To ask the Secretary of State for Social Services what account the Government's review of nurses' pay takes of the problem of high living costs in areas like Southend-on-Sea; and if he will make a statement.

The independent review body examined the question of selective pay supplements and said that for staff outside the London area it would be sensible to wait until the new grading structure has had time to take effect. The review body suggested it would then be possible to decide more accurately whether, and if so what, further geographical pay incentives may be required.

Is the Secretary of State aware that, while the nursing pay review was widely welcomed in the profession and owed a great deal to his initiative, nurses and other public servants working on national wage scales feel discriminated against because of the uniquely high cost of living in some areas, of which Southend is an example? As it is a long time since we had a visit from a Health Minister to our excellent hospitals in Southend, will my right hon. Friend, or one of his colleagues, be willing to visit one of our hospitals and speak to the nurses about their problems?

Having had some considerable involvement with the hospitals in my hon. Friend's area, I shall be delighted to accept his courteous invitation. Having said that, I stress that the recommendations of the review body and the problem of geographical pay beyond the Thames region will obviously not go away.

Since the fringe zone weighting in Sir James Cleminson's report goes out as far as east Berkshire, should it not reach as far as Reading? suggest that the cost of living in Reading is every bit as high as anywhere in the outer region of London, if not as high as in London itself. Does not the problem of recruiting nurses there owe much to the fact that the cost of living in Reading is as high as it is in London?

I stressed that I was repeating the comments of the review body. I am conscious of the particular problems of recruitment in the M4 corridor. The Government are conscious of some of the geographical pay difficulties and will not ignore the point that my hon. Friend has made.

To ask the Secretary of State for Social Services if he will make a statement on progress towards a pay award for the National Health Service ancillary staff and how it is to be funded.

To ask the Secretary of State for Social Services if he will make a statement on progress towards a pay award for the National Health Service ancillary staff and how it is to be funded.

Pay of NHS ancillary staff is a matter for negotiation in the ancillary staffs Whitley council. I understand that negotiations stand adjourned until 18 May. Health authorities are expected to meet general pay increases from their cash allocations and cost improvement programmes.

The Minister's reply is wholly unsatisfactory. When will the Government stop treating ancillary workers as the poor relations of the Health Service and provide health boards with enough extra funds to give ancillary workers a fairer deal, without cutting any other aspect of the Health Service?

I wonder whether the hon. Gentleman is aware that under the present Government ancillary workers have had an increase in real terms of just under 4 per cent., which compares with a reduction in real terms of 10 per cent. under the Labour Administration.

Will the Minister turn his eye away from history and look at the present? Does he realise that all health authorities see the people they employ as part of a total team committed to caring for the patient? Will he now commit the Government to a similar award for ancillary workers and ensure that the health authorities have the money to fund it properly?

Having spent eight years as a member of an Administration who have made this country's economy the strongest for a generation and made possible real terms increases in pay of many workers in the Health Service and elsewhere, to which I have referred, I have no intention of turning away from that history.

Is the Minister aware that scientists in the NHS, as well as ancillary workers, have no pay review body and that their pay has fallen behind by 48 per cent.? Does the Minister have any intention of establishing a pay review body for them?

The answer to the latter part of the question is no, but if the hon. Gentleman is referring to medical laboratory scientific officers, who form an important group, he will know that there has been active examination of restructuring proposals, which I hope will help to solve some of the problems there.

The Minister cannot pass the buck for the negotiations. Is he aware that the Whitley council adjourned so that the management side could consult him? What answer did he give? Does he recognise that, in the seven years since Clegg, the pay of ancillary staff has fallen behind the retail prices index, leaving the poorest even poorer paid? Will he concede that these are often the same people who are experiencing whopping cuts in their housing benefit? How long is he prepared to be Britain's largest employer of Britain's lowest paid workers?

I have already said that this group has had a real terms pay increase under this Administration, compared with a real terms pay reduction under the Labour Administration. We shall negotiate in good faith on the basis of a further offer, which no doubt the management side will make when the negotiations resume.

To ask the Secretary of State for Social Services when he last met the chairman of the West Midlands regional health authority; and what subjects were discussed.

My right hon. Friend last met the chairman of the West Midlands regional health authority on 22 March. I have had the pleasure of meeting him three times since January. A number of issues were discussed, including expenditure on health services in the west midlands, which now stands at a whopping £1·2 billion, an increase of some 34 per cent. in real terms since 1978–79.

Will my hon. Friend confirm that the increase of 30 per cent. since 1979 has led to a large increase in medical staff and to an increase of 24 per cent. in in-patients being treated within the region? Will she also confirm that the districts within the regional health authority have set up their own version of the Government's resource management initiative to allow resources to be allocated not only on the basis of perceived need but to those districts which, like my own, use them most efficiently?

The West Midlands regional health authority is doing a cracking good job. Last year it admitted 700,000 in-patients—13,500 per week. It dealt with nearly 4 million out-patient visits last year—12,400 each working day. Many people have reason to be satisfied with the NHS in the west midlands.

Will the Under-Secretry of State check her diary and confirm that she was not present at the meeting on 22 March between the Secretary of State and the chairman of the regional health authority? I was, along with some of my hon. Friends, and we were given to understand that we would be informed of the cuts that were due to take place in this financial year before they took place in known areas, at the instigation of the chairman and with the agreement of the Secretary of State. We are still waiting for that information.

I am sure that my right hon. Friend enjoyed the meeting that he had with the hon. Gentleman and his hon. Friends. However, I think that the hon. Gentleman misheard me. I said that expenditure on the west midlands health services now stands at £1·2billion, which is a record in both cash and real terms. The authority is employing a record number of staff, it has a record hospital building programme, and it is looking after a record number of patients.

At meetings with the chairman, did my hon. Friend discuss waiting lists in the west midlands, which are worrying many people? Has she any news to give to the House on that matter?

Yes. Again, the west midlands has been making considerable progress. The latest figures that we have, for the summer quarter ending September 1987, show that waiting lists had dropped by 6 per cent. in six months, that 42,000 people had been treated from the waiting list, and that the median wait was only six weeks, and falling.

To ask the Secretary of State for Social Services what resources his Department is devoting to monitoring the effects of the recent social security changes.

The effects of the social security reforms are being monitored using a wide range of data derived from my Department's management, expenditure and statistical returns and from the family expenditure and general household survey. The collection and analysis of this data involve a substantial staff effort, but it is not possible to provide a reliable estimate of the cost.

Why are those on junior rates, who are mostly under 25 and students, excluded from the transitional arrangements?

I am not absolutely certain how that relates to the orginal question, but I shall endeavour to answer it. The transitional arrangements refer specifically to certain groups—the disabled, widows, pensioners and families with children. Throughout the social security reform an attempt was rightly made by the Government, after long consultation and debate, to target help away from those who are younger and independent.

Following the changes that my right hon. Friend recently announced, how soon local authorities will be given details so that they can implement the changes to housing benefit? Similarly, when will DHSS offices know about the changes involving hardship cases?

I hope that my hon. Friend will be able to confirm in reply to later questions that by the end of this week we should be able to notify specific local authorities. The new unit is being set up this week, and free phone facilities should be in operation within 24 hours.

Is the Secretary of State aware that the way in which industrial injury benefit and invalidity benefit are taken into account for housing benefit is having a dramatic effect on tens of thousands of homes? I spent a most depressing week in my constituency talking to constituents who have lost £10, £15, £20 and £25 a week. That is outrageous. What will the Secretary of State do about it?

If the right hon. Gentleman checks the very helpful letter that my hon. Friend the Minister for Social Services and the Disabled wrote to him last Thursday, he will see that transitional protection covers the particular problem to which he is referring, as it relates to those who are above income support level but for whom there were local authority discretionary schemes which theoretically under the law stopped at the beginning of last month. They are covered by the transitional arrangements.

I welcomed the announcement two weeks ago that in future beneficiaries in certain categories should not be more than £2·50 a week worse off, but am I correct in thinking that that does not take into account the 20 per cent. contribution to rates? If so, as a large number of the complaints that I continue to receive are about the effect of having to pay that contribution, may we have an assurance that that will continue to be monitored? If the conclusion reached is that the principle is good, may it be that we are going too far too quickly?

As my hon. Friend the Minister of State said on another occasion, we shall continue to monitor this area. However, I would not want to give my hon. Friend false encouragement, because the 20 per cent. contribution to local authority rates was not expected to be covered by the transitional protection.

One of the things that the Department is monitoring over the transitional period is the number of single payment claims which were outstanding at 11 April, about which I have a later question. Will the Secretary of State give us the average figure, for regional offices within Scotland, of outstanding single payments?

I would not wish to abuse the Order Paper and leap to a further question. However, we have had only the first month of initial monitoring of offices in Scotland, and that would be an incorrect statistical basis on which to make a judgment. For example, I know that the hon. Member for Linlithgow (Mr. Dalyell) would not like us to make judgments on the basis of the Bathgate office, where, not untypically, only half the loans provision was used in the first month—a fraction of the grant. However, we are watching the details with great care, and we shall keep the House well informed.

I congratulate my right hon. Friend on his swift and sensitive adjustments, but will he make it absolutely clear that if any further injustices appear he will also be swift and sensitive in rectifying them?

I thank my hon. Friend for recognising that the Government moved very fast in making these adjustments. This Government, who were involved in a rapid change affecting 8·5 million people and an expenditure of £14-plus billion, and who made modifications to the tune of £100 million, deserve my hon. Friend's congratulations.

Does the Secretary of State accept that the Department ought to heed the results of the monitoring within the Department and by outside reputable bodies? If it had heeded the advance warnings that it received over the last three years about the results of the changes, the transitional protection, for which the Secretary of State has just claimed credit would have been unnecessary, and a great deal of suffering and anxiety would have been avoided. Will he pay special attention to the monitoring of the social fund, from which most applicants, including the young, will be excluded because of its totally inadequate budget?

We shall monitor carefully all aspects of the changes. We have already made a clear public commitment to commission independent research into the social fund. It has already been announced in a private notice question that that research will start in the spring of 1989. I confirm that announcement.

To ask the Secretary of State for Social Services when he expects the first payments to he made from the Independent Living Fund; and what arrangements for interim payments he has made.

To ask the Secretary of State for Social Services when he expects the first payments to be made from the Independent Living Fund and what arrangements for interim payments he has made.

Payments from the Independent Living Fund will be made in the near future when it is legally established. Meanwhile, a number of applications have been received and decisions on interim payments are being made by officials, with professional advice. Final decisions will be taken by the trustees.

Is the Minister aware of the anger and frustration of the voluntary organisations involved in the care of severely disabled people in the community? Will he give a categorical assurance now that the scheme will he fully in place within a very short time?

The fact that the scheme is not fully in place should not inhibit anybody from making an application. We have sent out 70 forms in response to inquiries, and 25 completed forms have been returned. Visits by social workers are beginning to take place. The fund is working. I urge anybody who feels that he might be entitled to benefit from the fund to apply as soon as possible to the Department.

Is the Minister able to say why the sum of £5 million was established for the fund? Was it based on the likely number of applicants? Does the Minister have the power to increase its budget should that be necessary?

Bearing in mind that there is transitional protection for claimants who were receiving benefits before the change to the new system, I am confident that the £5 million is sufficient to cope with the demand this year. We have said that we will look at the budget amount for subsequent years in the light of experience gained during the first 12 months.

The fund is a useful interim step towards helping disabled people to live in the community, but the real step that is now urgently needed is to implement in full the Disabled Persons (Services, Consultation and Representation) Act 1986. Given the highlighting of very difficult and heartrending cases on the Esther Rantzen programme in the last three weeks, will the Minister now give an undertaking that section 7 of the Act will be implemented as rapidly as possible to minimise the difficulties that face people who are trying to live in the community after having left long-stay institutions?

Discussions are taking place on the further implementation of the Act. We need the results of the survey by the Office of Population Censuses and Surveys, and in due course we shall have to look at the pattern of benefits in an overall and coherent fashion.

As the extreme hardship that this fund was supposed to prevent dates from 11 April, is it not outrageous that on 10 May the fund has still not been legally constituted? Has the Minister seen the charge made by the major voluntary organisations for the disabled, that he has seriously underestimated the number of hardship cases? How can he possibly defend a regime that leaves hundreds of thousands of disabled people worse off by reference to a scheme that will help fewer than 300 and that still has not been formally set up?

I think that the right hon. Gentleman ought to have listened to the reply that I gave earlier about the arrangements that had been made to ensure that nobody suffers or endures delay because trustees have not yet been appointed or the trust deed agreed. Anybody who feels that he is entitled to benefit should apply now. I am confident that the £5 million will be adequate to cope with the demand on the fund in the first 12 months.

To ask the Secretary of State for Social Services what information he has as to the levels of state pensions in each of the member states of the European Community, taking account of the cost of living in each country; and if he will place in the Library a copy of a league table based on those figures.

Only three countries in the European Community—the United Kingdom, Denmark and Ireland—have flat-rate pensions payable to most pensioners. Earnings-related pensions in the other countries are linked to the individual's own earnings, and there is no fixed pension level. Spending on programmes for the elderly in the United Kingdom as a share of gross domestic product is the third highest in Europe.

Does the Minister agree that it is a deplorable state of affairs when old-age pensioners visit our advice surgeries driven to tears because they do not know how they will cope with the harsh change in their circumstances that has arisen in the past three weeks? Does he agree that this country has a moral obligation to ensure some dignity and comfort in old age and not to squander the nation's money, turning the rich into the super-rich?

That is why I am happy to tell the hon. Lady that we are spending 9·6 per cent. of our gross domestic product on services and benefits to the elderly and that that is the third highest figure in Europe. I hope that she will be well content with that. She will be aware that only a small minority of pensioners were losers under the reforms, and that measures were taken on 27 April to provide further transitional protection to many of those groups.

Does my hon. Friend agree that to produce that league table would be misleading because it would ignore the fact that there are benefits available to the elderly in this country that are not available anywhere else in the world?

That is indeed the case. Last year the Leader of the Opposition and Lady Castle provided a league table that was discussed with the European Community's statistical office. That office stated that the comparison between the United Kingdom and other countries appeared to have been carelessly done because it was not accompanied by any comment on the fundamental differences between various social protection systems. That same letter of 27 April 1987 went on to say that the only statement that the office could back was that made by my predecessor, my hon. and learned Friend the member for Mid-Bedfordshire (Sir N. Lyell), that the third highest proportion of GDP spent on the elderly was spent in this country.

What European example are the British Government following by cutting the pension of a 74-year-old constituent of mine by the amount of industrial death benefit that she receives in respect of her husband who died 22 years ago? Does the Minister agree that it is disgraceful that 30,000 widows should be handicapped because they are in receipt of industrial death benefit and that the Government have not honoured a commitment that they made some time ago that existing recipients would not be harmed by the changes?

We are almost alone among European countries in paying additions to men's benefits in respect of their wives. That is a major feature of our benefit system.

In addition, our supplementary benefit rates for pensioner couples are about 20 per cent. higher than, for example, those in Germany, after taking account of the differences in the cost of living. If the hon. Gentleman wishes to go into European comparisons, I am happy to do battle with him.

To ask the Secretary of State for Social Services what representations he has received from nurses following the pay rise proposals.

My right hon. Friend met representatives of the nursing professions at the time of the announcement by my right hon. Friend the Prime Minister of the Government's decision on the pay review body's recommendations. They expressed their satisfaction that the Government had decided to implement the recommendations in full and fully fund the award. The result is that nurses now enjoy the highest ever levels of real terms pay.

Will my right hon. Friend remind nurses how much better off they are under this Government than they were under the Labour Government? Will he also encourage former nurses to return to the profession, in view of the declining number of school leavers?

The real terms increase in nurses' pay since 1979 will now be about 44 per cent., which, as with ancillary staff, compares with a real terms reduction under the Labour Administration.

We urge health authorities to encourage former nurses to return to the profession and very much hope that the pay increase will assist that process.

I appreciate the increase in salaries and welcome the fact that it is fully funded, but does the Minister recognise that there has perhaps been an impact on nurses in the hospice movement that has not been considered? Has he received any representations from such sources regarding such an impact? For example, in the Northern Ireland hospice, the outlay each year of £700,000 should be increased by £100,000 if it is to be fair.

Yes, I have had at least one direct representation about this matter. I shall consider the point, but I should observe that many hospices are in part funded by health authorities, and it would be appropriate for them to consider the matter in the light of the additional money being made available to them.

Is my right hon. Friend aware that our right hon. Friend the Secretary of State recently made a most successful visit to Macclesfield, where his words of wisdom about what the Government have done for the Health Service went down very well with a discerning audience? Will my right hon. Friend confirm that the Government's commitment is to meeting the nurses' pay review body award in full, and not just the average increase? There is considerable anxiety among administrators and some nurses that it is just the average increase, rather than the full increase, which the Government have rightly agreed to implement, and which is so welcome.

We shall shortly make allocations to regional health authorities in respect of the additional funds. They will have to consider how to allocate to the districts. The general proposition, and the basis on which the figures have been calculated, is a full funding of the award. As for the earlier part of my hon. Friend's question, I am sure that any audience of which he is a part is discerning.

Will the Minister give us a clear commitment that he will fund the pay award for nurses in voluntary hospices to the same extent as for those in the NHS? Is he aware that charitable hospices believe that they cannot meet the pay increase by rattling collection boxes and that if pay awards are not fully funded services for the terminally ill will be cut and some hospices, especially in northern England, which do not have a wealthy community to back them, will close?

I think that, in effect, I have already answered that question. The hon. Lady puts it in an absurd form. If the Government funded voluntary hospices as they fund health authorities, those hospices would cease to be voluntary, with all that goes with it. Many health authorities, through contractual arrangements or in other ways, assist hospices, and I would expect them to take account of the pay award.

Will my right hon. Friend keep an open mind about the possible need to extend regional premiums outside the London area? There is great fear in the East Berkshire authority that, in view of our proximity to London, our existing problems with recruiting nurses will be exacerbated by the premium that is payable just over border.

My hon. Friend will know that some thoughts on this subject were put to the review body, but it felt that further consideration was needed on the basis of experience. However, we shall bear that point in mind.

To ask the Secretary of State for Social Services if he will make a statement on recruitment levels at schools of nursing.

I understand that in the year 1986–87, 22,825 people entered basic nurse training. At 31 March 1987 there were more than 61,000 learners undertaking basic nurse training in England.

Why do the Government not treat nurse education with the seriousness that it deserves? Why has there been an 18 per cent. cut in expenditure on nurse education by the Government? Is it not a disgrace and a shame that hospitals such as St. Thomas's in London will have no further student recruits this July, which means that they will have to wait until October before they can get more nurses? That will lead to more ward closures or, at the very least, to more bed closures. Is that not a disgrace? Is it not time that the Government pulled their finger out and monitored vacancies to ensure that they are filled?

The hon. Gentleman might just remember that part of the answer to the first part of his question was given by my right hon. Friend the Minister for Health in the debate on 19 January, when he said that one of the reasons why basic nurse training costs a little less now is that fewer people drop out, so there is less wastage. As for the hon. Gentleman's point about St. Thomas's, he is obviously not aware of what is happening in Liverpool, which covers his constituency. The Sefton school of nursing tells me that it is fully booked for nurse training and is having no problems with recruitment. The Liverpool school of nursing says that it expects recruitment to be the same this year as last year and that it is experimenting with changing the educational test for admission so that it does not have to rely wholly on people with 0-levels. There are many good people without educational qualifications who would make excellent nurses, especially in Liverpool.

Is my hon. Friend aware of how vital it is to open nursing recruitment to groups other than the young? I refer specifically to people who have brought up their families and who then wish to train for and pursue a second career in their early middle years. I am sure my hon. Friend will appreciate the contribution that they could make to the nursing profession.

My hon. Friend is absolutely right. I was making a similar point to the hon. Member for Liverpool, West Derby (Mr. Wareing), as such a policy is already being pursued in Liverpool. I am sure that my hon. Friend will join me in welcoming the increasing number of male recruits.

Does the Minister agree that there is a problem with drop out, particularly in the first year of training? Does she agree also that it may be partly overcome if those recruited into nursing could be confident that the Government would fund the regrading implemented in the nurses' pay award? Will the Minister give a guarantee that any increased expenditure incurred by health boards due to regrading will be fully funded by the Government?

We expect this year's total pay bill for nursing to run to more than £5,000 million for the whole of the United Kingdom, and we have a record number of nurses. Our job is to ensure that we recruit, train and retain all the staff that are needed.

To ask the Secretary of State for Social Services if he will make a statement on the progress of the review of the funding and organisation of the National Health Service.

We are continuing to examine a range of options for improving services to patients and will bring forward proposals as soon as we can.

Will my right hon. Friend bear in mind that we on the Government Benches are looking for greater choice for patients in their selection of doctor, treatments and hospitals? We want also to see greater efficiency and value for money in the Health Service, through internal and external competition.

I take note not only of what my hon. Friend said, but also of the intent behind it. He is concerned not only about increasing competition, but about improving benefits to patients through greater choice and additional resources in health care.

Will the Minister take on board the point that his policy, and that of the Government, of increasing competition has led to chaos in my health authority? Laundry is now having to be transported 90 miles to Grimsby and hospitals are regularly without clean linen.

Competition has brought £100 million of additional money into health care in England for the benefit of patients. I should have thought that even the unreconstructed Labour Benches could begin to welcome that improvement.

While welcoming my right hon. Friend's review, may I ask whether he is aware that many of us hope that he will pursue an evolutionary rather than a revolutionary approach to the problems? Many of us believe that we continue to have one of the best health services in the world and that the challenges we face are still largely of management rather than of funding.

As always, I welcome my hon. Friend's contribution. We are looking at all ideas. Our prime and only concern is the better health of our nation.

To ask the Secretary of State for Social Services how he intends to monitor the implementation of the new clinical grading structure for nurses.

By means of guidance from my Department, visits by officials, and returns from all health authorities showing how many staff have been allocated to each of the new grades from each old grade.

Will the Minister give a clear and unequivocal assurance that all the money necessary will be found by the Government for health authorities to enable them to staff all established posts, as opposed to all posts currently filled?

Health authorities' establishment requirements are for them to determine within the total of their overall resources. We have committed ourselves to providing, and have provided, the additional money required to fund in full the recent pay award.

Can my right hon. Friend say when a response will be made to Project 2000? Will he reject proposals to train nurses away from wards? Does he agree that the best learning experience is practical experience?

I hope that we will respond to Project 2000 quite shortly. We certainly intend any proposal to ensure that the training of nurses continues to have a strong practical element.

To ask the Secretary of State for Social Services if he will make a statement on progress towards a pay award for the National Health Service ancillary staff and how it is to be funded.

To ask the Secretary of State for Social Services if he will make a statement on progress towards a pay award for the National Health Service ancillary staff and how it is to be funded.

I refer the hon. Members to the reply I gave to the hon. Members for Glasgow, Shettleston (Mr. Marshall) and for Bridgend (Mr. Griffiths) earlier today.

The Minister will be well aware that many of the problems in the Health Service were caused by the Government's failure last year to fund increases. He has spoken about the matter this afternoon, but will he give a commitment that in the event of a shortfall in any health board—and we have heard rumours that there will be such shortfalls—his Department will make up the difference to ensure that there is no knock-on effect on other health services?

I do not see how any question of shortfall could arise at a time when negotiations are proceeding on the subject of the hon. Gentleman's question, namely, ancillary staff. We expect that health authorities and boards in Scotland will be able to meet the results of any negotiation out of the resources available to them.

Is the Minister aware that many ancillary workers earn poverty wages below the European guideline on decency levels which are set at £32·5 per hour? Does he agree that that is miserly pay for people who do such a valuable job in the Health Service?

I readily recognise that many ancillary workers make an important contribution to the provision of the service as a whole. I have also said—one or two hon. embers may not have heard me say it, so I shall have to say it again—that the wages of that group are higher in real terms than when the Government came to office, and that when the Labour Government left office they were lower in real terms than when they took office.

To ask the Secretary of State for Social Services what action he is taking to reduce waiting lists at the Eastbourne district general hospital.

In addition to the improvements that we are seeking within existing resources, last year we made an extra £110,000 available to Eastbourne from the waiting list fund. This was used for nearly 100 additional hip operations. This year we have increased the allocation to £155,000, and it will be used for gynaecology and ear, nose and throat patients.

Is my hon. Friend aware that for some specialties the waiting lists in Eastbourne are becoming longer, as is the time involved? Does she agree that for a woman to have to wait two years for a hysterectomy is absolutely unacceptable?

My hon. Friend raised these issues in his Adjournment debate on 29 April. I assure him that there has been a good deal of activity in Eastbourne since then. He was then particularly concerned about gynaecology. He has my firm promise that we will get the waiting lists down, and I will write to him in more detail by the end of the week.

To ask the Secretary of State for Social Services whether he has any plans to promote HIV screening on a voluntary basis.

I refer my hon. Friend to my reply to him of 12 April, at column 101.

My hon. Friend will be aware that the French Government promote voluntary testing and have a large number of regional centres to which they encourage the population to go for such testing. Why have we followed a different course in this country?

My hon. Friend will be well aware that we have given extensive publicity to the availability of testing and made it very clear in our information material that people who are worried about being infected should seek expert advice. That was made clear, for example, in the leaflet distributed to all households. Of course, if further steps are required we shall be prepared to consider them. y hon. Friend will know that we shall shortly be examining the report from Dr. Joe Smith of the Public Health Laboratory Service on various related issues.

My hon. Friend will be well aware of the concern in large parts of the medical profession that we are not adequately aware of the trend of HIV in this country. I hope that he will seriously consider taking on not only voluntary but compulsory testing where necessary, perhaps in the armed forces or the prison population, so that monitoring of the progress of the virus can be accurate and adequate.

I note my hon. Friend's suggestions, but he will know that we have not so far felt it right to go down the path of compulsory testing. There is no doubt that it would raise some substantial issues. Again I refer in part to the report from Dr. Joe Smith, which we shall be studying.

To ask the Secretary of State for Social Services if he will make a statement on Health Service spending in north-west regional and district health authorities.

Gross revenue expenditure has increased from £382·6 million in 1978–79 to £922·8million in 1986–87. That represents an increase of 24 per cent. in real terms.

During the same period gross expenditure of £277·3 million has also been incurred on completing 32 new capital schemes within the region. With the benefit of that funding record levels of patients have been treated.

Nevertheless, does the Minister not recognise that there is a history of the health of people in my region being worse than that of people in the more prosperous south-east and that that spending has done nothing to narrow the gap? When will the Government do something serious about the huge health disparities that exist in Britain?

I know of the hon. Gentleman's interest in this matter well enough to know that he is aware that the gap has narrowed. The north-west region is a so-called RAWP-gaining region and it has done substantially better than many others for precisely that reason.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

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

Does the Prime Minister agree that critics of the community charge have conspicuously failed to come up with anything better?

Yes. Any alternatives would be infinitely worse, as we all know when we have been through a rating revolution. A rating revaluation based on capital values would be even worse, and a local tax would be abhorrent to most people.

Was not any change that the Prime Minister was to make supposed to be related to the ability to pay?

Yes, it is. Nine million people will pay less than the flat rate.

If that is the case, why is the right hon. Lady having such difficulty persuading her party in this House and the other place?

Perhaps the right hon. Gentleman did not notice that the Bill went through this House.

Has my right hon. Friend had her attention drawn to the practice attributed to President Reagan of consulting an astrologer before taking decisions? Has she considered appointing a resident astrologer at No. 10 Downing street? I should make it plain that I am not applying for the post.

No. I come under Libra, which is a very balanced sign.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

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

Is the Prime Minister aware of the widespread dismay that there will be about the news that the United States Senate has decided to delay ratification of the INF treaty? As the Prime Minister is such a strong public supporter of the treaty, and as she knows of the damaging consequences that there would be for East-West relations if the treaty were to fail, will she use all her influence in Washington to ensure a speedy ratification of it?

I share the hon. Gentleman's view that it is important that that treaty be ratified, and I have made that view known. I understand that the Senate postponement relates to United States-Soviet Union differences over interpretation of inspection rights. Among those are rights under the treaty to inspect missiles and missile stages leaving those missile assembly plants subject to permanent monitoring. It is not for us to interpret the treaty, but I believe that there is sufficient time for that to be properly resolved before the President visits Moscow, and I hope that the treaty will be ratified by that time.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

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

Is my right hon. Friend aware that Derbyshire county council now levies the highest rate in England and Wales, but that none the less, local people in Amber Valley have rejected scare stories about the community charge and elected a Conservative council for the first time ever.

Yes. I congratulate my hon. Friend's constituents on having the wisdom to do that. It was important that they should do so, because councils elected now will be those which impose the first community charge. We have to remember that councils decide the community charge.

Has the Prime Minister had time to consider the reply that the Parliamentary Under-Secretary of State for Employment gave me last Tuesday? If so, will she confirm that it is Government policy to employ people on the grounds of merit alone? How does that square with the recent list that was put in the Library in answer to my question about employment in the Civil Service?

Of course it is our policy to employ on merit alone. There has never been any other policy.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

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

In view of the increasing difficulty faced by young people on low incomes in obtaining homes in rural areas, will my right hon. Friend agree to review the allocation of Housing Corporation funds, only 3 per cent. of which go to rural areas, even though 20 per cent. of the population live in those areas?

I know that the proportion is very small, but the guidelines covering Housing Corporation allocations to rural areas have recently been revised. Funding will be targeted on smaller and more isolated agricultural settlements, with a view to doubling the present level of housing association provision in those areas. It is not a great deal, but it is a start. As my hon. Friend is very well aware, one also has to get planning permission for increased housing in rural areas.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

I refer the hon. Gentleman to the reply that 1 gave some moments ago.

As a result of the recent housing benefit cuts, many senior citizens in my constituency of Glasgow, Pollok and elsewhere have been asked to pay double their previous rent and rates from resources that are already overstretched. Will the right hon. Lady consider ways of ending the fear and hardship that her Government's policy has imposed upon the elderly?

If the hon. Gentleman's constituents are in local authority housing, their rent and rates are a matter for the local authority.

Order. Sir Nicholas Bonsor.

Does my right hon. Friend agree— [Interruption.]

Order. This takes up time.

Does my right hon. Friend agree that one of the greatest threats to world peace at the moment is the amount of chemical weapons stored by the Soviet Union? Does she further agree that the use of chemical weapons in the middle east has greatly exacerbated that threat? Is she prepared to take a lead among the leaders of the free world to find a solution to this appalling threat to our future?

I agree with my hon. Friend that the use of chemical weapons in the Iran-Iraq war has been very worrying indeed, as none had been used since world war 1. It concerns us all. I also agree with my hon. Friend that it is a matter of great anxiety to the West that the Soviet Union has a very large stockpile of chemical weapons and has modernised them, whereas we got rid of ours long ago. We shall use all our diplomatic skills to try to get an agreement on chemical weapons, preferably to abolish them altogether, but, as my hon. Friend is aware, verification is the most important factor. I believe that we may get further in negotiations on this matter.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

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

I refer the Prime Minister to the absolutely unsympathetic and misleading reply that she gave to my hon. Friend the Member for Glasgow, Pollok (Mr. Dunnachie), when she tried to put the blame for the change in housing benefit on local authorities. I draw the right hon. Lady's attention to a letter today in The Times from a widow of 89 who worked until she was 75 and who, because her income was 85p over income support level, has had her housing benefit decreased by £1·25.Will the right hon. Lady confirm that that was the Government's intention, so that the poor elderly should subsidise tax cuts for the better off?

No. The amount spent on housing benefit now is about £5·3 billion, and every two households are contributing not only to keeping themselves but to keeping a third house. With regard to the recent reforms, as my right hon. Friend the Secretary of State for Social Services said:

"We do not think it right to compensate"—

Reading.

Of course I am reading. I am reading precisely what my right hon. Friend said. He said:

"We do not think it right to compensate for those increases in rents introduced to coincide with the new housing benefit scheme, nor increases in rates."—[ Official Report, . 27 April 1 988; Vol. 132, c. 360.]

The new system does not compensate for those latest increases. It offers transitional protection for the system just before then and for the rent and rates then levied.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

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

Is my right hon. Friend aware that a brand new textile factory is being built in my constituency at a cost of £3 million, without Government subsidy? Is she aware that this is the first new textile factory to be built in the Colne Valley for over half a century? Does my right hon. Friend agree that this is an illustration of the growing confidence of industrialists in Yorkshire and of the success of the Government's economic policies in bringing jobs and prosperity back to the north of England?

I congratulate my hon. Friend on the fact that he has a new factory in his area. The textile industry is doing very well. It is effective and competitive. It produces excellent designs and is providing many jobs. As my hon. Friend knows, unemployment is now falling in all areas, including the north-west.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

I refer the hon. Gentleman to the reply that 1 gave some moments ago.

Does the right hon. Lady recall that the last question that 1 put to her was on the subject of litter? The right hon. Lady acted with great alacrity in having a photo-call in St. James's park, which nationally achieved good results. If other hon. Members had done the same in their constituencies, it would have helped the nation to get rid of this curse. Will the right hon. Lady now turn her formidable talents to asking local authorities and the members of the farming community to stop cutting their verges surrounding our countryside? Will she try to persuade the farming community to stop cutting hedges at the same height and width, or we shall finish up with one National Hunt course?

I am sure that the hon. Gentleman agrees that the landscape that we seek to conserve has largely been created by farming. There was a period when grants were given to take hedges out, but that period has long since ceased. I agree with the hon. Gentleman that we do not want a countryside that consists largely of prairies, without many of the old hedges that we used to see.

Is my right hon. Friend aware that this week there are six Chinese parliamentary or Government delegations in London, including the Inter-Parliamentary Union group, which she met earlier today? Will my right hon. Friend take this opportunity to say what she sees as the present relationship between Her Majesty's Government and the People's Republic of China?

I saw a representative of that group today. The relationship between Her Majesty's Government and China is very good. We have the excellent arrangement of the Hong Kong agreement that we signed. Trade is increasing and we wish to increase contacts between the Chinese people and this country. Cultural contacts are also increasing.

To ask the Prime Minister if she will list her official engagements for Tuesday 10 May.

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

Is the Prime Minister aware that the north of England tourist trade needs a boost and that if she visited the Lake district, the Yorkshire dales and north Wales that might help to boost the tourism industry of the north-west?

I agree with the hon. Gentleman that tourism creates many jobs and that we wish to increase it. I wish him well in that area.

On a point of order, Mr. Speaker.

I will take points of order after the Standing Order No. 20.