To ask the Secretary of State for Health if he will meet representatives of ambulance staff to discuss pay and conditions.

To ask the Secretary of State for Health if he will make a statement on the future of the National Health Service ambulance service.

To ask the Secretary of State for Health what recent representations he has received regarding ambulance men's pay.

The pay and conditions of ambulance staff are the responsibility of the NHS management executive and I have no intention of meeting staff representatives myself to discuss this with them.

Will the Secretary of State give his blessing to the talks that are likely to take place on Thursday? Will he assure the House that neither he nor any Government Department will interfere with those talks in any way, and that any increase will not have to be met from the existing budget but will be Government-funded? Failing that, should we not take the matter to arbitration and stop pussyfooting about?

I followed with interest the announcement of a fresh meeting on Thursday, which I heard of when I left the Chamber last night. The management made its final offer to the trade unions in the Whitley council and the other negotiating body last week. The management made it clear this morning that its last offer is final. Nevertheless, it has agreed to talks, and I hope that Mr. Poole will have something new to say when he arrives at the talks on Thursday.

Will my right hon. and learned Friend confirm that approximately 10 per cent. of ambulance service work deals with emergencies and that approximately 90 per cent. is important but routine transportation? If that is the case, does it not make sense to respond to demands for parity with the other emergency services by restricting parity to those who provide an emergency service? Does he agree that, not to put too fine a point on it, NUPE's record on public service industrial disruption is second to none?

The final offer made by management last week would provide £500 each year on top of the general offer for those with paramedical training. People involved in the service tell me that they are sure that the future lies in developing the accident and emergency part of the service and giving the necessary training, status and pay that follow to those who require it. Northumbria and Wiltshire have found that the same rules need not apply to the important but routine services that account for 90 per cent. of the work. NUPE's campaign reminds me of some of its other activities. The union has taken extreme action against patients from time to time in the past.

Does my right hon. and learned Friend agree that Conservative and Opposition Members who are concerned about the NHS should oppose industrial action under any circumstances? Does he further agree that the best way in which people can have their claims reasonably considered by management is to withdraw any form of industrial action?

I agree strongly with my hon. Friend. In comments on the dispute, it has sometimes been lightly assumed that people who fall outside the TUC guidelines and are not emergency cases can lose the service without suffering hardship. Many elderly and sick patients have great difficulty getting to hospital for the treatment that they require, because of the industrial action that has been targeted at them. That is no way to solve problems of pay and conditions in the NHS. For that reason, management was right to keep revising its offer until it put forward the final offer which, I am glad to say, is still being considered by one of the trade unions involved.

Will the Secretary of State take this opportunity to pay tribute to the ambulance staff in London who have maintained a 999 service without pay for the past two months, while the Army and police simply could not cope? Does he think that the best way of dealing with the problems of the ambulance service in London is to pay and equip the staff properly and stop abusing them and trying to break the union and the dispute as he has done?

I gladly pay tribute to the work of the ambulance service in London and elsewhere when it is working normally, as it was until the dispute started. Obviously, we are grateful to it for the accident, emergency and other services that we are accustomed to it providing. But the idea that it continues to offer those services in London is a myth that has been completely exploded by events. We should also pay tribute to the Army, the police and the members of St. John Ambulance and the Red Cross. The people of London must be grateful to them for the provision of the accident and emergency services which the trade unions sought to deny them.

Does my right hon. and learned Friend agree that there is already a significant pay differential between ambulance staff with paramedical skills and those without? Does he further agree that that fact has not come out during the dispute?

There is, and the offer by management concentrates on recognising those skills yet further. That has not been brought out; nor have many other facts. The figure of 6·5 per cent. is no longer used by anybody, but until recently it was being trailed about as the offer made to ambulance men in London. The present 18-month offer is worth at least 9 per cent. to everybody, but for those people in London who acquire the paramedical skills that we want more people to have, it is worth more than 16 per cent. That is why I trust that on Thursday the unions will tell management that they accept the offer.

Is the Secretary of State aware that in the week before Christmas the London ambulance service can receive 200 calls an hour? How can the Government hope to respond to those calls with only 100 Army and police vehicles? Does the Secretary of State realise that Thursday's talks are the last chance to make sure that those calls are answered, and that he cannot leave it all to Roger Poole to make a success of the talks?

I would take the hon. Gentleman's concern about the accident and emergency service in London more seriously if he would condemn the actions of those who have withdrawn it and made it necessary for the police, Army and voluntary bodies to provide that necessary service. I am astonished that Labour Members are prepared to maintain the fiction—that the service is being offered by the unions—which union leaders have largely abandoned.

To ask the Secretary of State for Health what is the latest figure he has for the number of hospitals, health districts and specialist units which have expressed an interest in becoming a self-governing National Health Service hospital trust.

One hundred and eighty-eight units have expressed interest in NHS trust status, including a number with more than one hospital. Seventy-nine of those units intend to proceed with preparing applications for the first wave, of trusts, which we would expect to be established in April 1991. However, applications will not be invited until Parliament has approved the necessary legislation.

Does my right hon. and learned Friend agree that the Opposition's scaremongering, directed almost entirely at senior citizens, has proved to be complete nonsense and that hospital trusts will be publicly owned and paid for by the taxpayer? Will he confirm that the campaign of preprinted cards which Labour Members told us would arrive at the Department in their millions has been a complete shambles, with only about 50,000 arriving? Does that not show that Conservatives are the caring party and Labour the scaring party?

The NHS trusts will be NHS hospitals providing free treatment paid for from taxation. Local people who run them will strive to improve the service, particularly to elderly people, because theirs is the fastest-growing area of demand to which an ever-growing amount of resources will be distributed. I agree with my hon. Friend that the cards were a complete fiasco. Back in August I read accounts of the hon. Member for Livingston (Mr. Cook) promising me hundreds of thousands of them. In the end, even with the complete membership of the Labour party undoubtedly filling in and buying the postage stamps for as many as possible, they could produce only 50,000.

The Secretary of State is fond of saying that self-governing trusts will enhance patient choice. He will agree that for that to make any sense, a proper information system must be available. There have been reports that some of those considering self-governing trust status have submitted figures to the Department of Health suggesting that some hospitals will require as much as £3 million to upgrade computer systems. What estimate has the Department made of the proper systems technology that will be required for the aims to which it aspires in the proposals to be reached?

The entire National Health Service requires investment in information technology. Quite apart from the White Paper, it will be necessary for this giant organisation to invest in catching up on modern methods of collecting management information and then using it. It is not necessary for our reforms for there to be vast investment in computers and software ahead of the 1991 implementation. The development of computers and software should proceed at a sensible pace with systems being worked up and proved in practice before they are widely adopted. As we develop the idea of NHS trusts, we shall explain to those interested that they should not be misled into believing that millions of pounds worth of information technology are a prerequisite of a more sensible method of matching resources to patients in the service.

Why does not the Secretary of State admit that it is useless to massage the facts and figures about hospitals showing an interest, as he calls it? I wrote to the Secretary of State asking for the names of the people in Sheffield hospitals who had shown an interest so that I could provide them to all the people of Sheffield. The Under-Secretary of State replied that that information was private. Eventually, we met representatives of Sheffield health authority, which admitted that a group of working parties composed only of consultants had asked for it—

Briefly, please.

There is no democracy in that. It is a travesty of the truth. Why does not the Mininister come clean?

If and when we receive a formal application for self-governing status from Sheffield or anywhere else, it will be worked up by those sponsoring it and subjected to public consultation next summer. There is no point in the hon. Gentleman trying to get partial information at this stage about expressions of interest which he no doubt wishes to see to confuse still further the political debate that he is trying to set off in Sheffield. The hon. Gentleman should wait until we have proper applications that explain what the proposal is really about. That will make it more difficult for the hon. Gentleman and his friends to go on about opting out of the National Health Service and other such nonsense.

To ask the Secretary of State for Health whether there has been any experience within the National Health Service of using contracts for patient services.

To ask the Secretary of State for Health if he will make a statement on the use of contracts for patient services within the National Health Service.

We believe that about 60 per cent. of health authorities have used contracts to obtain patient services from the public and private sectors. As part of the development work to prepare for the implementation of "Working For Patients", the Department is currently supporting projects working on various aspects of contracts.

My hon. Friend will recall that yesterday's debate and my contribution to it emphasised the importance of raising quality and standards in the National Health Service as it moves forward. Will he confirm that contracts placed by district health authorities will have to take account of service standards and quality of care as well as cost? Does he agree that they will enhance the power of general practitioners, as they will be consulted and the new system will have to reflect their referral patterns?

I very much agree with my hon. Friend—[Interruption.] It is no great surprise. A great advantage of contracts is that the health authorities, which will be responsible for drawing them up, will be able to specify quality targets for the supply of not only hospital services but community health services.

Will my hon. Friend confirm that, under the proposals to improve the Health Service, district health authorities such as those in Northumberland would be obliged to maintain a reserve of resources to meet the demands of special cases? Will he confirm that that will satisfy the criteria relating to GPs' freedom of referral and patient choice?

I can confirm that. We expect health authorities to begin consulting GPs about the existing referral pattern of their patients now, so that the authorities can draw up contracts reflecting that pattern. Given that referrals may take place outside the contract pattern, a contingency fund will be provided in all health authorities—including those in my hon. Friend's constituency—to cover such non-contractual referrals.

How are local health authorities supposed to place contracts with anyone when they are in a position like that of the authority in my constituency? It has already spent £1·5 million over its budget, and is so desperately short of resources that it has no beds for victims of the current flu epidemic.

My right hon. and learned Friend the Secretary of State recently announced an increase of 8·4 per cent. in cash terms for the hospital and community health services next year. That is a substantial increase in the resources available to district health authorities. After April 1991, health authorities will have the job of placing contracts to acquire health services, and they will have the resources to do that.

Given his previous answer, will the Minister join me, and a consultant at the Freeman hospital in my constituency, in condemning as wild and bizarre the decision to spend about £200,000 transferring heart patients from that centre of excellence in Newcastle to Wythenshawe in Manchester? What a waste of money. Should not the money be invested in the region?

As I am sure the hon. Gentleman knows, that is a supra-regional service. People who require complicated heart operations should not necessarily seek service within their own districts; such complicated and expensive treatment should be provided as quickly as possible wherever it can best be provided.

To ask the Secretary of State for Health how many dentists are employed by the National Health Service now and in 1979.

There were 15,300 dentists in the National Health Service in England in 1979, and just over 18,000 last year.

The whole House will welcome the excellent news about additional resources for dentistry. Will my hon. Friend confirm that that means that the teeth of the nation—particularly those of the nation's children—are receiving more attention and are consequently in better condition, and does he agree that that is a good reason for smiles all round?

I am grateful to my hon. Friend, and I can confirm that, over the past 10 years, the teeth of the nation have been in far better shape. There has been a dramatic reduction in decay caused by dental caries in children under the age of 16—a fall of about 40 per cent. between 1973 and 1983—and a reduction in the number of adults with false teeth from about 30 per cent. in 1978 to about 20 per cent. in 1988.

Does the Minister accept that people are not smiling so much in Scotland? Although it is not his responsibility, he will understand that Scots are angry about the closure of Edinburgh dental school. Will he have a word with his Scottish colleagues, and advise them to keep the school on? We need it: it is important to the health of Scotland's people.

The hon. Gentleman should take a broader national view. The number of dentists that Britain will need over the next two decades will increase, but at present we are training too many.

As one who spent the morning at the dentist, I am not sure that I welcome extra money being spent on dentistry. Does my hon. Friend agree that the number of dentistry courses has increased dramatically over 10 years,—from 27 million to 32 million—which is a welcome sign that the expense of dentistry is clearly not putting people off having their teeth repaired?

My hon. Friend is right. There are more courses, and people are going to the dentist more often. The use of fluoride toothpaste, particularly by children, has made a big difference to the health of their teeth.

To ask the Secretary of State for Health what representations he has received on the White Paper on community care; and if he will summarise the views expressed.

To ask the Secretary of State for Health what representations he has received on the community care White Paper.

We have received several representations following publication of our White Paper "Caring for People: Community Care in the Next Decade and Beyond." Most have expressed a general welcome for our proposals.

Have there not been many protests about the proposal to privatise care for the elderly? Are the Government not about to treat home helps in the same way as National Health Service cleaners, by undercutting the low-paid and penny-pinching in the service that they provide? Why is it that the care of the elderly and the disadvantaged is acceptable to the Government only if it makes a profit?

Unlike Opposition Members, the Government have no obsession about the ownership of services to help the elderly and the frail. We are establishing a framework of care for the next decade and beyond. Individuals want their needs to be properly assessed and choice of provision. Wherever possible, they want to stay in their own homes. We want resources to be used effectively and properly, high standards to be maintained and choice and dignity provided to those who need care.

Will the Minister clarify the Government's intentions regarding section 3 of the Disabled Persons (Services, Consultation and Representation) Act 1986, which was so ably promoted by my hon. Friend the Member for Monklands, West (Mr. Clarke)? Also, if in the words of the White Paper,

"promoting choice and independence underlies all the Government's proposals",

The existing provision for disabled people will be unchanged by the introduction of our proposals for care in the communiy. What is important is that all people will have their needs assessed before care is provided.

Does my hon. Friend accept that it is a crying shame that community care proposals have been tagged on to a Bill that relates to the NHS, when community care relates mainly to local government? Will my hon. Friend, and my right hon. and learned Friend, consider ring fencing community care expenditure so that it is not lost within the general expenditure allocated to local government?

I resent my hon. Friend's comment that these matters are being "tagged on" to the end of the National Health Service and Community Care Bill. In my view, they are extremely important proposals. The Bill provides an ideal opportunity to establish our plans for those who need health care alongside the plans for those who need social care—a group that my hon. Friend, too, has championed greatly over the years.

Does my hon. Friend agree—

Oh!

Order. The hon. Members who have just come in should realise that it is bad form to walk in front of the hon. Member for Newbury when he is asking a question.

Send them to Sardinia.

Order. Settle down please.

Is my hon. Friend aware that voluntary bodies such as the Children's Society are disappointed that the provisions of the NHS and Community Care Bill do not consider the needs of carers and users of the services, and that there is no scope for the incorporation of review and complaints procedures in the current draft of the Bill? Does my hon. Friend intend to add those to the Bill at a later date, or will she bring forward a code of good practice that will be published after the Bill becomes law?

I urge my hon. Friend to look at the White Paper again, because explicit mention is made of the needs of carers, and the important part that they play. We are working closely with voluntary organisations and local authority associations so that when we bring forward a code of practice they will give the recognition to carers that he and I want them to be given.

Will the Minister take a second opportunity to reply to my right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris), who asked a specific question about the Disabled Persons (Services, Consultation and Representation) Act 1986? How many people have made representations supporting the full implementation of the Act, and how many of them supported sections 1, 2 and 3 which give rights to consumers and carers? Or do the Government take the view that community care is everybody else's responsibility—the independent sector, voluntary organisations and carers—but not theirs?

The Bill offers a major step forward for carers and consumers of services. We have made it very clear that an assessment will be required before care can be provided. We are turning our backs on the old system, in which the provision of resources was often irrelevant to the needs of the individual. Frequently, under the system it was more likely that residential care was provided, rather than the domiciliary care that is often more appropriate, and more in line with the dignity of the individual. Our measures move on from the disabled persons Act, but we shall continue to review it. The Bill will be a major step forward, and will provide an opportunity to hear the views of consumers and carers.

Does my hon. Friend agree that we do not need ring fences in community care, but we need the local authorities to concentrate on their responsibilities, and to bring down the ring fences that stop voluntary bodies, such as Crossroads, playing a full role?

One of the difficulties with ring fences is that they tend to lock services in a historical framework. We want collaboration and innovation, with various agencies working together to ensure that a better service is provided for the frail and the disabled.

Will the Minister kindly tell us what plans exist to increase the number of occupational therapists in the community? There is already a shortage in hospitals, and if more people are to go into community care, will more also be required in the community?

I can say that there has been a substantial increase in the number of professionals involved in the provision of care in the community in recent years. I anticipate that we shall also need an increase in the number of occupational therapists.

To ask the Secretary of State for Health what is his Department's cash allocation for Yorkshire and Humberside health authority for 1989–90.

The Yorkshire regional health authority received an initial revenue cash allocation of £951·2 million in 1989–90. There has been a real terms increase in expenditure of about 31 per cent. for Yorkshire over the past 10 years.

Does my hon. Friend agree that that is record expenditure, and that it represents spending of £280 per man, woman and child in Yorkshire and Humberside? Does he also agree that, based on last year's experience, that will probably provide treatment for more than 4,500,000 patients in that region alone? Does my hon. Friend agree that patients are a more accurate guide to the success of the NHS than the politically motivated comments of Opposition Members?

Expenditure for the NHS as a whole is about twice the figure that my hon. Friend quoted. He has cited only the hospital service. My right hon. and learned Friend the Secretary of State for Health expects to make a statement shortly on regional health authority allocations, which will show continued advance in real terms for the NHS in the regions.

Is the Minister aware that seven district health authorities in the Yorkshire region confront a deficit which will have a serious effect on patient care?

I am aware of the financial problems of certain districts in Yorkshire. It is the responsibility of health authorities to manage their affairs within the resources allocated to them. Under both Labour and Conservative Governments health authorities have been cash limited. It is their responsibility to manage. Our reforms, which bring the allocation of funds on a weighted capitation basis to districts, will provide a fairer and more automatic system of fund allocation.

To ask the Secretary of State for health when he last met the representatives of the British Medical Association; and what was discussed.

To ask the Secretary of State for Health when he last met representatives of the British Medical Association; and what was discussed.

I last met representatives of the British Medical Association on 18 October, when we had a friendly and constructive discussion about the implementation of our proposals in the White Paper "Working for Patients".

Is it not a shame that the right hon. and learned Gentleman will not face up to the truth—that his proposals, which are causing the BMA and virtually every other medical organisation anxiety, are just a smokescreen for underfunding the service? He says that he is spending much more, but that means nothing to patients who are sent home with life-threatening diseases. In my constituency, a patient with cancer of the oesophagus was sent home three times because an intensive care bed was not available for him. Will the right hon. and learned Gentleman provide more money for medical staff rather than for more administrators, which is what his scheme envisages?

We are providing money for the NHS on an unprecedented scale. Neither the British Medical Association nor anyone else has put it to me recently that underfunding is the sole problem. We have just announced an increase for next year which is 5 per cent. ahead of inflation. That represents an increase in funding during the past two years of more than £5 billion.

Does my right hon. and learned Friend recall that, at a previous meeting with the BMA, he managed to get it to admit that it had misled the public about indicative drug budgets? In view of his great success at that meeting, will he arrange others in the hope that the BMA will withdraw other scare stories that it has put about?

The claim that some people might not get the drugs they needed caused more alarm among patients than any other allegation made last summer. I share my hon. Friend's feelings about the fact that that allegation has been disposed of.

Does the Secretary of State agree that not one general practitioner practice in Wales which would qualify under his proposals has indicated any desire to have its own budget? Does he agree, therefore, that the central plank of his proposals are utterly irrelevant to Wales?

It is not the central plank of the proposals, although it is an important one. I intend to give details of the programme for GP practice budgets tomorrow. That will be the first time we invite general practitioners seriously to decide whether they are interested in proceeding with it. I cannot believe that general practitioners in Wales will be more backward than their English colleagues in considering the advantages of the scheme. The more go-ahead practices which are anxious to develop services for their patients that the GP wishes to provide will be interested in the proposals I shall be putting forward.

Did not the BMA spend some £3 million of its own money on peddling what it has now admitted to be misinformation? In his talks with the BMA was my right hon. and learned Friend able to suggest that it should now spend a further sum on setting the record straight?

Certainly the BMA spent a great deal of money—at least £3 million. It is now organising a fundraising campaign to replenish its war chest, but I do not think that it intends to go in for the same advertising again. That advertising campaign has virtually ceased. I think that that is because the BMA has decided to improve the climate and get down to sensible and constructive discussions that we have been trying to encourage throughout

In this new friendly atmosphere with the BMA, will the Secretary of State listen to the concern that it has expressed today about the 45 patients who have been transferred from the Freeman hospital in Newcastle to the Wythenshawe hospital in Manchester simply because it is cheaper? Is he aware that there is spare capacity at Wythenshawe only because it has run out of money to treat its own patients? How can he possibly justify shipping patients halfway across England to a hospital with an even longer waiting list? Does that not reveal the dangers of a Bill that puts the price of contracts before the patients' choice?

The hon. Gentleman refers to the unreformed National Health Service. The hon. Gentleman has discovered that quite a lot of patients move around the country, and sometimes have to travel considerable distances. They do so because patients and doctors are prepared to allow patients to travel to a better or quicker service. The Bill seeks to extend that opportunity to patients who are willing to travel for a better and cheaper service. I assume that the hon. Gentleman is talking about a nationally arranged service where the location of services is decided by the supra-national committee. If he is not, I shall look at the 45 cases, but I am quite sure that the consultants or doctors in charge of those patients decided to move them to somewhere where good quality service was quickly available. But it is quite wrong to seek to intervene in that politically.

To ask the Secretary of State for Health how many district health authorities provide infertility investigations and treatment.

To ask the Secretary of State for Health how many district health authorities provide infertility investigations and treatment.

The investigation and treatment of infertility is part of the normal practice of gynaecology and is therefore available throughout the country.

Will not indicative drugs budgets and GP practice budgets deter GPs from sending women for infertility treatment and from taking on women who are already receiving expensive infertility treatment? Will that not add to a very human tragedy for many couples?

The introduction of prescribing budgets is a sensible way of containing the costs of prescribing and ensuring that prescribing practices continue to develop. Dramatic advances have been made in infertility treatment. Many of the treatments are very costly and are available in increasing numbers of centres throughout the country. We see no reason to believe that it will not be possible for women to continue to benefit from those remarkable new initiatives.

When dealing with matters of fertility and infertility, will my hon. Friend remind consultants of the fertility of the imagination of the hon. Member for Livingston (Mr. Cook)?

Yes, Sir.

Does not the Minister's earlier answer show that she is unaware that Lady Warnock described provision of fertility services within the National Health Service as "haphazard and unsatisfactory"? Is it not unacceptable that whether a childless couple can have the child that they long for depends on where they live and how much money they have? When will the Government act on the Warnock proposal, which does not need legislation, to improve fertility services throughout the National Health Service?

Since the Labour party was in Government, there has been an increase from 661 to 746 in obstetrics and gynaecology consultants, who provide better and higher quality services. The local district health authority must decide the priorities of various services. The district health authority in the constituency of the hon. Member for Halifax (Mrs. Mahon) has chosen to have a new hospital costing £21 million and has increased day cases by 25 per cent. and in-patients by 10 per cent. It is clear that choices must be made in the Health Service, but there is much greater provision for infertility treatment of all kinds throughout the country.

To ask the Prime Minister if she will make an official visit to Shrewsbury.

At present, I have no plans to do so.

Although I am disappointed that my right hon. Friend cannot visit Shrewsbury, is she aware of the long connection between that town and the armed forces, particularly the light infantry depot that is based there and the military headquarters of the west midlands? Is she aware that the personal determination and compassion that she had to demonstrate in order that a statement on the uprating of war widows' pensions could be made was warmly welcomed in Shrewsbury? She is to be congratulated on that move in policy.

I am grateful to my hon. Friend. Hon. Members recognise the very special debt that we owe war widows. Their case is unique and distinctive, and I am glad that we have been able to offer them extra help, which hon. Members learned of yesterday.

Will the Prime Minister think again about visiting Shrewsbury when she has had the opportunity of going to shire hall and hearing from county councillors across the political spectrum—from Church leaders, teachers, pupils and parents—about the overwhelming opposition to the establishment of a city technology college? If £8 million of public money is available for education, will she spend it not on the few but ensure that it is spent on buildings, equipment and books for the benefit of all the children in the town?

City technology colleges are a great new opportunity for young people from all backgrounds and ethnic groupings. Whenever they are opened, they prove very popular with teachers, pupils and parents alike.

Has my right hon. Friend visited the signal box outside Shrewsbury station? Is she aware that it is one of an enormous number of listed buildings that British Rail is expected to maintain as part of its normal operations? Does she agree that looking after listed buildings and running its own police force imposes an unfair burden on an industry that must compete on unfair terms with the road transport industry?

I confess that a visit to the signal box at Shrewsbury has not been at the top of the list of my heritage visits, but I look forward to that experience.

To ask the Prime Minister if she will list her official engagements for Tuesday 12 December 1989.

This morning I had meetings with ministerial colleagues and others, including one this morning at which I joined the task force of Westminster residents, which is designed to improve and protect the environment in Westminster. In addition to my duties in the House, I shall be having further meetings later today.

What does the Prime Minister have to offer the 48,000 people who are two months or more behind with their mortgage repayments and face a bleak Christmas as a result of the Government's incompetent economic management? Does she tell them to put their faith in her enterprise culture, or does she agree that an equally realistic approach is to post a letter to Santa?

The latest figures that we have about people behind with mortgage payments and in difficulties show that in the first half of this year—the latest full half-year—only one tenth of 1 per cent. of mortgage holders are in serious difficulty. That means that the overwhelming majority are enjoying the benefits of home ownership.

My right hon. Friend will be aware that a great deal of help is given by the Government to overseas countries through the Overseas Development Administration joint funding arrangement. One of the countries that is not eligible for the assistance is Vietnam. In view of the tremendous need to help that country rebuild its economy to make a home for the boat people, is my right hon. Friend prepared to change that rule?

We are giving some help to Vietnam in connection with the return of some of the Vietnamese boat people. If we were to consider giving any more help, it should be done, in the first instance, through that scheme to help those returning to that country.

What excuse has the Prime Minister for giving instructions that in the middle of the night armed riot police should raid children, women and men, shove them in caged lorries and forcibly deport them to the country from which they have fled?

I understand from my right hon. Friend the Foreign Secretary that they were not armed police. May I also point out that at the international conference on Indo-Chinese refugees in Geneva in June, the international community agreed that refugees would be resettled in other countries and that those who did not qualify as refugees would not be resettled and should return to Vietnam. Therefore, we returned some of those—as the right hon. Gentleman knows—to Vietnam. The people in Hong Kong could not go on taking any more. Many other countries nearby have pushed away the Vietnamese boat people but we have not. Those who are refugees—and there are 13,000 of them—will not be returned. However, it is perfectly in order to return illegal immigrants to their country of origin.

The Prime Minister is trying to defend the indefensible. Does she realise that she is the only person in the whole shameful episode who cannot make the excuse, "I was only obeying orders"? She was the person giving the orders and the orders are tyrannical.

The right hon. Gentleman's remarks are feeble and nonsense. Illegal immigrants have to be returned to their country of origin. It is the custom of international law that such illegal immigrants are received back. The people of Hong Kong were suffering greatly from having some 57,000 Vietnamese boat people there, and more and more would come when the season came for them to leave Vietnam. It is perfectly in order to return them and those countries that are protesting at their return would do better if they offered to take some of them.

Is the Prime Minister telling us that she is prepared to see day after day and night after night the scenes that people have witnessed in those Hong Kong camps so that she can avoid her responsibility for looking after the welfare of people who are now being returned to poverty and oppression?

It is to help clear the camps where conditions are not good, where fighting sometimes breaks out and where there is disease. Those who are refugees will not be returned home. I must remind the hon. Gentleman that we have to put back about 30,000 Chinese immigrants over the border each year. He cannot go on inflicting his anger on the people of Hong Kong and expect them to—[Interruption.]

Order.

It is perfectly in order to return illegal immigrants to their country of origin. There would be international chaos if they could travel anywhere and never be made to return.

Is it not true that the alternative to repatriation to Vietnam is the continuation for many years—something nine, 12 or 13 years—of families living in temporary and appalling prisoner of war camps in which the children of the Vietnamese families would have to grow up? Is it not more humane to let them return to their country and resume their lives?

Yes. It is much better and, as I said in reply to an earlier question, we are giving some money to the Vietnamese Government so that those people can be resettled in the villages from which they came. Our ambassador is monitoring what happens and sooner or later, we hope to be able to involve the United Nations High Commissioner for Refugees, although the refugees, as such, are not being returned to Vietnam.

Will the Prime Minister, in her busy day, take some time to reconsider the shameful example set by her Government's actions last night in Hong Kong? Apart from the use of riot police at the dead of night and the blanket of secrecy, we must consider the appeal tribunals which condemned people to return to the hands of a Communist Government. Those people have no rights to attend the tribunals, no rights to legal representation, no rights to judicial review and no rights even to know why decisions have been taken against them. Does the Prime Minister think that that is a good example to set to the Chinese Government, to whom we shall hand over the safety of our citizens after 1997?

Each person who comes in is interviewed to see whether he is a genuine refugee. He has a right of appeal and the British Council report shows how excellent is the system that we operate. There are some 13,000 refugees. The countries that have shown anger about this matter have not yet even agreed to take any of the 13,000 for whom we still seek to find a home. It is impossible for the people of Hong Kong to take more and more of the Vietnamese boat people, many of whom are pushed away from other countries and it is impossible for them to continue to live in camps in what is already an overcrowded island. It is perfectly in order, as I said, through the Geneva conference to return those people to Vietnam and to give the Vietnamese Government some money to resettle them.

To ask the Prime Minister if she has any plans to appoint a Minister for United Kingdom tourism.

I am satisfied with the present arrangements. I know that my hon. Friend has long been a strong champion of tourism, which is one of Britain's fastest growing industryies. Last year alone it brought in over £6 billion from overseas tourists to this country. I congratulate my hon. Friend on being fortunate in representing a constituency that is, deservedly, one of Britain's leading tourist attractions.

In view of the importance of tourism to the United Kingdom economy, as it is the fastest growth industry in Britain and brings in some £19 billion—although it is always derided by the Labour party as a candyfloss industry in a Mickey Mouse world—will my right hon. Friend confirm that responsibility for tourism is at present split between Ministries in England, Scotland, Wales and Northern Ireland? As tourists from abroad look on us as Great Britain, will my right hon. Friend re-examine the possibility of appointing a Minister with overall responsibility for that important industry?

As my hon. Friend knows, those who live in Scotland, Wales and Northern Ireland prefer the responsibilities to be with the territorial Ministers, but I must point out that my right hon. Friend the Secretary of State for Employment is the Minister who is responsible for tourism for Great Britain as a whole, as well as for England in particular. That arrangement best suits most people in these islands.

Will the Prime Minister give an assurance that the Scottish tourist industry and the Scottish tourist bodies will retain their autonomy, given the importance of the industry to many areas and islands of Scotland?

I believe that the responsibilities are set out in the Development of Tourism Act 1969 and we have no plans to change it.

Does my right hon. Friend accept that the agreement in principle by Transport Ministers to liberalise European air transport will bring tremendous benefit to tourists and all consumers? Is not that the sort of measure with which the Community should be involving itself, rather than trying to impose on its members such contentious proposals as the social charter?

Yes, Sir. My hon. Friend is quite right. It was very good news when last week the European Community agreed to deregulate air fares, which means that we shall get very much cheaper air fares to Europe. Hitherto, it has cost much more per mile to travel by air to Europe than to the United States. We have been working for several years to try to secure deregulation. In the past we had to do it by bilateral arrangement—it was Britain and the Netherlands that were keen on deregulation—but now the principle has been extended and will apply much more widely. That will help tourism and bring pleasure to many people who will now be able to fly more cheaply to European countries.

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

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

Is the Prime Minister aware that most people in Britain think that our country is now too unequal and too divided? Does she know that the combined effect of all her tax and benefit changes is that the bottom 50 per cent. of families have lost £8·50 per week whereas the top 10 per cent. have gained nearly £40 per week? Will she now, as many families look forward to a bleak Christmas, promise to increase pensions and child benefit and introduce a national minimum wage so that everyone who lives in this country can share in its wealth?

No, I do not agree with the hon. Lady's figures. She is well aware that people of all income groups—whether on social security benefits or earnings and those receiving treatment from the Health Service or in education—have benefited under this Government. All the benefits have gone up. In the last part of the hon. Lady's question she referred to increases for pensioners at Christmas. A Labour Government cancelled the Christmas bonus for two years in succession. Under Conservative Governments pensioners continue to receive their Christmas bonus.