I am most grateful for the opportunity to raise this very important subject today and to be part of establishing a new tradition, only recently started, of Wednesday morning debates.

I want to discuss the size of the problem of drug abuse among young people. It is notoriously difficult to get accurate statistics, but Home Office figures suggest that, of young people living in inner-city areas, some 42 per cent. of 16 to 19-year-olds, and 44 per cent. of 20 to 24-year-olds, have taken drugs at some time. We had a recent reminder of that in my constituency, with a haul of £25 million of drugs on board a catamaran that was towed into our new Sovereign harbour, and another reminder when there were some expulsions from a prominent local public school.

The figures vary quite dramatically. Home Office figures show that the total number of drug offenders has risen by 190 per cent. since 1983, in a 10-year period. Of course, the Home Office also makes the point that there is likely to be a significant understatement of the figures of drug addiction and drug use. In a survey in 1993, it was said that only 52 per cent. of boys and 57 per cent. of girls had not been offered any of the named drugs in year 11, aged 15 to 16. Those are, on any view, dramatic figures.

Nor, indeed, are the problems limited to urban areas. The East Sussex Drugs Advisory Council—ESDAC—produced the statistic that the incidence of drug taking in the north Wealden district of east Sussex was almost the same as that of Brighton, and that more than one fifth of 14 and 15-year-olds had tried an illicit drug, and, of those, 5 per cent. were likely to develop problems because of drug abuse.

I am particularly grateful to Mrs. Penny McKay, of the Eastbourne community drugs team, for producing other figures, such as those from the South Thames (East) regional drug misuse database, which suggest, for example, that the average age of first use of cannabis is under 15 years old. There is evidence that young people most often experiment with substance misuse between the ages of 10 and 14. For example, solvent abuse is the highest cause of unnatural death between the age of 10 and 16, after road accidents. We must ask ourselves why. What is the attraction?

The British Medical Journal, in its own investigations, felt that the most common reasons cited were

"to feel big, show off, look grown up … because friends do, trendy."

I should like this morning to concentrate only on cannabis, the most widely used of the so-called "soft" drugs. As the Government consultation document, "Tackling Drugs Together", said, the burden is on those who wish to legalise or decriminalise soft or hard drugs. One of the arguments that is made for legalisation or decriminalisation is that those drugs are no worse than alcohol or tobacco. That is rather a bleak argument. I am particularly impressed by something that was said by Detective Chief Superintendent Des Donohue, head of Dorset CID, who, a few years ago, received a Churchill fellowship to study the police response to drug abuse. When the point was put to him, he said:

"If I had been a bobby in the 16th century I would have nicked Sir Walter Raleigh for the illegal importation of drugs.

We are stuck with the social problems of drink and tobacco but that's no reason to legalise cannabis."

Another argument often used is that legalisation would reduce the criminality that tends to surround the use and supply of drugs. Of course, if one legalised burglary, the crime statistics would doubtless improve. But that is not the way to tackle that particular problem.

There are also some practical difficulties. First, how could a workable system be established that distinguished between possession of drugs for personal consumption and possession for trafficking purposes? Secondly, I assume that even those who advocate legalisation would want a system to protect children and young persons. Thirdly, how would we deal with the question of driving under the influence? There is much evidence to suggest that driving under the influence of cannabis, which can take a week or so to leave the human system, is rather more dangerous than driving under the influence of alcohol.

Would not the legalisation of so-called soft drugs such as cannabis act as a gateway to harder drugs such as heroin, and would not that be extremely damaging? The best idea, surely, is to introduce drug education into as many schools as possible to show our youngsters at an early age how damaging the use of cannabis can be.

My hon. Friend is right. I shall develop the "gateway" or "pathway" argument shortly.

Legalisation would also involve Britain's withdrawal from the United Nations convention on narcotic drugs, thus risking our international isolation. It has been argued that legalisation would reduce the allure and attraction of drugs, but I consider that argument flawed. I also think that comparisons with tobacco and alcohol are meaningless, as those substances are not legally restricted in any real sense except in respect of minors.

Why should drug barons and others who currently make a good living from organised crime not seek to control an ever-expanding market, albeit a legalised or decriminalised one? As for the "libertarian" argument—the John Stuart Mill approach—I fear that we are dealing with the real world, not that of philosophers.

It is interesting to note that even the Dutch Minister of Justice recently announced to the United Nations that his country was reviewing its so-called "coffee shop" policy, whereby cannabis dealing and use are tolerated at certain outlets, because of a perceived sharp increase in the availability of drugs.

Let me deal next with the arguments against the legalisation of cannabis. The argument about its effect on human beings has raged for many years, but there is no conclusive proof that so-called soft drugs are non-addictive or completely harmless. As the Royal College of Psychiatrists put it,

"There can be no reasonable dispute that cannabis can cause acute mental impairment in terms either of intoxication or a transient but very bizarre and worrying psychological experience."

There is a growing body of medical opinion on other physical effects. A recent article in The Big Issue—not a publication renowned for its slavish support for pro-establishment views—set out some of the evidence that is emerging, particularly in America, of damage caused by cannabis or marijuana. Apparently, research shows that it can damage the human immune and reproductive systems and the brain. There is also strong evidence that the drug is more carcinogenic than tobacco. According to Professor Sridhar of the university of Miami's cancer research centre,

"Cannabis smokers develop cancer 15 to 20 years younger than you would expect. I am convinced it is a highly dangerous drug."

At a time when most commentators agree that there is a need for even more health education and even more effort by those leading social policy to persuade people to give up substances such as alcohol and tobacco, would it not be wrong for hon. Members or anyone else to 'be seen to endorse a product that involves many of the same difficulties? It would run contrary to all the current social thinking.

My hon. Friend is right. The fact that we allow the legal consumption of alcohol and tobacco does not mean that, if we started with a clean sheet in respect of both commodities, we would find ourselves in our present position.

Cannabis is very much an unknown quantity. It took some 50 years and literally thousands of research projects, papers and investigations to discover that smoking tobacco causes cancer. I believe that there are about 100,000 tobacco-related deaths a year in this country alone. It is hardly surprising, however, that cannabis is harmful: it contains more than 400 compounds that convert to over 2,000 chemicals when it is ignited.

The element THC, which is the main ingredient of cannabis, is important in terms of its strength in a given dose and the way in which it builds up in the body over long periods. Some scientists estimate that the present levels of THC in cannabis are some 16 times higher than at the time of the Woodstock festival, which some of the older hon. Members present may remember. There are also suggestions that cannabis can reduce fertility, as well as weakening the immune system and the body's protection from infection. Studies show that cannabis smokers are up to six times more likely to develop serious mental illnesses.

In my constituency, as in my hon. Friend's, the problem of drug abuse among young people is particularly serious. The effect of cannabis consumption on health has been particularly marked in Blackpool, and Dr. Mohammed Musa, who works in my local drug advisory clinic, strongly believes that it adversely affects the general health of all drug users in the town.

I am not surprised. I do not know whether Dr. Musa has a view on the issue raised by my hon. Friend the Member for Ribble Valley (Mr. Evans)—the extent to which the use of so-called soft drugs leads to the use of so-called hard drugs.

Picking one's way through the mass of literature on the subject, it is difficult to arrive at a clear, definitive medical answer. It would be dishonest not to accept that opinions vary, but I stress what I said at the beginning of my speech: the burden of proof must be firmly on those who wish to legalise or decriminalise those substances.

Even the Government now state that, as well as affecting psychotic illnesses and lung diseases, cannabis affects the user's judgment, leading to pregnancy and numerous other spin-off problems.

My hon. Friend is absolutely right. One of the most dramatic illustrations of that point is contained in research into road and train accidents, particularly that conducted in the United States.

According to the Royal College of Psychiatrists,

"It is clear that a person who uses cannabis is statistically more likely to try other illicit drugs than one who does not."

The argument that the hon. Gentleman is about to deploy is a familiar one, but what he has just said is unexceptional. Obviously, someone who starts using cannabis is statistically more likely to move on to another substance; but it is equally true that someone who drinks a dry sherry is statistically more likely to end up as a total alcoholic. What point is the hon. Gentleman trying to make?

I do not know whether the hon. Gentleman was at Woodstock. I was about to deal with his point, which some experts call the "pathway" argument. I am not saying that everyone who tries cannabis will move on to something harder, and I do not entirely disagree with what the hon. Gentleman has said. A number of studies show that, as people become adjusted to a drug such as cannabis, there is a tendency to increase the dose, or to move on to something that is somewhat stronger.

Is my hon. Friend aware that there are now variants of cannabis that can cause hallucination, so the idea that cannabis is some sort of safe drug with a recreational flavour is inaccurate? Skunk, a variant of cannabis, is imported from the Netherlands. Such variants can cause hallucinations that can drive people on to experiment with harsher drugs.

I am grateful to my hon. Friend for that information. I know that he has made himself very much an expert in those matters, and that he has spent a great deal of time and effort in his constituency trying to combat drug abuse problems, especially among young people.

Another argument is that, if cannabis is legal, in a sense, it loses the attraction of being out of bounds, especially to young people, and they may choose to move on to something that appears to have a more superficial romance about it because it is illegal. The hon. Member for Newham, North-West (Mr. Banks) talked about pathways. It is true that many addicts, perhaps even most addicts of, for example, heroin have previously used cannabis. Some of the studies that I have read show that it is equally true that alcohol is a pathway. Children who start drinking alcohol at a young age—and it is surprising how many do nowadays—will graduate to the other drugs that I am talking about. That is an important point.

The next argument against legalisation is that it reduces social disapproval of the use of those drugs. People may argue that drugs should be legal, but I doubt whether many people argue that they are positively beneficial. By legalising them, one would send a confusing message to our young people, a point made by Sir Paul Condon recently, when he said:

"By continuing to debate the possibility of legalisation we are diminishing the dangers of drugs in the eyes of the young. We must take the utmost care not to make drugs appear attractive."

Merely by debating the possibility of removing legal constraints, we may unwittingly be encouraging their use.

Another argument often put forward is that legalisation would reduce the street price. Again, the evidence is clear that, if the availability and ease of access to drugs is increased, one will increase use and abuse, especially among young people. As Professor Griffith Edwards of the National Addiction Centre said,

"access to drugs has been proved significantly to encourage use of drugs."

There is abundant research evidence from America, both in the medical profession and among American ground troops in Vietnam. In both situations, for different reasons, drugs were freely available and there was a much higher level of addiction than among the rest of the population.

On health costs, I have said that there is no conclusive proof that cannabis is non-addictive. There is ample proof that it damages health. If one considers the problems that we have in society with alcohol and tobacco, which are already legal, one may realise the sort of difficulties that a massive expansion, potentially, of drug use would cause, plus other costs to society.

What I call the social effects are often ignored. The regular use of drugs often involves a surrender to unreality, a retreat into a world that has neither pain nor achievement. That has a long-term effect on any society.

The evidence, therefore, is clear. I feel that no responsible group or political party would advocate legalisation or decriminalisation, except possibly one. As you will know, Madam Speaker, the Liberal Democrats voted to decriminalise cannabis at their last party conference. I see hon. Members shaking their heads. I am willing to give way on that point.

I hope that I might catch your eye later, Madam Speaker, to explain that the Liberal Democrats did not vote for that. I spoke in the debate and I shall ensure that the House understands exactly what we did vote for. We voted for a royal commission to consider a range of issues, including whether there should be a change in the legal position. That is clear and I hope that the hon. Gentleman will no longer misrepresent what we decided.

I am sorry to disappoint the hon. Gentleman. This is an important and disturbing issue, which surfaced in my constituency. I have taken great trouble to ascertain the true facts about the wording of the motions, and the two separate votes that took place. The hon. Member for Southwark and Bermondsey (Mr. Hughes) is free to say whatever he wishes in the Chamber, but some of the points made by his friends in my constituency border on the libellous. They are certainly attempts to rewrite history. For the record, let me assist the House.

There was a separate vote to refer these matters to a royal commission. It is probably not unusual for a Liberal Democrat party conference to pass motions that are contradictory because, after all, it does the same thing every day of the week in this place. However, it had a vote and then a separate vote, where conference called for

"The decriminalisation of the use and possession of cannabis in order that the police and Customs and Excise are able to target their resources on the vital battle against the use of hard drugs."

The vote on that was 426 in favour and 375 against.

Only because the hon. Gentleman is being so misleading, I should point out that he read part of a sentence—I have the motion as passed here. I hope that he will listen and not misrepresent the position again. The wording of the sentence is:

"Conference calls for the establishment of a Royal Commission to investigate and consider strategies for combating drug misuse, including"

and there is a list of six things, of which the last is the question of decriminalisation. The royal commission, therefore, would consider six issues, one of which is what the legal position should be. For heaven's sake, the hon. Gentleman must not lie in the House.

Order.

I am sorry, Madam Speaker. I withdraw. The hon. Gentleman must not misrepresent our position in the House.

I am obliged, of course.

I did not intend to spend a long time on this and I am running rather late, but it is time to nail that gross misrepresentation by the Liberal Democrats. I do not blame them for being embarrassed by the vote. Their leader was extremely embarrassed. I seem to remember that he stormed off the platform. They should be embarrassed. This is a disgrace.

As the hon. Member for Southwark and Bermondsey is so much in love with the facts, and I am looking at the Liberal Democrat agenda paper for Monday 19 September last year—

We were there.

I sometimes wonder. I have already accepted that that conference passed a separate motion by a separate vote to refer the matter to a royal commission, but, at the same time, it passed by another vote a separate motion. I have already read out proposal 6 in Amendment 1, put forward by the Saffron Walden constituency and moved by Alan Dean.

Lest the hon. Gentleman would try to persuade the House either that black is white and white is black, or merely that this is a brief aberration on his party's part, let me remind him of his own words in his role as community affairs spokesman. He said:

"Lots of absolutely perfectly respectable, normal members of society take drugs as normally as many of their fellow citizens smoke, drink beer or have sex."

If the hon. Gentleman wants to withdraw those words, I am happy to give way.

Nor was that vote just an aberration. At the Scottish Liberal Democrat annual conference in 1993, delegates also voted to decriminalise the possession of cannabis. I draw a line under that part of my speech.

Will my hon. Friend join me in condemning not only the Liberal Democrats' vote at their party conference to legalise cannabis, but the vote to make contraception available to 11-year-old girls without reference to their parents? Did he share my horror on reading in The Times this morning that this year they are going to debate euthanasia? What is happening to the Liberal Democrat party?

I hope that the hon. Member for Eastbourne (Mr. Waterson) will not pursue that line of argument. It is not part of the Adjournment debate.

I had no intention of doing so, but I shall make two points. First, I would not wish to remind the hon. Member for Southwark and Bermondsey of more than one issue on which his party is attempting to distance itself from the actualité. Secondly, has my hon. Friend read the comments of Mr. Alan Hope—Councillor Alan Hope, I beg his pardon—of the Monster Raving Loony party who, after the Liberal Democrat conference, said:

"They are becoming loonier than we are. We are being out-loonied by the Liberal Democrats …We can't believe some of the loony policies they are advocating—legalising cannabis, condoms for 11 year olds and abolishing the monarchy. You can't get loonier than that"?

He got his information from The Sun, like the hon. Gentleman.

I was quoting from the Western Daily Press. Let us move on now that I have put the record straight. The next time a Liberal Democrat councillor or spokesman in my constituency accuses me of lying or falsehood, as has happened here today, I shall take action. If the hon. Gentleman wishes to repeat what he said outside the House, we shall get to the heart of the matter. I am conscious of the fact that time is moving on. I have accepted many interventions and been provoked beyond what is reasonable.

What are we doing to deal with the problem? As a country, we spent more than £500 million on the problem in 1993. I have already mentioned the excellent work of the community drugs team in my constituency. The Seaside centre in my constituency has also done excellent work under the leadership of Pat Armstrong. ESDAC draws together all the threads of information and policy to combat drug abuse in east Sussex. I pay particular tribute to my hon. Friend the Member for Lewes (Mr. Rathbone), who has been stalwart in his fight to increase awareness of those problems in east Sussex and in his support for organisations such as ESDAC.

The Sussex police have been active in many ways, especially in providing schools with liaison officers. I had a letter from Peter Westcott, the deputy chief constable, which sets out in detail the measures in which the police have been involved. It is estimated that in the country as a whole some 1,300 police officers are involved solely with drugs work.

Of course, health education is very important and some excellent leaflets have been produced by the Department of Health, East Sussex county council and many other bodies. Hon. Members may have seen the draft circular on this subject from the Department for Education, which makes excellent reading. Drugs education is now firmly a part of the national curriculum.

I believe that the formation last year of the central drugs co-ordination unit, under the leadership of my right hon. Friend the Lord President, has done much to focus attention on the problem. I am sure that my right hon. Friend the Minister will have much to say about the impact of the consultation document, "Tackling Drugs Together". It contains many useful ideas and focuses commendably on the importance of educating young people about the dangers of taking drugs. It is interesting that that very detailed document firmly rejects arguments for the legalisation of drugs. In fact, in a sentence that sums up the theme of my speech, it states:

"So, in general terms, the strongest arguments against legalisation of controlled drugs are the risks of wider use and addiction; these are very serious risks which no responsible Government should take on behalf of its citizens."

I agree. The Government must promote responsible policies that educate our young people about drug abuse.

In conclusion, the last thing that we want is the crackpot policy peddled by the Liberals, which would merely encourage drug abuse by our nation's young.

I am grateful for being called to speak and I welcome the debate on this matter, not least because it is the first since the Government published their Green Paper entitled "Tackling Drugs Together" to which the hon. Member for Eastbourne (Mr. Waterson) referred. My colleagues and I were under the impression until today that only politicians of our hue debated this issue, so the hon. Gentleman has done his party a service by putting it on the agenda.

It is perfectly obvious that the topic is hugely important. It is generally accepted by police forces across the country that two thirds of thefts are drug related. In a recent sample taken in the north-west, 95 per cent. of young people convicted of criminal offences admitted to using drugs.

I shall deal with, but not linger on, the point that clearly obsesses the hon. Member for Eastbourne—what is and should be the legal position of drugs. For a long time, there has been a debate about whether there should be decriminalisation or legalisation of any currently illegal or criminal drugs. Many people such as members of the judiciary, police officers and academics agree with those Members of Parliament who support the proposition that the law should be reformed. The tragedy has been that, until now, the debate has taken place not among elected representatives of the people but in the media, which have often misrepresented it—although that is not true of the serious press, which has dealt responsibly with the issue.

Legalisation or decriminalisation is certainly on the agenda in the country at large. According to some opinion poll soundings, more than 30 per cent. of the people support the argument for decriminalisation. If one walks around the streets of an urban constituency such as mine and talks to young people, one of the first issues that they raise is this very question because, as the hon. Member for Eastbourne said, many young people not only talk about drugs but often turn to them as their first choice recreational activity. That may apply more often to 15-year-olds, but also much younger children are involved, including those in primary schools.

Let me make it absolutely clear once and for all, although I am prepared to debate the matter with the hon. Gentleman in the House, in Eastbourne or anywhere else, that my party and, as it happens, I personally, have not been persuaded to support legalisation or decriminalisation. We believe, however, that there should be an informed and objective debate.

Will the hon. Gentleman give way?

No, I am trying to be brief and I wish to make this point categorically.

There are, of course, strong arguments against decriminalisation and legalisation, some of which the hon. Member for Eastbourne outlined. It is reasonable to argue that, if one alters where the line is drawn between what is forbidden and what is legal, the subsequently forbidden fruit is the fruit which is potentially more dangerous. Decriminalisation or legalisation may make it more likely that drug addicts or drug users will move here, as they have previously moved to Holland, a country which, I accept, is rethinking its position. Legalisation might not necessarily cut crime because crime would simply be connected with more serious drugs.

I disagree fundamentally, however, with the idea that having a debate determines whether more young people use drugs on the street. That is nonsense. Huge numbers of youngsters use drugs and they think that we are completely out of touch because we do not discuss the issue, and they do not understand why not. I am also not persuaded that the price goes up rather than down if drugs are legalised or decriminalised.

The Green Paper stated every reason against legalisation because its brief was to do so. That is not good enough. The matter must be looked at independently. Lord Nolan and his committee are respected because they take an independent view of matters of major public concern and everyone is looking forward to hearing what they conclude, because it is authoritative and not party political. If standards in public life can be the subject of objective analysis, recommendation and conclusion, exactly the same can be done with another central issue in today's modern society: how to deal with the amount of drugs in our society and on the streets. The Green Paper says:

"it is clear that the debate can be conducted in good faith by responsible people who can respect each other's views."

Amen to that. It means that the hon. Member for Eastbourne and his colleagues must not misrepresent what is decided in a democratic party, where, unlike them, we have the right to vote and debate amendments to motions.

Will the hon. Gentleman give way?

No, I shall not give way.

The motion that was finally agreed by last year's Liberal Democrat conference says:

"Conference calls for:

The establishment of a Royal Commission to investigate and consider strategies for combating drug misuse, including:—

1. Greater resources to be given to HM Customs & Excise …

2. The police to be given more resources …

3. All schools to be obliged to offer advice and guidance to all pupils …

4. Immediate action to set up rehabilitation centres throughout the country;

5. Much stiffer penalties for all convicted drug dealers;

6. The decriminalisation of the use and possession of cannabis in order that … Customs & Excise are able to target their resources".

That is the list that we want on the agenda of a royal commission, and the items are of equal importance.

Will the hon. Gentleman give way?

No, I shall not give way because I am trying to be speedy.

The motion was clear, but, of course, must be read as a whole. The Liberal Democrat party and the responsible members of the press who were at the conference understand that. Other politicians have understood that, too. Yesterday, the 'Prime Minister confirmed that he is not yet persuaded, but thinks that there should be a general debate on the single European currency. Equally, there should be an independent and well-informed debate on drugs. That is where we stand.

My hon. Friend the Member for Argyll and Bute (Mrs. Michie), who is on the Select Committee on Scottish Affairs, has also made it clear that the Liberal Democrats' Scottish conference voted, on an advisory basis, in favour of decriminalising cannabis.

That is all right, then.

No. The Scottish conference does not make policy for the federal party, because the legality of drugs is a United Kingdom matter. Federally, the party made its decision at last year's federal conference.

In 1984, the Government set up an Advisory Council on the Misuse of Drugs, which recognises the need for effective, broad-based education programmes. The Department of Education and Science, as it then was, provided £4 million to fund the appointment of drug education co-ordinators for each local education authority in England and Wales. They did very well and worked with schools and the youth service, but that initiative has fallen by the wayside and funding for those preventive health education workers ended in 1993 and was switched to schools.

Co-ordination through local authorities is far more effective than trying to get the work done with small amounts of money in individual schools. The Secretary of State acknowledged the key role of health education co-ordinators, but only £32 million was provided between 1986 and 1993 for that project. Moreover, it is not to be repeated. An average LEA with about 300 schools now receives about £30,000, which means that each school is expected to provide training for a total of about £100. With only that sum, teachers cannot be properly trained and equipped to deal with such a huge issue.

The Green Paper and the Department for Education's draft circular "Drug Prevention and Schools" have some encouraging aspects. The emphasis has changed from an uncompromising search for total abstinence, which was the original Home Office position in 1989, to acceptance that substance abuse has become a part of modern-day society and that education should concentrate more on constraining its expansion and lessening suffering.

indicated assent.

I am glad to see that the Minister agrees. Schools have been encouraged to develop a repertoire of responses to drug-related incidents. The Office for Standards in Education has been instructed to inspect the quality and effectiveness of schools' drugs policies as part of its school inspections. Alcohol and tobacco are also now in the DFE's draft circular, although they were not mentioned in the Green Paper. If we are to discuss drugs abuse among young people, the misery caused by the long-term health problems of alcoholism and tobacco addiction should be included.

It is important to discuss how we should persuade young people to make the right decisions. Given that the figure for illegal drug use among 14 and 15-year-olds is thought to be between the 14 per cent. that is given in the Government's document, albeit without statistical back-up, and the much higher and more realistic figure of 36 per cent., we must ask why young people decide to take drugs. A prevailing view seems to be that it is because they are under pressure, yet professionals on the subject say that it is because young people want to try drugs, as they want to try all sorts of other things. The Green Paper does not seek to tackle the root of the problem. Yesterday, we debated poverty and unemployment. Many issues contribute to young people's use of drugs, but poverty, lack of social activities, the rundown of the youth service, lack of work and broken homes are among those issues. We must tackle the causes that lead young people to make those decisions, and I hope that we shall do so.

The debate on this subject has only just begun in the country. I am glad that the Government are beginning to enter the mainstream of the debate, but we should have an objective assessment of the position for the future. My colleagues and I have argued for that and the Nolan committee shows that it is worth while. I hope that the Government will not now have a knee-jerk reaction, suggesting that only they and their advisers can get the matter right. Let us have a royal commission—even a standing royal commission—but, for the present, let us give education authorities the resources to co-ordinate dealing with the drugs problem in schools throughout their areas and the youth service the resources to work on the ground. We must be tough with dealers. We must recognise that young people know more about what is going on than older people, so we must take their advice and listen to them. We shall then understand how to deal effectively with drugs, which often harm their lives.

I hope that this is the beginning of an important debate that will be objectively carried on outside this place from now on.

I join other hon. Members in welcoming the debate and in thanking my constituency neighbour, my hon. Friend the Member for Eastbourne (Mr. Waterson), for initiating it.

I find myself in complete agreement with many of the points made by the hon. Member for Southwark and Bermondsey (Mr. Hughes), but I do not agree with his attitude to legalisation, to which I shall return in a moment, nor with his statement that the issue has not been debated. It has been much debated both within and between our parties. Most significantly, it was debated by the Council of Europe three years ago when it had 23 member states, and every representative of every party of every member state unanimously supported a motion against legalising drugs. To say that the debate has not begun is misrepresenting the pace. Today's debate is a useful continuum.

The fact of the matter, as is accentuated in the Green Paper, is that cannabis as well as other more serious drugs is harmful. As my hon. Friend the Member for Eastbourne pointed out, it is harmful to the heart, the nervous system and the reproductive organs, particularly those of young girls. It is also harmful because of its influence on a number of psychoses. It is a tragedy that those who argue for the legalisation or decriminalisation of cannabis play down those harmful effects, so that young people who are tempted to try cannabis and other drugs are reassured by those people's belief that it is harmless. That idea must be scotched and I hope that the debate will contribute to that.

The hon. Member for Southwark and Bermondsey (Mr. Hughes) suggested that the young know a lot about drugs, but does my hon. Friend agree that the medical evidence that he and my hon. Friend the Member for Eastbourne (Mr. Waterson) have quoted demonstrates that young people do not have access to that evidence?

I agree absolutely with my hon. Friend and I thank him for reiterating that point. Every doctor with knowledge about the problems of drug misuse has accentuated and reaccentuated the possible dangers of a drugs habit. We must do the same in the House and outside.

Legalisation would be harmful. Those who support it have conceded victory to drugs users—the weak-willed members of society and those people who feed that habit. That defeatist attitude sends exactly the wrong, negative message to our youth and that of the world.

The black market exists because demand exists. It will continue to exist whether cannabis is legalised or not as long as that demand exists and until more is done to reduce it. Legalisation of cannabis, should it ever happen, would inevitably lead to more frequent misuse of drugs and the mental and physical suffering that goes with that—just as we have found with alcohol. Alcoholism is still a far greater problem in this country and around the world than drug misuse because alcohol is readily and legally available. If we cannot learn from the problems of alcoholism and apply them to drugs, we are denying history to the detriment of the current generation and future ones.

I welcome the Green Paper, which accentuates the importance of demand reduction and the need for ever-greater emphasis on health education and prevention. We await keenly the Government's reaction to the consultation period, which has recently finished. Perhaps my right hon. Friend the Minister will offer us a keyhole insight into the Government's likely reactions.

I have the honour to be the chairman of the all-party parliamentary drugs misuse group. We put together a precise submission to the Government and I should like to stress two elements of it. The first is the hoary old question of funding, which must be considered. It is crucial that the necessary funds are made available to pursue the policies outlined in the consultation document. I agree with the hon. Member for Southwark and Bermondsey that funding should be available to teachers to educate young people about drugs. It should also be available for better treatment of drug addiction within the national health service. The list goes on. Allocating the necessary funds for the Government's eventual plans to be published in their eventual White Paper will require some hard bullet biting.

My second point relates not to funding but to strategy. The Government have set their way by publishing the consultation document. They have drawn together the various Government Departments in England and they must now continue that co-ordination by including Wales, Scotland and Northern Ireland. I praise the co-ordination unit and all those who work in it, which is chaired by my right hon. Friend the Leader of the House, but that co-ordination is required in strategic terms across the country. In this united kingdom we still fall down because we do not have a United Kingdom strategy to further the Government's efforts in every part of it and their contribution towards the fight against the problems of drugs misuse worldwide.

I, too, welcome the debate that has been initiated by the hon. Member for Eastbourne (Mr. Waterson). I endorse what the hon. Member for Southwark and Bermondsey (Mr. Hughes) said about the need for a continuing debate on a subject of great social significance in this country and around the world. We should debate politically sensitive matters in the House without predictable knee-jerk reactions.

I have considered this matter for some considerable time and I have personally come to the opinion—I stress "personally"—that we should legalise so-called soft drugs such as cannabis. I proposed that a royal commission should consider all the possible options for tackling the drugs problem long before the Liberal party did so. The evidence of medical people and those involved in enforcement should be further scrutinised to see whether we have got it right in Britain and whether people have got it right anywhere else.

I hasten to add that my call for the legalisation of cannabis is dictated by my own views and is not in any way connected with the policy of my party, which remains as determined to resist legalisation as the Conservative party. Our Opposition Front-Bench spokesman will make that quite clear today. I should also say that I am speaking for no more than a minority of Members who agree with me. Many hon. Members are prepared, however, to consider that possibility more openly.

It is worth dealing with the point about establishing a pathway, because I am quite certain that some hon. Members have used cannabis in the past. A number of hon. Members have told me privately that they have done so, but that they are not prepared publicly to endorse the use of soft drugs or any other drugs because of the political implications of doing so. They have not turned into potheads or ended up mainlining heroin any more than anyone in this House who has had a dry sherry in the past has turned up as a hopeless alcoholic in the Strangers Bar or anywhere else. Certain people will, of course, naturally move on from drinking sherry to alcoholism or from using cannabis to using heroin. That will happen naturally to some people, but the vast majority do not make that progression and that must be recognised.

The crucial argument is that medical evidence suggests that at least 4 per cent. of the population—it could be more than double that—are prone to become addicts. We do not know who they are, but we must protect them.

The hon. Gentleman could be correct, but he is being imprecise when he says that it could be 4 per cent. of the population or double that. I should like to deal with precise facts rather than anecdotal evidence. That is the important point. I agree that there are obsessive people in our society, as there are anywhere else, who will progress from one particular habit to another. Someone who starts by a turning a car over and stealing a radio might eventually become a serial killer—there would be a connection—but, for the vast majority of people, that causal link simply does not exist. I am simply asking the House to be prepared to consider coolly and rationally a subject as significant as the one that we are discussing, and not to rely on anecdotal evidence and knee-jerk reactions.

Human beings have used drugs and alcohol since time immemorial. Many of the so-called "illegal substances" that we call drugs, which we now ban, used to be freely available to people and were prescribed by doctors, even to members of the royal family. The Balmoral records, which were made available a year or so ago, show that laudanum and opium were prescribed for Queen Victoria's pre-menstrual tension. We have changed our attitude towards the use of drugs but, throughout history, human beings have used alcohol and have used drugs. It is simply that there are prevailing moods in societies that cause us to say at some moment that we do not like what is being done, which is why America moved to prohibition in the 1920s. We know about the chaos that that caused.

I feel it necessary to put on the record, as I have to do regularly when I become involved in this fairly politically sensitive area, that I have never used cannabis or any other illegal substance. I do not say that from any moral point of view, as the permissive 1960s appear to have passed me by altogether when I was at university—a matter of profound regret in my old age. I have tried to make up for those things that I missed in the 1960s, but. I hasten to add that one of the things that I have not tried to make up is the use of drugs.

The fact that I won a competition recently on a television programme to roll the longest joint, in which I beat a number of prominent pop stars who readily confessed to using the stuff, was merely a sign of my proficiency with nicotine in my earlier years when I "rolled my own". I still have that skill, although I no longer smoke nicotine.

The hon. Member for Eastbourne mentioned 100,000 or so smoking-related deaths. From a health point of view, it is far more damaging for people to smoke cigarettes or to drink alcohol than to use cannabis. Many of the health-related side-effects of using cannabis occur because cannabis is mixed with nicotine. That is the important thing. If someone were to take cannabis in a "space cookie" or a cup of tea, some of those medical side-effects would not be present.

I remind the hon. Gentleman that I argued that it took a long time, a great deal of use of cigarettes and nicotine and a great many studies to discover that nicotine was harmful—indeed, deadly—and we are much less far down the road in terms of cannabis. If use of cannabis were widespread, one might discover, some years on, exactly the same or worse effects.

Tobacco companies continue to resist the link between nicotine and lung cancer for straight economic reasons. I am happy for those matters to be considered, which is why I spoke about a royal commission. There is conflicting medical evidence, but if one is able to lay it out, as it were, and we are able to approach it objectively as legislators, and if, in the end, it is our considered opinion that the medical side-effects of using cannabis overwhelm any freedom arguments, of course it would be right for us to reaffirm our political position with regard to the enforcement of cannabis as an illegal substance. I am simply asking the House, as it is perfectly proper to do—unusual, perhaps—to examine the facts before adducing the arguments.

The title of the debate on the Order Paper is "The abuse of drugs by young people". It is right to link those two together. There are obvious links between the circumstances in which many young people find themselves and their use of illegal substances. The Cambridge study that was published today, which received considerable coverage on the radio and in the newspapers, shows that the link between unemployment and crime cannot be denied, however much Ministers might like to do so. They are responsible in great measure for high unemployment, so, for God's sake, they do not want to be linked with the fact that crime has also increased. We know that it has. One can no longer deny that link.

Many young people are using drugs because the use of drugs is linked with ignorance, with poverty, with the absence of hope and with unemployment. As the hon. Member for Eastbourne said, drugs offer relief—an escape from reality. Reality is harsh and unpleasant for many people, especially young people, and they want relief. It is escapism. It does not work, because one has to return to reality. It is the people who do not want to return to reality who tend to move on to harder and harder drugs, seeking a bigger and bigger fix because they cannot bear to accept reality.

The reality for many of our young people is one of hopelessness in our society. Where are drugs most readily available, and where is all the criminal activity associated with a supply of drugs rampant? The answer is, in the black communities, especially in the United States and indeed in this country, because those communities make up the social group that finds it most difficult to secure a stake in United States society or in this society. I do not want to make too much of that in a short debate, but a royal commission should be prepared to consider those issues.

We have a drugs problem in my constituency and in the borough of Newham. Newham is the most deprived local authority area in the country, so it tends to fit in with the image that I am describing, but the problem is not of cannabis as much as of solvent abuse—glue-sniffing. The substances that are used are not illegal as such. They are freely available in shops and people are able to buy them. In many ways, we tend to be sidetracked in the House on to issues such as cannabis, but there is an awful lot of abuse of substances that are available in shops which inflict far more damage on young people's health than cannabis would ever do. That has not been mentioned until now.

I say without fear of contradiction that drug abuse is a serious social problem in this country and elsewhere, and I think that it has two main causes: first, drugs are illegal and, secondly, large numbers of people use drugs. When it comes to it, what are we going to do with the 3 million to 5 million people in this country who use cannabis? Are we going to put them all in gaol? It will not work. One can no more ban the use of cannabis in this country than one could ban prostitution.

We have taken a step to regulate and control prostitution. I think that that is the way forward for the use of cannabis—regulation and control. When we do that, through legalisation, we shall be able to tackle the serious social problems that the use of illegal substances poses to our society.

I join other hon. Members in congratulating the hon. Member for Eastbourne (Mr. Waterson) on raising this important subject and in hoping that it promotes a wider debate on some of the issues. It is important also for another reason. The problem is not confined to inner-city areas. It affects outer estates, such as those that I represent, and rural market towns. Every part of Great Britain is affected to some extent by the abuse of drugs by young people. It is important, therefore, that we discuss those matters in the House and develop strategies for tackling those problems.

I start by setting the record straight on the position of the official Opposition on the legalisation of cannabis. My hon. Friend the Member for Newham, North-West (Mr. Banks) characteristically and generously said that the opinions that he expressed were very much and distinctively his own, not those of the Labour party, and I can confirm that that is precisely the case. I might say of my hon. Friend, for whom I have boundless affection and respect, that, in relation to that issue, although perhaps not to many others, he shows an uncharacteristic attachment to market forces. However, no doubt he will reconcile that apparent contradiction in the fullness of time.

The hon. Gentleman has mentioned the legalisation of cannabis. Does he hold an opinion on whether the clear vote at the Liberal Democrat conference to legalise cannabis was helpful or unhelpful?

The deputy leader of the Labour party said that it was helpful.

I shall come to that point. The hon. Gentleman is trying to prompt me into saying what the deputy leader of our party may or may not have said. I can hold a speech together without the hon. Gentleman's help.

I shall come to the Liberal Democrats in a moment. The Labour party believes that, whatever the merits or otherwise of cannabis, the party would send out entirely the wrong message to young people if it were to subscribe to the legalisation argument. The real crisis in our society at present is that too many young people become involved in the drug culture, for many different reasons. It is not appropriate for an official, a political party or the House to send out a message in favour of the liberalisation of any drug laws—particularly those regarding cannabis, which is commonly available. We do not support the legalisation move.

I have listened to the various exchanges between the hon. Members for Eastbourne and for Southwark and Bermondsey, but I am none the wiser as a result. Whatever happened at the Liberal Democrat conference, the impression created —

Will the hon. Gentleman give way?

I shall finish the point that I am making and then give way, although my speaking time is limited.

Whatever the precise wording of the motion that was passed at the Liberal Democrat conference, the message that went out to young people in particular is that the Liberal Democrats condone the misuse of certain categories of soft drugs. I understand that the Liberal Democrats were attempting to have a serious debate and I am not knocking them for that. However, we must be very careful about the messages that we send to young people. I shall now give way to the hon. Member for Colchester, South and Maldon (Mr. Whittingdale).

I am most grateful to the hon. Gentleman. I shall try to help him in his confusion about Liberal Democrat views. Does he agree that the Liberal Democrat conference voted clearly for an amendment in favour of the decriminalisation of cannabis which made no mention of a royal commission? Does he agree that that was deeply irresponsible?

I do not wish to follow that path. I want to make some serious points—I am not saying that the hon. Gentleman is not making a serious point—but, to be honest, I have not read the text of the amendment or the motion, as the hon. Gentleman has clearly done. I do not want to get involved in trying to confirm what did or did not happen at the Liberal Democrat conference. It is probably the most irrelevant of all events in the political calendar.

Does my hon. Friend agree that of more relevance are the two reports that were published last year—one from a right-wing think tank, the Institute of Economic Affairs, and another from a left-wing think tank, the Institute for Public Policy Research—both of which concluded that ending the prohibition of soft drugs will cut the profits made by the people pushing those drugs, reduce consumption of those drugs and also reduce drug-related crime?

My hon. Friend has known and trenchant views on that matter. Like my hon. Friend the Member for Newham, North-West, he shows an uncharacteristic faith in the ability of market forces to resolve the problem. I do not subscribe to that view. I think that I have dealt sufficiently with the issue of the legalisation of cannabis.

In talking about young people and drug misuse and abuse, it is important to differentiate very clearly—as the hon. Member for Eastbourne has done in choosing the title for the debate—between younger people who use drugs and older drug users. The problems of each group are different and therefore must be dealt with differently.

Young people often first use drugs experimentally—that does not excuse it; I am simply commenting that it happens. In most cases, a brief period of experimentation with drugs is followed by abstaining from any drug misuse. Although most young people who experiment with drugs do not misuse or abuse them in later life—we are dealing with the pathways argument—a minority move on to addiction and the misuse and abuse of often harder drugs. We must be concerned about that pathway which exists, albeit in a minority of cases.

On that point, is the hon. Gentleman aware of the statistics in the House of Commons Library research paper which show that 40 per cent. of deaths due to solvent abuse in 1991 resulted from apparent first-time drug use?

That is another kind of abuse of substances which are readily available in high street stores. It is a serious problem and one about which we must be equally concerned. I am conscious of the fact that, because I have given way so much, I have taken up more time than I should have. I shall try to move towards a conclusion.

The Green Paper entitled "Tackling Drugs Together" is very welcome. I wrote to the Lord President on behalf of the Opposition and, despite a few criticisms, I confirmed our support for the approach taken in the Green Paper. We must try to build a consensus across the Floor of the House and within the Government themselves: first, that the problems of drug misuse and abuse must be dealt with; and, secondly, that they should not be tolerated.

On that point, I do not believe that the case for reducing the number of customs control staff has been established properly. The Labour party and those who work in the service fear that the Government's recent announcement about redundancies in that area may curtail the ability of Customs and Excise to intercept—as it has done so successfully in the past—the illegal importation of drugs. I hope that the Minister will give more attention to that matter.

It is important that we send out two messages to the community: first, drugs are harmful and wrong; and, secondly, there is a growing consensus that the problem must be dealt with as part of mainstream politics and government. Those messages should be upheld at every opportunity.

I do not often have the opportunity to welcome a consensus approach in the House, but I welcome the offer by the hon. Member for Knowsley, North (Mr. Howarth) on behalf of the Opposition for a consensus approach to this matter. I also welcome his positive response to the Green Paper.

As for the hon. Gentleman's point about customs officials, the Government intend to target their effectiveness and we do not wish to see their excellent work in seizing illegal drugs undermined in any way. I welcome the hon. Gentleman's opposition to the decriminalisation of cannabis as a way of tackling the scourge of drugs. I hope that members of the Liberal party will come to their senses and join in that consensus in the House so that we can send the clear message that we will have no truck with drugs in our country.

The Minister is being uncharacteristically unfair. Surely he must understand by now exactly what occurred at the conference when we asked that a royal commission be set up to consider six matters, one of which was the decriminalisation of drugs. That is a most serious matter. Is the Minister suggesting that we should not have discussed it and opted in favour of establishing a royal commission?

I do not know whether the hon. Lady remembers how previous Governments set up royal commissions in order to kick problems into touch. Royal commissions take a very long time to consider matters and we must deal with the serious drugs problem immediately.

The hon. Member for Southwark and Bermondsey (Mr. Hughes) distanced himself from the hon. Member for Argyll and Bute (Mrs. Michie) when he said that the Scottish Liberal conference had voted for decriminalisation and added that, of course, in our federal system it does not make policy for the United Kingdom as a whole. The hon. Lady speaks for the Scottish party and she must take the consequences of what her party members voted for at that conference. It would send out a very positive message if she were to confirm that the Liberal Democrats will join the Labour party and the Government in denying that decriminalisation of drugs is the way forward. I shall happily give way to the hon. Lady to allow her the opportunity to do that now.

As the Minister invites me to intervene, let me explain again that the Scottish Liberal party made a decision that was supported by a majority, although many voted against it, including me. Is the Minister saying that we are not allowed to discuss such a serious matter and reach a conclusion? The conclusion that the Scottish Liberal party reached was that a federal United Kingdom Parliament would then legislate on such matters. That was the conclusion of the Scottish Liberal party, to which the federal party then has to listen.

Of course I am not saying that the Liberal conference in Scotland does not have the right to vote for the decriminalisation of cannabis—I am most grateful that the hon. Lady confirmed that it did so—but it is a thoroughly irresponsible message to send to the country and the Liberal party must take the consequences for what its members decide. It is no good Liberal Members coming to the House mealy-mouthed, trying to distance themselves from their decision. If the Liberal party is serious about tackling the problem of drugs in the country, it ought to join the Government and the official Opposition in having no truck with decriminalisation as a way forward.

Does my hon. Friend find the hon. Lady's intervention rather strange, given that, as a member of the Select Committee on Scottish Affairs, which discussed drug abuse in Scotland, she voted for the Labour chairman's draft report which called for the decriminalisation of cannabis and voted against an amendment by my hon. Friend the Member for Kincardine and Deeside (Mr. Kynoch), seeking to remove that from the report?

Like all of us in the House, the hon. Lady is entitled to take a view. It is clear that the Liberal party sees decriminalisation as the way forward. We do not.

Will the hon. Gentleman give way?

As I referred to the hon. Lady, I shall give way once more to her.

That is kind of the Minister. If he speaks to the hon. Member for Aberdeen, South (Mr. Robertson), he will find out exactly what happened in the Scottish Affairs Committee when I was not allowed to move an amendment on the Chairman's report, so it was put out lock, stock and barrel.

The hon. Lady is stuck with a party which has voted for the decriminalisation of cannabis, and all the protests, floundering and flummery we have heard this morning show that, in their hearts, she and her colleagues know that it is an absurd policy. I feel very sorry for them and hope they will use all the power and rhetoric at their command to get the policy changed. It is deeply irresponsible and underlines more clearly than anything else how unfitted the Liberal party is to hold any office or responsibility in Britain.

I am grateful to the Minister for giving way. He must realise that we voted to set up a royal commission, and the party political posturing by his party does him no justice whatsoever. Drug abuse is a serious issue and everyone in the House should be working towards eradicating it.

If it is such a serious issue, it is a pity that the hon. Lady was not here to hear the excellent debate, instead of cruising in at the end of the debate. If she considers it to be so serious, I should have thought that she would want to hear the excellent speech by my hon. Friend the Member for Eastbourne. I congratulate him on choosing this topic.

It is particularly difficult to assess the extent of drug misuse among young people, not least because it is a clandestine, illegal activity. However, all the evidence shows that drugs are a growing menace, particularly among the young.

As my hon. Friend the Member for Eastbourne said, in the inner cities 42 per cent. of 16 to 19-year-olds and 44 per cent. of 20 to 24-year-olds have taken drugs at some time. Drugs are not restricted to inner cities; they afflict rural communities as well. There is not a community or school that is immune from the menace, nor is drug misuse a problem peculiar to Britain; all the indicators show it is a growing problem across Europe.

Whatever the experience of others, however, we must be concerned about what is happening in Britain. Why do youngsters get involved in drugs? For many teenagers, any illicit drug use tends to be occasional or experimental rather than habitual. For those young people who at the weekend take cannabis, LSD, amphetamines or other drugs, it is no longer a conspicuous statement of anti-authoritarianism; indeed, it is much more a matter of fashion, of "picking and mixing" among licit and illicit intoxicants, in the words of Professor Howard Parker of the university of Manchester. Some of the key leisure industries of our time—popular music and, above all, television, provide the necessary backdrop by placing drug misuse prominently in the fast lane of soap opera life. Key developments in the popularisation of drug use include its spread among young people of all social classes, coupled with the growth of an extremely pervasive black market.

Drug misuse attacks the fabric of our society and the welfare of individuals in different ways. We know that drugs may directly cause or contribute to other criminal behaviour. Without doubt, a proportion of all acquisitive crime is committed to obtain the funds to purchase drugs, but those funds also come from a wide range of sources—legitimate earnings, state benefits, prostitution, begging, and so on.

Drug addiction is a serious health problem in Britain. Addiction or experimentation with drugs has serious and dangerous physical effects. Young people need to know that they can never be sure what substance they are taking, how strong it is and how their minds or bodies will react. The deaths of young people who have taken Ecstasy at raves, perhaps for the first time, are all too tragic a reminder of the ultimate price which is paid.

As well as the physical consequences, drug misuse can have a devastating effect on a young person's life at school and college and in employment, training and personal and social relationships. Taking drugs is illegal and there is a real risk of prosecution or even imprisonment. Family life may be disrupted by the worry that children may be involved in drugs. Families can be thrown into turmoil when a young person is found to have a drugs problem.

On a wider scale, drugs can harm entire communities. The greatest concern is crime committed by addicts to pay for drugs. Drugs misusers, particularly those dependent on drugs such as heroin or crack cocaine, can become involved in committing acquisitive crimes to help to fund it.

Drugs are a threat to the whole of society, but the young are particularly at risk. Our first response to the problem must be to reduce the supply of drugs as much as possible. There are three essential elements to our fight against the dealers and traffickers who supply drugs to young people. First, we must have effective, vigorous enforcement action. Secondly, genuine tough penalties must be available to the courts to deal with those whose involvement in that evil trade is established. There was consensus in the House today that the pushers and traffickers of drugs should be given no place to hide. The legislative framework is already in place. Trafficking in drugs such as cocaine and heroin carries a maximum sentence of life imprisonment. Thirdly, we must ensure that the courts have the powers to seize drug traffickers' ill-gotten assets, and we introduced that power in the Drugs Trafficking Offences Act 1986.

I believe that, with concerted and innovative action on the prevention and education front, we can have a positive influence on young people's attitudes and behaviour. We have examples that such changes can be made: witness the 60 per cent. reduction over the past 10 years in the number of fatal and serious road casualties involving drink driving—a reduction due in no small measure to the publicity campaign which started in the late 1970s.

We have heard today about the terrible threat posed by drugs. Drugs are widely available and young people are experimenting with them and putting themselves at great risk. Those who get hooked risk their health, the well-being. of their families and their lives. Drugs also generate crime and damage the lives of many innocent people in the process.

We must tackle drugs misuse together. We look to the police and customs to continue their vital work in tracking down the traffickers and dealers and in intercepting the drugs being targeted at us.

We look to the courts to punish severely those found guilty of trafficking and dealing. But we must all become involved to protect our young people from the scourge: parents, teachers, youth workers, police officers, probation officers and representatives of all the other agencies involved must work together with young people, with sensitivity and understanding, to inform and educate them about the dangers of drug misuse. Co-operation and partnership are the key.

The Green Paper contains our strategic plan, which proposes the most far-reaching action plan on drugs. It focuses on what the Government and other agencies, nationally and locally, can do over the next three years to tackle the problem. The strategy is founded on the principle of partnership. At the heart of that strategy are proposals to help young people to resist drugs. I am sure that the House would wish to do all that it can to achieve that important goal. I congratulate my hon. Friend the Member for Eastbourne on raising the subject in today's debate and welcome the Labour party's constructive approach to the issue.

I shall first explain why I am introducing a debate on this distressing subject. First, in purely chronological terms, an all-party group on breast cancer was formed about one year ago today. The hon. Members—including my hon. Friend the Member for Halifax (Mrs. Mahon) and the hon. Member for Rochdale (Ms Lynne), who are present—who were instrumental in setting it up were rightly determined that the group should not consist only of women. I think that that is why I was urged to attend meetings and was installed as secretary.

I have attended all the group's meetings. A string of experts have talked to the group over the past year to explain the problems and issues involved in breast cancer. We have all been struck by the unanimous message given by those experts, and it is that message that I and others want to relay today.

The second reason for the debate is a particularly Scottish one. Half way through last year, a campaign was formed in Scotland called the Scottish Breast Cancer Campaign. It has been a truly remarkable campaign; it was begun by a woman of tremendous drive and determination called Audrey Jones. With great energy and organisation, she created a network throughout Scotland that has campaigned on breast cancer services and research. It is on those two issues that I want to focus this morning.

The network's efforts culminated last Tuesday in a magnificent lobby of Parliament and a march on Downing street, with a petition of more than 200,000 signatures, obtained in less than six months. That was merely the end of the first phase of the campaign and the group is now determined that the campaign should link up with groups in England—it wants a United Kingdom campaign. That is why I am pleased that today's debate is on not just a Scottish issue, but a United Kingdom one. The problems and challenges are the same in Scotland, England and Wales.

I fully accept what my hon. Friend says about this being a United Kingdom-wide debate, but is not it deeply disappointing that there is no Scottish Office Minister present to listen to it?

I would have to agree with my hon. Friend on that, but we shall see what the Parliamentary Under-Secretary of State for Health, the hon. Member for Bolton, West (Mr. Sackville), says. I wrote to the Scottish Minister responsible for health, who is in another place—which always creates problems during Scottish health debates—and suggested that he should have a word with the Under-Secretary of State. I hope that he has managed to give at least a brief message to the Minister who is to reply.

As I learnt more about the subject, I became more aware of the scale of the problem. I was immediately struck by the horrendous statistics on breast cancer in this country. I learnt that one in 12 women is likely to develop it and two thirds of those women will die. According to the chief medical officer, the survival rate here is worse than in other European countries and north America. The mortality rates for breast cancer in the United Kingdom are the worst in the world. Another stark fact that drives the message home is that breast cancer is the single biggest killer for women between the ages of 35 and 54. A sobering and shocking thought is that, in the course of today's one-and-a-half hour debate, three more women will die of breast cancer.

It is not just the statistics that are horrendous—we have all heard terrible stories about the contrasts in treatment that women receive. We hear of misdiagnoses, long waiting times for women being referred for initial diagnosis and inadequate treatment. Balanced against that, we also hear of excellent treatment in many of the breast cancer units, such as that in my home city of Edinburgh.

The stories about things going wrong are not just media scare stories. The fundamental message given to the group by the experts was that there is a tremendous unevenness in the treatment received by women. That is the key message that the experts have given to us—they want something done, and it is up to us as politicians to take up that message and do something about it.

One of the experts who spoke to us was Professor Karol Sikora, professor of clinical oncology at Hammersmith. He has expressed the problem as follows:

"Britain's high death rate for breast cancer is not due to lack of medical knowledge, but to bad management. America has a higher incidence of breast cancer—one in eight of the female population. But proportionally a staggering 50 per cent. fewer women die. The difference is that in America diagnosis and treatment are organized better.

In Britain, surviving breast cancer is a lottery. The recent mortality-rate 'atlas' released by the Department of Health shows shocking geographical variations."

The problem can be considered in terms of when people are referred for treatment and, more importantly, where people are referred for treatment. There was an example of the time problem in Scotland recently at Ninewells hospital in Dundee. Due to a staff shortage, some women had to wait three months before they were seen for an initial diagnosis—because of the campaigning in Scotland, that problem appears to have been sorted out. Women must be referred promptly once there is a suspicion that something is wrong.

The issue of where women are referred is even more important. According to the experts who talked to us, the key issue is whether women go to a specialist unit where there are experts who deal with breast cancer on a regular basis. The experts said that the most alarming factor was that so many women are still referred to general surgeons or medical staff who do not deal with the specific problem for a great enough proportion of their time. The experts explained that that was the fundamental problem in the organisation of breast cancer services.

I was alarmed by the statistics for some—I think, two—Thames regions. Only 20 per cent. of women referred for breast cancer surgery went to hospitals where more than 100 women were operated on in a year. Some 25 per cent. went to hospitals where between 75 and 99 women were dealt with, 20 per cent. went to hospitals where between 50 and 74 women were dealt with and 22 per cent. went to hospitals where between 25 and 49 women were dealt with. Some 9 per cent. went to hospitals where between 10 and 24 women were operated on for breast cancer.

I asked for figures for the whole of England and Wales this week, but was told that they were not available. I received figures for Scotland and they show that the scale of the problem is not quite so dramatic there. However, we know that many women in Scotland go to general surgeons who are not used to dealing with people who have breast cancer.

It is the experts who are telling us all that. Some medical practitioners are saying that some of their colleagues should not deal with breast cancer because they do not spend a sufficient amount of their time dealing with it. We are told that half of women are referred to general surgeons when they should be referred to specialists. That is the core of the organisational problem that has to be tackled. One result of that is that the treatment that women receive is not as good as it should be. Without getting too technical, I can give one example of that.

I am told that when women are operated on, lymph glands should be sampled routinely. It is staggering that 50 per cent. of women under the age of 50 who should have such sampling do not get it. We hope that that will change. We are told that women under 50 should be given chemotherapy routinely, but the experts tell us that that often does not happen. The problem has been graphically described to us.

The answer has to some extent been taken on board by the expert advisory group on cancer set up by the Government. It has come up with the model of cancer services centralised in cancer centres, of which 20 are proposed for England and Wales, and cancer units, of which a much larger number is proposed. I thought that the same model was to be introduced in Scotland, but when I wrote to the Minister of State, Lord Fraser of Carmyllie, about the matter, he said that the model might not be appropriate. At present, we have five cancer centres and no cancer units. I believe now, however, that the Scottish Office is beginning to take the problem on board. In Scotland, we certainly need a large number of cancer units to complement the five cancer centres.

I am given to understand that Lord Fraser, who is the Scottish Office Minister with responsibility for health, is to appear before members of the Scottish Grand Committee to he questioned on health matters. Perhaps that would be an appropriate moment to question him more closely on this important subject.

My hon. Friend's point illustrates to our colleagues the difficulties that we have in Scotland in questioning the Scottish Minister responsible for health.

The best general structure of cancer services has been agreed, but specialised breast units are needed within it to complement the cancer centres. The British Breast Group has published a study and argued for specialist breast units. It said that they should be located either within the cancer centres or within the cancer units. So everyone knows what the correct model is.

Within the specialist breast units, surgeons, radiologists, oncologists, nurse specialists and others would all work in co-operation in teams. It has been agreed that that is the correct model, but implementation of the model may well be another matter. There are two sets of problems with implementation. They are resource problems and problems connected with the internal market. We do not want to be too party political on this issue, but we must face up to the fact that the internal market creates obstacles.

My hon. Friend was at the same meeting that I attended, at which consultants and professors told us that the abolition of the regional health authorities was a great worry because they had played such a crucial role in setting up the screening programme. The internal market is fragmenting the programme.

I am glad that my hon. Friend has raised that purely English issue. I have had correspondence with the British Medical Association about the effect of reorganisation on screening. I hope to read some of its letter later to convey that particularly English problem.

Professor Karol Sikora has said that about £300 million would be needed to provide the required number of specialists, including breast care nurses, and additional equipment for the units. That nettle will have to be grasped if the model is to be implemented. As for the internal market problems, Professor Sikora made the point that the development of the internal market meant that purchasers were less likely to buy from specialist units because they tended to be more expensive. That issue will come up next week when the Cancer Relief Macmillan Fund brings out a directory of services to be provided to GPs so that they can refer patients to the best unit. There will be a problem in whether health boards have contracts or would be willing to have such contracts with those units.

There are also problems on the provider side. Many provider units may not want to lose their breast cancer work as part of their general surgery. In a private conversation, a leading consultant told me that, particularly in England, many general surgeons wanted to keep the work because it was part of their private practice. That is another issue that will have to be tackled. It is important that breast surgery and breast cancer treatment should be on separate contracts. They should not be part of general surgery contracts. They should be contracted for separately. That is another recommendation of the British Breast Group report.

We are told that one of the differences between Britain and other countries in its provision of breast cancer services is that we have far fewer oncologists, both clinical and medical. That is another funding issue, which is also connected to the issue of special units. I have been told in answers to parliamentary questions to which I have received replies this week that the number of oncologists has not increased very much. There are slightly more for the whole of the United Kingdom. We now have 272 clinical and 68 medical oncologists. To put that into perspective, I am told that there are 2,500 medical oncologists in France.

We have also been told that each clinical oncologist in Britain sees 560 new patients a year. The recommendation is 350. We are told that in America they see 200 and in Norway they see a staggering figure of only 75. So there is the problem of the number of oncologists, who are essential to the work of breast cancer units and general cancer units and centres.

Apart from the problem with the number of oncologists, there is a problem with their funding. That became an issue in Scotland last year. As a result, I tabled a question about the matter. I was told that seven out of the 11 medical oncologists in Scotland last year were funded by charity. I was not being mischievous when I tabled another question last week. I simply wanted to know how much the position had changed by now. I am told that the Government think that five are funded by charity out of 12. Something strange is going on there which will have to be investigated. At least the Scottish Office had an answer. The English Department of Health does not know how many oncologists are funded by charity. We have been told by the experts who came to our group that it is a large number. That is a scandalous position, given the key nature of their work in the model of cancer treatment that is proposed.

Apart from their work in treating breast cancer and other forms of cancer, medical oncologists are essential for research. Research is the second aspect of today's debate. Once again, we are confronted by the two problems of resources and the internal market. On the resource side, the experts—I keep referring to them deliberately because all that I know has been told to me by the people who know about those matters—are unanimous in what they say. They tell me that in Britain uniquely a large proportion of cancer research is funded by charity.

We have been shown graphs, which show that in other countries research is funded mainly by Government money, with a little charity money. In Britain, it is the reverse. That is a fundamental problem, not only because it is the Government's responsibility to fund research, but because charitable funding in the nature of things is short term. The experts say that they need long-term funding. Charitable funding also fluctuates. I noticed recently that the funds of one of the cancer charities fell by £6 million last year. That creates problems for research.

I have tabled some questions on breast cancer research in particular. It appears that there was an increase in funding between 1991–92 and the following year. Some money—about £700,000—came from the Department of Health and less than £100,000 came from the Scottish Office. Proportionately, however, that was a greater contribution than that of the English Department of Health. The Medical Research Council money, being the main source of Government funding, was £1.6 million in 1991–92 and £3.1 million in 1992–93, which appears to be progress. However, I note that last March the Minister responsible for science said, in referring to the £3.1 million:

"Included in that figure was £836,000 which was directly related to basic laboratory research into cancer."—[Official Report, 29 March 1994; Vol. 240, c. 680.]

Of course, that is vital work, but I wonder whether the basis for the figures has been changed from year to year.

I do not want to quibble, but we need to put into perspective what £3.1 million means compared with the sort of money that is needed. A graphic illustration of that is the fact that the Royal Marsden hospital is trying to raise £15 million for just one project. Professor Baum, Marsden's professor of surgery who deals with breast cancer, told us that that research was absolutely essential. He said that it was to look at the molecular biology of normal cells and the genetic defects that result in their transformation into cancerous cells. He said that that was the most hopeful area for a research breakthrough. The context, therefore, is that £15 million is needed just for the one project, yet total Government funding for breast cancer amounts to only just over £3 million. There is obviously a funding problem.

There is also an internal market problem with research. An article in the British Medical Journal on 13 August 1994 by the United Kingdom Co-ordinating Committee on Cancer Research showed the results of a survey of contributors to clinical trials in breast cancer. The survey found that half had difficulties, many of which sprung from the nature of the internal market in the health service.

The article stated:

"The financial imperative from a market based NHS to avoid the 'unnecessary' expense in undertaking a trial is the basis of real conflict. If, for example, clinicians really are uncertain about which of two treatments is best, why not settle for the cheaper? But the NHS has a commitment to improve treatment. This requires a commitment to undertake and complete trials, accepting that such a strategy carries financial implications …A problem now being encountered"—

and this repeats something that I mentioned in a different context earlier —

"that is a direct result of the new purchaser-provider agreements is that patients are being treated in local hospitals rather than being referred to specialist centres. In recent years several studies have shown that there is a survival advantage if treatment is given at a specialist centre, and this advantage will be lost if contracts are increasingly given to local hospitals that lack specialist cancer services. Also, as it is generally the specialist centres which enter patients into trials a decrease in referrals to cancer centres means that there is a reduced pool of patients being invited to participate."

The article explains that there are also problems because of the new set-up with trusts relating to insurance, the storing of samples and increased paperwork. Leading British clinical researchers have expressed concerns about the new health service set-up as well as about the underlying funding problems.

I wish briefly to raise two aspects related to research. One area where research is required is screening. That has already been mentioned by my hon. Friend the Member for Halifax. There are many issues relating to screening. A British Medical Journal article just two weeks ago said that it is time for Britain to screen women over 50 every two years. Research has shown that, among women being screened in their third year, the number found with cancerous growths was much the same as the number among the unscreened. In other words, those women should have been screened after two, not three years.

Surely even every two years is not adequate for screening. What is really needed is a comprehensive public education programme so that women constantly screen themselves. A lump in a breast can become fatal within a few weeks of it first appearing. We need a huge public education programme to raise the profile of the issue, so that women constantly screen themselves. There is no substitute for that.

I am sure that the hon. Gentleman has a point, but it cannot replace the screening programme. We should follow the example of other countries where a two-year interval is normal for women over 50.

The article said that better results would be obtained if two mammograms were taken—indeed, a 20 per cent. improvement in the detection rate. It said that there would be another 15 per cent. improvement if two radiologists read the results. The article also said that considerable financial and staffing implications were involved in bringing about such improvements.

Another issue is screening of the over-65s. That matter is often forgotten. Although the largest number of women who develop breast cancer are over 65, there is no routine screening for them. There is also the issue of high-risk young women. I am aware of the debate about screening young women—I will not go into that now—but something must be done to ensure that such women are looked after properly.

My hon. Friend the Member for Halifax mentioned the effect of the Health Authorities Bill on the screening programme. I feel duty bound to read out a brief excerpt from a letter from the British Medical Association:

"We remain unclear on how the programme will operate after HA reorganisation …All cancer registrations and efficient data handling depend upon integrated computer systems. The complexities and financial implications of replicating this at district level are considerable. Devolving the programme down to local level will demand many more personnel in order to make medical and clinical audit meaningful. It is unlikely to be cost-effective at local level and clinical audit between health authorities and providers is bound to be compromised."

There is great concern about the environmental causes of cancer. A recent television programme featured the pesticide lindane. I and other hon. Members wrote to Ministers about that. Lord Fraser, the Scottish Minister responsible for health, said that the Advisory Committee on Pesticides was currently reviewing lindane's agricultural uses. I hope that the review will be completed speedily, because organochlorine pesticides are banned in most countries. Lindane is the only one still widely used in this country. Indeed, its use has doubled during the past seven years. I hope that the experts will speedily look at the evidence from Israel, which was presented in the television programme, and also at evidence from America, which suggests that lindane stimulates the production of a hormone that damages DNA.

I want to explain how America has dealt with the problem of breast cancer. Figures that I gave earlier show that although breast cancer occurs more frequently in America—one in eight women rather than one in 12—proportionately, 50 per cent. fewer women die. Yet America, with a so much better record than Britain, had an enormous campaign. I like to compare it with our Scottish campaign, although it was on a different scale. Proportionately, of course, the two campaigns are quite similar because the American campaign collected 2.5 million signatures, while the Scottish campaign has already collected 200,000—so in terms of population, the Scottish campaign has probably done better.

The American campaign was thrown on President Clinton's desk and he took action immediately. His Health Secretary convened a conference, which established a national action plan for breast cancer. My hon. Friend the Member for Halifax may say something more about that later. Part of that action plan was a shifting of $210 million from the defence budget to breast cancer research. The British Government should look to that example. This country's problem, as I have explained, is more serious than America's, so a correspondingly greater response is required of our Government.

The Scottish campaign and its members are my inspiration and guiding light on this issue. Their petition asked for more resources for specialist units and for more Government funding for breast cancer research. They are determined to continue their campaign and to extend it throughout the United Kingdom. With the help of several hon. Members, that is what they intend to do in the months ahead.

I know that there is a great deal of activity on this front. The Select Committee is investigating the matter; my hon. Friend the Member for Halifax will introduce a Bill on this very subject. We are determined that this most distressing issue gets the response from the Government that it most assuredly deserves and requires.

I compliment the hon. Member for Edinburgh, Leith (Mr. Chisholm) on drawing the House's attention to the serious subject of breast cancer. As he rightly said, the incidence of breast cancer in England and Wales is the highest in the world; it is in fact five times as high as in Japan, causing about 15,000 deaths a year. It is interesting to note the distinctly different impact of breast cancer on the various socio-economic groups in this country: there is 50 per cent. more breast cancer among group 1 women than among women in groups 4 and 5.

The hon. Member for Leith was right to draw attention to the need for improved breast cancer services. I entirely agree with that objective. He was also right to draw attention to the problems that there have been with treatment and care. We should not, however, underestimate the difficulties of judging the best course of action at any particular time. Many of these problems have arisen simply because of a lack of knowledge or because of faulty medical judgments—entirely understandable, but based on limited scientific knowledge of the illness.

The hon. Gentleman was right to juxtapose the issues of services and research, because the former so crucially depend on the latter. It was to be regretted that he did not draw enough attention to the real progress that has been made and to the distinct improvement in the services that are available. First and most important is the national screening programme. This country was the first in the European Community to bring in comprehensive national screening—an important international first, and a sign of the importance that the Government attach to dealing with the problems posed by breast cancer.

The hon. Gentleman also did not draw enough attention to the Calman report, published last year, which stressed the need for reorganisation and a national programme to ensure that the swiftest, most effective forms of treatment were brought to bear on women who were found to have developed breast cancer. The report distinguished between three important levels of care. First, it stressed primary care; secondly, the need for designated units; and, thirdly, the need for designated cancer centres. Speaking about the importance of specialist centres, the hon. Member for Leith did not give sufficient emphasis to the relevant part played by primary care services and by the designated units at a more local level, which are an important part of the process.

The hon. Gentleman was right to stress the need for similar standards of care throughout the country. He was right to focus on the deficiencies in that area, but I was not sure that his simple emphasis on centres of excellence was necessarily the best approach.

The Calman report's conclusions have already been acted on in many areas. I should like to draw the House's attention to the real progress that has been made in the Bromley area, which includes my constituency. Bromley hospital is starting its first breast care clinic later this month. It will be a multidisciplinary clinic, and there will be one surgeon who is already there and a new one who is a specialist in breast cancer. At the same clinic there will be a breast cancer specialist oncologist, and a nurse counsellor who has been specially trained for the purpose. Finally, there will be a personal prosthetics expert on hand to help women who may need support.

All that specialist provision will be available at one local clinic. That is a big step forward. It is important to ensure that, while the regional centres of excellence are available when needed, there are also local, accessible services to provide a quick response for women who have tested positive or who have been referred on by their GPs. This saves waiting and anxiety, because it enables testing and results to be acted on locally and swiftly.

I am pleased about this step forward in my area, and I hope that it will be repeated across the country. Apart from producing a great improvement in care, it will also enable much of the later treatment to be carried out locally in a co-ordinated fashion. There will be facilities for performing chemotherapy and some surgical procedures, but when necessary patients will automatically be referred to one of the nearby regional centres of excellence.

There is no question of any patient being given second-rate treatment or being diverted to some secondary, poorer tier of service instead of to the regional centre if that centre is the right place for the patient. The clinical judgment on where a patient should be treated, however, will depend on how her form of cancer has presented. As most people involved in the field will know, that will vary considerably from one case to another.

I should like to refer briefly to the important screening programme. The Forrest committee reported in 1987 that screening was the single most important way of reducing deaths from breast cancer, and predicted that as many as 25 per cent. of deaths from it could be prevented by the year 2000, giving an average 20 years more life to the people who were afflicted. If everyone called attended screenings, 40 per cent. of deaths could be prevented. That was why breast screening was introduced nationally.

I should like to enter a few words of caution, although I do not want them misinterpreted, because I fully support breast screening and believe it to be important. It would be wrong to think that screening is a panacea and that no problems will result from it. There are four or five areas of difficulty, of which the first is false expectation. The fear is that, with the availability of universal screening, people will relax and think that the problem has been solved: because screening is available, early detection is possible, so a cure will follow. That is of course not correct. A cure does not always follow, even with very early detection. There is of course a much greater statistical chance of a cure, but it is still limited.

Secondly, there is the difficulty of unnecessary treatment. Any suspected form of cancer detected at an early stage is the subject of medical uncertainty as to whether it will develop into malignant cancer or turn out to be benign. There is thus the danger of unnecessary treatment following on from mass screening. More research needs to be done on that; it would certainly not he beneficial to put women through the trauma and pain of treatment if that treatment is later found to be entirely unnecessary. It is also a complete waste of resources when money and expertise are devoted to putting right a problem that was not there in the first place. Important research is required in that respect. There is always the problem of cancers being missed because of technical limits on screening processes. However efficient they may be, because cancer varies from individual to individual some cases will be overlooked. Serious failures can occur in the computerised administration and follow-up systems, and much attention should be paid to making them as perfect as possible. We must be realistic, however, and accept that perfection cannot be achieved in dealing with so many people, and that there will always be an element of failure.

The extent of screening, medical judgment, the age of screening, and how frequent it should be—a point made by my hon. Friend the Member for Colchester, North (Mr. Jenkin)—type of screening, the radiation and other risks and other forms of care should be researched. Over the years, experts have changed considerably their assessment of appropriate treatment—whether there should be minor or major surgery, chemotherapy or radiotherapy and, if so, which comes first.

The hon. Member for Edinburgh, Leith (Mr. Chisholm) was right to stress that research is the most important factor in tackling breast cancer. Research will dictate the most effective action in detection and treatment. Let us hope that it will ultimately produce answers to the causes and development of breast cancer, and that steps can then be taken to prevent it. After all, prevention is always better than a cure.

I congratulate my hon. Friend the Member for Edinburgh, Leith (Mr. Chisholm) on securing his Adjournment debate. He is a hard-working member and secretary of the all-party group on breast cancer. I am joint chair with the hon. Members for Rochdale (Ms Lynne) and for Congleton (Mrs. Winterton). Its members have been on a learning curve for 12 months, but the group is a success.

I became more interested in the subject in 1992, when I was visited by two breast care nurses who were worried about the care and service given to suffers in the Yorkshire region. I commissioned a survey of the 12 regional health authorities in England to obtain a better picture. They were asked to provide details of the number of their breast clinics, breast care nurses and support groups by district, to assess provision and the contribution that each region was making to the national screening programme.

It is important to understand the scale of the problem. The British Breast Group's latest statistics show that the incidence of breast cancer in the UK is 25,000 cases per annum, which is among the highest in the world. Mortality is also high, at 16,000 deaths a year. Apparently, the survival rate in this country is poorer than in other European countries or the United States. The cause of high incidence and poor survival is unknown, but the latter may partly be attributable to poor management of the disease, which should be seriously examined.

According to research, the death rate from breast cancer has remained virtually unchanged over the past 50 years, and women are paying the price. They are the foot soldiers of that dreadful disease. Their suffering is matched only by that of their families after the premature death of a sufferer. As my hon. Friend said, it is important not to view breast cancer as just a woman's disease because it brings devastation and grief to families affected by a sufferer's early death.

I pay tribute to Jacqui Bokowsky and my hard-pressed staff for their work on my report, which left me convinced that the screening programme saved lives because the Government acknowledged the importance of funding it and set aside £25 million.

The other important aspect was the national nature of the programme. There is great concern about the disbanding of regional health authorities, which played a crucial role in screening. They acted as the strategic authorities and did a superb job. I do not want to seem grudging, because I congratulate the Government on implementing that programme, which was an important step forward. I should like it to be extended to provide screening every two years and for the over 65s.

Unfortunately, four regional authorities did not complete the questionnaire and so our data are not comprehensive, but it was still a worthwhile exercise. The Library also provided statistics. Our findings were shocking. Some regions provided an excellent service while others were poor. It became clear that the service was fragmented, and geographical location had a bearing on the treatment that patients received. As one might expect, public transport problems and widespread poverty in some regions prevented some women from taking full advantage of the facilities on offer. As my hon. Friend said, some treatments vary widely.

In some inner cities, the only provision was the local out-patients department. The north-west region had breast clinic provision for only 0.29 per cent. of women per 100,000 population. In the Yorkshire and north-west Thames regions, the figure was 0.85 per cent. The survey also revealed that breast care nurses—one third of whom are provided by the Macmillan fund—form the mainstay of care groups and after-treatment. Their work is vital in providing continuing care to patients in hospital, but also in the community—to patients, their husbands and families. Those nurses are highly valued by women. Members of Bosom Friends, a support group in Bradford—some of whose members are very young—told me that their breast care nurses, in particular Norma Russell, make a tremendous difference to their lives. She works hours of overtime for nothing. Should we skimp on such a valued service?

Cuts have been made in the service, even though the incidence of breast cancer is as bad as ever. The working party's report was endorsed by the British Breast Group in July. It is adamant that services could be improved by grouping them together in specialist units. It states that all patients with breast disease should have access to the highest-quality care. It emphasises the importance of accurate and timely diagnosis, appropriate treatment and follow-up, effective communication, which means breast care nurses being in place, access to other specialist facilities and the provision of high-quality services between specialists from different disciplines. They include surgery, radiology, pathology, medical, clinical oncology, nursing and palliative care. It is essential that those multidisciplinary teams are at set up together in specialist units.

There will be a problem, because purchasers might be tempted to buy from a provider who is buying in the service of an oncologist for just a few hours a week. It will be nothing like as good as a specialist team. We know that because of the experience of the specialist hospitals in London, which are funded only in the short-term and are worried about their future. For anyone with an interest in the subject, the working party's report is well worth reading and it contains excellent recommendations.

Next week, I shall introduce a ten-minute Bill. It is an attempt to persuade the Government that we need a national action plan, such as that in America, to tackle this killer disease. The all-party group has had tremendous help from specialists in the past 12 months and, above all, from the women who have suffered from this dreadful disease. They want and deserve a national action plan. I hope that, when I present my Bill next week, the Government will take note of what they are saying to us.

Last week, I visited the Cancer Research Institute, which has a world-class reputation for research and is based in my constituency. It works in close partnership with the Royal Marsden hospital.

I was given a guided tour by Professor Peter Garland, the chief executive of the institute, who leads 600 staff, making it the largest research institute in the world dedicated to the conquest of cancer. In particular, it has done excellent work in connection with breast cancer. It has recently pioneered important genetic work allowing it more accurately to identify those women at risk from breast cancer, who would consequently need special screening and preventive measures. It has been discovered, for instance, that some women are likely to have more than one gene, inherited from the family, which predisposes them towards the development of breast cancer. Indeed, it has been found that such genes are responsible for 5 to 10 per cent. of cancers, or about 1,000 of the 15,000-plus people who die each year in the United Kingdom from that disease. Perhaps a woman who has been identified as being at risk from breast cancer could be put on a trial new drug called Tamoxifen. It is part of a large, international trial, which, I hope, will substantially prevent the disease from starting in the first place.

The institute has a very exciting programme of work in curative measures for other areas of cancer: ranging from treatment of testicular cancer, 90 per cent. of which is treatable; to tremendous advances in treating ovarian cancer; to developing a vaccination to prevent and eliminate cancer of the cervix; to treating childhood leukaemias, and much other work. One will understand why I am so enormously proud that the institute is in my constituency.

The tantalising thing about success is the intense frustration which is felt: in wanting good work to continue, work which, of necessity, is held back through the constant battle against other competition for more resources. The real question that I ask the Government is: are they really giving essential research the full support that it undoubtedly deserves? I congratulate the Government on making the United Kingdom the first country in the European Union to develop and introduce breast cancer screening, but it is no use embarking on further major cancer screening programmes if the follow-through, in terms of research and treatment, is not given the fullest possible back-up, otherwise one will be faced with only half a loaf—the cancer identified but not adequately treated. Successful treatments come about only by a heavy commitment to research.

The Medical Research Council works wonders, but it has a finite budget of around £210 million and must cover all diseases. The MRC is excellent for fundamental work, much of which is generic, but quite simply it does not have the resources to carry everything through to application. The university sector is mainly supported in terms of educational activities. Cancer is but one subject or specialty among many, and few universities can put together a critical mass for research.

The cancer charities raise and spend some £200 million a year, mainly on research but also to improve services. Without them, the quality and extent of research and service in the United Kingdom would be greatly weakened. I am not at all happy at the thought of cancer charities substituting for, rather than complementing, Government support. In the case of the Cancer Research Institute, £25 million is required to run 600-plus staff.

The Cancer Research Institute receives just £2.5 million from the Higher Education Funding Council for England; even it recognised, by its own calculations and procedures, a shortfall of at least £2 million, but it has refused to do anything about it, except for vague promises in the future. It is not acceptable to argue that if the council allocated more resources to the institute, it would be to the detriment of other universities, the great majority of which, by the HEFC's own assessment, rate less well, often markedly so. That shortfall is a substantial handicap to the institute's work. It makes up the shortfall with charitable moneys, which go towards heat, lighting and sundry expenses rather than the direct research for which it is intended. More than that, the HEFC is contradicting its own stated policy. It should be buying the very best research that it can. The fact is that it declines to do so in the case of the institute.

As Sir Peter Swinnerton-Dyer, the former chief executive of the Universities Funding Council, said:

"Within each subject, it must therefore be right to concentrate most of the research funding in those departments that are likely to provide the best value for money."

In my view, he is absolutely right. It is very short-sighted to set up a ambitious screening programme without a fully supported research programme to give the very best possible treatment to all patients, otherwise one would be putting the cart before the horse by screening without the back-up research facilities to ensure that a sick woman becomes well or that we can prevent cancers from developing in the first place.

I shall be brief, as hon. Members wish to speak in the debate.

We should all put on record our thanks to my hon. Friend the Member for Edinburgh, Leith (Mr. Chisholm) for securing the debate and for speaking so well on the subject. As the report of the British Breast Group working party said:

"Breast cancer mortality in the UK is the highest in the world. The reasons for this are poorly understood, but the wide dispersal services for breast cancer patients may be a contributing factor and certainly impedes clinical research."

If ever there were a brief description of the horrendous problem and of the need for the Government to introduce a national programme as quickly as possible, that is the summary of it. I hope that, next week, the ten-minute Bill to be introduced by my hon. Friend the Member for Halifax (Mrs. Mahon) will get a clear run in the House, and that for once a ten-minute Bill will be successful in changing policy.

The reasons for breast cancer are poorly understood and are not evenly shared between different socio-economic groups. Indeed, if anything, it appears that the higher income groups suffer slightly more greatly from breast cancer, but they also have greater longevity anyway, so there may be a connection there. The incidence is much higher in western Europe and north America than in what we choose to call third-world countries. There may well be environmental and dietary connections. There are an awful lot of possible connections that need to be examined as rapidly as possible. In the United States, President Clinton responded quickly and magnificently to the request for a national action plan, and that is something for which ire—as must all the men and women throughout the United States who campaigned for it—be applauded. President Clinton should also be congratulated on the fact that he was prepared to shift money from the defence budget to a national action programme. I would love to think that the British Government will see the error of their ways in financing yet another Trident submarine and start shifting those resources into health care; we should all be better off as a result.

The seminar held in the House in December was, I think, very valuable: I could not attend, but I have read reports of it. A recurring theme was the need for multidisciplinary teams to work together from a single specialist centre. All the evidence suggests that the dispersal of services and the lack of centres of excellence lead to inadequate care. Moreover, they lead to differing standards of care: the system that decides to whom a patient is referred is almost a lottery.

My hon. Friend the Member for Leith cited the Thames regional health authority. There is no earthly reason why the health authorities—all surrounding London—should not be able to look to one or two centres of excellence; that, surely, would be better than dispersal of services among certain hospitals. After all, one in 12 women in this country are likely to develop breast cancer, but only 40 per cent. of patients will be able to see specialist oncologists. The average number of patients seen by oncologists in the United Kingdom is 560—the highest number in Europe. The recommended number is only 350. That means that oncologists are overworked; the resources must be spread, and I hope that the Government will act.

One of the problems is that surgeons often have little experience of breast cancer. It is difficult for hon. Members who are not medically qualified to hold forth about the way in which patients are treated by individual doctors, but I feel that there is an overwhelming case for demanding specialist treatment. A surgeon who is a "generalist" is unlikely to have the time or the inclination to become a specialist. Far too many women are having mastectomies which could possibly have been avoided if treatment, or even screening, had been provided earlier.

There are also serious problems with radiotherapy. They have been highlighted by Radiotherapy Action Group Exposure—also known as RAGE—a group of women who have been given radiotherapy for breast cancer. The organisation has heard from 1,400 women; some of the letters that it has received came from the families of women who died not from cancer but from the injuries caused by their treatment. In many instances, it appears that overdosing and serious side-effects were involved. I hope that the Minister will say that his Department is prepared to take an interventionist line, and set up a national action programme that will direct research appropriately and establish regional centres of excellence.

We have been considering the resources that should be made available to women suffering from breast cancer. As we are now in the age of the charter, let me suggest some services that should be available under such an arrangement. First, general practitioners should be able to refer patients promptly to a team specialising in the diagnosis and treatment of breast cancer, including a consultant. The GP should not have to think, "Goodness, what do I do now? Where can I find a specialist?"

Secondly, the patient should be given a diagnosis within four weeks of being referred to a hospital. All too often, GPs in my community tell me that they spend hours on the telephone every day simply trying to refer patients to hospital. My main local hospital, the Whittington, can deal with no new cases—other than life-and-death emergencies in the local population—until April, because of inadequate funding. That in itself is a serious problem.

Patients also need a confirmed diagnosis before they consent to treatment, including surgery. There is still an information barrier between the patient and the medical professions. Every woman should be fully informed of all the implications of every kind of treatment that is available—or not available—before surgery. Patients should have access to specialist breast care nurses who are trained to provide information and psychological support: psychological support is vital to the person concerned, who is undergoing a very traumatic experience.

The national health service should enable patients to meet others who suffer from breast cancer. Too many people must deal with the horror of cancer in isolation. I have encountered cases of people who do not want to tell their families that they are suffering from such a disease: they are unable to share the experience with anyone. Although any promotion of such discussions between sufferers by the Department of Health would not be a medical action as such, I consider that the opportunity for sufferers to meet other patients and former patients is very important—as is the provision of information about support services for patients and their families, who can at least give them support and some understanding.

Breast cancer is a crucial issue on which this country has a dreadful record. We have had a short opportunity to raise that issue today; I hope that the Government will respond by devoting real resources and real action to it.

I greatly appreciate the opportunity to speak, and congratulate the hon. Member for Edinburgh, Leith (Mr. Chisholm) on securing the debate. I also congratulate him and other members of the all-party breast cancer group—to which I belong—on the work that they have done. They have brought much into the open during the debate, and I endorse much of what has been said. As a result, this has been a very useful debate; perhaps we should discuss the subject more regularly.

It is difficult to imagine a disease that touches the lives of so many of our constituents. Every Member of Parliament has a direct interest in ensuring that the dreadful figures that have been given are improved. I want to enlarge on points that have already been raised—including, notably, the need for a national plan not just on screening but on research and treatment, along the lines of the model set out in the United States National Cancer Act of 1971.

It is interesting to note that the President himself has a cancer panel, such is the priority that the American Administration attach to the problem. It is, in fact, due to the still rather unfashionable President Nixon that the panel exists; President Clinton merely used legislation that was already on the statute book. We lack any legislation of that nature with which to tackle this huge disease. 'We probably spend less time discussing cancer than we spend discussing AIDS, which—in terms of the number of deaths that it causes—constitutes a tiny fraction of the problem created by breast cancer.

I want to concentrate in particular on the unfortunate group of women who belong to Radiotherapy Action Group Exposure. I became involved in the subject because one of my constituents suffered serious injury as a result of radiotherapy. We are fond of thinking that people who have been cured of breast cancer are fortunate, but a sizeable group of them have been afflicted by appalling and painful injuries of which they were given no warning when they were considering what treatment they should accept and what hope they had of a cure. Something must be done. The injuries occur at different rates, and at different treatment centres. That underlines what the hon. Member for Islington, North (Mr. Corbyn) said about treatment being a lottery: there is a lack of consistency between different centres and different parts of the country, and the chances of injury at some hospitals are far greater than at others—I shall not name any hospitals. No one seems to know why that is.

The women concerned are suffering from very disabling effects. Some, like my constituent, are in constant pain, often so bad that they seek amputation of a limb. The radiation damage to their bodies often requires such amputation, or causes death. No Member of Parliament who has listened to the stories of those women can underestimate the pain and suffering that they experience.

I am able, however, to congratulate the Government on setting up a proper inquiry into the matter. Following meetings with the chief medical officer, the president of the Royal College of Radiologists, RAGE and Professor Karol Sikora, the Under-Secretary of State, my noble Friend Baroness Cumberlege, authorised an audit of brachialplexus neurologically related injuries, to be conducted by Dr. Thelma Bates and Dr. Richard Evans. It started on 1 September 1994 and its aim is simply to find out what has happened and why.

I hope that my hon. Friend the Minister will continue to respond to RAGE's representations. I congratulate the Select Committee on Health on inviting RAGE to give evidence to its breast cancer inquiry. Let us hope that the Select Committee will continue to return to the subject on a regular basis.

We are fortunate that we are a generation that talks about the disease, which is prepared to discuss it and to raise its profile. I hope that the Government will continue to respond positively to the representations that are made to them on this subject.

I add my congratulations to my hon. Friend the Member for Edinburgh, Leith (Mr. Chisholm) on securing a debate on this important subject, on which a tremendous consensus appears to exist. I congratulate the all-party breast cancer group on its work. As we have heard, breast cancer is a common and, far too often, fatal disease. The statistics have been rehearsed already, but it is worth confirming that we have the highest breast cancer mortality rate in the world—its incidence is five times greater here than in countries such as Japan. One woman in 11 will develop breast cancer. Sadly, between 25,000 and 29,000 new cases arise every year.

Unfortunately, the reason for the high incidence of breast cancer in the United Kingdom is not fully understood. Obviously, further research is needed into the causes. It would appear that the disease is associated with western developed countries. There are high incidence rates in the United States of America, in Canada and in Europe, and some social and environmental factors have been stated as possible causes, including high-fat diet, hormone treatment, oral contraception, alcohol and stress, to name but a few.

Sadly, as the House has been told, each year between 13,000 and 15,000 deaths occur as a result of breast cancer. That is a grave cause for concern. It is the sixth commonest cause of death in the UK, and the commonest cause of death for women aged between 35 and 54. Clearly, we must address ourselves to prevention, to early diagnosis and, as we have heard, to better treatment. We should also, however, look towards researching the causes of breast cancer. I was interested to hear the comments of hon. Member for Sutton and Cheam (Lady Olga Maitland). The position is so bad in this country that we must deal with it. We cannot rely on charitable funding for research.

Breast cancer was recognised by the Government and included in "The Health of the Nation" White Paper. A target was set to reduce the breast cancer death rate in the population invited for screening by 25 per cent. by the year 2000. The rates have varied from 95.1 deaths per 100,000 of the population in 1990. The target is to reduce that figure to 71.3 deaths per 100,000. Problems still surround the diagnosis and treatment of breast cancer, despite the setting of that target; hence the Government's expert advisory group on cancer, which reported in May last year.

Various opinions exist on the value of a screening programme. The British Medical Journal view of "The Health of the Nation" doubted the efficacy of screening and described the White Paper's targets as optimistic. In 1985, there were 98.3 deaths per 100,000 of the population; in 1990 the figure had reduced to only 95.1 per cent. So there could be some difficulty in achieving the target.

The journal suggested that the Government should take other steps. With an eye to this Friday's debate in the House, it stated:

"Above all else, it"—

that is, the Government—

"should make it clear that it is willing to reduce smoking through legislative means. Only then are screening, diet, information, and counselling kept in proportion."

Suggestions have been made that the screening interval is too long, and that an age limit set at 50 is too high. I accept that it has been found that the screening programme is more effective for post-menopausal women—hence the setting of the age level at between 50 and 65. Studies have been conducted, however, into what are known as "interval" cancers, which occur within the three-year screening time. According to a study in the North Western regional health authority, an increased number of interval cancers occurred between screenings.

I acknowledge that, in a circular in January this year, the Government set out guidance on screening, and required screening units to take two X-rays to try to ensure a more efficient screening programme, but perhaps we should begin to consider whether those interval cancers are "new" cancers, or existing cancers that have been misdiagnosed.

Sadly, errors of diagnosis have been made. It seems that errors occur with all screening programmes. In May 1994, all 90 screening units were required to check their clerical systems because of errors. Some 30 per cent. of the cancers highlighted in the study of interval cancers undertaken in the North Western regional health authority were subject to misdiagnosis.

It is clear that the treatment of breast cancer has not been as good as it could be. Many of the problems have been acknowledged—inequalities of treatment, geographically and economically; the low number of cancer specialists; the internal market; the purchaser-provider split and how that impacts on the purchase of cancer care; and women treated by specialists who perhaps have inadequate training or experience in particular cancers, especially breast cancer. We have heard from hon. Members about delays in referrals.

The women who are diagnosed as suffering from breast cancer deserve sympathetic and expert treatment from specialists who are experienced in the disease. The inequalities were exposed by the Thames cancer registry recently. Health Service Journal stated in September 1994:

"The Thames study highlighted 'variations and inequalities' in treatment and said the chances of a woman surviving the disease were 'likely to depend on where she lives and how well off she is'."

That is a disgraceful position, which must be dealt with, and which I understand the Government will deal with when they respond to the expert advisory group.

We have heard that the abolition of regional health authorities will bring about an uncertain future for many screening programmes and cancer registries. I hope that the Minister will assure the House that screening programmes will continue, and that the registries will be able to continue their work under the new regime. That information is crucial to research in this matter.

It is sad that, in this country, five-year survival rates can vary by almost 20 per cent., depending on how affluent the area is where a person resides. That was brought out by the regional health authority study. One can only guess at the variations in affluence that might occur between various parts of the country, north and south. My hon. Friend the Member for Halifax (Mrs. Mahon) mentioned the problems that she had trying to find out what treatments were available in Yorkshire.

I have of necessity to be extremely brief, but I wish to refer quickly to the Macmillan cancer care fund, which last year issued a 10-point programme for breast cancer care. It will also announce an initiative next week which, I hope, will prove successful. As we have heard, the expert advisory group will set up primary care centres and designated cancer units and centres. I hope that the Government will respond as soon as possible to the consultation, which has now concluded. I understand that their response is due early this year.

I hope that, with the Department of Health's initiative and with the various charities involved in research, we can look forward to a comprehensive system for the treatment of breast cancer, something that the country greatly needs.

I congratulate the hon. Member for Edinburgh, Leith (Mr. Chisholm) on his eloquent appeal for the highest quality of care and service for women with breast cancer and thank all hon. Members who have contributed to the debate. I share the hon. Gentleman's regret that there is no Scottish Minister here, but I am glad to hear that he will have the opportunity to question the relevant Minister in detail. I assure the hon. Gentleman that the Scottish Office Home and Health Department—like the Department of Health—is committed to reducing deaths from breast cancer as part of the aim to reduce cancer mortality overall.

The hon. Gentleman has very ably led the parliamentary all-party group on breast cancer, which has done so much to make its presence felt in lobbying on behalf of the thousands of women who contract this terrible condition. I therefore appreciate having this opportunity to set out briefly the Government's commitment to providing the highest quality of prevention and treatment.

We are, I hasten to say, neither complacent about nor ignorant of the very real threat that the disease poses to public health and to individual women. No Government could underestimate the seriousness of a condition that affects so many and results in so much suffering and so many deaths each year. My hon. Friend the Member for Colchester, North (Mr. Jenkin) mentioned the wider problem of the damage unwittingly done through the use of excessive radiation in treatment. I assure him that there are initiatives to minimise the risk of any further slip in quality assurance and plans are in hand to ensure that all radiation units are subject to the strictest guidelines so that the unnecessary and disastrous damage to which he referred cannot occur in the future.

It has been pointed out that we have made breast cancer a central element in "The Health of the Nation". Our goal is to cut the number of deaths among women invited for screening by 25 per cent. by the end of the decade. However, it is a tragic fact that breast cancer is still on the increase in this country and abroad. We do not know precisely why that is so, but several social, environmental and genetic factors are at play. Apart from age, factors that appear to increase the risk of breast cancer include late childbearing, the early onset of the menopause, obesity and ionising radiation. They may also include diet, the prolonged use of hormone replacement therapy and a number of other elements into which further research is needed. Given that background, let me summarise what the Government are doing.

It goes without saying that there is a wide network of cancer treatment facilities around the country although, of course, I can necessarily speak in detail only of those in England. However, 7 per cent. of all national health service expenditure goes on the treatment of cancer. Many new units and facilities are being created, and I mention in particular the soon-to-be-opened breast care clinic at Bromley hospital in the constituency of my hon. Friend the Member for Beckenham (Mr. Merchant), which is typical of the new facilities coming on stream.

We have established a national population-based breast screening programme for all women aged between 50 and 64 in support of which new guidelines have been issued to ensure that screening is as effective as possible. We have provided significant funding for research which is supported by, but in no way dependent on, considerable help from major cancer charities. We have also funded the promotion of health material to increase awareness and to encourage women to come forward for screening and to report symptoms.

In the short time remaining, I shall take up the references to the steps taken in the United States. Mention has been made of the apparent switch in spending from defence to health in America. There is no doubt that the defence budget, like many budgets, is stable or dropping while the health budget in this country continues to increase considerably. There has been a 4.4 per cent. increase to all the regions this year, which is well ahead of inflation. I have no doubt that there will continue to be an increase in the share of public spending going on health. A substantial proportion of that will be spent on new cancer facilities because, as has been mentioned, there is too much inequality in provision around the country for the diagnosis and treatment of cancer.

It is well known that too many cancer sufferers, especially women with breast cancer, are not diagnosed swiftly enough. They are not seen sufficiently quickly by people with the appropriate level of expertise, which means that treatment can be delayed. Whatever the clinical effect of waiting for diagnosis and then waiting for treatment may be—it can be serious—the emotional effect is clearly considerable and we need to take action.

Hon. Members have mentioned the chief medical officer's expert advisory group's report. It is a very important document that will change the way in which we examine cancer and its treatment. The fundamental idea is that we must be clear about the different levels of expertise needed in diagnosing cancer. General practitioners need to be absolutely certain how and where to refer patients. If patients are or might be suffering from rare cancers, it may not be appropriate to make a final diagnosis or offer treatment in district hospitals, so there need to be three levels of involvement: the GP, the district hospital and a cancer centre—at least one in each region but perhaps more than one in some—where the most difficult and rare cancers can be treated. There is no point in sending cancer patients to see consultants or doctors who seldom see rare cancers. The expert advisory group's report will ensure the proper referral of cancer patients and that the proper resources are invested to ensure that the appropriate specialty is available for every cancer patient.

Again, I congratulate the hon. Member for Leith on his eloquent speech on what I regard as the most serious problem that faces the health service.

I am grateful for the opportunity to raise an important subject which affects the future of more than 200 families in my constituency and an important workshop which has served the British Army well for a number of years. Last year, the director of the Army Base Repair Organisation referred to it as the "jewel in the crown". ABRO took over the workshops of various support units which serve the Army and its vehicles, renovating various vehicles coming from Europe or wherever.

The Ashford workshops, in common with many other ABRO workshops, have been examined as part of a Ministry of Defence and ABRO study of workshop overcapacity in Britain. Given the cuts in the Army, Navy and Air Force, we know that support services must also be cut back. Indeed, announcements were made today for cuts in some Navy store support services in the west country.

An additional complication has arisen in this case, as one of the main workshop sheds is directly in the line of the channel tunnel rail route announced by my right hon. Friend the Secretary of State for Transport in April last year.

The study of overcapacity has been going on for a considerable time. Last October, when I was in Moscow on parliamentary business, my right hon. Friend the Minister took considerable steps to explain to me by telephone, that it was proposed, as part of the study on overcapacity, that the Ashford workshops should be closed. He agreed over the telephone that the rail link through the site was not a key factor in the decision to close the workshops. He further agreed to meet a delegation from the work force in my constituency.

Accordingly, on 12 December I met my right hon. Friend with such a delegation. My right hon. Friend was extremely courteous and heard what we had to say. One of our main complaints was the lack of market testing of the workshops in Ashford so that it was difficult to see precisely how good or bad they were, although I and the work force believe that they are very good and have served the Army well. A few days later, my right hon. Friend went to Ashford and saw the workshops for himself. As a result, he wrote me a letter just before Christmas saying that he had asked for a further investigation into the various proposals that had been made, not least the investment options. He said that there would be an extended period for consultation and that he would be in touch with me again in due course. So there was a short temporary reprieve.

At the end of December, however, both the work force and I were concerned and felt some consternation when Brigadier Drew, chief executive of ABRO, replied to a number of my constituents who had written to him. In a letter dated 20 December 1994 he said:

"The decision to recommend the closure of ABRO Ashford results from a number of factors. A rationalisation study commissioned by the organisation identified significant overcapacity within our workshops. For those workshops, such as Ashford, providing a service to Army units within their geographical area, the study team recommended that the overcapacity should be addressed via the market testing process (that is in the preparation of a bid in competition with industry to provide the service to the Army). The team was also asked to consider the impact of external factors on rationalisation and the intended use of the Ashford site for the high speed rail link was taken into account. In order for the closure of the Ashford workshop to be effected in time to meet Union Rail requirements, the existing workshop site must be excluded from the market testing options."

That letter went down like a lead balloon with all concerned, as it seemed totally to foreclose any conclusions that my right hon. Friend the Minister might make. It appeared to say that the considerations for Union Rail, which is currently responsible for the channel tunnel rail link, were more important than considerations for my constituents, ABRO or the British Army.

Consequently, I wrote to my right hon. Friend what I hope was a courteous though terse letter expressing my concern about those matters. That resulted in a meeting between us and others of the ABRO team at headquarters last week. Indeed, it has resulted in today's debate. So far, no final decision has been taken.

Over the past month or so, the workshop has provided headquarters with information, as a result of which it has been proposed that there should be either 70,000 man hours work district load, plus an additional 35,000 hours special project work from the workshop or, alternatively, just a 70,000 man hours district load, which would reduce by 2,000 or 3,000 hours with the closure of the Queen Elizabeth military hospital in Woolwich in a few months' time. Currently, the workshop does some 200,000 man hours and the work force believes that market testing would show that it could more than meet that job. For example, as the Minister and I have seen, the workshops do a good job on Land Rovers for the Army. I have been told privately that they are probably the best Land. Rover service and refurbishment centre in the world, not just the United Kingdom. Be that as it may, if the workshops were able to market-test against Rover, we could find out whether they were as good as they and I think they are. The 200,000 hours may not be pie in the sky.

Proper consultation has not been carried out between the management teams in Ashford and ABRO headquarters. If everyone's heart was in the right place, efficiencies could have been found just by sitting, round the table and discussing the matter. It is a pity that some of the information technology that Ashford requires to make itself more efficient has been withdrawn for other parts of the system in recent months.

If the national market tests are as important as the brigadier said, why was the decision taken even before the workshops were given a chance to market-test? Why was the investigation appraisal not carried out as part of the market study? That would have made a lot of sense. My constituents sent in information on how they could cope with the various loads and make further efficiencies.

ABRO considered that on some of those matters, such as staff costs, contracted-out services, costs of utilities, property management, equipment costs, vehicle maintenance and petrol-oil lubricants, my constituents had been over-optimistic. It therefore scaled them down in the investment appraisal to the tune of some £100,000 a year, which is significant in view of the possible savings that may be made. I do not know whether such scaling down is right, but it would have been helpful if the management team in Ashford could have discussed the matter with the management team at ABRO headquarters. We would then all have had a clearer idea of what was going on.

There is no question that the existing "A" workshop will have to be demolished. That leads on to the question of replacement. My right hon. Friend has confirmed in writing and verbally—there is no dispute about it—that the cost of replacement of the workshops will be borne by Union Rail or the company who build the high-speed rail link in precisely the same way as they will provide compensation or cost of replacement to various other companies within my constituency that will be similarly affected.

As a result of investigations, two excellent possible replacement sites are available at Sevington. They have been produced by Eurotunnel developments and would offer brand new, energy and utility efficient sites, properly laid out with excellent access. They are being built at the moment and will be ready soon. The total cost, which will be borne, once again, by Union Rail and not by the Ministry of Defence, would be about £5 million.

Another alternative site, which is even nearer home—just across the road from the current workshops—is the former East Kent Bus depot. With a little refurbishment and modernisation, that would provide an energy efficient replacement workshop at a total cost of about £1.5 million.

Alternative sites for the workshops are therefore readily available at costs within the terms of the compensation that Union Rail would be prepared to pay. Those sites would be available for the market testing that my constituents are keen should be conducted. They would provide an excellent relocation site for the workshops if, as I hope, they are reprieved by my right hon. Friend.

The crunch behind the country-wide exercise is what money will be saved. There is no point in embarking upon such an exercise, the result of which may mean that many people will lose their jobs and commerce in the area will be badly affected, if the savings achieved are minimal or even non-existent.

Other workshops have been closed at Donnington and Old Dalby and the savings achieved, if not huge, have not been insignificant. In cash terms, the savings over the long-term costing period, which I understand is 10 years, range from £18 million to £35 million. In net present value terms over the LTC, long-term costing, the savings range from £14 million to £27 million. Those are considerable sums of money and were no doubt taken into account when considering the future of the organisations at Donnington and Old Dalby.

According to ABRO's own figures from headquarters, given to me by my right hon. Friend, the likely savings to be achieved at Ashford work out at a different level. If one takes the first option of the 70,000 man hour load plus the 35,000 hours special project work, one finds that the cash saving over the 10-year period is about £300,000 a year and the NPV, net present value, saving is about £250,000. Those sums are arrived at either by comparing the cost of transferring all the current work to a new-build workshop provided by Union Rail or by closing the ABRO workshop and transferring the work to other ABRO facilities, for example, to Aldershot and to contract repair.

If one takes the largest option, covering the 35,000 hour special project work and the 70,000 man hour load, one is talking about savings of between £200,000 and £300,000 whether that is worked out in cash or NPV terms. If one considers the 70,000 man hours option and none of the special work, the figure saved is even lower at about £210,000 in NPV or about £260,000 in cash a year over the 10-year period.

That is not the end of the story, because on top of that one must add the redundancy and replacement costs of all those affected—some 200 people gross or perhaps 150 net given the mobility of some of the work force and the redeployment of others. According to my sums we must be talking in terms of £3 million for the first cash redundancy payments alone. That is more or less equivalent to the projected entire savings over the 10-year period. That £3 million, however, is up front and is not spread over 10 years. I am aware that that cost does not fall upon the budget of the MOD, but I am a Member of Parliament and a taxpayer and my right hon. Friend is a member of the Government, so we must be interested in the taxpayer and public expenditure as a whole.

We must also accept that some people will not be able to rush out and get a similar job, so we must remember the on-going costs of unemployment, income support, the loss of income tax paid and national insurance and other contributions. We soon find that huge sums are run up. Are we really to deny the Army of a facility that has worked extremely well and efficiently—the nearest facility to continental Europe and to the channel tunnel—in exchange for an overburden on and increased cost to the taxpayer?

I speak as a former Defence Minister and, in terms of MOD figures, when we talk of savings of between £200,000 and £300,000, that is the equivalent to washers. Such sums are within the calculating errors that may occur. If my right hon. Friend wants to save that sort of money I can point him in various directions where I am sure he knows that more than that money could be saved.

The proposed closures are not worth the candle at the end of the day. Alternative premises could be made available at no cost to the MOD, which would be more efficient than the current premises. If that happened we would retain a workshop for the Army that does extremely well and which could then be market-tested against anyone else. My constituents are more than confident that they would emerge triumphant from that test. In any event, the financial argument in favour of closure does not stand up.

I know that my right hon. Friend goes carefully into such matters. I hope that, with all those facts in mind, he will be able to tell me and my constituents, if not necessarily today, certainly within a few days, that he has examined the figures and looked carefully again at the possible alternative sites that I have mentioned. I hope that he will say that it will be possible for the jewel in the crown to remain the jewel in the crown of ABRO.

I congratulate my hon. Friend the Member for Ashford (Sir K. Speed) not only on his robust defence of his constituents, in the best interests of the town of Ashford, but on succeeding in raising the matter on the Floor of the House. A formal Adjournment debate can serve many purposes and at least one of them is to ensure that the facts are properly available to everyone.

I shall certainly study the record of what has been said, although my hon. Friend will not expect me to answer all his questions today. I do not intend to take a decision today or next week, because the issue needs to be subject to proper analysis. The Ministry of Defence is considering several dozen proposals for rationalisation, all of which affect jobs. Approximately, in the decade 1985 to 1995 the defence budget has fallen by 25 per cent. in real terms, with a much sharper fall in recent years for the support services. We are wrestling with the need to reduce support costs by up to £750 million per annum by 1996–97, which presents difficult choices.

One thing is clear: every decision must be taken in a proper, rational fashion which in turn can be justified in a robust fashion to the House. We are certainly not in that position yet regarding Ashford. It might help if I sketch in some of the background and answer some of the points that have been raised.

We are talking about the district workshops and not the base repair workshops, such as those at Bovingdon, which were market-tested. The in-house team won that contract for the repair of tanks. On 31 January, I announced the decision to withdraw work, sadly, from Old Dalby and to concentrate it, for planning purposes, on Donnington. In due course that site will be subject to exposure to competing for quality, which may include market testing. I hope that the private sector and other parts of the MOD will take the opportunity to present proposals for tackling some of the work packages at Old Dalby rather than letting them go to Donnington. That must be a more efficient option than that work going to Donnington.

On Old Dalby, is the Minister absolutely convinced that the figures on which he is working are accurate? According to the figures that I have seen—I accept that they have been produced by people who have a direct interest in and would suffer the consequences of any changes at Old Dalby—the rationalisation plans, far from achieving any significant savings, may result in insignificant savings, have a deleterious effect on Old Dalby and cost the MOD in the long run. Can the Minister say anything about those figures?

I should be glad to go through the figures for Old Darlby, either in writing or in a briefing to the hon. Gentleman. I am sure that the margin of savings there, as my hon. Friend the Member for Ashford said, is of a different order of magnitude from the margin of savings for Ashford. I am cautious about Ashford at this stage for the reason that my hon. Friend outlined—the fact that some of the figures bear thorough analysis, and I do not think that we have reached that position. There was an extensive survey for Old Dalby. Even making assumptions—perhaps taking into account more pessimistic assumptions about transport costs of moving equipment—I am satisfied that the decision on Old Dalby was robust and sensible. However, if the hon. Member for Motherwell, North (Dr. Reid) wishes me to pursue that another time, I shall be glad to do so.

Why have we proceeded to consider Ashford prior to, as my hon. Friend the Member for Ashford describes it, a market test for the district workshops? We need to rationalise now before the market test for all the district workshops, which will be done nationally. We are market-testing the service of the district workshops—not the sites—and therefore we are testing the alternatives for providing immediate support to the Army in terms of repairing vehicles.

Why do we seek some rationalisation now? The Army needs some savings in its votes, and it is easier to market-test if one is able to offer the private sector a clear and sensible range of services and, indeed, current workshop sites. It is more difficult to market-test if there is any serious doubt about where the locations will or will not be.

We have overcapacity of about 40 per cent. in our district workshops. That is a function not only of the run-down in the size of the armed forces but of the fact that rationalisation has not occurred in the past. Prior closures have included York, Bridgend and Liverpool, all in 1993. Therefore I believe that it was sensible for ABRO to consider Ashford now, to discover whether there was a case for closure of that workshop.

Why select Ashford when there are other workshops? There are three reasons, all of which are sensible. First, Ashford is not a garrison town and, compared with Catterick, Colchester, Aldershot and Warminster—other district workshop locations—there are relatively few Army units in the area. The location of the channel tunnel is not so relevant as might at first have been thought, because heavy equipment will enter the military port of Marchwood and then be sent for onward transmission to the appropriate district or base workshop. The existence of the tunnel and the rail link, projected and present, is not so relevant to the issue as some people might initially have thought.

The second reason for selecting Ashford is that the site is obviously affected by the route of the channel tunnel rail link. Indeed, I am grateful to my hon. Friend the Member for Ashford for not drawing attention to the obvious fact, which I want to put on the record, that I was the Minister who announced the route through Ashford. However, I assure him that I now discharge a different function and approach my job on behalf of the Ministry of Defence. I am not trying to justify the implications of that original decision.

The routing of the channel rail link is not a compelling reason for closure in itself. It is relevant only for the reason cited in Brigadier Drew's letter, which my hon. Friend the Member for Ashford quoted: the existence of the site right in the middle of the proposed channel tunnel rail link means that one cannot market-test that specific workshop on that specific site. He did not mean to say—I am happy to correct the position—that that would preclude considering the reprovision of the workshop, either within the specific army property where it is located in Ashford, which contains several other units, or elsewhere in Ashford.

The third reason for selecting Ashford was the declining workload. It is an efficient operation and we pay tribute to the work force. However, efficient labour productivity should not be confused with an inefficient work site, which may be a function of the excessive size of the premises and the overheads that go with guarding, maintaining, heating and lighting a very large workshop. The men are obviously efficient; the site may not be, even without the impact of the rail link, and even without the impact of the need to rationalise the district workshops.

Those were the reasons for selecting Ashford. Incidentally, I should put on record that it is proposed to enter into a direct exchange scheme for Land Rover engines. That has not happened, but I am advised that that is proposed, and that it should provide greater efficiency. I say, "should"; it needs to be tested, and argued rationally in ABRO, before ABRO decides to proceed, but it intends to proceed with that scheme to improve the efficiency of engine repair.

My hon. Friend the Member for Ashford was right; consultation papers went out on 27 October 1994, a delegation visited me on December 12 and I visited the workshops on December 15. I then asked for a fresh appraisal to be done because it had not been assumed that the workshops—indeed, smaller workshops—would be reprovided by Union Railways, either in the premises owned by the Army or elsewhere in Ashford, and I am happy to confirm that the new investment appraisal assumes that. There is, at worst, a nil effect on the appraisal because of the assumed reprovision. As we have assumed reprovision at someone else's expense, the running costs of the new workshop will fall. It will be smaller and will be more efficiently heated and lit. I understand that it will be cheaper to run by about £6 million, expressed in net present value terms, over 10 years. That saving is not taken into account in the investment appraisal.

No decision has been taken, but I will repeat the facts for the record. The appraisal assumes 70,000 man hours per annum of what is called district load—regular repair work to vehicles, and so on. In addition, it assumes 35,000 hours of special project work. That is work which can be directed by the ABRO organisation from anywhere in the United Kingdom specifically to Ashford—for example, the demountable rack offloading and pickup system vehicles used in Bosnia to move ammunition and other supplies.

The net present value cost, a standard way of conducting an appraisal, discounts the stream of cash costs of running the operation into present-day pounds. If one stays in Ashford, in a new building, the net present value cost to us will be £13.9 million. If one closes Ashford and moves 50 per cent. of the work to Aldershot—at marginal cost, simply because Aldershot has the capacity to do the extra work—and 50 per cent. of the 70,000 man hours of district load are contracted out into the local community, to local engineering and shops and garages, at local rates, the net present value cost will be £11.4 million. That is a saving of £2.5 million in net present value terms.

However, there are redundancy payments. My hon. Friend the Member for Ashford was right to mention those. We have assumed that 192 staff would be affected. Twenty-one mobile grades would be redeployed, leaving 171 staff who might be eligible for redundancy payments.

Some redundancy will happen anyway as, irrespective of whether one moves work from Ashford, one needs to slim down the activity. I have assumed that that would cost about £500,000. If one moves the special project work elsewhere, the total redundancy bill could be about £1 million in any case; that would affect about 60 jobs. If one closes the whole of Ashford, the full bill would be about £2.7 million for those 171 people. That is a very significant sum, and it is up front, as my hon. Friend fairly said. So the saving of £2.5 million that I referred to earlier—

rose—

If the hon. Gentleman will forgive me, I must finish and I have only two minutes. The saving of £2.5 million in net present value terms is substantially reduced, perhaps by as much as £1.7 million, which is the additional incremental redundancy payments that would be involved in closure in addition to that which might happen anyway. One is left with a margin of perhaps £750,000, as the net present value—that is a lump sum, not expressed on an annual basis—of the closure. Obviously, it is finely balanced, which is why no decision has been reached at present.

I conclude by putting on the record two factors that would support closure. I would welcome further comments, not only from my hon. Friend the Member for Ashford, but from representatives of the work force at Ashford. If we look over 20 years, for example, the savings will grow even larger because of running cost savings, as the hon. Gentleman pointed out. Even if we discount that stream of saving, the total value of savings will grow over 20 or 30 years.

Some local employment will be created by withdrawing from Ashford, although is difficult to estimate how much. However, I estimate that 35,000 man hours of work will be created through contracting out, as well as a couple of dozen jobs which either will not be lost or will be created in the engineering works in Ashford.

I thank my hon. Friend the Member for Ashford not only for his courtesy but for his thoroughness in raising the issue. I assure him that the Minister of Defence will reflect on what has been said today and it will continue its appraisal of the proposal to close Ashford and concentrate work within the district workshops in order to reach a sensible conclusion.

In 1988, Parliament strengthened the law on a daily act of worship in maintained schools by an overwhelming majority of 264 on a free vote. It followed widespread concern that worship was becoming a secular ceremony in too many schools. Broadly Christian worship was made the norm in the Education Reform Act 1988, but non-Christian faith communities were given extensive rights to worship according to their own faith. In the other place, the reforms were welcomed by the then Chief Rabbi Lord Jacobovits. At the time of the debates, the present Chief Rabbi, Jonathan Sacks, said that

"if Christianity suffers, so, in a curious way, does every other faith as well … Might not teaching children their own traditions"—

that is, Christianity—

"do more for tolerance, and for faith than teaching them everyone else's?"—[Official Report, House of Lords, 3 May 1988; Vol. 496, c. 420.]

Why is education in worship so important? The reason is that education is not really complete without consideration of the spiritual and moral dimension. That dimension is now statutorily enshrined as an essential feature of school life.

My right hon. Friend the Prime Minister has given his strong support to the present law. He put the case very well in his letter to me of 13 December last in response to an approach from a Selby constituent. He said:

"Schools are required by law to provide a daily act of collective worship for all pupils. This should provide the opportunity for them to worship God and explore their own beliefs. It will also contribute to the development of community spirit, promote a common ethos and shared values, and reinforce positive attitudes. Collective worship in non-denominational schools is required to be wholly or mainly of a broadly Christian nature … Schools should make every effort to secure the support of parents and the wider community for the values which they espouse."

A circular from the Department for Education matches the Prime Minister's admirable reflections and it rightly emphasises that Jesus Christ is to be given a special status in Christian worship.

We should remember that experience of worship can provide a life-long spiritual resource. My friend Baroness Cox recently said, rather pertinently:

"Anyone who has contact with the people who are in extremis, as I have as a nurse, knows how often they find comfort in the scriptures and in the prayers and hymns learnt in childhood. To deny our young people this experience and this knowledge is an ultimate betrayal."

Christianity, like leaven in the lump in Christ's famous parable, has worked its way deeply into the British character and attitude to life. The publication British Social Attitudes—probably one of the most academically respected surveys of public opinion—found in its 1994–95 report that 87.6 per cent. of our population claim to have been brought up in the Christian faith, with more than 57 per cent. still seeing themselves as belonging to a specific Christian denomination. Just under 20 per cent. of the population say that they go to church at least once a month, but 27 per cent. of the population say that they pray every week. Only 3.7 per cent. claim to have been brought up in a non-Christian faith.

That last statistic should help us to keep a sense of proportion about schools. It is commonly accepted that fewer than 300 schools, out of a total of 25,000, have significant numbers of pupils from a non-Christian background of faith.

British Social Attitudes found that the overwhelming majority of the population—some 70 per cent.—want schools to offer a daily act of collective worship, with fewer than 10 per cent. strongly opposed. Against that background, it is certain that neither Parliament nor the nation's parents are seeking to abandon daily Christian worship in schools. However, the same cannot be said of some union leaders and teacher trainers.

The secular eduction system in France and the United States has recently been praised by a number of union leaders, including Nigel de Gruchy of the National Association of Schoolmasters/Union of Women Teachers. He has called for the scrapping of the present legislative arrangements. The leadership of the National Association of Head Teachers has also made clear its opposition to the 1988 reforms.

Last May, that union carried out a survey of all of its members. On 28 May, The Times reported that the survey showed that 87 per cent. of secondary and 65 per cent. of primary heads believed that they could not meet the law's requirements. I am convinced that that was a bogus survey and it is worth putting some facts about it on the record.

Of the 32,412 survey forms sent out by the NAHT, only 1,747 were returned from members in county schools—that represented fewer than 6 per cent. of all United Kingdom schools. That is a tiny, wholly unrepresentative sample. In its desire to yield a favourable outcome to the secularist cause, the NAHT appears to have sent questionnaires as far afield as Gibraltar, Hong Kong and Cyprus. Head teachers in those far-flung parts of the globe and in Scotland and Northern Ireland were asked their views about legislation that affects only England and Wales.

There are factual errors throughout the survey. For example, one question attempts to gauge whether the Education Act 1993 has had an impact on the number of teachers who are unwilling to lead worship, but that Act made no changes to the law on school worship. Professor Kevin Glazebrook of Newcastle university has said that

"it is not possible to draw any conclusions"

from the NAHT survey. I note that the Christian Institute, which has helped me in the preparation of my speech, will soon publish a shocking report citing serious arithmetical and other errors in the NAHT survey.

Far from 65 per cent. of all primary schools breaking the law on worship, as the NAHT would have us believe, the chief inspector of schools commented in his latest report to Parliament that "virtually all" the nation's 20,000 primary schools comply with the law. In a whole year of inspections, Ofsted could not find a single English primary school which broke the law.

Will my right hon. Friend give way?

I am afraid that I have very little speaking time left so I must ask my hon. Friend to forgive me. I will give way to her later if there is any time left.

The situation with the 5,000 schools in the secondary sector is very different. Ofsted has reported that there is basic compliance with the law in 60 per cent. of secondary schools but that even those schools are not perfect.

On that point, I wish to raise one particular issue with my hon. Friend the Minister. Inspection reports tend bluntly to state whether a school complies with the law. That information is far too limited. Some schools may be almost complying, others might be nowhere near it. One school might be holding assembly on four days a week, another on only one day.

Some schools are being criticised by inspectors for holding Christian assemblies. One school was told that its assemblies should be more multicultural. In another large urban secondary school, staff are determined to meet the law's requirements. Assemblies are held in the assembly hall for three days a week and in form classes for two days a week, yet the school was told that it had failed to comply with the law on a technicality. That inner-city school should be commended rather slated on a minor technicality.

Let us be clear about the issue. Do we want a secular education system? We should take careful note of what happened in the United States. The Supreme Court banned school prayers and religious teaching in 1963. Since then, teachers have been dismissed for allowing prayer in school and parents have had to resort to legal action so that bible clubs or Christian Union groups can meet on school premises.

There have been 25 bleak years of secular dominance, but in the past few years things have been changing. One recent Gallup poll found that the Supreme Court ruling banning prayer is being flagrantly broken in 75 per cent. of high school graduation ceremonies. Three states have passed laws guaranteeing the right to have religious teaching and worship in schools. In the recent congressional elections, the Republicans stood firmly on the school prayer ticket and everybody knows with what results. Even President Clinton has now declared his support.

The Christian Action Research and Education organisation, representing 100,000 church members, recently concluded that in the matter of school worship:

"We judge that the alternative to the present position, with all its imperfections and ambiguities, would lead inevitably to a thoroughly secularised system.".

If we should ignore the secular voices, we should also ignore those teacher trainers who call for cultural anarchy. In his recent lecture at the Royal Society of Arts on 12 December 1994, Professor John Hull of Birmingham university called for the complete repeal of section 7 of the Education Reform Act and for the term "collective worship" to be abolished in favour of "collective spirituality". That new term is reminiscent of 1960s new-age hippy culture and has distinctly left-wing overtones. The suggestion that all religions are to be harmonised into "collective spirituality" is nothing less than a call for the restoration of the full-blown, multi-faith mish-mash that was so vigorously criticised when the 1988 Act was put on the statute book.

I know that my hon. Friend the Minister will resist the call for collectivisation, as he so ably resists all other calls of such character. I am grateful to my right hon. Friend the Secretary of State for making it clear that the Government stand firmly behind the present arrangements for school worship.

I am also grateful to the Archbishop of Canterbury for his public comments in support of daily Christian worship and to my distinguished constituent the Archbishop of York for the admirable letter to The Times on 9 January outlining some clear, realistic and perfectly attainable aims for school worship in non-church schools. Other bishops and officials in the Church of England should take heart from the lead given by the two archbishops and march confidently behind them.

In respect of teaching or leadership resources, my friend, Mr. Clive Calver, general secretary of the Evangelical Alliance, in a letter published in The Times on the same day as Archbishop John Hapgood's, referred to the resources lying potentially available from 5,000 evangelical churches and 700 member societies that are affiliated to the Evangelical Alliance.

Secondary schools need to be encouraged to establish closer links with local churches. In far too many cases, schools are refusing offers of help from the community.

Secondary schools would do well to learn from our primary schools, which have a superb track record in keeping the law on school worship and in securing the support of the local community. Undoubtedly, there should be more research on the issue. How is it that some secondary schools keep the law while others do not? It cannot be just a matter of accommodation, as some allege.

Dr. Carey recently said:

"There is a danger in giving the impression that secularism is all dominant in our society. Most people still have some links to the Church, however tenuous those may be."

The Archbishop pointed out that one quarter of the population went to church last Christmas. He went on to say that the

"establishment does not equate with privilege but with responsibility."

Churches need to be mobilised to offer support to schools. A major effort is needed here, particularly by the Church of England. Strenuous efforts should be made to make the law work in secondary schools as it already does in primary schools. Let us see the Church once again, in the words of the Anglican prayer book, as the Church militant rather than the Church hesitant. I have 30 seconds to give way to my hon. Friend.

I wish simply to confirm that the standard of religious education in my local primary schools is excellent. It is also very good in my local secondary schools. Not long ago, I visited a school in my constituency where the headmistress gave the best exposition of the trinity I have ever heard from anyone, even from a church minister. Fortunately, we are not lacking in either of those sectors.

I am grateful to my hon. Friend for reinforcing the evident scope and capacity for building on what is already good and solid ground.

I congratulate my right hon. Friend the Member for Selby (Mr. Alison) on obtaining this Adjournment debate and very much welcome his choice of subject. It is a matter in which the House knows he has sustained a great interest over a long period. We know that he plays a very distinguished part in Church matters and the important relationship between the Church and the House.

I immediately welcome my right hon. Friend's support for collective worship in schools. As he reminded the House, the Education Reform Act 1988 requires the curriculum to address the

"spiritual, moral, cultural, mental and physical development"

of pupils and, as such, in the Government's view collective worship has a vital role to play.

Her Majesty's chief inspector's report for 1993–94 confirms that collective worship and religious education make a powerful contribution to a pupil's spiritual development and the sharing of moral values. Surely all that must be central to a school's efforts to establish its own distinctive ethos that will underpin all its activities and, most important, will be seen in the relationships and expectations within the school community.

The wording of the 1988 Act and the words of HMCI reflect closely the basis and thrust of my right hon. Friend's argument in this short debate. I should also confirm that the Government have no plans to change the legal requirements for collective worship, which give schools considerable flexibility in their arrangements for worship, not least because I agree with my right hon. Friend in his estimation of parental expectations in that regard. It would be a foolish person indeed who, given the strength of evidence that my right hon. Friend has brought before the House today, would seek to make some case for a radical change in the legal requirements and arrangements that are in place. In my view, we can continue to build on them.

As my right hon. Friend pointed out, the legislation rightly has Christianity at its heart, but it recognises that worship in schools will necessarily be different from worship in a community with beliefs in common. It does that by referring to collective rather than corporate worship.

The overall aim of the legislation is to offer pupils from a variety of backgrounds the opportunity to worship together wherever possible. It then gives flexibility—rightly, in my view—in the organisation of worship. Acts of worship need not be first thing in the morning but can be organised at any time during the day. Nor is there a requirement that the school should worship as a single group. It is open to a school to provide worship in separate age or class groups. The content of the worship in county schools and the equivalent grant-maintained schools can reflect faiths other than Christianity as long as the majority of the acts of worship over a term are wholly or mainly of a broadly Christian character. That gives the right balance and sufficient flexibility to those in different communities.

My right hon. Friend mentioned 300 schools of an overwhelmingly non-Christian nature. I will not argue with that figure, but flexibility in the arrangements is necessary to give cognisance of such schools and allow them to arrange their collective worship in the most appropriate way, bearing in mind the fundamental requirements of the legislation.

The detailed requirements for collective worship are spelt out in the Department's circular 1/94, which was—logically—published in January 1994. It does not contain proposals for change, as some have suggested, but offers guidance on the existing requirements of the Education Reform Act and the Education Act 1993 for religious education and collective worship. It contains no new requirements beyond those of the Acts. The basic requirement for daily collective worship flows from the Education Act 1944, as does so much of our education system.

I am gratified that my right hon. Friend chose to quote from the evidence in Her Majesty's chief inspector's report. That showed that the picture on compliance with legal requirements is not as bleak as is sometimes suggested. The evidence is worth repeating. As my right hon. Friend said, nearly all primary schools were found to provide a daily assembly and about 80 per cent. were judged to be complying with the detail of the law.

My hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman) confirmed that in her constituency—to no one's surprise—her excellent schools are doing even better. Her view is that her primary schools and secondary schools are complying with the requirements. Regrettably, that is not necessarily so everywhere, as my right hon. Friend the Member for Selby said. The chief inspector's report stated that the majority of secondary schools did not provide daily collective worship for all pupils, but it said that worship, where it took place, was frequently of good quality and made a good contribution to pupils' spiritual and moral development.

It is right that Ofsted should monitor the provision of collective worship at school level. The new inspection regime ensures that arrangements in every school are inspected. Ofsted then comments on whether the statutory requirements are being met. That information is made available to parents and the public, as is the action plan, which schools are required to publish, showing how they intend to remedy any shortcomings. The schools are primarily answerable to parents on that matter and many parents, rightly and understandably, attach considerable importance to that sphere of school life.

My right hon. Friend has quoted some highly relevant statistics from the British social attitude survey to bear that out. A poll conducted by The Independent in 1993 found that about 70 per cent. of parents wanted their children to say prayers at school. As in so many other sectors of education today, if parents are not satisfied with the arrangements made by the school their children attend, they have access to the local curriculum complaints machinery established by the 1988 Act or they can take up the matter through the school governors. Parents with pupils at county schools can take up the issue with county councillors. If parents cannot satisfy themselves in those ways, the matter can ultimately be referred to the Secretary of State. However, it should be possible to resolve problems well before that. I urge all parents who are not satisfied with that important part of the provision in their child's school to take up the matter vigorously with the head teacher, parent-governors or other governors to ensure that the opinions quoted by my right hon. Friend and borne out by The Independent survey are properly reflected in the arrangements made by primary and secondary schools.

I note my right hon. Friend's remarks about the need for Ofsted reports to go beyond a simple statement of whether a school is complying with the law. Ofsted is aware of the importance of commenting, too, on the positive contribution that a school's collective worship provision makes to pupils' spiritual and moral development, even if it is not meeting the letter of the law. Her Majesty's chief inspector's latest annual report does just that.

Many schools are doing valuable work in that sector and we should recognise and acknowledge their achievements. Ofsted's draft revised framework for inspection, published yesterday for consultation, proposes that, where inspectors find that a school is not meeting the law on collective worship, the report should give the head teacher's stated reasons for failing to do so.

I support what my right hon. Friend said about the importance of establishing links with churches and other places of worship in the local community—an important element of the argument. Although teachers, including head teachers, have the right to elect not to participate in collective worship for reasons of conscience, it remains the responsibility of the head to ensure that the statutory requirements are met. It is open to head teachers to invite members of the community, including religious leaders, to help to conduct collective worship, if they are able and willing to do so. Many schools have built up worthwhile relationships of that sort—with local clergy regularly making stimulating contributions to the schools' programme of collective worship.

My hon. Friend the Member for Lancaster said that that was the case in her constituency. If it can be demonstrated that it is possible in Lancaster, one is forced to ask why it cannot be done more readily and systematically in other parts of the country. We must urge not only the schools but local churches to see what can be done—in co-operation with each other—to try to ensure that, where heads and teachers have a genuine difficulty in meeting the requirements of the law, they can call on the support of local religious communities and leaders to help schools to comply with the law.

My hon. Friend the Minister has made a point that is worth emphasising. It should not be just up to the school and those responsible for religious education and worship to take the initiative and contact churches. Churches must take the initiative and contact schools to offer them help and show interest in what they are doing. Does my hon. Friend agree that, as we have just passed education Sunday, February might be a good time for each church and parish to contact all their schools—secular as well as denominational—to ask what more they can do to help them in their important work?

That was a typically positive and helpful suggestion from my hon. Friend. There must be more scope in local communities for that sort of co-operation between schools and local churches. I hope that we shall see much more of that so that assistance can be given to those heads and teachers who, for a variety of reasons, have difficulty in meeting the requirements of the law. I am sure that that would be widely welcomed. Schools that experience difficulty in meeting the legal requirements can turn to their local standing advisory council on religious education for advice. That is a local permanent body with responsibility for supporting the provision of both religious education and collective worship in the area.

There is no doubt that the subject is of the greatest importance. My right hon. Friend has expressed consistent views in the House over many years and has highlighted the importance of the subject. He has allowed us briefly today to demonstrate not only the importance of the subject but the ways in which schools can be helped to comply with the law, which is not going to be changed. We want greater compliance—happier compliance—with the law so that we can ensure that the great religious tradition of this country can benefit pupils up and down the land, regardless of their personal, parental or family religion. Pupils must benefit from the core beliefs of the Christian religion, which is, and continues to be, so important to our society and our education system. I am grateful to my right hon. Friend and hope that the few words that I have been able to say today have given him the reassurance that he sought in bringing the subject before the House.

Like many other Opposition Members, before the Christmas recess I voted against what were loosely called the Jopling proposals for the so-called modernisation of Parliament. However, I am pleased to take part in today's debate, because I regard these debates as perhaps the only positive thing that came out of the decision taken before Christmas.

I notice that my hon. Friend the Member for Jarrow (Mr. Dixon) is present. I am pleased about that, because the subject about which I intend to speak affects many of his constituents as well as constituents in the whole of the former Tyne and Wear metropolitan authority area.

It does not give me any joy to have to raise this subject today. There are many disturbing aspects on which I hope the Minister can reassure me. Although the prescribed industrial disease, mucous membrane disease, has been with us for a long time, only in relatively recent years—from about 1990—has it become better known, as medical knowledge of it has improved.

There are various welfare rights agencies throughout Britain. I am sure that they do a good job in advising people on how to claim benefits and find their way through the maze of legislation. I imagine that there is none better than Sunderland centre for the unemployed, run by Dave Towler. I have the utmost admiration for him. He has done a tremendous job for the people whom he represents. He will always have my support whenever he requires it, because I am aware of the quality of his work.

There is a close relationship between the Liverpool centre for the unemployed and the one in Sunderland. In many ways, there is an interrelationship between the industrial backgrounds and heritages of Merseyside and Wearside and Tyneside. In April 1992, it was agreed that there would be a mass campaign to make claims in respect of prescribed disease D4, or mucous membrane disease.

After a few months, a total of 18,000 claims had been made, of which 5,000 were from Merseyside and 13,000 from the Tyne and Wear area. Early in the campaign, it became obvious that there was a tremendous disparity between the decisions made in Liverpool and those made in Sunderland. For example, we found that at the level of the adjudicating medical authority—which sounded much better when we called it a medical board—85 per cent. of those who claimed in Liverpool received satisfaction while in Tyne and Wear fewer than 1 per cent. did so. We are not talking about some inconsequential difference. There is a tremendous disparity. It begs a question that until now certainly has not been answered.

Many of those who underwent medicals for the adjudicating medical authority had received reports from ear, nose and throat consultants that they were suffering from the disease; yet the general practitioners employed by the DSS largely disregarded those reports. We found that somewhat unusual. I have always understood that a consultant's report should take precedence over what a GP might think on a subject of which he probably does not have so much knowledge.

My hon. Friend the Member for Sunderland, South (Mr. Mullin) and I wrote joint letters to Mr. Tinnion, regional chairman of the independent tribunal service, Judge Thorpe, who was in charge of the national tribunal system, the Secretary of State for Social Security and the Lord Chancellor. We drew attention to the disparity. The replies that we received suggested that there was nothing to worry about; indeed, they appeared to deplore any parliamentary interference in their jealously guarded system of justice.

Following that response, Sunderland centre for the unemployed commissioned a statistical survey by Dr. Peter Kelly who lectures in statistics at Newcastle university medical school. The aim was to find some pattern between what happened in Liverpool and in Tyne and Wear. We have all the information, which I shall be only too pleased to make available to the Minister should he require it in order to take some action.

The survey highlighted the fact that, following the refusal of either the industrial tribunal service or the Department of Social Security to take action on the matter, some of the medical appeal tribunal consultants in the Tyne and Wear area began to be more favourable to appellants, even though we were told that there was nothing wrong and nothing needed to be changed.

My hon. Friend the Member for Sunderland, South and I wrote again to the various authorities that I mentioned. We received much the same sort of response. The fact that things seemed to have improved was ignored. Eventually, the various advice centres and Sunderland centre for the unemployed decided that the only way ahead, in view of the response that we had had—to say that it was tardy would be to suggest that it was rather better than it was—was to make use of the proper procedures of the full majesty of the law.

Between 150 and 180 appeals made from various offices were sent to the social security commissioner. The commissioner considered two cases. They are known as the Greer decision and the Blackwell decision. The decision was almost unprecedented for the commission. I shall read it out in full. It said:

"The medical appeal tribunals who re-hear the cases should be composed of a different Chairman and different members all of whom have never sat on a medical appeal tribunal in Tyne and Wear in relation to the prescribed disease D4."

It is fair to say that, despite all the reassurances that my hon. Friend and I received from the various bodies, the commissioner most certainly thought that there was something wrong which needed to be put right.

Does my hon. Friend agree that one of the odd things about the case is the way in which the decisions made by medical people, who are presumably there as scientists rather than politicians, appear to reflect the political needs of the hour rather than the actual condition of the people whom they are supposed to examine?

My hon. Friend makes a fair point. I am afraid that I am too cynical an individual to give him the answer that he requires. It should be surprising. Unfortunately, I do not find it surprising. The point that he makes is one of which the Minister should certainly take note.

The commissioner was saying that there was something sadly wrong with the system in the north-east. The decision dealt with both adjudicating medical authorities and the medical appeal tribunals—two bodies which are supposed to be completely independent in every way—yet it would appear that the commissioner was not prepared to accept that they were independent.

I am sorry, Mr. Deputy Speaker, that I must use so many terms in the debate. It must be perplexing for people who are trying to follow the debate. It is easy enough for the likes of me, the Minister or other hon. Members who know the system well. There are so many sets of initials. It is sometimes difficult to keep up. It had been stated consistently in writing by the Benefits Agency medical service that no research had been done into mucous membrane disease, except the research that involved chromate-related damage to the mucous membrane. That is not true. A great deal seems to have been overlooked by the Benefits Agency medical service, certainly in the north-east of England.

Consultants acting on behalf of appellants throughout the sorry saga were so worried about the matter that a symposium was held on 20 June 1994 in York. It was attended by many ear, nose and throat consultants from Britain. They were addressed by eminent colleagues from Scandinavia and the United States who had carried out in-depth research into mucous membrane disease.

The symposium concluded that there was a condition called industrial rhinitis. I was pleased to have the privilege of attending that symposium. I do not pretend that it is a subject about which I know very much. I found the symposium enlightening but disturbing in some ways in view of what had happened before it took place. In attendance at the symposium was a representative from the Industrial Injuries Advisory Council who later advised the Secretary of State on the list of prescribed diseases. Following the symposium and as a result of information that had been sent to the council by consultants, trade unions, and so on, in September 1994 the IIAC recommended to the Secretary of State that mucous membrane disease, prescribed disease D4, should be broadened to include industrial rhinitis. Out of this whole sorry saga, that is the one consolation.

I should be pleased to give the Minister all the information that I have in my possession—much of which came from his Department. A number of questions need to be answered. Those with the disease in the north-east have suffered an injustice and we want that to be put right along the lines set out by the commissioner. That has not yet happened and it shows no sign of happening.

My first point is how do the Government explain the difference between Liverpool and Tyne and Wear when the industrial backgrounds are the same? Secondly, we have proof that the full-time medical adviser gave misleading information to the Wearside adjudicating officer's department. I am pleased that one of my constituents, Brenda Jackson, has given me permission to use her name. Obviously, I will not name the doctor concerned. That is not for me to do; it is for the Department to find out and do something about him. I would never say anything in this place that I was not prepared to say outside it. However, the information is available if the Minister wants it. There has been a similar occurrence with a constituent of my hon. Friend the Member for Houghton and Washington (Mr. Boyes), with which I have no doubt he will deal in due course. I have appraised him of the situation. It is believed that my hon. Friend's constituent lost his case because of misleading information.

Thirdly, the adjudicating medical authority is still not complying with the commission's written directions. When can we expect some progress on that? Fourthly, how can an organisation such as the DSS, with all its resources, not fund research, yet advice centres and independent consultants—sometimes even charitable bodies—seem able to do some research and produce tangible, worldwide evidence on the disease?

Fifthly, in some agreed minutes between the DSS and the advice centre in Sunderland about a meeting held on 3 August 1994, it was recognised that there was a need for uniformity in decision making. It was said that training was required, through the Benefits Agency, of the Department's general practitioners—the majority of whom are either part time or retired. Why has that not been done?

Sixthly, why are consultants' reports treated with such disregard—I might almost call it disdain—by those general practitioners? If they were in the mainstream of medicine and referring their patients to consultants, they would abide by the consultants' opinions. Why are there different standards?

Seventhly, because of fresh evidence supplied to the DSS and because of the threat of advice centres pursuing the matter to judicial review, has the DSS now agreed to review all prescribed disease D4 cases?

Eighthly, after the re-boarding of medicals there is documented evidence that appellants were deemed by the adjudicating medical authority to be suffering from various forms of rhinitis at their original medicals two years ago. As those decisions would now be brought within the commissioner's interpretation of prescribed disease D4, the review medicals by the same general practitioners show that those people are suddenly not suffering from any form of rhinitis.

Ninthly, boarding doctors are refusing to abide by even DSS policy division directives on how they are to proceed at review medicals. Doctors are refusing to examine appellants on review.

The impression that I get—I say this with some sadness—is that there is a force of opinion within the medical section of the Benefits Agency medical service in Tyne and Wear that has taken it upon itself to ensure that, come what may, appellants suffering from distressing conditions do not get their rightful entitlement. We can reach no other conclusion.

Is there a case for sending the evidence to the ombudsman? It appears that there is some malpractice which should be investigated.

I have to give my hon. Friend a somewhat cautious reply. So many things are wrong that I can honestly say that I do not know what is the best way forward. I hope that today's debate is the best way. I am just sorry that it has had to come to this.

I want to refer to the proceedings of a social security appeal tribunal held on 31 January, which involved my constituent to whom I referred earlier. I shall read out the relevant passage about misinformation from a doctor employed by the Benefits Agency. It states:

"Mr. Towler invited clarification about document 28"—

which is the misleading document. It continues:

"He submits that Mrs. Jackson has clearly not been examined by Department of Social Security consultants, only doctors of GP status. To this extent the document carries a wholly false (not just misleading) impression."

Miss Guthrie, the adjudication officer, conceded that point. It is a sorry state of affairs when I have to come to the House and report something that is basically the equivalent of perjury.

I know that the Minister is a sympathetic person, because of his involvement with bronchitis and emphysema. I hope that he will ensure that my constituent and the other 13,000 people in the north-east who are claiming in respect of the disease will have their claims reheard and that they will receive the same sort of justice as that received by the people on Merseyside.

I congratulate the hon. Member for Sunderland, North (Mr. Etherington) on securing the Adjournment debate. From the presence of several of his hon. Friends, I recognise that there is widespread concern that goes beyond his constituency alone. I appreciate his concerns and I am aware of his active interest in this matter over a considerable time.

The prescribed disease in question, known as prescribed disease D4, has a long history and raises some difficult issues. I should like briefly to explain the background. The origins of the present prescription are to be found in the Workmen's Compensation Act 1906. It provided, from 1907 onwards, for compensation for ulceration of the mucous membranes of the nose and mouth. The original occurrence which led to the condition being added to the list of diseases at that time was the adverse effect—bleeding from the gums—found to be experienced by men unloading a certain type of iron ore.

It was recognised even then that because the condition prescribed was common among the general population, a clear link with a particular job could not be assumed in the individual case. The burden of proof that the disease arose as a result of work was, therefore, always left with the worker.

When the industrial injuries scheme was introduced in 1948, the present PD D4 was included as part of the adoption of the prescribed list of occupational diseases used by the Workmen's Compensation Acts, which the new scheme replaced. The disease is presently defined as:

"inflammation or ulceration of the mucous membrane of the upper respiratory passages or mouth produced by dust, liquid or vapour".

The occupational requirements are:

"any occupation involving exposure to dust, liquid or vapour".

It can be readily appreciated from what I have just said that both the disease and the occupational cover are in very general and wide terms.

One of the major problems with the present prescription of PD D4 is that the signs of the disease, such as running nose, feeling of nasal obstruction, occasional bleeding and loss of smell, are extremely common among the general population and have a multitude of possible causes. The disease is usually short-lived and generally causes very little disability of any serious or lasting nature. Furthermore, it can be extremely difficult to identify the specific cause of the condition. There are many different causes and other general factors, such as smoking or the drying effects of central heating, which can worsen it. It is not surprising, therefore, that consistent diagnosis of the condition is very difficult; making a clear link with an occupational cause is even more difficult.

Until fairly recently, as the hon. Gentleman said, there were in fact very few claims made each year for PD D4. Then, in the spring of 1992, local trade unions and unemployment centres in the north-east of England mounted a campaign to encourage people to claim for the prescribed disease. The campaign subsequently spread to the north-west.

It was the increased number of claims received as a result of the campaign which highlighted the very general nature of the prescription and the difficulty that it presents in deciding claims. This, in turn, raised questions about the precise nature, causes and effects of the disease, since, if they could be laid down more precisely, much of the confusion to which the hon. Gentleman referred could perhaps be avoided.

My predecessor, my right hon. Friend the Member for Chelsea (Sir N. Scott), looked into the problem in 1993 and rightly decided in September 1993 to ask the Industrial Injuries Advisory Council to consider and advise on the question of whether the present prescription of PD D4 should be changed and, if the council concluded that it should, to ask it for recommendations on revised terms of prescription. The council is the independent, expert body which has the statutory role to provide such advice; Ministers rely on it for advice. It has examined all the relevant scientific evidence that was available—the hon. Gentleman referred to members of the council taking an interest in these matters. The council completed its report towards the end of last year.

My officials are considering the implications of the council's findings. I expect to receive the report shortly and will respond in due course. However, any changes proposed by the council will not have retrospective effect and current claims must be decided on the basis of current legislation.

I should like at this point to explain the decision-making process for industrial injuries claims, because the hon. Gentleman asked several questions about that matter. The first question, which is decided by an independent lay adjudication officer, is whether the claimant satisfies the prescribed occupational requirements. Because the present prescription covers any occupation involving exposure to dust, liquid or vapour, few claims for PD D4 fail at this stage. Claims which satisfy the occupational requirements are then referred for medical examination. In the north-east, these examinations have been carried out by medical practitioners with higher qualifications in the specialty of ear, nose and throat surgery.

If the examining medical practitioner considers that the claimant is suffering from PD D4, he then acts as an independent adjudicating medical authority and assesses the degree and likely duration of any resulting disability. Where a prescribed disease has been diagnosed, adjudicating medical authorities also give advice to the lay adjudication officer on whether they consider the prescribed disease is due to the nature of the claimant's occupation. For most prescribed diseases, if the claimant satisfies the occupational test and is diagnosed as suffering from the disease, it is presumed that the disease was caused by the relevant occupation, if the claimant worked in it shortly before developing the disease. But as I explained earlier, there is no such presumption for PD D4, because of its very common nature, and the link between the occupation and disease needs to be proved on the balance of probability in each case.

The claimant has a right of appeal to a medical appeal tribunal against the decision of an adjudicating medical authority, and to the social security commissioner—but only on a point of law. The adjudicating medical authority may review the decision if it is satisfied by fresh evidence that the original decision was given in ignorance of a material fact or was based on a mistake as to a material fact. I shall say a little more about that later.

I should make it absolutely clear to the House, especially in view of the intervention by the hon. Member for Sunderland, South (Mr. Mullin), that the adjudicating authorities, both lay and medical, are entirely independent. Neither Ministers nor officials can intervene in their decisions.

As I have already said, the characteristic features of PD D4 are very common indeed among the general population. Sometimes, it is not an easy task to determine whether these symptoms are due to a specific agent when they occur so commonly and widely. In these circumstances, diagnosis and clinical assessment are not an exact science; it is a matter of clinical judgment by the experienced independent doctors dealing with the cases who take account of the facts in each individual case.

Comprehensive training and continuing medical education programmes are pursued by Benefits Agency medical services to ensure that their doctors are expert both in the legal aspects and in the disablement assessment issues of all prescribed diseases. The training received for assessing PD D4 is part of that.

Doctors who serve as members of the adjudicating medical authorities are also trained by senior Benefits Agency doctors according to a well-established programme. Senior managers in Benefits Agency medical services regularly undertake quality assurance of the work of adjudicating medical authorities and set standards of performance.

Since 1992, as far as I know, there have been more than 8,000 claims for PD D4 in the north-east. In the vast majority of cases, the adjudicating medical authority has not found the claimant to be suffering from PD D4. Even where the disease has been diagnosed, in most cases the degree of disablement assessed has been below the 14 per cent. threshold which qualifies for payment of disablement benefit. On the latest figures available, less than 0.5 per cent. of the north-east claims have attracted an assessment of 14 per cent. or more.

The hon. Gentleman asked about differences between the north-east and the north-west, mentioning Liverpool in particular. Even in the north-west, fewer than 1.5 per cent. have had an assessment of 14 per cent. or more. In both cases, the proportions are very small. This low success rate reflects the fact that the disease is not generally very disabling. It is true that there is some difference between the level of diagnosis of PD D4 in the north-east and that in the north-west. This is a sign of the difficulty that medical authorities have had in deciding claims, for all the reasons that I described. That is why we asked the Industrial Injuries Advisory Council to review the present prescription.

I mentioned earlier that reviews of medical authorities' decisions may be sought on the basis of fresh evidence. Last April, the Sunderland branch of the Trades Union Congress, acting on behalf of claimants, sought fresh evidence reviews of a number of such decisions on the basis of a series of research papers from abroad. As from May, instructions were issued to all Benefits Agency medical service doctors on the interpretation of what constitutes fresh evidence. This information has been imparted to all authorities. I understand that the authorities have accepted that there is fresh evidence, enabling a review of earlier decisions. On review, however, in most cases they have not found that the earlier unfavourable decision should be revised.

The hon. Gentleman explained the principles laid down by the social security commissioner in two cases, and referred to the ruling given last November. The commissioner set out how, in his view, the medical adjudicating authorities should proceed when considering the diagnosis of PD D4. The Benefits Agency medical service issued guidance to adjudicating medical authorities on 19 January, four weeks ago, in the light of the commissioner's decisions.

Review cases still held at the medical board centre in Newcastle or at district offices in Wearside awaiting action will be scrutinised by the BAMS and any decisions that do not appear to comply with the principles laid down by the commissioner will be referred to a fresh adjudicating medical authority for consideration of review on the ground of error of law. Where the fresh evidence review decision has already been communicated to the claimant, it is open to him, if he is unhappy with that decision, to apply for an error of law review or to appeal to the tribunal. Redress is available if people feel aggrieved, but I do not want to raise undue hopes that, as a consequence of further reviews, significantly more cases will result in payment of benefit, because—for all the reasons that I gave—occupational cause of the disease is difficult to demonstrate.

I assure the hon. Gentleman that the BAMS will continue to monitor the situation. I particularly welcome the good local liaison arrangements that are in place, particularly with Sunderland TUC. I shall ensure that the hon. Gentleman's concerns are brought to the attention of the appropriate people in the Benefits Agency, and I shall bear in mind his remarks when I consider the Industrial Injuries Advisory Council report in the near future.

I believe that the hon. Gentleman asked nine questions, I shall read the debate in Hansard, to make sure that I answered them all. If I have not, I shall write to the hon. Gentleman with the answers.