Object.

To ask the Secretary of State for Health how many accident and emergency units are currently proposed for closure in Greater London.

A number of London health authorities are considering proposals for change to the current pattern of accident and emergency services.

Should not ease of access by road and proximity to the main centres of population be the overriding factors in determining the location of accident and emergency units? Do not those considerations point overwhelmingly to the continuing need for Oldchurch hospital in that all-important life and death role?

I congratulate my hon. Friend on the fact that on the two occasions that I have so far appeared at the Dispatch Box, he has been able to represent the interests of his constituents in this matter, which he does extremely assiduously. As I told him in the debate on Friday, his representations will be considered by my right hon. Friend the Secretary of State, as the matter is now before her.

Will the Minister undertake to make a visit to Harold Wood hospital so that he can see for himself the great difficulty that my constituents will encounter if the proposed closure of the accident and emergency department at Oldchurch hospital goes ahead?

I am be extremely keen to inform myself in whatever way is absolutely necessary to be sure of all the facts. I have undertaken a number of visits to accident and emergency units around London since I was appointed to my post. I remind the hon. Lady that the overriding requirement for the reformation of accident and emergency services across London is continuing quality of patient care and the proper provision of services for all patients.

In terms both of the accident and emergency services and of the other services, will my hon. Friend pledge to do all that he can to save Edgware general hospital from closure?

Those are clearly matters to be decided at a local level. Even in my short time at the Dispatch Box, I have noticed with interest that many people are in favour of changing the structure of services in London, but when it comes to their constituency interests they make particular representations. One cannot restructure services in London without making sure that that is done in a proper and sensitive way. I repeat to my hon. Friend the point that I made earlier—quite simply, it is the quality of overall patient care in London that will inform us as we proceed with any changes.

On a point of order, Madam Speaker. In view of that reply, I beg to give notice that I will raise this matter on the Adjournment.

I am sorry, but I cannot accept that request from the hon. Member because Question 1 was not his substantive question.

To ask the Secretary of State for Health what assessment her Department has made of the effect of motor vehicle emissions on respiratory diseases.

While there is, as yet, no conclusive evidence that motor vehicle emissions cause respiratory diseases, including asthma, high levels of motor vehicle emissions may exacerbate existing respiratory conditions and may trigger attacks in some asthmatic people.

Is the Minister aware of a report published earlier this year by Noel Olsen, the director of health in the Plymouth and Torbay health authority, who concluded that there is a strong link between asthma and motor vehicle fumes? He said that, shortly, 10 per cent. of children in Plymouth will need inhaled steroids. Is the Minister aware that that view has been strongly reinforced today in a report from the Select Committee on Transport? When will his Department do something about it?

A great deal is being done by the Department of Transport about vehicle emissions. I remind the hon. Gentleman that asthmatics also suffer from pollen, fungal spores, house mites, smoke and a series of other factors.

Are not high levels of motor vehicle pollution a grave exacerbating factor in many respiratory conditions, particularly in London? Has not the incidence of asthma and other serious respiratory diseases increased in direct proportion to the increase in motor vehicle traffic? Should not the Department of Health, therefore, concert effectively with the Department of Transport, to get more people onto public transport, especially the tube and railways, rather than using their cars?

There is undoubtedly a connection, which is why my right hon. Friend the Secretary of State for Transport has brought in a series of new measures to tighten up diesel emissions and emissions from catalyst and non-catalyst cars, and to put inspectors by the side of roads in inner cities to find those who are polluting the atmosphere. My right hon. Friend has promised to "get tough", particularly on those who drive smoky diesel vehicles. Having worked for him for the past two years, I am now glad that I do not pollute the atmosphere for a living.

I appreciate that the Minister's second response was a little more positive than his first. However, may I press him to speak to the Minister responsible for transport because, despite clean air zones in our cities, the pollution has intensified, as we are now discovering again this year through fogs?

I confirm that we are working closely with the Departments of the Environment and of Transport. We are also organising a major conference on the causes of asthma. We have invited the National Asthma Campaign to organise it jointly with us.

To ask the Secretary of State for Health what progress has been made in taking forward the private finance initiative in the South Thames region.

Good progress has been made in taking forward the private finance initiative in the South Thames region. Since the initiative was launched in November 1992, seven projects have been approved, each with a capital value of£1 million or over. This is bringing in more than £26 million of private sector capital to the region.

I thank my right hon. Friend for that answer. Will she confirm that, since the private finance initiative was launched, it has resulted in additional investment nationally of some £100 million and that a further £500 million has been earmarked? Is not that excellent news for patients? How will those latter opportunities be realised?

I thank my hon. Friend and can certainly confirm the figures that he gives. The private finance initiative is an excellent opportunity for us to extend patient care further and faster. With the great range of projects, we are giving advice and keeping a data bank so that good practice can be developed. The criteria in every case is that projects should be good value for money and lead to good patient care.

Has the Secretary of State seen the regional private finance initiative referred to in The Independent today? The Worthing district health authority has accepted a bid from an outfit called Westminster Health. Is the Secretary of State absolutely satisfied that those who run it are suitable people to be in charge of the care of our elderly long-term sick? After all, they have been involved in a substantial fraud case in Texas and have had about 150 separate allegations of abuse pending against them since the 1980s. In any event, was not the NHS trust bid cheaper?

First, I welcome the hon. Gentleman and the right hon. Member for Derby, South (Mrs. Beckett) to their new jobs. I am pleased, from the point of view of private finance, that it was the hon. Gentleman who said:

"public and private finance working together in transport, in housing, in capital projects, in health and education"

To ask the Secretary of State for Health what representations she has received about redundancies in hospitals run by the Cheviot and Wansbeck hospital trust.

We have received letters from two hon. Members. I also met the right hon. Gentleman and the hon. Members for Blyth Valley (Mr. Campbell) and for Wansbeck (Mr. Thompson) on 13 July, to discuss their anxieties about redundancies at the trust.

Now that the equivalent of 51 posts have been lost in the Cheviot and Wansbeck group, now that safety standards have been publicly questioned even by a consultant, and now that there is even a threat of the closure of the Rothbury cottage hospital, will the Minister reconsider the situation and answer the question: why do patients have to suffer if the first year of operation of the trust system throws up something that would probably never have happened under the old system?

Let me say how glad I am that the actual number of redundancies has been reduced to 27, the large majority of which are in administrative grades. I do not accept that patients will suffer. I have been given an absolute assurance that those changes will be made without detriment to patient care.

Has the Minister seen the letter that I sent some time ago about the case of Charlene Bentley from my constituency, who broke an arm, went to the Wansbeck general hospital, was unable to receive treatment at that hospital because of the lack of beds in the children's ward and had to be transferred to North Tyneside to have treatment? Is that the satisfactory arrangement that he endorses in terms of that hospital and those staffing levels?

I am aware of that case, and it is unfortunate that that little girl had to be transferred to another hospital. Let me remind the hon. Gentleman that the trust works on several different sites and is at a disadvantage in that way. It is not possible to provide all acute services at all sites.

To ask the Secretary of State for Health how many disabled people have been struck off local general practitioner lists in each of the past four years.

Only 1.2 per cent. of patients deregistering from general practitioner lists do so at the request of the GP. Those patients are not categorised in any way.

If the Minister does not know how many of those people are disabled, perhaps he should speak to Toby Harris, the director of the National Association of Community Health Councils, or even the health service ombudsman, both of whom are extremely worried about the number of patients who are being struck off by GPs. A Manchester report recently said that 1,700 patients, many of whom were disabled people, had been struck off lists by their doctors. Indeed, Mr. Harris said recently that one could be struck off for being too ill.

I have looked carefully at Mr. Harris's press release and the other report to which the hon. Gentleman referred. Neither of them refers specifically to people with disabilities being struck off. That type of evidence has not been presented to us.

Surely the Minister is concerned when, according to a report from the National Association of Community Health Councils, about 30,000 patients are estimated as being struck off and, as he says himself, he has no knowledge of what percentage of those are people with severe long-term illness, disabilities and so on.

There is no evidence to support what the hon. Lady says. Let me first welcome the hon. Lady to her responsibilities. [HON. MEMBERS: "Right hon."] I apologise, the right hon. Lady. We look forward to many years of enjoying her position across the Dispatch Boxes.

To ask the Secretary of State for Health how many junior doctor posts which entail working more than 83 hours remain in the South Thames region; and if she will make a statement.

To ask the Secretary of State for Health how many junior doctor posts entailing more than 83 hours remain in the North West region; and if she will make a statement.

All posts contracted for more than 83 hours a week in the South Thames and North West regions have been eliminated. That is a remarkable achievement as there were more than 3,300 such posts in those two regions in September 1990.

I thank my right hon. Friend for that most encouraging news and I congratulate her on the success of a policy that she initiated when she was Minister for Health. Is she aware that reports are emerging of a significant reduction in the number of applications for doctors' jobs in my region? Will she comment on the fact that Conservatives cut junior doctors' hours while the Labour party cut their pay?

I take note of my hon. Friend's comments. The way in which juniors are trained—their rotations and accommodation and many other conditions—requires further consideration. I welcome the discussions that we have with the junior doctors to ensure that we continue to train and support some of the best junior doctors so that they can help the health service. Their pay has increased substantially during our term of office. I am pleased, however, that there have been such significant cuts in their hours.

Will my right hon. Friend join me in paying tribute to the Southport and Formby community health service trust which, in March this year, met its important 1994 target of reducing the number of hours worked by junior doctors? Will she give me an assurance that, as the acute trust continues to make progress in that important sector, it will continue to have the support of the regional task force?

I certainly pay tribute to the Southport and Formby community health service trust and can assure my hon. Friend that the task force will continue to play a crucial part. I know his region well and have met junior doctors from there. Only three years ago, when I was in Blackpool for a certain purpose, a number of the juniors came to see me and my hon. Friend the Member for Wyre (Mr. Mans). Two years later, we were able to visit them on their night shift at the Blackpool Victoria hospital to talk about the new systems, the way in which shifts have been introduced and the fact that extra resources have been put to good effect and the junior doctors' hours reduced.

Is the Secretary of State aware that one of the arguments advanced for the closure of the Brook hospital in the South Thames region is the requirement to meet the junior doctors' hours? Is she further aware that the future plans of the health authority depend on the acquisition of the Queen Elizabeth military hospital from the Ministry of Defence? Is she aware that the national health service may be gazumped by a private bidder? What steps will she take to ensure that that hospital remains in the public sector?

I am aware of the facts of that situation, but the hon. Gentleman will understand that the Minister for Health deals with those matters as I have a close personal relationship with one of the hon. Gentleman's neighbouring Members of Parliament—that is in the Register of Members' Interests. I am aware that the effects of the reductions in junior hospital doctors' hours have implications for service delivery. It is extremely costly to provide juniors on duty overnight in a great number of establishments and we have to look carefully at that aspect. We also want to safeguard patient care and the quality of doctors' training. The dialogue that we have established between Ministers, the junior doctors' leaders and the NHS is leading to sensible outcomes, and improvements for juniors and the service.

Is the Secretary of State aware that some of the reductions—which are by no means universal—have been achieved by some grades of nurses having to take on tasks formerly performed by junior doctors? That has led to considerable stress, especially in hospitals in Wolverhampton where, I understand, the Minister has imposed a block on further recruitments of junior doctors. Will the Secretary of State respond to that?

The hon. Gentleman will understand that the recruitment of junior doctors is connected with a long-standing agreement with the profession over the number of juniors trained for the number of consultant posts available. I hope that we may move towards more flexibility in some of those matters as time goes by, but there has been a steady increase—of 3 per cent. a year—in the number of consultants in the health service and that is a significant achievement in itself. The hon. Gentleman rightly points to the part played by nurses in taking on some of those tasks. Managers, much denigrated by the Labour party, and administrative support staff have also taken on some of the tasks previously done by junior doctors.

Does my right hon. Friend remember the case of my constituent, Alan Massie, a talented young junior hospital doctor at Warrington district general hospital who died some months ago? Is she aware that the coroner's report has now found that he died from stress and overwork because of the abnormal number of hours that he was forced to work? Will she therefore keep the matter of junior hospital doctors' hours under continual review, to ensure that young, talented people such as my constituent do not die because of their commitment to the health service?

I well understand the case to which my hon. Friend refers. The stress of being a junior doctor is associated with a number of factors, not least rotations. I was interested in a scheme being developed in New Zealand, where there is talk of a mentoring system to give support to junior doctors in training. Reducing the number of hours has been a clear priority. In 1990, 13,000 doctors were working rotations of more than 83 hours: none are now. There has been a fall of one quarter in the number of hard-pressed posts involving more than 72 hours. We want to do very much better than that by the end of the year; it is an important priority for us all.

To ask the Secretary of State for Health what progress is being made in respect of the mortality reduction targets set out in "The Health of the Nation", Cm. 1986.

The latest figures show that good progress is being made towards virtually all the mortality targets set out in "The Health of the Nation" White Paper. The targets were deliberately set to be challenging and it is most encouraging that so much has already been achieved.

Speaking between two planted questions, may I ask whether the Minister accepts that poverty is an important factor in determining death rates? That is shown by the fact that deaths from coronary heart disease among poor men and poor women are respectively 44 per cent. and 61 per cent. higher than would otherwise be expected. Does the right hon. Lady appreciate that in the past 15 years in just four regions of the country—the north, the north-west, Yorkshire and Merseyside—there have been 125,000 more deaths from coronary heart disease than should otherwise have been expected? That amounts to the Government, by their neglect, killing off two constituencies of Labour voters.

I am with the hon. Gentleman to the extent that the Government are committed to wealth creation, job creation and the relief of poverty, and we have been remarkably successful in that. I am also with him to the extent that I am aware of the severe problem of coronary heart disease in his constituency. That is why I hope that he will welcome the £23 million going into primary care in the Birmingham area precisely so that more GPs can deal with those issues and with the multi-factor causation of coronary heart disease and strokes. A great number of factors are involved; the whole point of "The Health of the Nation" strategy is to look into the causes of disease.

Does my right hon. Friend agree that the highly successful programme of childhood immunisation has made a major contribution to reducing the numbers of untimely deaths and improving the health and well-being of children? Will she take this opportunity to reinforce the message that, with the threat of a measles epidemic, it is vital that parents ensure that their children are vaccinated?

I thank my hon. Friend. I can confirm the great success of the immunisation campaign. It is bizarre that the Labour party so stubbornly resisted the new GP contract, which has resulted in well over 90 per cent. of children being immunised against avoidable childhood diseases.

What account is the Secretary of State taking of the clear links that have been established between unemployment and mortality and ill health? What is the right hon. Lady doing about that, and will she restrain her hon. Friends from hounding the unemployed and persuade her Government to act to provide more real jobs?

I am vigorously championing the success of the Prime Minister and other members of the Government in reducing the number of unemployed. A reduction of 400,000 in the number of unemployed since the end of 1992 is a remarkable achievement. I am certainly not pursuing populist gimmicks such as compulsory paternity leave which would be imposed by Brussels and would drive jobs out. A minimum wage would also be counter-productive in terms of providing real jobs for our people. I want to make sure not only that we have people in employment but that we have healthy people in employment.

Is not the progress towards meeting the targets in "The Health of the Nation" extremely encouraging? But does my right hon. Friend share my disappointment at the poor figures in relation to reducing the incidence of smoking among young people and especially girls? What are her plans to reduce the largest avoidable cause of premature death?

My hon. Friend is a persistent and wise champion of the cause of reducing the extent of smoking. As he will know, in that respect we have been more successful than any other European country apart from the Netherlands. That is largely because we believe that price is a crucial variable. Every 10 per cent. increase in price leads to a 3 to 6 per cent. fall in consumption. We are meeting the target for adults and pregnant women. The problem is in meeting the target for young people. The most important factors are parental disapproval and education in schools. I am pleased that through our "Health of the Nation" strategy we are reinforcing our messages to parents and to those in control of young people and are increasing the extent of anti-smoking education.

To ask the Secretary of State for Health what monitoring her Department is undertaking of the placement of children by local authorities in private children's homes unregistrable under the Children Act 1989.

The social services inspectorate is currently undertaking a study of children's small homes in England.

How can the Minister undertake adequate monitoring when his Department has absolutely no idea how many children are placed in children's small homes? His Department does not specifically request that information from local authorities. As he knows, a lot of nonsense is coming from his Department about such homes. When will he introduce legislation that will require those homes to register and enable them to be inspected so that the same standards can apply to all children's homes irrespective of size?

That is precisely what the current study is doing. It is establishing a database of small homes and considering whether the regulations that apply to them are adequately understood and applied. As the hon. Lady knows, unlike homes for adults, small homes for children are covered either by foster home regulations or placement regulations, and that is in addition to the welfare responsibilities of the authority in whose area the home is located.

As most of the worst cases of bad treatment of children in homes—for example, pin-down—occur in local authority-run homes, why are we being asked to monitor only the private homes?

My hon. Friend is right. Sadly, the cases of abuse that we have had to investigate occurred in homes run by or under the auspices of local authorities. The homes that we are discussing here are for four children or fewer. Except in my discussions with the hon. Lady about her concerns and with the hon. Member for Streatham (Mr. Hill) about the impact on the community of children from such homes, I have not heard anyone say that children in such homes are at risk.

Will the Minister acknowledge the importance of professional training for officers in charge of residential homes for children? Will he confirm that the Utting report found that 21 per cent. of officers in charge do not have relevant professional qualifications, and can he give the House an assurance that the Government are on target to achieve the Utting recommendation of having all officers in charge of residential children's homes fully qualified by 1995?

The hon. Gentleman is right. The Warner and Utting reports both contributed to our policy making. As he will know, we have set up the support force, which is doing excellent work around the country. He will also know that we have a budget of some £70 million for training and that there are now 5,000 more qualified social workers every year. We are seeking to meet the targets to which he refers. The proof of that is that, 20 years ago, 38 per cent. of field social workers were trained, whereas the figure is now more than 90 per cent.

Only this morning, I was speaking to the owner of a private unregistered children's home in my constituency who stressed that such owners want to be registered and distinguished from what he termed "the cowboys" involved in private care. I met the Minister's predecessor—

Order I am waiting for a question from the hon. Gentleman.

Bearing in mind the fact that it is now nearly two years since my hon. Friend the Member for Stockport (Ms Coffey) and I met the Minister's predecessor at the Department of Health to discuss this matter, why has it taken so long to plug what is, frankly, a dangerous loophole in our child protection legislation?

There is no way that I would be satisfied if I thought that regulations were inadequate to protect children in those homes. That is why we have issued a circular reminding local authorities of their very real powers in such matters. That is why, from now and in future years, the annual gazetteer of children's homes will include the numbers of children placed in such homes so that we know what the position is and can continue to protect children in small homes as well as in the larger ones.

My hon. Friend will know that one of the great difficulties in the care of children, whether in small or in large homes, is that there is such a rapid turnover in the people who look after them. Will he take steps to give much more robust guidance to the statutory services, to encourage caring volunteers to act as long-term mentors for those children and keep an eye on the way in which they are being looked after by the statutory services?

My hon. Friend makes an excellent point. So much can be done by statutory services—by inspection, regulation and visits—irrespective of the size of the home. What is needed are friends for children—key workers looking after children and making sure that they are in touch with those individual children's lives, ambitions and hopes so that if they get into difficulties, somebody is there to take note and alert the proper authorities.

To ask the Secretary of State for Health what response she has received on the Government's proposals for NHS dental services and charges.

We expect the dental profession's representatives and those others consulted to respond to Green Paper "Improving NHS Dentistry" when the consultation period ends on 1 November.

Does the Minister realise that a 25 per cent. increase in dental charges would further increase the number of patient deregistrations because many people would no longer be able to afford to visit the dentist? In view of the recent Denplan survey, which revealed that more than three quarters of dentists would be more likely to leave the national health service if the Government's Green Paper proposals ever became a reality, and forecast that 69 per cent. of patients would be private by 1999, will the Government scrap the Green Paper and instead take steps to ensure an adequately funded dental care system within the national health service?

Certainly not. The hon. Gentleman should remember that Denplan is a private organisation. Its headquarters happen to be in my constituency, so I know the company extremely well. It is hardly surprising that a limited survey carried out by an organisation with such an interest has come up with such a finding.

To ask the Secretary of State for Health how much money was spent last year on cancer research; and what percentage of that was provided by charities.

The latest figures are for 1992. They are £250 million and 45.9 per cent. respectively.

Why is much less money spent on cancer research per million of population in the United Kingdom than in other countries? Why is it that in this country, uniquely, most of the money comes from charities? That makes long-term research difficult. Will the Minister undertake today to give more Government support to research into breast cancer—the biggest single killer of women between 35 and 50—as part of a much-needed national action plan on breast cancer?

That is a collection of questions. Of course, it makes sense to combine with our counterparts abroad to ensure that the resources of the world are devoted to combating cancer. According to the Office of Population Censuses and Surveys, Britain is spending 7 per cent. of the NHS budget on cancer—that is some £2.8 billion. The hon. Gentleman must be aware that this country leads Europe in its breast cancer screening programme and on investment in that.

Does my hon. Friend agree that charities give all sorts of people the opportunity to contribute directly to the extension of knowledge, to the fight against cancer and, very often, to mutual support groups?

My hon. Friend is absolutely right. The work of charities and their ability to attract resources from individuals is a great asset and one which we should nurture. They are especially good at attracting resources from individuals for the fight against cancer.

To ask the Secretary of State for Health what representations she has received from employees afraid to speak publicly on NHS matters.

None.

Does the Minister agree that there is growing concern about the increasing number of dedicated health care professionals who are being disciplined or even dismissed by their health trusts for speaking out about the decline in standards? What will he do now to put a stop to draconian gagging clauses?

There are no draconian gagging clauses. The procedure is set out clearly in the guidelines that have been issued, which emphasise not only that there is a right to speak out and go through the proper procedures but that there is a duty to raise such matters in the proper way and to have them dealt with thoroughly and properly.

What representations has my hon. Friend received from the proprietors of private nurseries who are being harassed—

Order. [Interruption.] Order. I am on my feet. If the hon. Lady will relate her question to the question on the Order Paper, I will hear it.

What representations has my hon. Friend the Minister received on health matters from the proprietors of private nurseries, who are afraid of speaking out publicly for fear of their being closed for the most minor infringements?

None, to my knowledge.

Is the Minister aware of the concern at Burnley health trust, where many of the employees are not able to speak about what is happening? Is he further aware that one consultant was dismissed last month with three hours' notice and that the chief executive was asked to resign yesterday? Should not there be an inquiry into what is happening at that health trust?

The guidelines are precise. They state that fair procedures should be set out which allow openness and that a climate should be established between those who manage the institutions and those who are employed in them so that such matters can be properly investigated. The hon. Gentleman should refer to the guidelines. If it is the case that the institution to which he refers is not living up to them, that is a matter which needs to be looked into.

To ask the Secretary of State for Health when she last met representatives of junior doctors to discuss the implementation of the new deal.

I last met the junior doctors' committee chairman to discuss the new deal on 29 September, and before that on 28 July. Ministers have met the representatives of the junior doctors on numerous occasions since we launched the new deal.

Given the success in reducing junior hospital doctors' hours, does my hon. Friend agree that it is now important to do what we can to ensure that all accident and emergency departments have the appropriate level of junior and senior doctors on duty at the most critical times?

It is always extremely important that all accident and emergency units have a proper mixture of staff. However, those patterns are changing and, in many cases, it is possible to break down boundaries between the nursing profession, junior doctors and consultants. Where that happens, a far better mix of patient care is available for those who need it.

To ask the Prime Minister if he will list his official engagements for Tuesday 25 October.

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

Does the Minister for business probity still command the full support of the Prime Minister?

I shall be making a statement immediately after Question Time and the hon. Gentleman should contain himself.

To ask the Prime Minister if he will list his official engagements for Tuesday 25 October.

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

During the course of his busy day, does my right hon. Friend ever pause to reflect on how easily little bits of bad news can push major items of good news out of the headlines? In congratulating my right hon. Friend on his continuing achievements in Northern Ireland, may I ask whether he agrees with me that the end of 1994 will be remembered not for the media's obsession at the present time, but for the achievements in Northern Ireland, which have brought stability, hope and peace beyond our wildest expectations?

It is attractive from time to time to maintain a proper perspective on political matters and I do believe that we have now entered a fresh phase of the peace process in Northern Ireland, as I set out in my speech in Belfast last week. As I saw for myself across the community in Belfast last week, there is enthusiastic support in Northern Ireland for the progress that has been made and appreciation and understanding of what still needs to be done. But there is greater hope that peace may now be permanently achievable than we have seen at any time in the last quarter of a century.

Will the Prime Minister investigate the affair of Healthcare International at Clydebank and tell us why more than £30 million of public money has been put into creating a private hospital and what will now happen to rescue that hospital? Will he guarantee that any such rescue effort will not be at the expense of NHS hospitals in Glasgow and the west of Scotland?

I am sure that my right hon. Friend the Secretary of State will examine carefully what the hon. Lady has said. As the hon. Lady will know, year on year, the resources available to the health service in each part of the United Kingdom have increased, as have the number of patients treated and the quality of service offered by the NHS, and we intend that that will continue.

To ask the Prime Minister if he will list his official engagements for Tuesday 25 October.

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

I invite my right hon. Friend to use the time between now and the start of the intergovernmental conference in 1996 to persuade our partners in the European Community to adopt a moderate rather than ambitious agenda. Does he agree that a stately minuet would be preferable to the rain dance that he described in his celebrated article in The Economist one year ago?

My hon. Friend sets out my view with great clarity. It will be necessary in 1996 to look carefully at changes that have occurred. I do not personally believe that there is a great appetite across the European Union for dramatic changes. We will have to wait to see what is placed on the agenda, but my judgment is that changes deserve to be modest and should be no more.

Does the Prime Minister accept that it is not sleaze but his party's basic values that have been exposed? Is it not the case that, now that public service is set at naught and the marketplace rules, Conservative Back Benchers are operating in that marketplace?

If the hon. Gentleman examined improvements across the range of public services over the past 15 years, he would realise that his remarks are utterly and totally misguided. Service to the public is what matters. Where that can best be provided in the private sector, it should be. Where it remains in the public sector, we have done more to improve service than any previous Government.

To ask the Prime Minister if he will list his official engagements for Tuesday 25 October.

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

Does my right hon. Friend agree that choice and diversity are essential if we are to continue improving the nation's schools? Will he reconfirm yet again his support for grammar schools, grant-maintained schools, the assisted places scheme and city technology colleges? Can he tell the House how many children are being educated in those schools?

My hon. Friend's point follows on rather well from the previous question. Education is a service to the public and now offers more choice at a higher standard than previously. It does so as a direct result of the policies that we have followed. Giving parents more choice and more information on which to base their choice is a fundamental part of our policy will remain so. That means that we need more grant-maintained schools and CTCs. I cannot immediately tell my hon. Friend how many pupils are attending those schools but I will do so in writing. Something like 1 million parents have benefited from those schemes, and many more will do so in future.

When I was first elected to the House, I believed that I was elected to perform a public service. Will the right hon. Gentleman make a comprehensive statement at 3.30 pm, to ensure that other Conservative Members believe that we are here to give public service and not for self-service?

Clearly the hon. Gentleman was not listening a few moments ago. I set out clearly our determination to improve all services that must remain in the public sector, as many must. I commend to the hon. Gentleman my speech at the chartermark awards a few days ago, which he would find of some interest.

To ask the Prime Minister if he will list his official engagements for Tuesday 25 October.

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

Does my right hon. Friend agree that those who have something to contribute to public life should be encouraged to serve on public bodies? Has not the obsession with sleaze reached absurd heights when the Labour party accuses General Sir Peter de la Billière and the Duke of Kent of being Tory placemen on public bodies?

I believe—[Interruption.]

Order. The House must settle down.

My hon. Friend the Member for Eastbourne (Mr. Waterson) is entirely right in pointing to the fatuous nonsense that appeared in a Labour pamphlet published last week. There is a serious debate to be held about public service and non-departmental bodies but it cannot be held by claiming that General Sir Peter de la Billière and the Duke of Kent were placed on quangos because of donations that they made to the Conservative party. Where there are issues, let us look at them.

Order. I am sure that the House does not want more of me. Quieten down now.

To ask the Prime Minister if he will list his official engagements for Tuesday 25 October.

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

Given the Prime Minister's avowed intention to maintain the highest standards in public life, will he reassure the House that the disgraceful tactics used by the Government to crush the Civil Rights (Disabled Persons) Bill will not be used again when disabled persons' legislation comes before the House in future?

I indicated earlier in the year that we would send out a consultation document on the question of anti-discrimination legislation for disabled people. We have done so. We have received more than 1,000 responses to that document. We are examining those carefully and, as soon as we have finished that, we will make an appropriate announcement.

Does my right hon. Friend agree that the creation of 1,000 additional jobs by Rover at the Longbridge plant on the edge of my constituency is a demonstration of good Government policy and superb local management, and will he support it?

All extra jobs are worth while and we have had a lot recently. Unemployment has fallen by more than 400,000, partly as a result of growth in the economy, partly because of the increased competitiveness and partly because of the sort of investment in this country that would not take place if the policies of the Opposition parties had been followed. We now have output rising at 3.5 per cent., inflation at a 27-year low, unemployment down by 400,000 and business confidence at a high level. I look forward to more jobs being created in my hon. Friend's constituency and elsewhere.

To ask the Prime Minister if he will list his official engagements for Tuesday 25 October.

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

When, this time last week, the Prime Minister answered my question about making his Administration a sleaze-free zone, why did he not admit to the House that he had had an inquiry for three weeks into the behaviour of members of his party? Why did he not come clean with the House at that stage, instead of waiting for newspaper revelations to force that information out of him?

When the hon. Gentleman reads the Cabinet Secretary's report, which I will be publishing this afternoon, he will see that his question is wrong and he will owe me an apology.

Is not the point about public appointments that, if we had not had denationalisation, the Government would still be left appointing their own placemen to run half of British industry? Has not one of the great gains of having a Conservative Government for the past 15 years been that we have got rid of most of those appointments and that we do not need to have trade unionists on every board in the country?

My hon. Friend is entirely right about that. It is also entirely to right to say that we need people who are public spirited to serve on non-departmental public bodies. That is the case and it has been for a long time. [Interruption.] Perhaps I may remind hon. Members who shouted out, "They are all Tories" of a Labour party national executive committee advice note published recently? It reads as follows:

"Labour Party members may take up places on non-elected authorities and use them as a platform for our campaigning".

"Members accepting appointments of this kind should inform Walworth Road so that the … Shadow spokespeople and Head Office policy officers can maintain a network of contacts, informing appointees of Labour policy and collecting useful information in return."

Why are the Prime Minister and his Government spending so much time chasing would-be or wishful job seekers, instead of concentrating on his right hon. and hon. Friends who have too many paid jobs?

We are seeking to put as many people as we possibly can who are at present without jobs and unemployed—whom the hon. Gentleman claims that he cares about—back into work. The job seeker's allowance seeks to play its own part in doing that. It is a necessary innovation; I welcome it, and I believe that it will be very successful.