To ask the Secretary of State for Health whether it is proposed that general practitioners who opt for a practice budget will be entitled to keep any savings that there may be for their own personal use.

No, Sir. The Government intend that savings generated within practice budgets should be spent on practice improvements and on offering more and better services to patients.

What would be the criteria for practice improvement expenses? If doctors improve their lifestyles with better suits, cars or holidays, will not patients be tempted to think that that may be taking the place of proper medical treatment? It is not the doctors' fault, but the fault of the Secretary of State for creating a system that replaces trust between patient and doctor with mistrust.

If doctors acquire better cars and suits it will be only because of the generosity of the pay awards that the Government have been implementing following the review body's recommendations. If savings are made on practice budgets we shall expect them to be ploughed back into improvements to the premises or new facilities so that services to patients can be made better. Financial and medical audits will ensure that that is done.

Is my right hon. and learned Friend aware that the reaction of some general practitioners suggests that they have either misunderstood or misinterpreted the proposals? First, will he confirm that this is a voluntary matter—that it is up to a group practice to choose whether it takes on the budget system? Secondly, would he care to spell out for their benefit the advantages of the scheme?

We are sending all GPs the working paper on the subject. I agree with my hon. Friend that the proposal is at first sight rather complicated, and I think that the working paper will improve understanding of it considerably.

Section 16 of the Health and Medicines Act 1988 provides for funds to be given to certain practices through the family practitioner committees, especially in deprived areas. Will that still happen or will the budget knock it on the head? Will GPs still receive the cash to improve their properties?

The practice budgets will be set to reflect the social nature of the practice being served. The proposals in the Health and Medicines Act still stand, with the undertakings given by my hon. Friend the Minister when it was implemented. We shall soon be putting to the profession our proposals for a package on GP remuneration, and that will show how we intend to reflect the extra work that can be imposed on GPs in deprived urban areas.

Is not the implication behind the original question that money spent on the Health Service can be spent more efficiently? Will my right hon. and learned Friend take this opportunity to confirm that any GPs taking practice budgets will not have any difficulty if they overspend, and that chronically sick and geriatric patients will not be turned away?

I can certainly confirm that. It is another misunderstanding that we should quash straight away. There is no question of a GP not being able to provide proper medicine or care for an elderly or chronically sick patient, or for anyone else. Nothing in our proposals gives rise to any such danger.

Does the Secretary of State agree that his proposals for practice budgets and, indeed, for general practice overall, reduce both patient and GP choice? Has he read the Coopers and Lybrand health and management update report No. 22, section 8, which says that the Government's proposals will reduce choice for patients and GPs? Will he come clean and admit that, rather than increasing choice, the proposals will simply increase bureaucracy?

I do not agree with the hon. Gentleman's assertion, or with Coopers and Lybrand, if the report supports what the hon. Gentleman says. General practitioners who do not elect to have practice budgets will still have freedom of choice on referrals although they will have to work more closely with their district health authorities than hitherto in deciding on referral patterns from their areas. As I explained to my hon. Friend the Member for Chislehurst (Mr. Sims), a GP practice that elects to have a practice budget will have much greater choice for itself and the patients and much greater control than GPs have had in the past over quite large amounts of NHS resources.

To ask the Secretary of State for Health what percentage of abortions at 25 weeks, 26 weeks and 27 weeks was performed (luring 1987 because the child was likely to be born handicapped.

The figures are eight out of 11, six out of nine and all three at 27 weeks, respectively. For the convenience of the House I shall publish in the Official Report a table which presents this information more fully.

In view of the fact that even at the late ages of 25 and 26 weeks' gestation there are still some social abortions is my hon. Friend satisfied that his Department is complying with the spirit and the letter of the Infant Life (Preservation) Act 1929?

My hon. Friend is certainly right that based upon the figures that I have just given, six of the abortions in 1987 where the gestation period was above 24 weeks were for reasons other than the potential handicap of the child. If the Infant Life (Preservation) Act 1929 were amended to insert "24 weeks" instead of 28 weeks, all 23 abortions would be called into question except where the life of the mother was endangered. My hon. Friend's Bill would call into question only six of the abortions.

The pro-abortionists claims that there is no majority in the House to amend the Abortion Act 1967. Will the Minister speculate as to why that self-same group spends so much time adopting procedural devices to prevent us from reaching a conclusion on the matter?

As the hon. Gentleman knows, that is not a matter for me.

Will my hon. Friend confirm that the answer that he has just given to my hon. Friend the Member for Maidstone (Miss Widdecombe) confirms that, quite rightly, there are very few late abortions—

Too many.

and secondly, that nearly all of those take place when there is a very clear indication that the baby is likely to be grossly handicapped?

My hon. Friend is right. I repeat the figure of six late abortions—using my hon. Friend's definition of late as being over 24 weeks' gestation—where the reasons were other than for the potential handicap of the child.

Does the Minister really believe that the possibility of something as trivial as a non-inherited skin disease represents a gross handicap? Does he not agree that amniocentesis and chorionic vilius sampling are increasingly used as the first part of a search and destroy mission, that far too much pressure is put on people to abort away handicap and disability and that that becomes a quality control on life and what is really needed is help for both the mother and the child?

The hon. Gentleman will realise that the certification of the cause involving the potential handicap of a child is not a matter for me but for clinical judgment.

To ask the Secretary of State for Health if he proposes to examine the role of the hospital matron in the National Health Service.

Health authorities are already free to use the title of matron for the senior nurse manager in a hospital, and some do so. One of the key aims of the Government's new proposals is to give hospitals much more control over the running of their own affairs, and decisions on the roles and titles of senior nursing staff will continue to be made locally.

Is my hon. and learned Friend aware that there is widespread disappointment that the traditional role of matron does not feature more widely in the current review of the Health Service? Is he further aware that the role of matron was unique in that she could deal with consultants and doctors, understood nurses and patients well, yet at the same time as was able to control very carefully items such as bed linen and bandages and had a good overall view of the whole system? Bearing in mind that people rather than structures make organisations run smoothly will he reconsider reinstituting the traditional role of matron in our hospitals?

I recall that that paragon was usually played by Peggy Mount in the films. However, there is nothing to prevent a hospital that is seduced by my hon. Friend's arguments from calling its senior nurse manager a matron, as some hospitals do.

I suggest to my hon. and learned Friend that it does not matter a row of beans who played the part of the matron in a film. Many people think that almost the biggest mistake ever made in the National Health Service was to get rid of the matron. If we had that particular figurehead, there is little doubt that she would be able to cope with the flood of thefts that is endemic in the NHS, that she would make the wards cleaner—many of them badly need to be made cleaner—and that she would manage the hospital with great efficiency, as she always used to do. Does my hon. and learned Friend acknowledge that apart from the fact that hospitals can bring back matrons, they ought to be positively encouraged to bring them back?

As I understand the argument in 1966, the feeling was that there were so many different sizes of hospital that one needed a more sophisticated profile for senior nurse managers to reflect the different sizes of units that were being managed. It is important that senior nursing offices should be invested with all the powers that are required to do the various jobs to which my hon. Friend refers. If a hospital chooses to call that senior nursing manager a matron, so he it. We have no objection.

To ask the Secretary of State for Health what are the latest figures for women affected by cervical cancer aged (a) 25 years or less and (b) over 25 years.

The latest information available is for 1984. In England and Wales there were 41 registered, newly diagnosed cases of malignant neoplasm of the cervix in women aged under 25. There were 4,002 cases in women aged 25 and over.

Does the Minister agree that over 2,000 women a year are dying from cervical cancer? Why do the Government not spend the additional £20 million that would provide a 90 per cent. coverage? The hospitalisation bill is £15,000 per patient. That is equivalent to £30 million. The project to screen women once every five years costs £30 million. All the Minister needs to do is to spend £20 million and he would be £10 million in pocket.

I confirm that there are 2,000 avoidable deaths each year. If the policy of introducing screening for all women between the ages of 20 and 54 at least once every five years were introduced and if it covered all women between those ages, it would cut deaths by about 85 per cent. Our policy of screening women at least once every five years will enable us to reach more women and therefore to save more lives. To concentrate on a shorter frequency in the long run is, I agree, the ideal, but if we went for a shorter cycle we should inevitably reach fewer women.

Will my hon. Friend remember those who die of breast cancer? The numbers are now quite horrendous. Will he therefore expedite the provision of mammography for all women in the particularly vulnerable age group of 50 and older?

I am grateful to my hon. Friend. She is absolutely right that the breast screening programme—which is new, unlike screening for cancer of the cervix, which commenced in 1966—is most valuable and saves the lives of many women. We are keeping that programme under close review, and I shall bear in mind what my hon. Friend has said.

Does the Minister agree that the latest date for which information is available is 1984 and that that is appalling? When will that be improved?

I share some of the hon. Gentleman's concern, but he ought to appreciate that the information that is collected by the Office of Population Censuses and Surveys depends in part on figures that come from voluntary organisations. It is not, therefore, within my power to ensure that comprehensive figures are available for the most recent years, much though I should like to do so.

To ask the Secretary of State for Health what representations he has received on the recent White Paper on the review of the National Health Service.

To ask the Secretary of State for Health if he will make a statement on the response from members of the public and the various interest groups to his White Paper proposals on the future of the National Health Service, published on 31 January.

To ask the Secretary of State for Health if he will make a statement on his assessment of immediate reactions to the proposals contained in the White Paper entitled "Working for Patients".

Reaction to the White Paper "Working for Patients" has been extremely positive. We have published a series of working papers outlining some of our key proposals in greater detail, and we shall be discussing the implementation of these proposals with interested parties in the coming weeks.

I thank my right hon. and learned Friend for his answer. In acknowledging that we have received a warm response from most members of the public and the medical profession, does he believe that the introduction of the White Paper's proposals ought to be fairly flexible? Does he agree that consultations with the medical profession and the consultative committees should take place so that we can provide the absolutely best possible deal for the National Health Service?

The proposals are complicated and go into details about how the service is managed and financed, which normally, as a patient, the average member of the public would not encounter, so understandably there is some public reserve about the proposals. A great deal of discussion is needed, particularly with those who are intimately involved with the way in which the service is run and financed. That is what we propose to embark on in the next few weeks—having published the working papers yesterday—and we are open to all constructive suggestions about how these proposals can best be implemented for the benefit of patients.

Is my right hon. and learned Friend aware that many of his ideas in the White Paper have been received warmly and positively? Does he agree that in principle it is possible for specialist national hospitals to consider opting out while remaining within the NHS system if they are threatened with closure or removal or both, provided that the scheme is viable and the funding properly organised?

I agree with my hon. Friend about reaction to the proposals, and I am surprised that we have not had the bitter outpouring of opposition that sometimes comes automatically on any health service subject from a whole range of people. Only the Labour party and a few trade unions have responded in that way.

With regard to general practitioners managing their own budgets, will my right hon. and learned Friend take this opportunity to clarify the precise mechanism by which practitioners will have spending power once their indicative budgets are used?

I am not sure whether my hon. Friend is questioning me about the practice budgets, about which we had an exchange a few moments ago, or about the indicative drug budgets which all practices will have.

Will the Minister explain precisely who will be allowed to decide whether a hospital opts out? It is difficult to understand from the discussion documents just what the position will be. Indeed, the discussion papers are bizarre. May we be told in simple terms who will make the decision?

The hon. Lady refers to opting out. She may have been misled by her hon. Friend the Member for Kirkcaldy (Dr. Moonie) into thinking that we are talking about opting out of the NHS, which we most certainly are not.

Not yet.

We are talking about NHS hospitals which will be run by their own managers, doctors and nurses and not be so subject to the district, region and Secretary of State in their day-to-day affairs. The decision as to whether a hospital which wants to become self-governing shall become self-governing will in the end be taken by the Secretary of State for Health after he has received a report and advice from the regional health authority.

The right hon. and learned Gentleman should speak and listen to the consumers of the NHS. Most people see this as the first steps towards privatisation. In that sense, are not the Government abrogating their responsibility for the health of the people of the nation?

If a significant proportion of the population believe that this is a step towards privatisation, they have been absurdly misled by the Labour party. There is not a word in the White Paper which makes it any easier, or any more difficult, for any Government to privatise the NHS. It is obvious to anyone who reads the White Paper that its proposals have nothing to do with privatising the NHS, on which the Government have turned their back.

Does the Secretary of State acknowledge that although there are already reservations, greater reservations may arise when the discussion documents are examined? What place will be given to consumers in local committees, especially with the abolition of participation by councillors?

The various bodies in question—family practitioner committees, district health authorities, regional health authorities, and the boards of NHS hospital trusts—will have a majority of non-executive members; lay people as opposed to professional people. Obviously, we expect to find on all committees people drawn from the local community to represent the consumer interest in its widest sense. They will also be able to make a personal contribution to the management and development of the Health Service.

Does my right hon. and learned Friend agree that rather than take into account the present situation in attempting to preserve the cumbersome bureaucracy of the Health Service—as the Opposition wish to do—one of the Government's most beneficial proposals is to allow hospitals to opt out of cumbersome district health authorities and into the hands of local management? Will he give an assurance that the determinant of opting out will not be the convenience of consultants but local popular demand?

I share my hon. Friend's dismay over the Opposition. I have been a Member of the House and in health politics long enough to recall that, over the past 20 years, the Labour party has opposed every proposed change to the Health Service. They vigorously fought the proposal to establish district health authorities in the form that they now have, and now oppose changes to reform them further. The Opposition opposed Griffiths and every advance in the Health Service, as long as anyone can remember. The acid test of a self-governing hospital, as of any of the reforms, must be whether it improves the service to the nation and makes it stronger and more effective in delivering care to the community. That must be the test which, above all, we apply to suggestions for implementing reforms.

Does the Secretary of State include among the positive responses to the White Paper last week's poll showing that of those members of the public who know of the right hon. and learned Gentleman's proposals, only 14 per cent. approve of them and 71 per cent. disapprove? Is that why the working paper published yesterday makes it clear that the Secretary of State will not risk a ballot on any proposal to opt out? If opting out is about local self-government, why is it that only the right hon. and learned Gentleman will make the decision on every single opt-out? If response to the White Paper is positive and favourable, why is the Secretary of State so reluctant to put opting out to the vote?

As I said a moment ago to my hon. Friend the Member for Harrow, East (Mr. Dykes), the reason for current public reaction is because the public does not yet altogether understand the proposals' details. They are complicated proposals, and the average member of the public does not understand what is done by a family practitioner committee, for example, and how the Health Service is managed and financed. While discussing matters with staff, we must at the same time explain to the public how the proposals will work in strengthening the service. I have no idea who the hon. Member for Livingston (Mr. Cook) thinks we should ballot. I presume that he asks for a ballot of trade union members in the hospital in question to determine the matter. We expect that when the proposals for self-governing hospitals are publicised and fully discussed locally, the decision will be made on the basis of whether that change will improve the ability of the Health Service to deliver care to its patients.

To ask the Secretary of State for Health what was the number of dentists in the National Health Service in 1979 and in the latest available year.

There were 15,293 dentists in the National Health Service in England in 1979 and in 1987, the number was 17,761—an increase of 16 per cent.

I thank my hon. and learned Friend for those figures. Does he agree that they hide substantial local variations, and that it is especially welcome that the Government are introducing, on a trial basis, arrangements to encourage dentists to set up in shortage areas by providing financial incentives?

My hon. Friend is right. The sharp increase in the number of dentists working in the NHS is welcome news to everybody, but it disguises considerable variations. For instance, there are twice as many dentists per head of population in North East Thames as in the Trent region. Plainly, we must do something to make the spread more even.

Will my hon. and learned Friend take another look at his Department's policy of discussing dental issues with only just over half the dentists, who are members of the British Dental Association, and ignoring all the others who are members of the General Dental Practitioners Association, because I, for one, find that confusing?

Our aim is to work with the grain of the profession and I shall bear in mind what my hon. Friend has said.

To ask the Secretary of State for Health what consultations he has had with representatives of the medical profession in respect of the Government's review of the National Health Service; and what their response has been.

I have had a number of useful discussions with representatives of the medical profession. I look forward to hearing their views on the implementation of the Government's proposals when they have had time to consider the detailed working papers that I published yesterday.

Is not the medical profession up in arms about those proposals because it realises that patient care is being sacrificed on the altar of a preparatory stage on the road to privatisation? Can the Minister confirm that one hospital that had opted out could concentrate on diabetics, another could concentrate on obstetrics and another on hip operations, creating a Health Service in which care was fragmented? Is it not true that whereas after the war the Labour Government created a comprehensive NHS, this Government are proposing a fragmented one?

Many doctors have many different opinions. The most common reaction that I have encountered from doctors and their representatives is a requirement for more detail in order to discuss the matter further. They now have the working papers and I await their reaction. No doctor has so far taken up with me the privatisation argument. I do not think that any doctor takes that seriously. They regard it as knockabout political nonsense put about by the Labour party. I have heard of fears about self-governing hospitals suddenly electing to go for some narrow specialty. Apart from those that are specialist hospitals already, such as the royal national orthopaedic, which my hon. Friend the Member for Harrow, East (Mr. Dykes) may have had in mind, I cannot see any sensible reason why any hospital trust and its doctors and managers should decide to start abandoning particular specialties in serving their town, and nothing in the proposals gives them any incentive to do so.

As the medical profession is there to serve patients, if a patient is not satisfied with the treatment that he receives or with the length of wait, will he be able to take his business elsewhere?

Certainly. We should make sure that the patient is completely free to do so. The rules that inhibit that freedom which are occasionally respected at the moment, will be removed by the Government.

Is the Minister aware that my constituents are very much opposed to the idea of the Walton or Fazakerly hospitals opting out? Is he also aware that we are very much opposed to the closure of the Walton hospital and the concentration of all services at the Fazakerly hospital? Therefore, will he give us an assurance that the Walton hospital will not be closed and that the ideas and high concepts of the people of the area will be accepted?

I am interested to hear that the hon. Gentleman wishes both hospitals to be subject to the direct control of the district and regional health authorities, but then expresses his strong opposition to a policy that those authorities might adopt. The closure of Walton hospital and the concentration of services at Fazakerly hospital will have to be decided first by the health authorities that are responsible for both hospitals at the moment; there will then have to be public consultation, and, if the community health councils disagree, my hon. and learned Friend the Minister of State will have to make the final ministerial decision. That is the present system and will remain the system after the White Paper has been implemented.

May I tell my right hon. and learned Friend how pleased I am to hear that all hospitals will be eligible to opt out, not just the large ones? Will he consider the opting out of Wells and district cottage hospital in my constituency, which would be a most excellent step to take?

Any hospital contemplating becoming an NHS hospital trust will have to draw up its business plan and proposals for serving patients in the area. It will then have to be examined to ensure that the hospital is capable of taking such control over its own affairs and that there is a satisfactory level of demand for its services in the area with an expected level of referrals to justify its existence as an NHS hospital trust. All that is set out in the working paper and I have no doubt that people in Wells and elsewhere will be studying it carefully to see whether it fits the circumstances of their hospital.

Has the right hon. and learned Gentleman consulted GPs about referring patients to hospitals? What will happen under his proposals where the patient and the GP choose a hospital with which the DHA does not have a contract and the DHA refuses to use its contingency reserve? Will the patient get treatment where he or she chooses and who will pick up the bill?

In the precise situation set out by the hon. Lady the same situation could arise as arises now. A GP is free to refer his or her patients if he wishes, but the hospital is not obliged to accept all referrals. Increasingly, in recent years, referrals have not been accepted because there have been no funds for treatment for an out-of-district patient. All our changes in the White Paper will make it easier for money to cross administrative boundaries, and it will be up to the GP to consult his own district health authority about referral patterns. If he wants to be free of the DHA he will have to contemplate having his own practice budget.

To ask the Secretary of State for Health how many abortions at 18 weeks and over were carried out in 1987 in clinics run by charities; and if he will distinguish between United Kingdom residents and non-residents.

Two thousand seven hundred and twenty eight in charitable, as opposed to non-charitable private clinics. Of these, 2,214 were performed on women resident in the United Kingdom and 514 on non-resident women.

When will my hon. Friend implement the recommendations of the 1973 Select Committee on abortion, which proposed that links between doctors and agencies referring women for abortions and the clinics in which they were carried out should be broken and that there should be after-care and follow-up facilities for women who come to this country from abroad for abortions?

We have these matters under consideration, but I can tell my hon. Friend that the majority of abortions performed in 1987 on women after a gestation period greater than 18 weeks were in private clinics. The proportion of non-resident women was just under one half and that proportion has fallen by about one half since 1983.

Is the Minister aware that the 60 per cent. of abortions carried out in private clinics bring in £2 million to the private doctors concerned? Does he not think that those doctors should be defenders of life not destroyers?

The private clinics and the doctors who work in them have an important role to play in the health care of the nation. Whether the abortions performed in those clinics or in NHS clinics are ethically correct is a matter for the hon. Gentleman's conscience and for mine.

To ask the Secretary of State for Health what is the present ratio of administrators and ancillary staff to doctors and nurses in the National Health Service; and what was the ratio in 1979.

In 1979, for every 100 administrators and ancillary staff there were 140 doctors and nurses. In 1987, for every 100 administrators and ancillary staff there were 190 doctors and nurses.

Does not my hon. and learned Friend's answer reiterate the Government's commitment to the Health Service and in particular to those at the sharp end? Does it not also illustrate that the Government are moving away from bureaucracy to patient care?

It absolutely does, because that figure—which I am glad that the House has welcomed—shows not only the increase in medical staff but a very major change in administrative, clerical and ancillary staff: a sharp reduction in ancillary staff but an increase of over 63 per cent. in administrative and clerical staff working in clinically related posts. That is a major change and a fundamental reason why the NHS is serving patients better today than it ever did when the Labour party was in power.

Will the Minister note that there was nothing wrong with the ratio of administrators to doctors in Middlesbrough general hospital during the time of the child abuse crisis, when 121 children were taken into care and 98 were returned by the courts? Given that state of affairs, what does the Minister make of the doctors' statement at the weekend that 90 per cent. of the children were abused then and are abused now?

I have every confidence in the Northern regional health authority and I support the decision it has taken to bring disciplinary action against Dr. Higgs. I cannot say more now, because the matter is sub judice. However, I can say that I read with considerable surprise the letter, signed by the 11 clinicians, that appeared in The Guardian. Neither I nor my Department can see any basis for the assertion that more than 90 per cent. of those children had been abused.

Is my hon. and learned Friend aware that the Government are to be congratulated on their policy of encouraging ancillary services to be put out to tender, which has enabled millions of pounds throughout the Health Service to be applied to patient care and has put an end to the nasty NUPE and COHSE cartel?

My hon. Friend is absolutely right. Competitive tendering has been a significant factor in enabling the National Health Service to treat a greatly expanded number of patients more efficiently. Once again, it is a sign of the double-talk of the Opposition that, although claiming to represent the interests of patients, they actually uphold the stranglehold of the cartel that NUPE and COHSE used to exercise over the NHS, but do no longer.

To ask the Secretary of State for Health how much has been spent on publicising the proposals in the recent health White Paper, 'Working for Patients'.

The sum of £1,250,000 has been allocated and spent on the launch of the White Paper.

Is that not an outrageous sum to have been diverted from patient care to give the Secretary of State greater publicity opportunities? Will that diversion of funds from patient care not be a characteristic of the reforms that he is setting out, not least if they involve a massive amount of invoicing, charging and recharging, all of which will add to the bureaucratic costs of the Health Service without helping patients?

I regard it as a bargain at the price when one considers that we were explaining complicated proposals to a service that employs more than 1 million people and consumes £26 billion of taxpayers' money each year. In the past, the Health Service has not communicated well with its staff and, at times, has been reminiscent of the worst features of the car industry in the 1960s and 1970s, by its complete failure to communicate with its own staff. We embarked on a modest attempt to explain to people the implications of our proposals for their careers and their patients. The costs, incidentally, include things such as the popular leaflet and short communications pack, which I know that many in the House are using, let alone people outside.

In welcoming the way in which my right hon. and learned Friend has taken time and effort to sell his policies and the way in which he has used money to do so, may I ask him to encourage some of his Cabinet colleagues to do the same?

I know that at least one of my Cabinet colleagues has been interested in my experience of teleconferencing, and the same method will be used again. Given that the Government explain their policies in White Papers and other ways, it is absurd that we are not allowed to explain them to those mostly directly affected, using the most modern methods of communication. The cost is modest. The literature, videos and everything else contain no hint of party political material and we adhere extremely strictly to the conventions that surround these matters.

To ask the Secretary of State for Health what estimates he has made of the additional administrative costs of National Health Service hospital trusts, general practitioner budgets and other proposals in the White Paper, "Working for Patients".

No overall assessment of costs can be made in advance of decisions about the details and pace of implementation. I have no doubt that the NHS needs to invest in modern management methods.

It is not irresponsible of the Secretary of State to bring forward these proposals without having estimated the administrative costs? Does he not accept that his proposals will absorb, in the administration of wasteful competition, resources that should go into patient care? Will he give the House a straight answer to a straight question? Will administrative costs fall or rise? If the latter, who will pay?

We made some provision for administrative costs in last year's autumn settlement when we allocated £2 billion. Money will certainly need to be put up front for investment in modern management techniques to achieve savings thereafter and to make better use of that money for patients.

To ask the Prime Minister what arrangements exist to ensure that the Civil Service is not politicised in circumstances where a single party has been in power for a decade or more.

I have been asked to reply.

Pursuant to the Prime Minister's oral answer of 2 February, column 425, on the circumstances of Sir Leon Brittan's appointment, what is the House of Commons to think other than that Mr. Ingham and Mr. Powell have become so highly politicised that they connived at the Prime Minister's corrupt and—[Interruption.]

Order. The hon. Gentleman must withdraw the word "corrupt".

Ted Heath said it.

Order.

I borrow the word of the former Conservative Prime Minister.

Order. The hon. Gentleman should resume his seat when I am on my feet. I do not care who else may have said that, but I ask the hon. Gentleman to withdraw that word.

Is there one rule for Back Benchers and another for former Prime Ministers?—[Interruption.]

Order. I have studied the Hansard of that exchange and it is my understanding that the former Prime Minister referred to the machinery at No. 10, not to the Prime Minister personally. I am asking the hon. Gentleman to withdraw the word "corrupt". I advise him that he will be taking time out of questions if he refuses to do so.

The last thing that I want to do is to get thrown out of the House of Commons. However, in view of column 657 on 27 January 1986, could we say specifically the Prime Minister's "misbehaviour"? Did they connive at that?

Order. Will the hon. Gentleman please withdraw the word "corrupt"?

Is is an important day for the House and the last thing—[HON. MEMBERS: "Withdraw."] Mr. Speaker asked me to withdraw; I will.

That was a long time acoming.

"No convincing evidence that the British Civil Service is being politicised."

"There has not been an overt or systematic politicisation of the top ranks of the civil service."

To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

I have been asked to reply.

Will my right hon. Friend find time to consider the greater degree of choice that the Government's housing policies afford to council tenants? Does he agree that allowing tenants to choose their landlord is the best way of raising standards? Is he aware that Gloucester city council is providing such a choice by offering its tenants the opportunity to opt for one of the best housing associations?

I wholeheartedly agree with my hon. Friend that the best way of raising council tenants' standards is to give them a choice of landlord. The Housing Act 1988 achieves that through the tenants' choice provisions and I am sure that council tenants will welcome those new rights. I am also aware of Gloucester city council's proposals for transferring its housing, but I must resist the temptation to comment on them, because the council may wish to apply to my right hon. Friend the Secretary of State for the Environment for a consent to dispose of that housing and I would not want to prejudice his consideration of the application.

May I inform the right hon. Gentleman—[HON. MEMBERS: "Question."] Mr. Speaker, may I inform—[Interruption]

Order. Come on, please.

May I inform the right hon. Gentleman that the Opposition fully support the firmest international action against the threats that have been made on Salman Rushdie's life? The great majority of Moslems, although devout in their faith and offended by what they have been told that Mr. Rushdie has written, are nevertheless law-abiding citizens who are opposed to any illegal act. I also repeat my conviction that Mr. Rushdie is free, under the law of this free country, to publish, and no power has the right to menace or oppress his liberty to do so.

I am grateful to the right hon. Gentleman and I am sure that his sentiments are shared by all hon. Members. I am sure that he will also be grateful that my right hon. and learned Friend the Secretary of State for Foreign and Commonwealth Affairs will make a statement at the end of Question Time.

To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

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

Will my right hon. Friend find time to look into the compensation arrangements that follow compulsory purchase? Does he accept that they are often felt to be unfair and resentment of them contributes to further delays in infrastructure projects?

My hon. Friend knows that we keep these matters under review and he will be pleased that we have substantially increased home loss payments to a minimum of £1,200.

To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

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

In view of yesterday's events at Shrewsbury, does the Leader of the House first accept that Opposition Members do not wish yesterday's events to be seen as a way of resolving the problems of a unified Ireland?

I know of no evidence to support what the hon. Gentleman has said, but I shall take note of it and see that it is examined by the appropriate authorities. The attack on Clive barracks was another callous attempt to kill and maim soliders as they lay asleep. It was thwarted by the vigilance of the guards, and their courage and presence of mind prevented a serious loss of life. I am sure the hon. Gentleman would not expect me to comment on security arrangements or any details of them.

Notwithstanding the supplementary question, which was a far from accurate reflection on the state of security on British forces bases, will my right hon. Friend take time during his busy day to ensure that the Secretary of State for Defence communicates to the commanding officer of the 2nd Parachute battalion the congratulations of the House on the vigilance of that battalion in having secured a large base? Will he also commend the courage of Private Norris, who fought off the attackers?

I shall certainly pass on what my hon. Friend says. I am sure the whole House would want to pay a warm tribute to the young men who, asleep or on duty, are at grave risk for our safety.

To ask the Prime Minister if she will list her official engagements for Tuesday 21 February.

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

Is the Leader of the House aware of recent reports that have suggested that contact with certain bleached paper products, particularly women's sanitary wear and children's nappies, could lead to the users being infected with dioxin? Does he agree that the manufacturers' response to that has been inadequate and in some respects patronising, and what will he do about that?

The hon. Gentleman is correct to say that there has been some trouble in this area, but it is of small proportions. It is being examined to check what can be done to relieve the problem.

Does my right hon. Friend agree that the valleys initiative, together with the 67 per cent. increase in this year's urban programme allocation, shows the Government's determination that all areas should benefit from the economic transformation that is taking place? Does he also agree that the Opposition's clear embarrassment by the initiative is simply because this Government are doing for their traditional heartland what they lamentably failed to do when in office?

My hon. Friend is right. I was present in the Chamber yesterday when the Opposition gave a great deal of publicity to the speech made by my right hon. Friend the Secretary of State for Wales this morning, in which he pointed out that in 1988 there was new inward investment in the valleys every two weeks, and more than half those projects were for more than £1 million. In total those investments will provide several thousand new jobs, and unemployment in the Welsh valleys has fallen by 38 per cent. over the past three years.

Will the Lord President make it clear to the Prime Minister that not even the best efforts of her publicity machine will persuade us that the German Government are out of step in NATO on the issue of premature modernisation of short-range nucler weapons? A fortnight ago she told the House that Norway was a loyal NATO ally. The Lord President may know that Norway and Denmark have joined the Germans in resisting this move. Does he accept that we believe that this country should spend the next two years seeking further reductions in nuclear and conventional weaponry on the Warsaw pact side, and that it is the British Government who are out of step?

My right hon. Friend had a successful meeting in Germany with the Chancellor. I believe that they had good discussions, and I hope that our positions are coming closer together.

During his busy day will my right hon. Friend consider the results of the ballots held under the Education Reform Act 1988? Does he agree that they show that the parents of this country prefer Conservative choice to a Socialist straitjacket?

My hon. Friend makes his point well; I certainly shall.

To ask the Prime Minister if she will list her official engagements for Thursday 21 February.

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

When the Leader of the House considers with the Prime Minister, as he must do from time to time, the legislative programme of the House, will they take on board the supreme difficulty, indeed the impossibility, of a British jury deciding on blasphemy in respect of' Christianity, let alone other religions, and accept the reality of life in this country, that in effect our national religion is one of freedom, and take the considered report of the Law Commission and bring forward legislation to abolish the law on blasphemy and replace it with public order offences?

I will certainly take the first part of the hon. Gentleman's question and discuss it with my right hon. Friend, but the hon. Gentleman would not expect me to answer him here now.

To ask the Prime Minister if she will list her official engagements for Thursday 21 February.

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

Many hon. Members and all Conservative Members will welcome the downward trend in long-term unemployment. Will my right hon. Friend accept the congratulations of the House on that and also express the thanks of the House to all those, often lowly paid, civil servants in jobcentres who made this trend come about?

My hon. Friend is absolutely right to draw the attention of the House to the excellent figures released today, showing that long-term unemployment is down by about 280,000. It has fallen in all regions, which is excellent news, and total employment is at its highest ever.

On a point of order right now, Mr. Speaker.

No. Statement by the Foreign Secretary, Sir Geoffrey Howe.