To ask the Secretary of State for Education and Science what recent representations he has received concerning clauses 82 to 113 of the Education Reform Bill, relating to further and higher education, as they affect Scotland.

Of those mentioned, only clauses 92 and 94, which deal with the new Universities Funding Council, extend to Scotland. We have received a number of representations about these provisions, though none specifically on their effect in Scotland.

I am sure that the Minister is well aware of the distinctive and historic traditions of Scottish universities, not least their diverse courses and four-year honours degree courses. What assurances can he give Scottish universities that the Scottish committee of the UFC will have scope and independence to allow that diversity and historic tradition to continue and that they will not be brought into the role of English universities?

It is good to hear the hon. Gentleman marching towards the sound of gunfire with his colleagues. Let us hope that he does not end up as red meat.

The hon. Gentleman is well aware that the relationship between the Government and the universities is conducted on an arm's length principle through the University Grants Committee, and will be, in future, through the UFC. It will be for those institutions to determine their policy in the organisation of universities in Scotland, as it is throughout the rest of the country.

Will my hon. Friend bear in mind that Scots do not take lightly the differences between our universities and those south of the border? We are proud of the four-year courses that we run in Scotland. All the evidence shows that they have been beneficial to those who have undergone the courses. More important, we should like to retain the independence that has existed in the past.

My hon. Friend is perfectly right about the value of Scottish universities. Indeed, three out of eight were rated above average by the UGC during recent research exercises. The Government recognise the special position of Scottish universities and their four-year courses by virtue of the fact that in Scotland one third more is spent per student than in England and Wales.

The Education Reform Bill will have an effect on Scotland. What guarantee can the Minister give with regard to the discussions involving Stirling, Dundee and St. Andrew's? If one of those parties fails to agree on proposals about sharing courses, what will be the effect of the clause on funding and the taking back of funds by the UFC, and will it apply in the new circumstances?

The present position will continue after the Bill is enacted, assuming that it is. There will be an arm's length relationship between the Government and the universities. It is up to the UGC—in future, the UFC—to to organise provision, in agreement with the universities.

Will the Minister explain why Scottish universities have done particularly badly under this Conservative Administration? Why have Scottish universities had a cut in resources of 20 per cent. between 1983 and 1987, while the rest of United Kingdom universities have had an average cut of 12 per cent.? Under the proposed legislation, how will he ensure that Scotland is adequately represented on the university body, and how will he get co-ordination between the UFC and central institutions to ensure that higher education right across Scotland is co-ordinated?

The Government have agreed that there should be a Scottish committee of the UFC, and one of its tasks will be to consider co-ordination with the central institutions. I have always understood that the Labour party was a national party—or at least that it intended to continue to be so. We are pursuing a national policy, as did the Labour party when in government. The UGC applies national criteria evenly and fairly to all university institutions throughout the country.

How can the Minister reconcile the UGC's statement that universities should recruit 900 new members of staff per year when financial stringencies are forcing them to draw up plans for 2,500 redundancies? What is his response to Sir Alwyn Williams, the principal of Glasgow university, who last weekend spoke about the disinherited generations of the next two decades, the scholars and researchers who, under this Government, and I quote—

Order. No quotations at Question Time.

Sir Alwyn Williams said that we were heading down the road to mediocrity.

In the past two years the Government have increased expenditure on universities by 18 per cent. We have specifically responded to redundancies by providing £155 million to be spent on restructuring over the next three years.

To ask the Secretary of State for Education and Science what plans he has to increase the level of nursery provision; and if he will make a statement.

None. My right hon. Friend has very recently restated the Government's policy on the education of under-fives in his memorandum on the report of the Education, Science and Arts Committee in the previous Session, which the House will remember was entitled "Achievement in Primary Schools".

I am sure that the majority of hon. Members appreciate the importance of nursery provision to future education and social development. Is it not deplorable that only 23 per cent. of our children get nursery provision? Will the Minister explain what provision he intends to make, bearing in mind that in 1972 the Prime Minister promised that by 1982 there would be nursery provision for 90 per cent. of our children? Is it not deplorable also that the Government hide behind the record of Labour local authorities that provide nursery provision—[HON. MEMBERS: "Too long".]—Not long enough. The 10 best performers are Labour-controlled local authorities and the worst 10 are Tory-controlled.

I ask for brief questions.

I remind the hon. Gentleman that provision and demand in the nursery sector are discretionary. Nevertheless, most education authorities are gradually increasing provision. At present there are 272,000 children in nursery schools or classes, and that is the highest number ever reached.

To ask the Secretary of State for Education and Science what recent representations he has received concerning the funding of the University of Wales colleges; and if he will make a statement.

About 500 letters have been received since the middle of last year, concerning principally the rationalisation of provision at Bangor and Cardiff. Apart from additional special allowances made for Welsh medium teaching and for the University Registry, the Welsh colleges are funded on precisely the same basis as all other university institutions in Great Britain.

Although there is a general welcome for the establishment of a Welsh committee of the University Funding Council, there is concern that the University of Wales is suffering worse cuts than universities in other parts of the United Kingdom. Will the Minister assure the House that that funding imbalance will be borne in mind when the allocation of resources is made to the University of Wales, bearing in mind the special needs arising from, first, the teaching through the medium of the Welsh language, secondly, the federal nature of universities in Wales and, thirdly, that departments tend to be smaller because of the nature of the colleges?

I have already mentioned the special factors that are taken into account by the UGC in its allocation to Wales. It is the policy of the Government, and indeed of most parties in the House—I know it is not the policy of Plaid Cymru, of which the hon. Gentleman is a member—that there should be a United Kingdom national policy for our universities. The University of Wales and its constituent colleges are treated in exactly the same way by the UGC as all the other university institutions in the country. The hon. Gentleman does no service to the University of Wales by asking for special pleading, especially when the University of Wales Institute of Service and Technology, Lampeter and the College of Medicine are rated above the average.

The proposal to close the education department at University college, Cardiff has absolutely nothing to do with education, but rather with Government cost cutting. Indeed, a report from the Minister's Department gave it an extremely good rating.

The hon. Gentleman must understand that the Secretary of State fixes the number of students required for initial teacher training, but the distribution among the universities is determined by the UGC. One of the paradoxes of the situation is that the Government are accused of taking centralising powers by the very people who constantly press us to intervene to direct the universities.

To ask the Secretary of State for Education and Science if he will list in the Official Report information available to him on those developed countries that do not test school pupils for literacy at some stage before the completion of compulsory schooling.

All developed countries have school-leaving examinations which reflect literacy skills. The assessment and testing arrangements to be established within the national curriculum will monitor pupils' language attainments at the key educational stages.

Does my right hon. Friend agree that the combination of that answer and the recent publication of the report of the Task Group on Assessment and Testing —the TGAT report—shows the spurious nature of the campaign that is being carried on by the Opposition parties and the teachers' unions in attacking the concept of testing, which is recognised throughout the rest of the world as an essential part of the educational process?

I am grateful to my hon. Friend for his support of the TGAT report—Professor Black's report — published last week. That report recommended assessment and testing at the key ages of 7, 11, 14 and 16. Our proposals on testing and assessment were supported in that report, and I wish to emphasise the importance of tests to determine a child's ability at those ages. If one cannot determine whether a child has literacy skills and can decipher a page of writing when he is seven, he is likely to suffer throughout his education.

Is it not the case that in other developed countries pupils at independent schools are also tested?

The right hon. Gentleman will know that the independent schools' courses are very close to the national curriculum and that those schools usually have tests and examinations on a much wider scale than we envisage for state-maintained schools.

Is it not right that all parents should be able to expect their children at least to be able to read, write and do basic mathematics when they leave school? How can we be sure that teachers are on their toes and that children are making progress towards that end unless we test?

My hon. Friend is right in saying that we want children to be able to do all those things. Let me say a bit more about the subject. Those are the basic skills which represent the core subjects in our national curriculum. It is true that children have to be assessed and tested, which is exactly what the TGAT report says.

Will the Secretary of State tell us what measures he will take to guard against cultural bias in the tests?

The Black report refers to these matters. I am sure that the hon. Gentleman has seen the ILEA report of research undertaken before Christmas relating to the achievements of black Afro-Caribbean children in London. One thing that was discovered—and this comes as no surprise — is that many of the black Afro-Caribbean children were much more motivated to do well at school than many of the white children. They got lower grades because they lacked basic skills, and that is one of the reasons why we have put basic skills right at the heart of the national curriculum.

Does my right hon. Friend agree that if a child is not achieving basic standards of literacy his parents have a right and a duty to find that out? Politicians and others who would stand in the way of that process do a grave disservice to children, parents and, indeed, the future of the country.

The report makes it clear that information about the assessments and tests should be made available to the child concerned—although the results should not be published so as to identify the child—to the teachers and to the child's parents, so that the necessary action can be taken. The right of a parent to know precisely how his or her child is doing is a fundamental necessity of education.

Given that TGAT, under the chairmanship of Professor Black, casts doubts on the validity of publishing assessment results of children aged seven, will the Secretary of State give a categorical assurance that the Government will not enact legislation to force schools to publish the results of such assessments, or are we to have a totally divisive and competitive system?

The hon. Gentleman will know from our debates in Committee that we broadly welcome the report, whose proposals are out to consultation. Professor Black's team made the point that there should be assessment and testing at the age of seven. It also said that to publish results as a judgment upon the school would not be entirely fair, and I acknowledge that there is some strength in that argument. However, it is important that the results of the tests and assessments at the age of seven should be made available to parents so that they may know how their child is doing in relation to national standards.

To ask the Secretary of State for Education and Science what recent representations he has received regarding the national curriculum.

When the Education Reform Bill received its Second Reading, we had received a total of 9,300 letters on our national curriculum proposals. Since then we have received about 660 letters from individuals and organisations on the same subject.

Will my hon. Friend inform the House of the number of representations that have been in favour of the national curriculum?

It is difficult to say how many haw been in favour. However, our statistics can point out the way in which some of the responses were opposed. For example, we analysed the 1,312 responses from organisations on a simple basis and, in principle, only 94 were opposed. My hon. Friend will be happy to know that of the 11,790 individual responses, only 1,536 were opposed in principle.

Has the Minister had an opportunity to read the new clause that has been tabled to the Education Reform Bill, which asks the Government to set up an Arts Education Council to promote the arts in education as part of the national curriculum? Is she aware of the great concern felt by parents, educationists and artists about the position of the arts in the national curriculum? Will she look again at the new clause and see it as a constructive way forward for promoting the arts in the curriculum?

We have not yet had time to consider the proposed new clause to which the hon. Gentleman referred. However, he will know that art and music form part of the foundation curriculum that we are proposing.

Does my hon. Friend accept that the proposals for the national curriculum will be welcomed widely by parents, who will see them as having particular relevance to the world of work? Does she further accept that many employers will welcome them because the national curriculum will help to bridge some of the gaps that have shown up in education and caused problems in industry when young people have entered business and commerce?

I am grateful to my hon. Friend for that question. Many parents are anxious to know how their children are doing. The national curriculum will assist them in that process throughout a child's school career.

Many employers have complained that some of the young people who have left school at the age of 16 and gone straight to work have not covered sufficient subjects during their education as it stands at present. The national curriculum will go a long way towards remedying that situation.

Having grossly underfunded the introduction of the new general certificate of secondary education, will there be a similar denial of resources to schools to accompany the introduction of the national curriculum?

I must advise the hon. Gentleman that the GCSE is one of the best resourced examinations ever to be introduced in this country. It was supported on a continuous basis through its pilot schemes, and when it was first introduced by several millions of pounds, so the hon. Gentleman's accusation is unacceptable. The national curriculum proposals are being looked at as a pilot programme.

Are Ministers succeeding in removing the anxieties of religious bodies and individuals, who fear that religious instruction may be squeezed and suffer when the core curriculum is introduced?

My hon. Friend knows that we are taking great care to respond to the concern of many people about the place of religious instruction in schools. Therefore, we have taken steps in our national curriculum proposals to strengthen the place of religious education in the school curriculum by strengthening the methods by which parents may have redress if they feel that religious instruction is not taking place as it was intended it should in the Education Act 1944.

To ask the Secretary of State for Education and Science how many representations he has now received on his proposals for schools to opt out of local education authority control.

I have received well over 900 written responses to my consultation paper from a wide range of sources, together with a variety of less formal representations.

Does my right hon. Friend agree that a balance must be struck between providing parents with the type of school that they want for their children and the creation of establishments, the outcome of which may well be further fragmentation of society — for example, a Scientology school? Will my right hon. Friend assure the House that he will take account of such dangers in reviewing opted-out schools?

My hon. Friend will know that grant-maintained schools will not initially be allowed to change their character. We intend to table amendments to the Bill to ensure that any proposal to change the religious ethos of a school is equivalent to a significant change in character, and such a change would be subject to full public procedures.

Is the Secretary of State aware that there is deep worry throughout the education community, and well beyond it—among parents—about the opting-out process? Is it not seen by many to be a blow struck at the local education authorities, which have been built up by a process of democracy over 100 years? Is it not an attempt by the Government to introduce private education by the back door?

The hon. Gentleman knows, because he is a member of the Standing Committee on the Bill and we are just reaching the relevant clauses, that the proposal for grant-maintained schools is designed to increase the choice available to parents. Many parents, I believe, will want to exercise that choice. There is nothing compulsory about it, and if parents and governors wish to come together and persuade the Secretary of State that a school should be grant-maintained, I see no reason why that should not be allowed.

Does my right hon. Friend agree that it was a tragic day for education when Mrs. Shirley Williams, then a member of the Labour Government, got rid of direct-grant schools? Will not the opt-out system restore that principle, not only for bright children, but for a wide educational and social range?

I think that many issues will be laid at the door of the right hon. Lady, who was one of my predecessors when a member of the Labour Government. Not only did she destroy the direct-grant schools, but she tried to legislate to destroy the grammar schools. We stopped that in 1980.

Grant-maintained schools will not be directly analogous to direct-grant schools, but they will provide a wider variety and choice for parents. That is the choice that we want—for comprehensive, grammar, secondary modern, Church and independent schools, and now for city technology colleges and grant-maintained schools as well.

The Secretary of State will know that there is deep concern that, while the decision to opt out will be made by a majority of parents voting, that could nevertheless represent a very small minority of parents in the school. Will he say how many representations he has received from his own Back Benches, and what he intends to do about it?

I know that the whole House is waiting with bated breath to know exactly what the new Liberal policy is on these matters. Until the last week or so the hon. Member for Caithness and Sutherland (Mr. Maclennan) was putting forward a policy in favour of schools opting in, and he has also said that he wants them to opt out. We should like to know the answer.

When it comes to the proportion of parents voting, 51 per cent. is indeed a high hurdle. No Government since the war have been elected with such a high vote.

Is not one of the causes for a school to consider opting out the proposal by a local education authority to close a popular school whose numbers have been artificially restricted and which has been deliberately underfunded by that authority? Although my right hon. Friend cannot comment on such proposals until they reach his desk, can he confirm that he is naturally sympathetic to such schools?

I know what is behind my hon. Friend's question, and I certainly cannot comment upon it. However, if popular schools have been underfunded, other measures in the Bill will improve that as well. It is absurd to have empty desks in popular schools, and our open enrolment clauses will put paid to that practice. Obviously, many different types of school in many different circumstances will want to consider grant-maintained status, and my hon. Friend may well have identified one such circumstance.

Will the Secretary of State confirm that the overwhelming majority of the 900 responses that he has received have been opposed to the opting-out proposal and anything like it? Is the weight of opposition to the proposal the reason why the Secretary of State is rigging the balloting arrangements, so that a very small minority of parents can determine the long-term future of a school?

A figure of 51 per cent. of those voting is indeed a very high hurdle in any ballot. If the hon. Gentleman is saying that our proposals are not popular, he should recall that a Gallup poll last October indicated that 1 in 5 parents are interested in opting out. According to the most recent poll, that has risen to 1 in 3.

Can my right hon. Friend say whether there will be established criteria for opting out, or whether each case will be looked at entirely on its merits, much as a section 12 notice?

I envisage each one being looked at on its merits.

To ask the Secretary of State for Education and Science if he will make a statement on the state of academic research in United Kingdom universities.

The volume and influence of Britain's academic research is second only to that of the United States of America with its vastly larger resources. We are currently reviewing our policies for the science base so as to ensure that this national strength is maintained and enhanced into the 1990s and beyond.

Does the Secretary of State agree that this is unacceptable in view of the role of the University of Wales in the Welsh economy, with Wales getting only 1·8 per cent. of research council spending, although it has 5 per cent. of the population of the United Kingdom? Will he accept that already, to make up for the deficit in research spending in Wales, additional expenditure of at least £20 million is required? Will he address the subject as the Minister responsible for higher education and for the research councils?

The hon. Gentleman should not be so disparaging about the quality of research in Welsh universities. In the UGC's survey Cardiff was considered to be outstanding in research in mathematics and mechanical engineering. The university nearest to his constituency, Bangor, was above average in oceanography and biomolecular electronics. The amount of research money that is devoted to individual departments depends upon their excellence. The excellent ones will attract more. That is really the whole thrust of the recent change in research funding.

Will my right hon. Friend ensure that there is proper co-ordination between the universities that are doing research into the atmosphere and the ozone layer?

Yes. Important work is being done in individual university departments on these matters. The National Environmental Research Council also has programmes in these matters and has to some extent a coordinating role in them.

Can the Secretary of State explain why the morale of so many academics who are doing such excellent research is so low? Why do the Government seem only to approve of research only if it confirms their economic and political prejudices? Is it not essential that the Government pay full tribute to all our academics and build up their morale, because successful research is essential for the intellectual development of the nation.

I have tried to show my support for British science by securing an increase above the rate of inflation for next year of 6·2 per cent., from £658 million to £699 million. There were three reports on the brain drain last year which all showed that the brain drain had not worsened in 1987. I was glad to see that. By concentrating research in greater centres of excellence, which is a generally agreed policy, I think that we will get better research and more satisfied researchers. [Interruption.]

I ask hon. Members to listen to the questions and the answers. Please let us have both brief questions and answers.

To ask the Secretary of State for Education and Science whether he proposes to make any changes in the funding of places for part-time students in colleges of higher education.

The allocations of recurrent funding to polytechnics and colleges in 1988–89, announced by my right hon. Friend on 18 December, provided enhanced funding for students enrolled on certain evening courses. If the Education Reform Bill becomes law in the current Session, decisions about the funding of part-time students in polytechnics and colleges in 1989–90 and beyond will be a matter for the new Polytechnics and Colleges Funding Council.

In view of what my hon. Friend has said about the freedom of the new funding body to determine appropriate multipliers, why have the existing inadequate multipliers been enshrined in schedule 7 to the Education Reform Bill? Does that represent the Government's assessment of an appropriate level of funding?

There has been some misunderstanding of the point. This is a welcome opportunity to make it clear. The Bill sets up the Polytechnics and Colleges Funding Council. It is required, therefore, to set criteria for the entry into the new sector of institutions. Among those are criteria relating to student numbers. When computing numbers, the question is how to count part-time numbers. That is the simple function of schedule 7, and it has no other function.

I had looked for a more hopeful answer from the Minister. Encouraging more people, particularly women, back into education demands a funding system that enables them to afford to do it. Will the Minister commit himself to working out ways in which more of our adults, particularly women, will be able to enter higher education?

There was a review last year of part-time students by the National Advisory Body. It is likely that the new Polytechnics and Colleges Funding Council will wish to review the matter. Meanwhile, may I say to the hon. Lady that the proportion of women in full-time university or higher education rose from 1979 to 1986 from 38 to 42 per cent.

Will the Minister re-examine help to part-time students, bearing in mind that over the past year some people have used their time profitably to study, but that under the new social security regulations, it is not likely that they will get grants for study?

The Government attach great importance to part-time study, and I shall certainly look at the point made by the hon. Gentleman.

To ask the Secretary of State for Education and Science what are the implications of his policy for scientific research of the concept of curiosity-motivated research, adumbrated by Dr. Max Perutz FRS; and if he will make a statement.

We are reviewing our policies for the science base in the light of the Advisory Board for the Research Council's recommendations on strategy and our wide-ranging consultations on those. This includes consideration of what the ABRC, Dr. Perutz and others have said about the need to support curiosity-motivated research.

Whose side of the argument are Ministers on at this stage; that of Sir David Philips, or that of Dr. Perutz?

The Government are still listening to the various voices speaking on the matter. We are considering proposals made by the ABRC, and extensive representations made by numbers of other people. We have not yet reached any conclusions in the matter.

Is my hon. Friend aware that what principally concerns my eminent constituent Dr. Perutz is the ludicrous concept put forward by the ABRC of three tiers of universities, the last of which would have no research at all? Is my hon. Friend aware that a university without research is a contradiction in terms, and can he categorically state that Her Majesty's Government will have nothing whatever to do with this nonsense and will reject this advice?

There is no doubt about the importance of the ABRC's advice that there is a need for continuing selectivity and concentration in our research effort. On the particular way of approaching that, for example by way of a multi-tier structure of universities, that is a question of the means of approaching the objective of selectivity. The Government are of course considering the proposal, but it does not necessarily follow that that is the appropriate way of doing it.

Does my hon. Friend agree that all good scientific research is based on curiosity and that the vast majority of scientists are motivated? Therefore, if he continues to support the science base, as he has indicated he will, will he concede that he will, therefore, by definition, be supporting curiosity-motivated research?

There is a requirement for curiosity-based research. Fundamental research is, as it were, the header tank that feeds applied research. That is why the Government support basic research, for example by a 6·2 per cent. increase in research council funding this year.

While the Minister argues for selectivity in research, has he concluded that there will be universities without research activities and functions, and if he has come to that conclusion, does he find that acceptable for any of our universities?

The Government have reached no conclusions in the matter. The principle of the necessary presence of research in university institutions is one that the Government understand, although I must point out to the hon. Gentleman that more than half the students in higher education in this country are educated in institutions whose mission does not embrace basic research.

To ask the Secretary of State for Education and Science what representations he has received from Leicestershire concerning the Education Reform Bill.

The Department has received about 70 representations from organisations based in Leicestershire, and many others from individual correspondents. All representations, except for those from individuals, have been placed in the Library of the House.

Is it not right that the vast majority of representations made from the county of Leicestershire, including the representation of the Conservative-controlled Leicestershire county council, are powerfully and vigorously against most of the recommendations in the Bill? Is the Bill not regarded by most people in the county as divisive, removing or reducing local powers and doing nothing whatever to assist the education authorities and other groups to meet the growing needs created by the cuts that the Government have imposed on our county?

The hon. and learned Gentleman will be disappointed to know that the representations that we have had have been nothing like as categorical as he has insisted they are. Indeed, the majority of the representations that we have had may have objected parts to some of our reform Bill, but they have accepted other parts. No such categorical statement on the whole of the Education Reform Bill as he suggests has been received by the Department.

Is my hon. Friend aware that in fact Leicester county council is controlled by the Labour party and the alliance together, not by the Conservatives, as the hon. and learned Member for Leicester, West (Mr. Janner) said? Is she also aware that that council does not allow parents to send their children to local education authorities in other areas, across the border, as it were? Has she had any representations from parents who find that there are schools just 100 yards down the road to which they cannot send their children, but instead have to send them sometimes seven miles or more to school? Has she had any representations requesting inclusion in the Education Reform Bill of freedom of choice across borders?

Our proposals within the Education Reform Bill on the matter of open enrolment will certainly mean that parents will have an opportunity of ensuring that they get the school of first choice for their children. This is an extremely important principle of freedom of choice for parents. I am a little surprised to learn from my hon. Friend that the authority is not allowing children to cross boundaries, because it is my understanding that there is the ability for children to cross boundaries under present legislation.

To ask the Secretary of State for Education and Science whether he will give the proportion for each year since 1979 of (a) girls and (b) boys taking O-level mathematics, craft, design and technology, and physics, who obtained grades A and B.

Over the period 1978–79 to 1985–86, the percentage of school leavers in England who had gained grades A-C in GCE O-level and grade 1 CSE has shown an increase in mathematics, craft design and technology and other science, and physics. Since 1978–79 more boys than girls have gained a higher grade in each of these subjects, but the proportion of those doing so has increased at a faster rate for girls than for boys. I shall publish the information asked for in the Official Report.

I thank the Minister for that answer. I hope very much that he shares my concern that boys are still achieving more highly than girls in science and mathematics subjects. Given that there is evidence, in mixed schools particularly, that there is an apparent lack of interest in and aptitude for science in girls as compared with boys, and given that the national curriculum will make those subjects compulsory for all, what specific plans does the Minister have to ensure that interest in those subjects by girls is encouraged and to help teachers avoid the presentation of science as a masculine pursuit?

We have specifically asked the mathematics and science working groups that are advising on

To ask the Secretary of State for Education and Science whether he will amend the student awards regulations so that married women are no longer dependent on their husband's income for grant purposes; and if he will make a statement.

No. The Government consider that, where the husband or wife of a student has the means to contribute to the student's maintenance costs, it would be wrong to increase the share of those costs which is borne by the taxpayer.

Does the Minister realise that the discriminatory nature of the present system prevents many mature women from returning to higher education? Does he not think that it is time for a change in the present system?

I must point out to the hon. Lady that there has been a substantial increase in the number of women university students between 1979 and 1986, from 38 to 42 per cent. It is a basic principle of the system of attainment targets and programmes of study to bear in mind that the curriculum should provide equal opportunities for boys and girls and to consider In their work the expectations and aptitudes of girls with regard to those subjects.

Does my hon. Friend agree that what is important about children's examination results is not the gender of the children but the authority to whose schools they go? Some of the highest spending authorities in this country have the worst examination results.

My hon. Friend is entirely right. Our proposals in the Education Reform Bill will, of course, bite on all education authorities, irrespective of their political nature.

Following is the information:

Information is not available in the form requested. The proportion of school leavers in England who had gained a higher grade at O-level or CSE in mathematics, physics or CDT and other science is shown in the following table:

To ask the Prime Minister if she will list her official engagements for Tuesday 19 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 this afternoon. This evening I am speaking at the Britain-Australia Society's bicentennial celebration at the Guildhall.

Will my right hon. Friend find time today to consider the many opportunities that could exist, but which are not being made available to volunteers of all ages, to assist the public services? Will she ask her Ministers to reconsider the work of their Departments to make available more opportunities to the many thousands who would like to contribute on an organised basis?

I agree with my hon. Friend that voluntary work has a great deal to contribute to our community life, and I think that the number of voluntary organisations is one of the characteristics of life in this country. I know how much voluntary work contributed to the clearance after the recent hurricane in my hon. Friend's part of the world. I shall, of course, ask Ministers to consider the matter again to see if they can do more.

If, as we are told, the Government have the money to cut taxes, why do they not the money to cut the waiting time for those children now in urgent need of vital operations?

The number of children being treated now, particularly for cardiac surgery, has increased enormously. Indeed — [Interruption.] — for every five cardiac operations that were carried out up to 1979, about eight or nine are carried out now.

May I say to the Prime Minister, in the words of Mr. Steve McCallum, a member of the west midlands "Young at Heart Campaign" yesterday that

"We are not political."—

[Interruption.] The parents of children needing cardiac operations will have heard Conservative Members laughing at those words. They continue:

"We are fighting for the lives of children. Children's lives are more important than party politics. We don't want to hear figures and statistics quoted for this year and that year. What we want is a National Health Service, a Birmingham Children's Hospital and the best service they can get."

Did the Prime Minister refuse to see Mr. McCallum and other parents and their children yesterday because she knew that if she did she would hear home truths like that?

I shall give the right hon. Gentleman the figures that he does not want to hear. He does not want to hear them because they are so good. Cardiac operations at the Birmingham children's hospital are up by 86 per cent. since 1978. In 1978 there were 155. In 1987 there were 288. The right hon. Gentleman says that he does not wish to use these matters party politically. That is the record. May I point out that one of the cases that were prominent in the House last week—that of Matthew Mulhall—was also mentioned again on Friday and it was pointed out that Matthew had a leaking heart valve and that his consultant advised his parents that it would be

"best to allow him to grow so that the largest possible replacement heart valve can be used."

It was envisaged that his operation would take place in four to six months' time. Finding the facts did not stop people falsely raising that case in the House.

Does my right hon. Friend agree that the £10·5 million of taxpayers' money being spent on the Commission for Racial Equality, the £3·4 million being spent on the Equal Opportunities Commission and the £2 million being spent on courses for trade unionists at our colleges would be better spent on the nation's health?

It has been our policy to do as much as we can to see that there is equality of opportunity in Britain, but I am sure that my right hon. Friend the Chief Secretary will have heard my hon. Friend's very effective question.

To ask the Prime Minister if she will list her official engagements for Tuesday 19 January.

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

As tourism is the fastest growing industry in the world, will the Prime Minister confirm that funds will be available for the British tourist industry, and, indeed for the north-west of England, which is the most beautiful part of Britain? When the Prime Minister replies, will she smile? I have been here seven months and I have never seen her smile yet.

I agree with the hon. Gentleman that tourism is an important and growing industry. Last year it helped to create 44,000 new jobs. My right hon. Friend the Secretary of State for Employment has announced that support for tourism will increase next year by 9 per cent., bringing the total up to nearly £50 million. Allocations to the regional boards, including the northwest, are now being considered.

Has my right hon. Friend noticed the report in The Times today about an unemployed man who started out with the enterprise allowance with a zero turnover, but who, in the space of nine months, has increased that to £560,000 a year? Does that not prove that under her Government enterprise is thriving in Britain and will continue to do so?

I am aware of that case. The enterprise allowance has been an enormous success and has enabled many young people to start up in business on their own, creating not only jobs for themselves but for many others, showing that enterprise and vitality are still very much present in Britain's young people.

To ask the Prime Minister if she will list her official engagements for Tuesday 19 January.

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

Exactly why would the Prime Minister not meet the parents of children who came to see her yesterday about their children's urgent and desperate need for heart surgery?

We do not normally receive petitions. There are quite a large number. As the hon. Gentleman is aware, we usually carry out between eight to 11 engagements in one day. There was a most excellent debate late on Friday afternoon on the Birmingham children's hospital, which met most of the points that were raised by the parents.

If I were to—[Interruption.]

Order. Mr. Dickens.

If I were to ask my right hon. Friend to give the House the recipe for the splendid performance of the British economy, what main essential ingredient would she list?

If my hon. Friend will allow me two, not one, I would say—[Interruption.]

Order. It is a perfectly legitimate question.

If he will allow me three and not one, I suggest: sound financial policies each and every year, the right legal framework, and incentives to enterprise.

To ask the Prime Minister if she will list her official engagements for Tuesday 19 January.

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

Will the Prime Minister take time today to study the representations made to the Government by the Irish Government and the European Commission about a proposal by the CEGB to undertake a test in Trawsfynydd power station in my constituency on 12 February, which will include operating the reactor without the normal cooling procedures? Will she respond to those representations and clearly tell the Secretary of State for Energy and the CEGB that such a test does not pass the test of community acceptability in the community that surrounds the power station? If she or the Government allow that test to go ahead, would she, because of her great commitment to nuclear power, like to attend the test and supervise it in person?

Much better than that, as I am sure the hon. Gentleman will agree, the test will take place only with the full approval of the independent Nuclear Installations Inspectorate, and will be monitored by it. It will be carried out only after the reactor has been fully shut down for its statutory inspection. All automatic safety systems will be operating normally. No safety systems will be cut off. I understand that there have been two similar tests in the past.

Will my right hon. Friend cause strong representations to be made to the American Government for allowing Seamus Twomey, a former chief of staff of the IRA, to be feted at a banquet in New York for raising funds for Noraid?

I am aware of my hon. Friend's strong views. I think we all feel strongly about this, but the American Administration and President have been forthright in condemning anyone who pursues violence as a way of achieving a political objective. The President has done everything possible to make it clear that that is wholly unacceptable.

It is—[Interruption.] It is always good to see enthusiasm. Is the Prime Minister aware that tomorrow a delegation of Scottish local authorities is coming to the House to protest at the sheer cost of introducing the poll tax north of the border? Is she aware that the £12 million that the Government have given in no way meets the £25 million of the cost of the administration? Would not that money be better spent on the Health Service in Scotland?

The community charge is a way of paying for local government which properly distributes the payment over a wider number of people. In fact, it meets only about a quarter of local expenditure. As the right hon. Gentleman is aware, the other three quarters is met by industry and the taxpayer.

The enthusiasm that the right hon. Gentleman heard expressed was because we thought he might be asking, or telling us, about his policy.

When my right hon. Friend considers the Government's much-awaited reform of section 2 of the Official Secrets Act, will she give serious consideration to formalising the role of the D-Notice committee and, in particular, consider introducing a publications review board along the lines of the one that has worked so well in America?

My hon. Friend had best wait until the White Paper comes out. We expect it to be out in about June.

To ask the Prime Minister if she will list her official engagements for Tuesday 19 January.

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

Is the Prime Minister aware of early-day motion 310, bearing 142 signatures, in which it is claimed that 25,000 signatures have been collected to fight to keep open the Nether Edge maternity unit in Sheffield? How can she justify her statement that the Health Service is safe in her hands when, in spite of all the pressures and arguments, the unit will still be closed? Will she personally meet a delegation from Sheffield and deal with the situation?

This is a matter for my right hon. Friend the Minister for Health and for my right hon. Friend the Secretary of State for Social Services, who deal with such matters. However, the hon. Gentleman will he pleased because I understand that a new children's hospital will he opening in Sheffield next year.

Unlike the leader of the Labour party, Conservative Members are not worried about elections, but supposing that at the next general election the electorate should make a slight mistake and not give us a overall majority, what lessons would my right hon. Friend learn from last week about trying to form a coalition with the Social and Liberal Democrats?

That is a mistake that the Conservative party will not make.

To ask the Prime Minister if she will list her official engagements for Tuesday 19 January.

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

Is the Prime Minister aware that only six out of 12 intensive care beds are in use for heart operations in the Yorkshire regional cardiothoracic centre at Killingbeck hospital in Leeds? Will she join the vast majority of senior medical staff at that hospital in requesting from the regional health authority three extra intensive care units, or will she tell the staff at that hospital who, in the vast and lengthening queue of patients, young and old, will have to wait for surgery?

The number of cardiac operations, the amount of resources and the number of doctors and nurses have greatly increased. We are looking carefully at why some regional and district health authorities are able to manage much better than others on their allocations of money, and why in some surgery wards in some hospitals the beds are left empty between patient treatment for one day while in others they are left for up to three days. We are now getting a great deal of interesting information, trying to make the best use of the facilities available and taking lessons from those who have been most successful in that.

Before the debate on the National Health Service, I must announce that I have selected the amendment in the name of the Prime Minister. I should repeat what I said earlier in answer to a point of order: no fewer than 58 right hon. and hon. Members have written to express their interest in speaking in the debate, and there may be others. Many of them are Privy Councillors, so I make a special plea for brief contributions.

The House has not given the Chair authority to limit speeches to 10 minutes, but it would be helpful if all Back-Bench speeches could be limited to 10 minutes on this motion.

I beg to move,

That this House notes that two out of three health authorities anticipate a deficit at the end of the current financial year and that attempts to balance their accounts have produced closures of hospital wards and cancellation of operations; affirms its commitment to the principle of a National Health Service providing comprehensive, free treatment to all citizens on the basis of need, not payment; further notes that current Treasury revenue substantially exceeds expenditure; and therefore calls upon Her Majesty's Government to release additional funds to end the financial crisis in the Health Service, and to drop proposals for new charges for dental examinations and for eyesight tests.

This is the second occasion on which the Opposition have named health for their Supply debate within the past two months. I wish to advance three reasons why we took the view that it was not only appropriate but essential that the House should have an opportunity to return to this vital matter today.

The first reason is the evidence, accumulating since we last debated the issue only two months ago, that the NHS is currently in financial crisis. Indeed, the weight of evidence pointing to that financial crisis is now so massive that even the Law Officers of this Government must be considering advising their client to plead guilty. May I produce the witnesses who have come forward in the past two months since we debated the issue to confirm the state of crisis in which they have to operate?

The first witness is the chairman of the consultants' committee of the British Medical Association. Last month he announced that that committee was setting up a survey of the acute specialties and he said:

"The acute sector is falling apart at the seams."

The director of the Association of Community Health Councils published its survey only this month. That survey showed that 56 out of 113 health authorities proposed to close wards — some of them entire hospitals — in this financial year. The director stated:

"Unless there is action now, some parts of the NHS, already on the brink of collapse, will simply fall apart during 1988."

In Oxfordshire, 296 general practitioners signed an advertisement opposing the closure of 140 beds. That advertisement said:

"These cuts will cause considerable suffering and very possibly hasten death in some patients."

Consultants at St. Mary's hospital, Paddington wrote to the press saying:

"We have a duty to inform the public that the fabric of the NHS is crumbling about us."

Consultants at the Birmingham children's hospital wrote to the press stating that they now turn away 30 acute cases every week, and added:

"We no longer accept that this service is safe in the Government's hands."

Most damning of all was a statement, not by any doctor or any nurse or even by Brian Redhead of the BBC, but by the hospital manager of the Manchester royal infirmary last week. He wrote to the 2,500 employees of that hospital advising them that he could no longer pay for drugs and that, by the end of the financial year, he may no longer be able to pay for their wages. He added:

"To all intents and purposes we are bankrupt. If we were a commercial organisation we would have gone into voluntary liquidation".

The Government pride themselves on introducing a commercial ethos into the NHS. They have now achieved a new first — they have introduced the concept of bankruptcy into the NHS. Looking at the amendment in the name of the Prime Minister and her colleagues, I am astonished that it has the nerve to express their support for the dedicated staff of the NHS. If the Government have such respect for the staff of the NHS, they should listen to what those staff are saying to them day after day.

In truth, in the past two months, the Government have sought to pin the blame on the very staff who work in the NHS. Last month, it was the fault of the consultants. Bernard Ingham, the true voice of the Government, briefed the press on the basis that too many consultants were nipping off to do private practice. I find it breathtaking that the Government, who have done everything possible to encourage consultants to do more and more private practice, should now identify that as their excuse. In 1980, the Government even changed the consultants' contracts so that those full-time NHS consultants might carry out private practice in the time when they are paid a full-time salary by the NHS. However, I welcome the Government's repentance and their belated recognition of the fact that, if one extends private medicine, the people who are neglected are the patients on the NHS waiting lists.

Such private practice by consultants is not the major source of the current crisis. At present, all round Britain, health authority managers are telling consultants to slow down and to cut their output. They are being told to go off to the golf course, do a spot of gardening, do anything but increase the rate at which they operate on their waiting list. Indeed, at the Queen Elizabeth hospital in Birmingham some surgeons have been instructed to carry out 10 per cent. fewer operations next year than this year.

Last week a new culprit was discovered. The right hon. Member for Chingford (Mr. Tebbit), who is to grace us with a speech in this debate, discovered that it was not the consultants but the nurses who were to blame—with a little help from the BBC. The right hon. Gentleman informed us that too many nurses were moonlighting. There is a fat lot of support for the dedicated staff of the NHS in that statement. I am not entirely sure that I follow the right hon. Gentleman's logic. Presumably, if those nurses stopped moonlighting, the staffing crisis in our hospitals would be even worse. However, I bow to the right hon. Gentleman's superior knowledge of moonlighting.

If the hon. Gentleman had listened to what I said, he might have perceived—although it is doubtful, as his abilities in that respect are limited—that my objection was to the crazy system in the Health Service which frequently precludes nurses from working overtime in their own hospitals but allows them to work overtime as agency nurses in another hospital. While a nurse is doing that, a girl from a second hospital is busy working overtime as an agency nurse in her hospital. That is my objection.

On moonlighting, Opposition Members might benefit from doing a little themselves. It might add to the debate if we had a bit more moonlighting and a little less moonshine.

I would acquit the right hon. Gentleman of the charge of merely having moonlighted. Since he retired as chairman of the Conservative party, he has gone through the whole galaxy of night-time work. On the explanation that he has offered of his speech on Friday, I am bound to say that if that was what the right hon. Gentleman intended to convey to the press, he signally failed to choose the correct words to put his message across.

Furthermore, NHS nurses do not fail to do overtime in their own hospitals. If the right hon. Gentleman had followed the documents that have been cascading from the professional bodies for the past two months, he would have seen the survey carried out at the request of the Royal College of Nursing by independent surveyors, who discovered that 60 per cent. of nurses did an average of five hours a week unpaid overtime in their own hospitals. Those are the people whom the right hon. Gentleman maligns.

At the weekend, the nurses were superseded by a new culprit. I was distressed to read that my opposite number, the Secretary of State, is now being fingered as the culprit. I feel a personal sense of involvement in seeking to acquit the Secretary of State. I am glad to see him back at the Dispatch Box and looking so well. It is as well that I should put that on the record, because it is not immediately apparent that all his colleagues feel the same. The charge being made in the alcoves of the Westminster bars is that he has created chaos out of order single-handedly and in seven months—taking two months off for illness the while. Think what he could have achieved had he remained in good health throughout the seven months. It is a ludicrous charge. The crisis that has erupted in the past few months has been years in the brewing.

Yesterday, I took part in a radio package in which the hon. Member for Reading, East (Sir G. Vaughan) also participated. The hon. Gentleman was Minister for Health during the first three years of this Government's period in office. I praise him for his refreshing candour and honesty. On "The World at One" yesterday the hon. Gentleman said:

"We have known this would be crisis year since 1981."

They knew it was coming. They did nothing to avert it. They deliberately planned the financial squeeze that gave rise to the current crisis.

I have no doubt that we shall again hear figures showing the growth in the NHS budget. I invite right hon. and hon. Members to bear in mind that one third of that increase took place before 1981 and was almost entirely attributable to the Clegg awards. Most of the increase since 1981 has taken place outside the hospital sector, among the family practitioner services, which are, of course, demand-led. We can see what would have happened to expenditure on those services had they been cash-limited by looking at what did happen to the hospital sector during the same period. In 1986, the Select Committee on Social Services reviewed the hospital budget between 1981 and 1986 and concluded that, in volume terms, the increase was 3·1 per cent. over the entire five years.

The Minister for Health has answered a question pointing out the demographic pressures on the hospital budget and quantifying it in percentage terms. During those same years, when the hospital budget increased by 3·1 per cent., on the Minister's own figures, demographic change added a 4·3 per cent. burden to the hospital sector alone. We do not have a report from the Select Committee for 1987, but it is possible to update those figures. Indeed, the King's Fund has done so and has identified a 3·4 per cent. increase in volume terms over the six years 1981–87 and a 5·4 per cent. increase in the pressure from demographic change during the same period.

Demographic change is racing ahead by two thirds of the increase in the budget of our hospitals. That is why they are now in crisis. That is why wards are closing and patients are being turned away. However, these are statistics that the Prime Minister has chosen not to use in her weekly exchanges with my right hon. Friend the Leader of the Opposition.

Will the hon. Gentleman give an undertaking that, if the Labour party is elected to government in the future, it is prepared to commit sufficient funds to the National Health Service to eliminate waiting lists totally? If he is prepared to give that undertaking, which flows from the logic of his argument, will he estimate the cost of that? If he is not prepared to give that undertaking, will he tell us which elements of the waiting lists he is prepared to live with and which he would prefer to eliminate?

Only last week, my right hon. Friend made a clear statement of the five points that we are putting forward as our commitment to the NHS. Those commitments have been costed. They mean making good the reduction in expenditure in the hospital sector during the past six years. They involve a planned and controlled expenditure increase to reduce waiting lists, rather than the ad hoc, one-off cosmetic gestures that we get from the Government.

There are other statistics which the Prime Minister chooses not to use, which shed a different light on the record of her Government. However, those statistics occasionally slip out when the guard is down. My hon. Friend the Member for Huddersfield (Mr. Sheerman) obtained an interesting answer last week, which showed that expenditure on nurse training has decreased from £479 million in 1979 to £439 million in 1986. That is one reason for the staffing crisis in our hospitals.

There are also the accelerating figures on bed closures in acute specialties. During the Government's first three years, we lost 5,000 beds for acute specialties. I concede straight away to the Secretary of State that that was more or less on trend with the long-term decline in the number of beds for acute specialties.

Will the hon. Gentleman give way?

No, I shall continue my speech.

During the next four years, we lost over 10,000 beds for acute specialties and last year we lost 5,000 acute specialty beds. That is three times the rate for the figure for only eight years earlier —[Interruption.] I am asked about waiting lists. Well, the waiting list for March 1987 was 15,000 higher than for the year before. We do not yet have the figure for September 1987 but, so far, every waiting list figure for September under this Government has been higher than any September figure under the previous Labour Government.

We also have the figures for infant mortality. Last year, alone among Western nations and for the first time since 1970, infant mortality increased in Britain. When the Prime Minister was taxed about that a fortnight ago, she was so shocked by the increase that for once she lost her confidence in statistics and said:

"It may well be that it is a statistical error."—[Official Report, 12 January 1988; Vol. 125, c. 141.]

I am afraid that there is no statistical error. However, I can say that the Prime Minister was absolutely right to point out that the increase did not take place in the first four weeks after birth—which is the period of intensive medical care — but in the subsequent 11 months, between the first and the 12th month of life: the post-neonatal period. I have before me a press statement by Peter Pharoah, professor of community health at Liverpool university, who said:

"Post-neonatal deaths are much more affected by social factors such as unemployment, housing conditions, low income".

That brings us to another set of statistics about the present Government. Survey after survey shows that unemployment makes people ill. The unemployed are 40 per cent. more likely to suffer from cancer, and 200 per cent. more likely to commit suicide. Even the wives of unemployed men have a higher mortality rate, and their children have a higher infant mortality rate. The current rate of unemployment, in the calculation of the British Medical Journal, causes an additional 3,000 deaths a year.

If the Government wish to trade statistics, there are plenty with which we can cap any that they produce. Ultimately, however, the trading of statistics is an exercise as sterile as any operating theatre in the National Health Service. Whether the position is better or worse than in 1979 is an argument of obsessional interest to professional politicians, and to just about no one else. People outside this Chamber see their wards closing and their operating theatres being shut down. They see a real problem, and they want to hear a solution to it. They may well have the wit to work out for themselves that those wards and operating theatres stayed open throughout the period of the last Labour Government. However, they are not interested in comparisions with the past; they want to know what plans have been made for the future.

That brings me to the second reason for returning to the issue. It is now clear that the Government are planning on the expectation that the coming year will be even worse than the one that we have just been through. On 18 November, the two junior Health Ministers met the regional health chairmen in Cambridge. One of the chairmen said afterwards:

"The chairmen went in to hang the table and make sure ministers understood just how bad things are out there There wasn't any need."

The two Ministers

"just acknowledged it and said in effect it was going to get worse".

I have with me the letter that the Minister for Health subsequently sent to the chairmen of the regional health authorities. I do not believe that he has yet placed it in the Library; perhaps he will do so after the debate. The letter is, of course, beautifully crafted by some civil servant and written in coded terms, but it is not difficult to break the code and decipher what is meant by the "need for realism" or

"more rational use of resources".

Paragraph 3 of the letter makes it clear that there will not be a penny more for 1988–89, while paragraph 6 states that there will be the same pressure for cost improvement programmes in the next year. The Minister accepts that

"some of the more obvious things have now been done and that attention will increasingly need to be given to the cost effective use of clinical resources."

In other words, cost improvement programmes will shift this year from ancillary services to patient care.

Paragraph 8 makes it clear that the health authorities must plan on the expectation that pay increases will not be fully funded this year:

"Authorities will therefore need to plan flexibly and recognise that they may well be called on to meet some pay and price pressures in 1988/89."

For "may well", we may read that they can bet their bottom nurse that that will happen.

I have a letter from the North-West regional health authority, which was sent out following that circular, instructing every district health authority in the north-west to cut its real budget by 1·5 per cent. next year. That of course includes Manchester royal infirmary. All the chairmen in the Yorkshire health authority area were summoned to a meeting with the regional chairmen on Friday, and instructed to cut their budgets by 1 per cent. in the next financial year. I have before me the papers put before Bloomsbury district health authority last week, which show that, in the coming financial year, there will be an additional shortfall of nearly £3 million.

My hon. Friend referred to Yorkshire. Is he aware that Bradford health authority, in a document that was leaked this week, is shown to be planning to cut health services by more than £3 million over the next two years. The infant mortality rate in the city is twice the national average, and the authority plans to close a maternity unit. Heart illness is way above the national average, and it plans to cancel the appointment of a second cardiac specialist.

The overwhelming majority of people would forgo tax cuts to improve and defend their local health services. What message has my hon. Friend for the people who want a better Health Service, and not more tax cuts? How will he persuade the Government to take that message on board?

When my hon. Friend allows me to resume, I shall try to ram that message home. The point that he makes underlines the statement by the British Cardiac Society only last week that 10 million people are living in district health authorities with no cardiac specialists in the hospitals. We are told that the response to the problem—

Will the hon. Gentleman give way?

No, I shall proceed with my speech if I may.

I want to take up a point that the hon. Gentleman has just made.

If the hon. Gentleman will bear with me, I am sure that he can aspire to catch your eye, Mr. Speaker.

We are told that the response to the problem is that expenditure must be more cost-effective, but the way in which we are managing our hospitals at present is ludicrously cost-ineffective. Whole operating theatres are standing idle because they cannot afford the marginal cost of operations. These may be cuts, but they are not savings. They represent waste on an extravagant scale: wasted investment, wasted technology and wasted skills. If we are going to bring those skills and investment back into use, we need extra resources.

Will the hon. Gentleman give way?

No, I shall not give way to the hon. Gentleman: I have made that perfectly clear to him. He is plainly not interested in hearing what I wish to say to him, and I therefore doubt very much whether he will listen to my reply.

For a moment last week, a light flickered. The Secretary of State met the three presidents, who emerged to say that he had discussed with them extra resources for the NHS. The very next day, the Chief Secretary puffed out that light: the Government would not budge from the commitment that they had made in the Autumn Statement.

The Secretary of State will know that, when he replies to this address, he will have to explain who has got it right. Was the Chief Secretary folded up in a corner of the office keeping notes while he met the three presidents, or were the three presidents right when they emerged to say that their fears had been allayed?

There is, of course, a weasel way out. The statement claims that there was a recognition of the need for extra resources. Perhaps the Secretary of State proposes to take the line that he recognises the need for extra resources, as long as they do not come from the Chancellor of the Exchequer. Let the money come from alternative funding, from income generation or from lotteries — anywhere but from the Government.

We now come to the interesting rhetorical body swerve that Conservative Members keep practising. Whenever they are pushed into a corner to admit the inadequacies of public funding, they start talking rapidly about private funding. But private funding of the NHS has nothing to do with value for money. The Government's handling of private pay beds has been a first-rate commercial disaster. They have increased private pay beds in our hospitals by a quarter, and, during the same period, the number of patients in those beds has fallen by one fifth. The total bad debts of the NHS from private patients has escalated every year, and now stands at £11 million—more than the Government anticipate that they will gain from income generation. In the light of that experience, only a Government who had smashed the learning curve could persist in the delusion that a financial problem can be solved with more pay beds.

Will the hon. Gentleman confirm that it is Labour party policy to end pay beds at a cost of some £60 million and, incidentally, to end competitive tendering at a cost of £100 million? Does he agree that such dogma resulted in the pay of nurses falling for three years out of four under the Labour Government?

If the hon. Gentleman wishes to talk about dogma, let us consider dogma. Let us look at the instruction from the Minister of State to the West Midlands regional health authority that it can have £250,000 to buy private operations in private hospitals, but only to buy private operations and not to spend in its own hospitals. It is a sort of Health Service parallel to the assisted places scheme. On inquiring of BUPA, the health authority discovered that a hip replacement operation in a private hospital would cost £700 more than in its own hospitals and that a hysterectomy would cost £400 more.

Meanwhile, in Wolverhampton the regional health authority has so starved the district that it has closed the operating theatre for the orthopaedic ward. All hip replacements in Wolverhampton have ceased. To save what? To save a sum that is actually less than the amount that the Minister of State offered to the west midlands, earmarked for the purchase of orthopaedic operations in the private sector.

If the hon. Gentleman wants a little dogma, I can think of no clearer and finer illustration than paying over the odds to subsidise the private sector while forcing the closure of identical facilities in the NHS. That has nothing to do with cost-effectiveness but it has everything to do with political dogma.

That brings us to the heart of the debate between ourselves and those on the Government Benches. In truth, this is not a debate about public spending priorities; it is a debate about political values. The reason the NHS is under siege is that the Government's vision of a private enterprise society cannot tolerate the contradiction of a public health system that is more efficient and more comprehensive than its private sector competitor.

Those who sit on this side of the Chamber have the advantage of being able to see the Prime Minister's face, so we notice a revealing feature that may be lost on those who sit behind her. Whenever the Prime Minister recites the extra spending on the NHS under her Government, she does not do it with pride, satisfaction or relish; she does it with self-evident resentment. In her eyes, the NHS commits two fatal offences. The first is that everyone is equal, regardless of ability to pay. The second is even worse than the first: the service is actually popular because of that.

I do not know whether the right hon. Member for Brent, North (Sir R. Boyson) is with us today. The right hon. Gentleman has participated in exchanges on this subject outside the House. I particularly relished his speech on the fringe of the Conservative party conference last autumn, when he advocated an insurance system, with the Church of England catering for those who could not afford insurance. That does not seem an adequate solution for those who live in Scotland.

The right hon. Gentleman expressed the difference between our parties very well, I thought. He is on record as saying:

"The problem with the National Health Service is that there is no link between what people pay and what they receive, and no way of influencing what they receive by what they are prepared to pay."

The right hon. Gentleman sees that as a problem. We see it as a strength of the NHS. Having glimpsed that gulf of political values between us, I think we can understand why the NHS is in financial crisis and why it will be kept in financial crisis. What we see as a crisis of the NHS some Conservative Members see as an opportunity to claim that the NHS cannot deliver and as an excuse to dismantle a service that they never liked. How else can we explain the persistent refusal to give it more funds, when we all know that the Chancellor's wallets are as ample as his presence?

That brings me to the third reason why it is important that the House debate the matter again. It is more than ever transparent that the Government can afford to fund the NHS. I note that The Times today quotes a Whitehall source as saying that the Secretary of State's argument will be

"If you haven't got it, you cannot spend it."

Possibly the Whitehall source, who may be with us, would stand up and disclose himself so that we may see who is responsible for that wonderful observation.

The fact is that, in terms of financial resources, the Government have got the necessary funds. The Chancellor would need a JCB to cart the current Treasury surplus around Whitehall. Only today the Treasury, with impeccable timing, released the public sector borrowing requirement figures, which show that the PSBR is now a minus figure; that is Treasury language for being in surplus. There is a surplus of £400 million rather than a planned deficit of £4,000 million. Greenwell Montagu estimates that next year the surplus could be £11,000 million.

Perhaps I may dampen the enthusiasm of hon. Members on the Government Benches. Greenwell Montagu might not be spot on. Suppose it is wildly wrong. Suppose it is only half right. Suppose the surplus is only £5,000 million. That would still be enough to cut tax by the 2p beloved by the Chancellor and to give £2,000 million more to hospitals.

We saw on "Weekend World" that the Harris poll discovered that 68 per cent. of Conservative Back Benchers would rather see tax cuts than increased spending on the NHS. Those hon. Members need agonise no more. They can have both their passion for tax cuts, without any nagging doubts as to whether they are being faithful to the wards back home, and more expenditure o n the NHS. If Greenwell Montagu is more wrong and if there is only a quarter of that sum, there can be no serious doubt that if the Government have to choose, this year the priority must be not tax handouts but rescuing the NHS.

rose—

No; I am moving to my conclusion.

If there is any doubt, may I conclude by reflecting on the people whose health and hopes are in our hands when we vote tonight? The most remarkable feature of the past year has been that tens of thousands of operations have been cancelled. No one knows how many, because no statistics are collected nationally. No one ever cancelled operations en masse before. We know that all districts have been postponing non-emergency operations until the next financial year. One district alone has cancelled 3,500 non-emergency operations.

Who are the patients who are non-emergency cases? They are patients in pain from hernias, patients going immobile from arthritis, patients who know that their hips will deteriorate and that the operation will be more difficult when they get it, patients going blind—like the lady I met at the weekend who waited six months for the first examination for cataract, only to be told that she had another nine months to wait for the operation. They are patients with cancer, consumed with anxiety by the knowledge that the longer the operation is delayed, the less chance that it will be in time to be successful. There are also the parents whom my right hon. Friend the Leader of the Opposition and I met yesterday, driven to distraction by worry that the next time their child is called for operation it may be cancelled as it was last time.

Time after time in the last few months, consultants have said that it was not reasonable, fair or just that they be asked to decide who gets an operation and who does not, who dies and who lives. Ultimately we decide whether those patients will get their operations. It is our responsibility. This year the Chancellor of the Exchequer has the money to ensure that we get a National Health Service that can deliver to its patients. Tonight the House will have the opportunity to instruct him to make those patients his top priority.

I beg to move, to leave out from "House" to the end of the Question and add instead thereof:

"applauds the achievement of the National Health Service in providing a record level of patient care; recognises that this achievement rests on the substantial additional funds from the taxpayer which a strong economy has made possible and which has supported the dedicated work of the National Health Service staff; and welcomes the Government's continued commitment to the most effective use of all the Service's growing resources to bring about a further rise in the standard of health care, both in hospitals and in the community".

May I start by genuinely thanking the hon. Member for Livingston (Mr. Cook), my "shadow", for his kind remarks with regard to my illness. He and I have known each other for many years and I am always conscious of his continuing courtesy and personal politeness, and I do appreciate it.

Having said that, I know that the House, as I think both I and the hon. Gentleman would wish it to, will treat a subject of this importance in the 40th anniversary year of the National Health Service with the serious, rational and thoughtful tone that it clearly needs. Health—or illness, as I certainly know to my personal cost—arouses deep emotion, but we will not find long-term solutions in emotion alone. It will require clear thinking. And above all—and I stress this in the light of the remarks that the hon. Gentleman finished with — it will require a successful economy.

May I start, therefore, with the fundamental point that good health needs and must have a successful economy. That has been the essence of the argument of the hon. Member for Livingston and of his right hon. and hon. Friends in the past few weeks. They have argued that the only answer—and they have put it in the motion in terms of a "financial crisis" — is essentially to spend more public money. They want more, that is, than the increases that we have provided and more than the increases we have promised. It is the only answer that they have offered. The awful, fascinating and terrifying thing for them is that that is the only offer we know they cannot deliver if, ever again, we have the tragedy of having them in office.

I know full well and accept entirely, because they are not dishonourable men and women, that they do not mean to hurt the Health Service, and never intended to do so when they were last in office. But when the economy collapsed in their period of office, let me first remind the House of the priority they put on health care, and their attitude towards staff. I will come to the contrast with our attitude afterwards. Let me remind the House of the way in which they handled future investment in the NHS and their responsibilities when in office. First, public spending on the Health Service fell from 5 to 4·7 per cent. of GDP while they were in office.

Will the Minister clarify that health expenditure next year will fall as a percentage of GDP under this Government?

No, I will not. In a little while I shall explain precisely the increases, as the hon. Member for Livingston asked me to do. I shall also go beyond the GDP decline and specify them for the Leader of the Opposition when I come to comparisons with the Government's period of office. I shall specify the actual amount of money we are talking about, and deal with the way in which Labour treated Health Service staff. Opposition Members are concerned quite rightly about staff, because they are a key ingredient in the success of the Health Service.

Ancillary staff had their incomes reduced in real terms in the five years that Labour were in office by 4·8 per cent. Administrative and clerical staff had their incomes reduced in real terms by 14·4 per cent. For doctors and dentists, the decline was 22·4 per cent. in real terms. Nurses had their pay cut in real terms for three years running, and in 1976–77 by no less than 10 per cent. in real terms. In the five years to 1979, nurses had a reduction in pay of 21 per cent.

I shall come to the comparisons with our record in a moment. I said that there were three pillars on which I wanted to compare the record before going on to deal with patient care. The third of those is investment in the future. I and many of my right hon. and hon. Friends have sat in the House when investment in the capital of the National Health Service was slashed by 30 per cent. in real terms. Is this a record of which the Opposition are proud?

What is the contrast to that appalling record that they have the temerity to criticise in this Chamber? I stress again that because of our successful management of the economy we have a bigger GDP to help finance our health services. Let us examine our priorities, because that is the key question. First I shall deal with the percentage of GDP we have spent. I shall come then to the specific questions fairly asked by the hon. Member for Livingston in relation to his comments in the newspapers.

I remind the House that the GDP percentage declined from 5 to 4·7 under Socialism. What has happened since? It has increased from 4·7 per cent. and not to 5 per cent. but to 5·4 per cent. of GDP, so the percentage of a greater GDP has increased. That is why we are able to spend such enormous additional amounts of money. I am not yet dealing with the points made about pressures, but with the actual amounts of money, quoted time and again, the increase of 33 per cent. in real terms.

Just suppose for a moment that we had had the tragedy, with or without North sea oil, of having the Opposition in office for the past eight and a half years, with the same increase in the size of the economy that we have achieved and 4·7 per cent. growth in GDP, which is the Opposition's chosen priority as a percentage. How much less would have been spent today, or in this year or last year? Spending would not have been £21 billion, but £18·1 billion. They would have spent £2·9 billion less, even with their own sense of priorities.

What about staff, who are treated so appallingly? I did say, Mr. Speaker, that before I dealt with staff I would cover the specific points made by the hon. Member for Livingston about what he thought was the difference between my views and those of my right hon. Friend the Chief Secretary to the Treasury. There is no difference at all; quite the reverse. People are able to do even basic calculations and consider matters post my party conference speech. Even though we now have the listening party sitting opposite, they do not necessarily spend their time listening to Conservative party conference speeches; but in my speech I made it quite clear that resources for the Health Service must increase.

What has happened since then? In the public expenditure round that was recently announced, there were the increases that had been planned before the general election, with £1·1 billion of further increases, which is £700 million more than had been planned. There were those increases, which I referred to in my meeting with the presidents of the royal colleges, and which were referred to by my right hon. Friend the Chief Secretary, and rightly, as the hon. Member for Livingston says, moneys that will come from the cost improvement programme and additional moneys that we hope will come from an increase in resources from the private sector.

Those figures have been tabulated, and we can consider the totals and calculate what has been spent in the past and what will go into health care next year. It might be of help to the House to know what they are. The total gross increase for 1988–89 in real terms will be 2·1 per cent. If we add to that the extra resources expected to come from CIP, that will be 3 per cent., which is far more than most of the Opposition have argued for. I am assuming those additions on the simple basis of the very good experience of the past few years.

I should like to ask the Minister, despite what he is saying about increases, whether he can explain the paradox of my own local district health authority? As a result of the extra moneys that were given to maintain services, which I suggest is an admission of gross under-funding, those sums of money will enable us at the end of this month in theory to open closed wards. But we cannot employ the nurses to staff those wards and, indeed, we shall be forced to close wards again at the end of the financial year. Even the increases that the Secretary of State has announced for next year will not enable us to keep those services in existence.

Before I comment on the specific point, the hon. Member for Livingston would not, I know, want me simply to talk about the increases within the National Health Service as a whole, because he rightly tried to distinguish between the acute care hospital sector and the National Health Service, while acknowledging that there had been massive increases in real terms in the primary health care services. If one just looks at the HCHS and at the total gross increase in the coming year, excluding the CIP programme expected yield, that will be an increase in real terms next year of 2·2 per cent., including the cost improvement programme at 3·4 per cent.

To be specific, the hon. Member for Lewisharn, Deptford (Ms. Ruddock) shares the dilemma of the RAWP disadvantage that many of us, including myself, who live within a Thames region have faced since 1977. Hon. Members who had experience and responsibility at the time will recognise the nature of the change, the reduction in the population and the problems associated with the Metropolis with regard to the attraction of' staff.

rose—

I know that a very large number of Members wish to speak. I have given way so far and I would like to get on as I have quite a few things to say.

Is it not also the case that within the acute sector the performance of hospitals varies enormously? I draw my hon. Friend's attention to some figures recently published by the North-West regional health authority, which show that last year the cost of an in-patient case at Stepping Hill general hospital was £605·28, yet at north Manchester general hospital, where NUPE had recently been on strike, the cost per in-patient case was £1,107·33.

I am very grateful to my hon. Friend. I was planning to tackle that particular point later.

I was comparing the percentage of gross domestic product spent on health care. I then wanted to compare the appalling record of the Labour Government with my own Government's record in regard to improving the remuneration of staff. We have heard many times in the House, and I will not burden hon. Members by repeating them, the figures of staff increases, but I think it especially important to remind the House how those dealing directly with patients have increased as a proportion from 59 to 65 per cent.

In particular, I think that the record on the pay of nurses merits attention compared with the appalling record of the Opposition when in office. We have not simply established the proper pay arrangements through the pay review body; we are seeking to establish a pay arid grading structure for nurses and midwives which recognises the particular individual's skills and responsibilities. I know that all hon. Members will be particularly pleased that the Nursing and Midwifery Staffs Negotiating Council has reached agreement on the new grading definition, which has been sent to the review body.

The third point that I said I wanted to touch on was investment in the future of the National Health Service. The building of the new NHS from the appalling slashing of programmes that existed when we took office has been proceeding massively in the last eight years. As opposed to a reduction of 30 per cent., we have seen an increase, in real terms, of 40 per cent. We are now running a programme where we are spending £1,000 million a year on building the new NHS in the United Kingdom. All of this shows what can be achieved with a successful economy under our Government in contrast to the failure of the economy under Socialism.

I now want to illustrate, because I think that this is what many hon. Members would want me to do, what, at the end of the day, this means to patients. This, surely. is what we are all talking about. What these resources and the enormous efforts that the National Health Service staff have put into improved efficiency, which must be recognised, have meant in terms of patient care is quite staggering. To describe the service as being on the point of collapse, in the light of these figures, is really appalling.

The achievements of the service, as my right hon. Friend the Prime Minister said last week—[Interruption.] I seem to have heard an interruption from a sedentary source asking why I did not use it. Happily, throughout my adult life, I have been able to benefit from the NHS, whether in Whittingham hospital, University College hospital or St. Thomas' hospital, and I am not sensitive in any way. I would assume that the listening party would like to listen to the end of these remarks.

Every member of my family has used and continues to use the NHS. I shall never forget the debt that I owe to the St. Helier hospital, where my mother died of cancer. I shall never forget the treatment that the doctors and nurses gave. But it is a bizarre feature of the world in which we now live that, because, as a consequence of my experience and knowledge, I was willing for many years, along with my wife, to pay less than I paid when I used to smoke as a modest contribution to the premiums of a non-profit-making organisation, when I chose this time not to burden the Health Service, not to force myself upon it, somehow it is regarded as wrong. That is one of the reasons why this country will never again elect the present Opposition to office.

Our great National Health Service deals with six inpatients for every five in 1978, 11 out-patients for every 10 in 1978—these are the realities for the constituents of Opposition Members—and nearly two day cases for every one in 1978. Those are the patients who are now receiving treatment in our acute care hospitals.

rose—

I will continue for a little while, if I may.

There is not just more treatment, but better and more complex treatment. For example, many of us know that the first coronary heart bypass operation took place in the United Kingdom in the mid-60s. Three such operations are now being done for every one in 1978. Members of the Opposition do not want to hear the facts.

rose—

I will give way in a minute, when I have completed these figures because these are the figures of real patient care—[Interruption.]

Order. Let us get back to the debate and the arguments, not personalise it.

Five treatments are being given for chronic renal failure for every two in 1978. Four hip replacements are being done compared with three in 1978. We are doing not only double the kidney transplants that we were doing in 1978, but more than any other European country. There were 30 bone marrow transplants in 1978; there is nearly one a day now. It is the Opposition, in the face of the reality of the great achievements of the National Health Service, who have lost their way. Finally, there were three heart transplants in 1979—in the whole year—but 176 in 1986, as well as 51 heart-lung transplants. Those are the figures of our NHS today.

If the Secretary of State is resting his case on the situation in our hospitals being so much better than it was under the Labour Government, can he explain to the House why during that Labour Government it was never necessary for the presidents of the royal colleges to go and see the then Secretary of State; it was never necessary for 1,000 consultants to go and see the Prime Minister; it was never necessary for general practitioners to pay for advertisements warning their patients what was happening to them; and it was never necessary for the BMA to set up a survey of acute specialties?

I will, of course, come to the way forward and the points on demography in a second but, since memories seem to be failing here, I will remind the hon. Member of what happened in 1978. On page 115 of Lord Donaghue's book, he said — and I believe that it is relevant—that in 1978

"Mr. Callaghan again sought ways to justify providing extra funds to the National Health Service and asked David Ennals to produce a paper on the NHS crisis."

Beyond that, morale in the NHS was falling in March 1978. I can give chapter and verse and quote after quote. The British Medical Association chairman said that a big injection of money was necessary to resuscitate the NHS. Nurses said that

"Lack of money prevents patient care"

and that it led to the NHS crisis in August 1978. It is almost beyond belief for the Opposition to have the temerity not to remember the winter of discontent in 1978–79.

The statistics are not just bald statistics. They affect millions of families who have benefited each year from our hospitals and many patients whose quality of life has been improved by operations scarcely possible a decade ago. The hon. Member for Livingston asked why, despite this success story, the service is still under such pressure.