this side of the House. We think that it is the parents' responsibility to care for their children. However, we recognise that day nurseries can help children in certain circumstances. Since the Government have been in power the total net spending by local authorities on all services has increased by 18 per cent. in real terms and has increased nearly twice as fast, by 35 per cent., on personal social services. If local authorities choose to spend that money, not on day nurseries but on peace committees and gay rights committees, that is their business.

I should like to say how strongly I agree with my hon. Friend about the primary responsibility for young children being that of the parents. Therefore, may I ask my hon. Friend to continue to ensure that that kind of care facility is available only to those whose need is the greatest?

Yes, I have a lot of sympathy with that view. It is worth putting the number of day nursery places into context. There are about 30,000 local authority day nursery places, nearly the same number in private and voluntary day nurseries, and about 250,000 children currently attend nursery classes in local authority schools. There are also child minders and play groups. Therefore, we are talking about a great deal of child care, most of which is provided by the parents themselves.

To ask the Secretary of State for Social Services if he will make a statement on the future of St. Paul's eye hospital, Liverpool.

As part of its strategic objectives for improving the pattern of acute hospital services in Liverpool, the Liverpool health authority has drawn up plans to transfer to the Royal Liverpool hospital-Liverpool Royal infirmary site, ophthalmic services at present provided by St. Paul's eye hospital.

The population of Merseyside and, indeed, of the north-west region will regard the Minister's remarks this afternoon as an absolute disgrace in terms of patient care. The hospital has a national reputation and has served the region for many years. The Minister's remarks are indicative of the way in which the Government are treating the National Health Service. They give assurances about the service being safe in their hands, but the reality is that people are dying, hospitals and beds are closing and people are waiting for years for treatment. That is how the Government treat the Health Service that was built up by the Labour Government.

The hon. Gentleman's original question was about St. Paul's eye hospital. That is an old building, built in 1912, with no scope for further development. It is in rather poor condition, and the health authority proposes to re-provide all the beds in more modern facilities.

Representing, as I do, a constituency within Merseyside RHA, and bearing in mind the answer that my right hon. Friend gave to the original question, may I ask him whether it is correct that Liverpool has more hospital beds per head of the population than any other district in the Merseyside region?

That seems possible. In common with other regions, one of the difficulties that Merseyside faces is that of ensuring a proper distribution of its services. That is something that we have tried to help it with through the so-called bridging fund.

If these buildings in Liverpool, such as St. Paul's eye hospital, have to be pulled down because they have been up for a long time, when will the Minister start on this place?

To ask the Secretary of State for Social Services if he will propose measures to tackle recruitment problems in the National Health Service; and if he will make a statement.

Since 1978, direct care staff in England have increased by 76,000. Nevertheless, the Health Service is not immune to the recruitment difficulties experienced by many large employers, particularly in London and the south-east, and faces the same declining pool of suitably qualified school leavers as they do. No single solution exists to this problem, but we have recently announced a range of initiatives designed to improve recruitment and retention, on accommodation, grading structure and training.

Is my right hon. Friend aware that there are new facilities at Wexham Park hospital in my constituency that are not fully used because of difficulties in recruiting sufficient numbers of suitably qualified nurses, and that the high cost of housing in east Berkshire is one of the principal reasons for those recruitment difficulties? Will he consider moving away from national rates of pay to allow the payment of premium rates in areas of high housing costs to help overcome some of these recruiting difficulties?

I know of my hon. Friend's connection with Wexham Park hospital, and that a modest improvement in recruiting is taking place there. He will be pleased to know that, already, several Whitley council management sides are seeking to negotiate, with our support, pay and grading structures that will enable the NHS to use staff more flexibly and take account of factors such as skill shortages and the pay rates needed to recruit and train staff in local labour markets. I know that my hon. Friend and the staff will welcome that.

Does the Secretary of State agree that the greatest barrier to recruitment in the National Health Service today is the low morale of its staff, and that that low morale is based on their belief that the Government are not committed to the Health Service? What does the right hon. Gentleman propose to do to improve the morale of staff in the service?

Like the hon. Gentleman, who served the National Health Service well for many years, I gather—[Interruption.] I fully accept that he did. Like him, I recognise the problem of morale. However, I genuinely ask him and hon. Members on both sides of the House whether the morale of the service, which has existed for 40 years, and into which vast amounts of money have been placed, and continue to be placed, will be improved by the quality of debate that we have been having in the last few minutes. I doubt it.

Does my right hon. Friend intend to tackle the two great problems that exist in the north-west Thames area in particular, as well as in the south-west Thames area, of a declining percentage of those leaving school choosing to go into the nursing profession and the fact that, at the same time, there are declining school rolls?

My hon. Friend is absolutely right. The change in demography is one of the fundamental problems that we face. We are considering very carefully the UKCC project 2000 proposals, which is looking at ways of widening the entry gate for nurses as well as encouraging qualified staff to return to nursing. Obviously, at this time, it is important that we do all that we can to encourage that.

Will the Secretary of State express a view on whether the new subsistence payments will increase or reduce his recruitment problems? Is he aware, with the blood transfusion service, that that new arrangement will result in a cut of more than £10 a week for staff who are paid less than £100 a week? If that is so, is the right hon. Gentleman really surprised that the result of that arrangement has been to provoke outrage among those penalised? Will he reconsider this arrangement, which is patently unjust and is hitting hardest those who are lowest paid?

I am delighted that the hon. Gentleman has raised that point. The changes in entitlement to day subsistence, over which there has been some industrial action, formed part of an agreement that was entered into freely by the staff side. Nevertheless, the management side has today made it clear that it is willing to discuss the issue further if the staff side so wish. I imagine that that is exactly what the hon. Gentleman is saying. Therefore, I hope that the staff will accept that offer and, as the management has requested, take all possible action to prevent further industrial action in the meantime.

My right hon. Friend will be aware that a high proportion of qualified and trained nurses leave after a period of service to marry and raise a family. Is he satisfied that the NHS, in the same way as the private sector, offers re-employment conditions that are sufficiently flexible to attract nurses back after they have raised a family?

My hon. Friend is on to a very important point—the key issue of trying to attract trained nurses who wish to come back into the NHS. My hon. Friend will know—as hon. Members on both sides should know—that 7,100 such nurses did come back to the NHS in 1986–87. Clearly, I am not satisfied that we have sufficient incentives and sufficient flexibility within the management structure to ensure that a larger number of that pool of trained nurses is attracted back into the Health Service.

To ask the Secretary of State for Social Services what further protection he proposes for disabled claimants who will have a reduced entitlement in April.

Existing claimants will generally have transitional protection and thus no reduced entitlement next April. We are addressing the problem of a very small number of severely disabled people, capable of independent living, who claim after next April. We will be considering a long-term solution once we have the report of Sir Roy Griffiths on his overview of care in the community and the results of the OPCS survey on disability. In the meantime, I am considering how best to find an interim solution with the help of the voluntary sector.

Does the Minister realise that this prevarication on the part of the Government is causing tremendous anxiety among severely disabled people, who stand to lose £50 or even more come next April? That anxiety is manifest in a mass petition that those people are getting up to present to Parliament. How much longer are the severely disabled to be sacrificed on the altar of uncaring Thatcherism?

In the first place, no one is being sacrificed. We have until next April to produce this scheme and there is no prevarication. I am determined that a proper scheme will be produced and I believe that it is more important to get it right than to meet some artificial deadline.

Would my hon. Friend care to look at the length of time that elapses between claimants first putting in a claim and the result of that claim, perhaps after one or two appeals? At the moment the way in which the system works militates against the severely disabled, and it would be in everyone's interest if someone got his finger out.

I am as anxious as anyone, and certainly as anxious as my hon. Friend, to make sure that the procedures are dealt with speedily and completed. I believe that it is more important that we should get the answer right than meet artificial deadlines.

Does the Minister accept that this problem has existed for months and that if he is to introduce an interim solution surely he should be in a position to do so by now? Therefore, can the Minister give a categorical assurance that the interim solution will be in place and effective by 1 April?

It is certainly my clear intention that that should be so. If, by any chance, it were not in effect by 1 April, I would consider the matter carefully to ensure that any subsequent claims were back-dated to 1 April, but I intend to meet the needs of this small group of people in a flexible way by 1 April.

Does the Minister not realise that, since the problem was identified in 1985, a whole variety of solutions have been put forward and that every time they have fallen because of the Government's unwillingness to put in further resources? How do they square that with the claim that these so-called reforms will target help on those in greatest need, when the biggest single losers will be the most severely disabled?

The hon. Lady should give us credit for the extra resources going in next April to cope with the problems of the disabled as a whole. Over £60 million extra is going in to cope with the needs of the disabled. Give us credit for that. There is a small group of people who, because of the complexities of the existing system, will not be dealt with in the same way from April. I am determined to find a solution to that and I hope that I shall have the hon. Lady's support.

To ask the Prime Minister if she will list her official engagements for Tuesday 12 January.

This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall be having further meetings later today.

Does my right hon. Friend agree that the continuing strength of British industry not only reflects the success of her Government's economic policies but generates the resources that enable tax to be cut at the same time as spending on public services is being increased?

Yes. The Government's policies of sound finance and incentives for enterprise have led to seven years of successive growth and, now, falling unemployment. The prospects for the coming year, with the continuation of the same policies, are good.

When consultants in every area of medicine report that they are failing to meet urgent patient need, and when parents in so many cases are desperate because of the delays in urgent treatment needed by their children, will the Prime Minister tell us whether she thinks that the crisis of underfunding in the National Health Service is now over?

As the right hon. Gentleman is aware, an extra £100 million was announced just before Christmas, which brings the extra spending this year up to about £870 million, and there will be further extra spending on the Health Service next year. The Health Service on the whole has had greatly expanding resources. Indeed, it has expanded by 30 per cent. over and above inflation during the lifetime of the Government.

Life or death operations are being postponed, staff levels are dangerously low in many areas, and beds and theatres are being closed. What is the matter with this woman—[Interruption.]—that she does not make the response that is necessary for the parents, children and patients of this country? Can the Prime Minister not see, or will she not see, that her figures are absolutely useless to parents who are distracted by worry at having to wait for urgent treatment for their children? I ask her now whether she will commit the resources necessary to clear the deficit this year to prevent a crisis next year. Does she not care that people have to wait in pain without hope and without help?

The Health Service is expanding with extra resources, over 30 per cent. over and above inflation. The medical staff is expanding in numbers. The number of patients treated is expanding. The number of treatments is expanding. Operations are taking place that would have been impossible in the past few years. The right hon. Gentleman is referring to problems in the west midlands. He will have seen that a special statement was put out this afternoon by the chairman of the area health authority. May I also remind the right hon. Gentleman that the resources provided in his constituency area have greatly increased during the lifetime of the Conservative Government.

Has my right hon. Friend's attention been drawn to the appalling revelation in the press that certain doctors have been taking bribes from Asian women in order to carry out tests to establish the sex of the child, and, if it is a girl, arranging an abortion? While this is undoubtedly illegal, does my right hon. Friend agree that revolting practices of this kind, which are close to abortion on demand, should be denounced?

As my right hon. Friend is aware, the Abortion Act does not permit abortions on the ground of the sex of the foetus alone. Any evidence provided to my right hon. Friend should go to the Secretary of State for Social Services. It will be examined and acted upon, because allegations of this kind are and must be taken very seriously indeed.

To ask the Prime Minister if she will list her official engagements for Tuesday 12 January.

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

How does the Prime Minister explain the fact that, according to official statistics for 1986, this country, alone of all European countries, has seen an increase in infant deaths?

That is correct, up to the first year. There has been an enormous increase in the number of babies saved immediately at birth and during the first month after birth. We do not know the reason for that particular figure. It may well be that it is a statistical error. If the hon. Lady will look at the report of the Health Service, she will find a fantastic number of improvements in the Health Service that have taken place over this period.

To ask the Prime Minister if she will list her official engagements for Tuesday 12 January.

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

Will my right hon. Friend confirm that all the signs are that in 1987 Britain was top of the growth league among major economies and that a recent poll showed that 97 per cent. of leading industrialists believe that the Government's policies will lead to continuing economic improvement? If we continue to grasp the excalibur of enterprise, can we not continue to be one of the most successful economies in the world, with all the attendant political influence that that gives to the country?

I agree with my hon. Friend that our policies have gained the confidence not only of domestic investors but of overseas investors, who are anxious to come to the country. The growth, and the way in which we have tackled our problems, have meant that we have had far more influence abroad since the Government has been in power. It will continue to increase because of the way in which we have tackled our problems at home.

Does the Prime Minister recollect that in March last year she officially opened the Ysbyty Gwynedd, albeit the hospital had already been opened three years previously? Is she now aware that the authority is labouring under an accumulated underfunding of £2 million? What is she telling us, as Members of Parliament for that authority, to tell the people of Gwynedd, who are faced with substantially reduced services under the control of her Welsh Office?

I remember the visit very well. The hospital was working extremely well and both patients and medical staff were extremely happy with it. I do not recognise what the hon. Member is saying. Vastly increased resources for the Health Service have been provided for Wales, because under the policies of the Government we have had growth which has enabled us to have both tax cuts and increased resources for the Health Service.

To ask the Prime Minister if she will list her official engagements for Tuesday 12 January.

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

I refer my right hon. Friend again to the Ministerial and Other Salaries Order 1987, which took effect on 1 January. In view of the disgraceful scenes in the House yesterday and the continuing inability of the Opposition Chief Whip to—

Order. That is not the responsibility of the Prime Minister.

In view of the—

Name him.

Order. The hon. Member cannot ask a question about the actions of the Opposition Chief Whip.

May I ask my right hon. Friend whether she believes, in the light of what occurred yesterday afternoon, that the salaries payable under the order can possibly be justified?

The salaries under the order have passed through the House and no one has any power, short of there being another motion, to change them. I agree with the spirit behind my hon. Friend's question. As this is the mother of Parliaments, we in this House have a very heavy responsibility for the way in which we conduct our proceedings, and a heavy responsibility always to support Mr. Speaker in the excellent way that he carries out his task.

To ask the Prime Minister if she will list her official engagements for Tuesday 12 January.

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

Will the Prime Minister take time in what remains of today to consider whether her Ministers may have inadvertently misled Parliament in 1982 when they reported to the House that the inquiry by Sir George Terry in relation to the Kincora boys' home would be fair and impartial? In order to do so, will she ask to see the confidential Sussex police files concerning investigated allegations linking Anthony Blunt with several promiment figures in Northern Ireland, who escaped prosecution for their crimes because, had a prosecution been brought, it would have revealed the immunity granted to Anthony Blunt? Were her Ministers aware when they appointed Sir George Terry, who was chief constable of Sussex, that his officers had been involved in this cover-up?

Prosecution is not a matter for me. It is a matter for the prosecuting authorities. If the hon. Gentleman has any new evidence, he should present it to them.

In the light of the many cases of alleged child abuse, will my right hon. Friend base her social policies firmly on the need to strengthen family life and to educate young people for parenthood, rather than give greater control of children to social workers and doctors? While retaining penalties for those who mistreat children, will my right hon. Friend recognise that the upbringing of children is a matter for parents?

I agree with my hon. Friend about the importance of family life and the lessons that are learnt at home. He links his question to child abuse, but he will be the first to know that this presents very sensitive problems to social workers and other people who have to decide when to go into a home because they think that a child is being abused, neglected or ill-treated. It is not an easy question for anyone to answer, but it is supremely important and involves social workers, legislators and neighbours.

To ask the Prime Minister if she will list her official engagements for Tuesday 12 January.

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

I am sure that the Prime Minister will want to assure the House that she is concerned about the protection of public health standards, particularly in relation to the prevention of AIDS and cervical cancer. Will she therefore assure us that she will not allow the back-door privatisation of pathology laboratories in order to save money, and that she will make sure that the protection of standards is the most important, indeed the only, issue that she is prepared to consider?

The protection of standards applies equally to the public and private sectors. It is the protection of standards that is important, not whether things are carried out in the public or private sector. If they can be carried out with better value for money in the private sector, that releases more money for more health care.

During the course of the day, will my right hon. Friend take time to consider material that she will have gathered from her highly successful tour of Africa? Is she aware that the vibes coming to those of us who recently visited Kenya suggest that it was an enormously valuable visit in assisting President Moi to deal with the difficult problems of containing racism and tribalism?

I am grateful to my hon. and learned Friend. It was an extremely interesting and valuable visit. Kenya and this country have a very friendly relationship. We give considerable aid to Kenya, something of the order of £50 million. One was able to see the excellent use to which that was put and the very good way in which that country is run.

To ask the Prime Minister whether she has any plans to pay a further visit to Newport, West.

I have at present no plans to do so.

Is the Prime Minister aware of the deep public anxiety felt by the people of Newport, West about the possibility of a new nuclear power station being added to the most crowded nuclear park in Europe, with eight nuclear reactors within a 25-mile radius of 241/4 million people? Is the Prime Minister aware of a statutory instrument which was introduced on the final sitting day before Christmas which will severely restrict the ability of the 8,000 protestors to present their case as fully and fairly as they could have done in the past? What action will the Prime Minister take to guarantee the right of protestors to present their case without obstacle or obstruction and with sufficient time?

I think that the rights of protestors at any planning inquiry in this country exceed those in almost any other country. They are considerable. Any difficulty or protest should be presented either to the inquiry or to my right hon. Friend the Secretary of State.