To ask the Secretary of State for Health what further research her Department will be conducting in 1995 into the possible causes of multiple sclerosis; and if she will make a statement.

My right hon. Friend the Secretary of State has written to you, Madam Speaker, and to the right hon. Member for Derby, South (Mrs. Beckett), to explain that today she is leading a trade mission to Japan and Korea to boost British medical exports and to bring inward investment and jobs to Britain.

In view of successful trials in the United States and completion of trials in the United Kingdom, will the drug beta interferon be available for multiple sclerosis sufferers on the national health service in the autumn and will trials on the drug rolipram begin in Britain this year?

As my hon. Friend knows, the cause of multiple sclerosis is not known, so as yet there is no cure. The research and clinical trials to which he refers have been on drugs to alleviate symptoms of the disease. Beta interferon, as a biotechnology product, now comes under the European Medicines Evaluation Agency and I cannot say whether, when or in what form a licence will be granted by it. The Medicines Control Agency in Britain has not yet approved any clinical trials on rolipram because no such proposals have yet been put to it.

To ask the Secretary of State for Health what restrictions apply to GP fundholders in respect of using public money to improve their property portfolio.

General practitioner fundholders may, with the agreement of their regional health authority, use audited savings for the benefit of their patients. This includes improving their surgeries to provide a wide range of services.

Is there not growing concern among medical practitioners that some—not all—fundholders are not treating a required number of patients in order to improve the value of their property so that at the end of their practice they can sell it and make a large personal profit? If a doctor approaching retirement has a choice between 10 hip operations or adding £100,000 to the value of his property, that is a choice introduced by the Government to allow fundholding doctors to turn themselves into small businesses and put profit before patients.

I hope that every general practitioner fundholder across the land will have heard what the hon. Gentleman has said, which is a slur on most of them, on those whom he was mentioning, and noted his tendentious use of the words "property portfolio" in his question when what he should have said was surgery premises. It is not unusual for public funds to be made available for the improvement of premises. That was always the case when grants were made available before to improve the capital asset with precisely the same effect as if GP fundholders use their savings now. I just wish that the hon. Gentleman would bear in mind the additional services that are being provided for patients—the improvements, the physiotherapy and the capital equipment that is brought into the premises. Fundholding is a great success and it does doctors no good when the hon. Gentleman denigrates them in that way.

Bearing in mind the fact that more and more GP practices are opting for fundholding with clear benefits to patients throughout the country, is my hon. Friend aware that the Opposition are now in as much of a muddle about the future of health care as they are on education? Will he give some help to the right hon. Member for Derby, South (Mrs. Beckett) to sort that out?

Not only am I keen to help the right hon. Lady; I have already done so. I wrote to her yesterday asking whether she might now be prepared to clarify her party's position on this important point. Perhaps she will have an opportunity to say whether she agrees with the Leader of the Opposition, and reveal that yet another layer of veneer is to be added to left-wing policies.

To ask the Secretary of State for Health what steps she intends to take to improve residential care for the elderly.

Our inspection regime ensures that local authority-run homes are inspected against the same standards as are expected of independent sector homes, and we have now applied citizens charter principles to both. Standards also of course benefit from the statutory direction on choice, which gives residents the right to choose their home.

Is the Minister aware of the anger and fear felt by elderly people whose homes, life savings and partners' pensions are confiscated to pay for residential care? Is he aware that, as the Southern Daily Echo has pointed out, those who can plan ahead and pay legal fees can avoid high charges, while others cannot? Is it not clear that residential care is now a national lottery in which frail elderly people are losing control of the type, quality and cost of the care that they need?

What is certainly clear is that such comments do nothing but undermine elderly people's confidence in the excellent care provided by residential care and nursing homes throughout the country—and, indeed, by social services departments and health authorities working together.

Is my hon. Friend aware of the admirable plan of Kent's director of social services to involve local communities much more closely in residential homes? Does he agree that such a clear use of the voluntary spirit should be encouraged, and will he do his utmost to encourage those admirable ideas?

Yes. We should involve all the relevant agencies in the planning of social care, including social services departments, health authorities, GPs and the voluntary sector—and, of course, users and carers themeselves. My hon. Friend is right to point out that volunteers can play an important part in the provision of services: they can back up the statutory agencies, and many can gain great benefits themselves from supporting others.

Given that the Government have cut 50,000 local authority care home beds, and the Department of the Environment's current proposal to remove the statutory requirement for local councils to provide their own care homes, will the Minister explain how his concept of choice applies to elderly people who choose to enter local authority care homes?

Would that some of the local authorities that are run by the hon. Gentleman's party gave individual residents and potential residents real choice. Real choice is informed choice, not just the choice between two local authority homes.

Is my hon. Friend aware that Lancashire has many excellent county and privately run residential homes? Is he further aware that it costs £93 a week or, in total, £10.8 million more to keep people in county-run rather than private sector homes? Should that matter not be looked into so that that £10.8 million could be spent in other ways?

My hon. Friend is right. As I go around the country and see the excellent provision by the independent sector, which is scorned and spurned by some local authorities for ideological reasons, I consider the cost of that provision and I notice, as my hon. Friend says, the savings that could be made. That could provide better quality and, very often, better comfort for individuals, and leave more money to be spent on people in need. Where hon. Members see such a waste of money, I hope that they will unfailingly send the details of it to the district auditor so that it can be considered in his assessment of value for money in local government.

To ask the Secretary of State for Health if she will make a statement about GP fundholders' savings.

Fundholders have achieved efficiency savings of nearly £110 million over the first three years of the scheme. That is about 3.5 to 4 per cent. of budgets set. That money is being reinvested in health services for the benefit of patients. In the hon. Gentleman's constituency, for example, it has been reinvested in physiotherapy services, the purchase of electro-cardiogram equipment machines, more space for doctors to practise and additional nursing cover. I am sure that he will welcome all that.

Why should a minority of family doctors be allowed to sit on what amounts to a huge public subsidy when more than 1 million people are waiting for hospital treatment? What action is the Minister prepared to take to ensure that public resources are made available now for all members of the public, or is he content merely to see the further development of a two-tier NHS?

The hon. Gentleman's expertise in these matters seems to extend no further than Essex, where he finds woks for sale in GP fundholders' premises. I am glad that he has treated the House to something slightly more serious than that. As he knows, those savings are spent on a rolling basis. Plans are not only agreed with the regional health authority but audited on an on-going basis. The money is spent on a year-on-year basis on patient care. I should have thought that, because much of that has happened in his constituency, he might have welcomed it.

Does my hon. Friend agree that the ability to make savings that can then be spent on more and better patient care is one of the main benefits that GP fundholding has been shown to have? Does he further agree that one of the places where that message has been heard loudest and clearest is the region represented by the right hon. Member for Derby, South (Mrs. Beckett), where nearly three quarters of the population have a GP fundholder—twice the national average?

My hon. Friend is quite right. I had the pleasure of visiting the regional health authority that covers that area. It explained how enthusiastic GP fundholders in the right hon. Lady's constituency were in taking up the challenge that the policy offers, and in bringing benefits to their patients. They will understand that it is a policy that, at least until yesterday, we understood that the Opposition were going to abolish.

Does the Minister agree that any benefits available to the patients of GP fundholders should be at least equally available to patients of non-fundholders who join joint commissioning arrangements, such as those that exist in Nottingham? Will he commend joint commissioning arrangements? If any savings are achieved from fundholding, will he consider applying them to the nearly 900,000 people who have been struck off dentists' NHS lists since the previous general election?

The hon. and learned Gentleman raises an interesting point about people who will not join GP fundholding practices, but who provide the benefits by other means. Of course, GP fundholding is voluntary. That is the preferred way of moving forward in a primary care-led NHS. That will continue to be the case, but, if others choose another means and manage to learn from the best practice that has been made available by GP fundholders, I welcome that.

To ask the Secretary of State for Health which administrative posts in the NHS are normally filled by nurses, doctors or other medically qualified persons; which are normally filled by people with other than medical qualifications; and if she will make a statement.

All NHS trust boards. must have a qualified medical director and a suitably qualified nurse as director of nursing. Otherwise, it is a matter for individual NHS bodies to decide what skills, expertise and experience are required.

Does my hon. Friend agree that medical people are best placed to understand the medical needs of hospitals and other facilities in the NHS? Will he make it a priority to appoint them to administrative posts, where their medical experience can be used, and please can we have the matron back in hospitals?

On the last point, many of my hon. Friends used to show a marked predilection for a strong woman in charge. I have no objection to the person in charge of nursing, or of any other responsibilities, being styled as matron or, indeed, patron.

Does the Under-Secretary recognise that not only has the number of those described as general and senior managers quadrupled since the Government's changes were introduced but the pay bill for those posts has trebled? Has the Under-Secretary seen the recent figures produced by the National Health Service Consultants Association, which show that, overall, the administrative costs of the health service are twice what they were before the Government introduced their so-called reforms? At a time when we are constantly being told that there is not enough money to provide essential care, does that not show how the Government waste public money?

I remind the right hon. Lady that a large proportion of the additional managers have been reclassified from their previous posts and the hon. Member for Newcastle upon Tyne, East (Mr. Brown) has admitted as much. I remind her also that half all managers come from a clinical background. If the right hon. Lady is worried about this, she should look to see that activity in hospitals has increased enormously. Outcomes have improved and waiting lists are down as a result of good management of hospitals. Hospitals do not manage themselves; they need good, committed managers.

My hon. Friend's response to the question from my hon. Friend the Member for Ealing, North (Mr. Greenway) was tinged with a certain amount of humour, which is always the case when matron's name is raised in the House. Does my hon. Friend agree that the matron was probably the most important and effective post in hospitals throughout their history? It was a sad day when the post of matron was abandoned. If the Minister wants to do something that will have a major effect on the way our hospitals are run, he could go back to his office this afternoon and write a letter to every hospital in the country, recommending that they reintroduce the post of matron without delay. Will he consider doing that?

Every hospital has the opportunity to recreate the post of matron, and some are doing so.

To ask the Secretary of State for Health what measures she proposes to ensure early specialist appointments following GP referrals.

For the first time, we have introduced a national waiting time standard for out-patient appointments.

After that unsatisfactory reply, will the Under-Secretary consider the effect of the 18-month demand on consultants which is required by the patients charter? Will he look at Withington hospital in south Manchester, where consultants are now writing to GPs saying that, because of that demand, they cannot accept further referrals? That is another hidden waiting list and it is time that the Minister got off his fat backside and started to tackle the problem properly.

The history of waiting lists and waiting times has been a major success of the NHS reforms. All the unacceptably long waits have been removed. Guarantees are being offered for out-patient appointments as well as for in-patients and for those waiting for operations, and the average waiting time has come down from nine to five months. That is a very real achievement.

Is my hon. Friend aware of the re-engineering project that has been carried out at Leicester Royal infirmary, which has enabled out-patients to see specialists and technicians at one place and during one appointment so that GPs receive the answers to their referrals within hours rather than weeks, which was previously the case? Is that not an example that should be followed by other NHS trusts and hospitals?

Yes, I congratulate Leicestershire on its achievement. We hope to encourage exactly that sort of initiative everywhere.

To ask the Secretary of State for Health what new proposals she has to improve mental health care.

A large range of measures for in-patient and community services is being implemented, and our new Mental Health Bill is being considered in another place.

Does the Minister agree that not only are mixed-sex wards unacceptable and distressing to patients, but so are wards which have an unacceptable range of mental ill health? A 22-year-old young woman constituent of mine, who had suffered a nervous breakdown, found herself sharing a ward with people who were deeply psychotic and she was assaulted twice by a young male patient. Is it not utterly unacceptable that our mental hospitals, as a result of the Government's changes, have been turned into places which increase anxiety and stress to staff and patients?

The hon. Gentleman refers to a hospital which is in his constituency in Wales and, therefore, is a matter for my right hon. Friend the Secretary of State for Wales. I understand that Welsh questions were yesterday. I shall, however, answer in the general sense, since the matter applies to English health questions as well. It is appropriate that every health authority in the country should look at its range of provision and ensure that it meets what it assesses locally as being its need. That is what we have been encouraging them to do and that is what they are doing. We are looking for the right mix of acute beds, long-term beds, medium-term beds, low, medium and high-secure beds and a range of facilities in the community. They are being provided in most parts of the country and we are determined that they will be provided in all parts of the country.

My hon. Friend will recall that about 12 months ago, the Select Committee on Health issued a report on these matters, in which it criticised the Government for the delay in implementing the homeless mentally ill initiative and for the lack of co-operation between his Department and the Department of the Environment. Will he assure me that those problems have been addressed and that the provision of housing for the mentally ill under that initiative is proceeding?

Yes. I thank my hon. Friend for his question. He will also recall that the homeless mentally ill initiative has been a remarkable success story, not least because of the outreach teams which have been reaching increasing numbers of homeless mentally ill people. The initiative has also been a tremendous success in providing accommodation, the first stage of which has been hostel accommodation. I have opened a number of hostels around London and I am due to open another one shortly.

Is it not the case that the Government are bringing forward controversial, unpopular and piecemeal initiatives on mental health rather than addressing the real issues such as the diversion of resources away from mental health into other parts of the national health service, the closure of long-stay institutions, the lack of a comprehensive strategy for mental health and the relationship between mental health and homelessness, unemployment and sexual and racial discrimination? Is it not time that the Government addressed the whole matter of mental health and perhaps committed themselves to a complete review of the Mental Health Act 1983?

I do not know where the hon. Gentleman has been. One of the five key parts of "The Health of the Nation" strategy is mental illness. We have been working hard with all the agencies involved to improve the standing of people with mental health problems. He will also know that we have been implementing our 10-point plan over the past 18 months, which has ranged from supervision registers and hospital discharge guidance through the training of key workers to supervised discharge, which is in the Mental Health Bill that is before Parliament.

To ask the Secretary of State for Health what assessment has been made by her Department of the likely savings to be made for the health services as a result of the Health Authorities Bill; and what savings will be made.

To ask the Secretary of State for Health what estimates have been made of the savings resulting from the abolition of the regional health authorities.

The provisions of the Health Authorities Bill, which will abolish regional health authorities and require district health authorities and family health services authorities to merge, will result in annual savings approaching £150 million by 1997-98. Some £100 million of the total savings will result from the abolition of the RHAs and the consequent reduction in the overlap of work between the national health service executive and the regions. All those savings will be retained by the NHS and reinvested in patient care.

I welcome that answer. Can my hon. Friend confirm that the changes will mean that there will be more money available for patient care, whereas Labour's proposals to create strategic health planning would take money away? Does my hon. Friend agree that this is another case in which the right hon. Member for Sedgefield (Mr. Blair) should tell the right hon. Member for Derby, South (Mrs. Beckett) that she has got it wrong again?

I would never presume to tell the right hon. Member for Sedgefield what messages he should give to the right hon. Member for Derby, South. All I notice occasionally is that, when he gives them, she does not pay a blind bit of notice to them; but never mind that. The position set out by my hon. Friend is absolutely right. Of course those funds will be available for patient care. I noted, when the Health Authorities Bill was in Committee, that the Labour party wanted to reimpose bureaucracy and to take the money that would be available for patients away.

Can my hon. Friend confirm that the welcome abolition of Wessex regional health authority is part of a general and consistent assault on bureaucracy throughout the national health service, not least in hospitals themselves? Can he confirm that the savings created from this will go not only to patient care, but to ensuring that consultants working in hospitals can get on with treating patients rather than worrying about paperwork?

My hon. Friend is right. The Government have a consistent record of cutting bureaucracy not only in administering the NHS and the country, but within the Department of Health, in Whitehall and in the NHS executive. Constantly paring away bureaucracy means that funds are released for patient care. That is a proud record, which the Labour party tries to interfere with and upset.

How many additional nurses will result from the savings?

The sum of £100 million a year is substantial. When it is redirected into the purchasing process, it will allow a substantial increase in activity. That figure would represent something approaching—this is a top-of-my-head calculation at the Dispatch Box to which I am sure the hon. Gentleman will not hold me—20,000 cardiac bypass operations. The hon. Gentleman wants to put the figure in the scale of things and to know what it will mean for patients; that is a pretty good try.

This is a refinement of the way in which the Minister answered the question in Committee. As he says that there is extra money to invest in the national health service, will he now explain to the House what the Prime Minister meant last Thursday when he said that there was available in Leeds

"a highly specialised form of treatment"?— [Official Report, 9 March 1995; Vol. 256, c. 454.]

The hon. Gentleman will know that he is distorting my right hon. Friend's words in a ridiculous way. First-class health services are available across the country, not least because the Government have put into place policies that mean that more money is directed straight to patient care than is absorbed by the rest of the service. That is why first-class services are available across the land. It is wrong of the hon. Gentleman to treat my right hon. Friend's remark in that way.

To ask the Secretary of State for Health what discussions she has had with the Human Fertilisation and Embryology Authority about the freezing of human embryos.

Officials of the Human Fertilisation and Embryology Authority are in close contact with those of my Department on the matter. When the authority has reported and submitted its review of current arrangements we shall consider whether further action is appropriate.

In how many cases has contact been lost with the parents of the 30,000 human embryos that have been frozen in the past decade? Will an amendment to the law to prevent those embryos from being destroyed when their shelf-life expires next year be among the proposed courses of action that the Minister has said will be considered? What account is being taken of the evidence published in The Lancet in the past month or so showing that the freezing of mouse embryos has led to mutations occurring in the mice subsequently born?

Clearly there will be many such cases, but the hon. Gentleman must remember that Parliament decided that treatment involving the implantation of embryos should go ahead, and that a feature of such treatment is storage.

Speak up.

Parliament agreed a maximum period of five years for the storage of embryos. That raises many sensitive issues, which is why the authority is now considering the matter.

If the hon. Member for Carrick, Cumnock and Doon Valley (Mr. Foulkes) did not talk so much he might be able to hear the Minister.

Has my hon. Friend had time yet to review the accounts of the Human Fertilisation and Embryology Authority that were published yesterday? If so, did he note that it will receive about 70 per cent. of its income next year from licence fees? Does he not think that that puts the gamekeeper a little too close to the poacher? Is there not an inconsistency here? Can he tell me how many licences have been revoked or withheld in the past year?

My hon. Friend's use of the word "poacher" is inappropriate, if I may say so. I have the highest regard for the people who work for the authority and for the way in which they carry out a very sensitive job. I believe that we are respected throughout the world for having set up an authority to regulate this difficult area, and I know of no reason for any suspicion of a conflict of interests of the sort that my hon. Friend alleges.

To ask the Secretary of State for Health what plans she has to extend general practitioner fundholding; and if she will make a statement.

In October 1994 we announced a major extension of the options for general practitioner fundholding, the development of a community option and the expansion of standard fundholding. In addition we continue to look at other services and other ways to develop the benefits that can be achieved through fundholding. Our aim is to extend the benefits for patients as widely as possible.

Is my hon. Friend aware that although 30 per cent. of my constituents enjoy the excellent services of GP fundholders, none the less that percentage is below the national average? What steps will he take to ensure that my constituents in Sutton and Cheam enjoy the same benefits as other people who are patients of GP fundholders?

I am sure that my hon. Friend will take her own steps, as she regularly does, to ensure that all general practitioners in her constituency are aware that fundholding status is available to them. Under the new scheme, about 85 per cent. of GPs are now eligible for fundholding status, and we fully expect the percentage of the population covered to increase dramatically over the next year or so. We are seeing progress to that end, and we expect that progress to be maintained.

Before extending GP fundholding, will the Minister look back at the answers to the questions that I have asked about it? He replied that he did not hold the information centrally and referred me to the regional health authority and the family health services authority. Is he aware that the regional health authority has given me two different figures covering the constituency of the hon. Member for Sutton and Cheam (Lady Olga Maitland), which in terms of underspending are more than £100,000 apart? For Camden and Islington, the figure given by the regional health authority is almost twice that given by the FHSA. Does the Minister agree that until he can get his house in order, monitor the figures and find out what is happening to the underspend, he should not extend the practice further?

Again, the hon. Gentleman is simply trying to deny the fact that fundholding brings additional benefits for patients, and I am surprised that Opposition Members have not caught up with the news.

It is a fiddle.

The hon. Member had better not say that to the Leader of the Opposition, as the Labour party has now changed its policy on the subject.

As more than 90 per cent. of my constituents will soon be enjoying the benefits of being treated by GP fundholders, does my hon. Friend agree that they will find the remarks of Opposition Members—particularly the hon. Member for Rotherham (Mr. MacShane)—deeply offensive? Does he agree that total fundholding as practised originally in Bromsgrove and now being extended to Bewdley in my constituency is a way forward to make GP fundholders the real gatekeeper of health services and to ensure that those services reach ever-higher standards for patients?

My hon. Friend is right. I have visited a number of total fundholding pilot projects, including one in Bath last week which will get under way on 1 April. They are exciting projects that must be evaluated, but remarkable achievements have already been recorded by projects that are under way. Progress to date has been extremely good.

Is the Minister aware that we receive literally dozens of letters from GPs protesting that, under instructions from Ministers, managers in their areas are attempting to browbeat them into becoming fundholders whether they wish to or not? That view is reflected in a survey in Pulse, which shows that 71 per cent. of GPs do not wish to become fundholders. Has the Minister seen the advertisement that has been placed in East Anglian newspapers by 32 GPs in Suffolk who are not fundholders? The advertisement states that the GPs are saving the Treasury more than £200,000 a year, and that not one penny of that money is available for patient care. Why is the Minister trying to force people to become fundholders when the practice is unproven, inequitable and very expensive?

That is marvellous, because the Leader of the Opposition is trying to force the right hon. Member for Derby, South (Mrs. Beckett) to support fundholding practices. We did not hear the right hon. Lady say today whether she agrees with the change in Labour party policy.

In my hon. Friend's busy day—[HON. MEMBERS: "Hear, hear."] I am grateful for the applause. Will my hon. Friend take time to be magnanimous and act as a mediator between the right hon. Member for Derby, South (Mrs. Beckett), the Leader of the Opposition and, I suspect, the deputy leader of the Labour party—

Order. The hon. Gentleman must ask a question that relates to ministerial responsibility.

This is precisely to do with GP fundholders and NHS trusts, because the right hon. Lady wants to get rid of them while the Leader of the Opposition wants to keep them. Will my hon. Friend help the right hon. Lady out?

I am always prepared to be magnanimous, but I am afraid that I am not prepared to be quite as magnanimous as that.

To ask the Secretary of State for Health how performance-related pay will be calculated for NHS employees; and if she will make a statement.

These are matters for local determination by national health service employers, having regard to the contributions made by staff to high-quality patient care.

Does the Minister realise that performance-related pay is totally inappropriate to the health service and that the practices of the supermarket and the office floor cannot be applied to doctors and nurses, whose jobs are to care for patients and to save lives? Whatever happened to the promise made by the then Minister of State on 23 November 1994 that the Government had no intention of introducing performance-related pay into the health service?

The hon. Gentleman will know that there are plenty of precedents in the health service, such as merit awards for senior medical staff. It is absolutely right that local employers should have the maximum freedom in how they spend the larger part of their resources, which is for salaries. We have given trusts the freedom to make decisions. One of those decisions is on pay.

The Minister compares merit awards with performance-related pay. The former is based on comparison with peers and we can understand why it is done, but may we have some definitive, objective guidelines on how performance-related pay can operate in the health service? Will it mean that the more patients a trust gets through the door the more people will be paid? Is that performance-related pay?

It is up to each trust to make those decisions. I remind the hon. Gentleman that some 60 trusts have already published offers between 1.5 per cent. and 3 per cent., as recommended by the pay review body. The majority of offers are at the higher level. I expect that trend to continue.

To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

I have been asked to reply.

The visit of the Prime Minister to the Gaza strip and the donation of equipment and aid are to be welcomed, but why have the Government chosen to donate police equipment when the entire community could have benefited from the excellence of British manufacturing facilities to provide clean water facilities, better health facilities and educational facilities?

The hon. Lady clearly was not listening. I said that a large delegation of British business people was with the Prime Minister precisely to see whether we can help with the kind of opportunities to which she refers.

Does my right hon. Friend share my disgust at the blatant and continued misrepresentation by press and media of the case of the 10-year-old leukaemia sufferer? Is he aware that Cambridge health authority's decision to refuse treatment had nothing to do with money but was taken because the overwhelming number of doctors and specialists were not prepared to inflict further suffering on that poor little girl?

It certainly has been made clear by the health authority that funds would have been available if the view of the doctors responsible had been that treatment would have been in the best interests of the child. It is first and foremost a matter of clinical judgment. I think that, however sad, that should be acknowledged. The other thing that should be said is that the whole House will want to wish the girl well in the treatment that she is undertaking today.

rose—

Hear, hear.

Order. That is a warm enough welcome.

Can the Leader of the House confirm the leaks that are emerging from the Prime Minister's tour of the middle east that the Greenbury committee proposes to recommend absolutely nothing to curb the greed of the bosses in the privatised utilities?

What I can confirm is that the Prime Minister and, indeed, all my right hon. Friends have made it clear that they attach importance to the work of the Greenbury committee and that they will want to study its conclusions with care and then consider whether it would be appropriate to make any legislative change.

Whatever the right hon. Gentleman may say, is not the Prime Minister's support for legislation against pay excesses a sham? Only yesterday the President of the Board of Trade once again defended boardroom greed. When will the Government realise that people in Britain want a fundamental shift so that power, wealth and opportunity are in the hands of the many and not the few?

It sounds to me as though the right hon. Gentleman will need to undertake another rewrite of clause IV before the ink on this one is dry.

Last December, our right hon. Friend the Prime Minister stated that Ministers would not talk to Sinn Fein-IRA before huge amounts of weapons were surrendered. This morning, I received a letter from our right hon. and learned Friend the Secretary of State for Northern Ireland stating that talks would take place with Sinn Fein-IRA before weapons were handed in. Which is current Government policy?

My hon. Friend has indeed received a letter from my right hon. and learned Friend today. I have a copy of it before me. It makes it absolutely clear that, before Ministers will engage in talks in the way that Sinn Fein currently seeks, there must be a clear and reliable assurance from Sinn Fein that constructive discussion, especially in achieving substantial progress on decommissioning arms, would be facilitated and accelerated by Ministers joining that dialogue. No such assurance has been received, and I think that what is being said and done is entirely consistent with what my right hon. Friend the Prime Minister and my right hon. and learned Friend the Secretary of State have said before and, indeed, with what is sensible and practicable in seeking a way forward in Northern Ireland.

To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

I have been asked to reply.

On executive pay, will the Leader of the House admit that the public know that the Greenbury committee is a con, because it is full of the very fat cats who are earning millions of pounds, who are protecting their own pay and positions? Does he not realise that asking that bunch to legislate to curb excesses of executive pay is like asking Dracula to guard the blood bank?

The answers to the hon. Lady's questions are no, no and no, in that order.

Would my right hon. Friend care to speculate on the possible reasons why the historic commitment to full employment, endorsed by generations of Labour party members, has now been abandoned by the right hon. Member for Sedgefield (Mr. Blair)?

It is perhaps not for me to speculate about the causes of Opposition policy changes, but, if I were driven to do so, I would venture the opinion that the penny has finally dropped that their commitment to a minimum wage, a social chapter and a further renewal of trade union powers is incompatible with full employment.

To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

I have been asked to reply.

Will the Minister note that the former and the present Secretary of State for National Heritage have not replied to the Select Committee on National Heritage report, "Privacy and Media Intrusion"? As it is now exactly two years since the Select Committee presented its report, why have the Government have failed to respond to it? What is he afraid of, and will he apologise to the House for the delay?

I have no doubt that my right hon. Friend the Secretary of State for National Heritage will seek to reply as soon as the very difficult issues involved have been thoroughly considered and studied.

Does my right hon. Friend agree with the hon. Member for Hackney, North and Stoke Newington (Ms Abbott) that the rewritten clause IV is 400 words of waffle—(Interruption.]

Order. I have been very tolerant today, but I remind hon. Members that we holding the Executive to account for their policies, not for the policies or the activities of any other party. If the hon. Lady can rephrase that question, I will give her an opportunity to do so, but she must seek to bring the Government to account.

Does my right hon. Friend agree that, if we were ever to have a clause IV, it would not contain 400 words of waffle?

I am afraid that my hon. Friend's question was slightly lost in Opposition Members' baying. I am certainly aware that the hon. Member for Hackney, North and Stoke Newington (Ms Abbott) has described the new clause IV as 400 hundred words of waffle. It is absolutely clear that it takes us no nearer to what we really need: some clarification of Labour's policies.

To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

I have been asked to reply.

We can understand the reluctance of the Leader of the House to answer questions about executive pay and share options, so perhaps we can move the debate forward a little. Do the Government intend to devolve other areas of Government policy to sub-committees of millionaires appointed by the CBI? Will the recommendations of those committees be final and, if so, is that what is meant by the "smack of firm leadership" from the Government?

I do not think that I have shown any reluctance to answer the questions—it is just that Opposition Members do not like my answers. As the main thrust of the question refers to a matter that is principally for shareholders to decide, it seems entirely correct to consult and to take the views of such a committee.

Will my right hon. Friend join me in welcoming the news that prizes from the national lottery now amount to almost £500 million? Is it not excellent news that a substantial amount of money has been allocated to the good causes supported by the lottery?

Indeed it is very good news. The national lottery is certainly giving pleasure to many people and it is yielding both large prizes for the winners and large amounts of additional money for the arts, sport, heritage, charities and the Millennium Commission. It has been a huge success, which is very much to the credit of my right hon. Friend the Prime Minister, and I think that that success will continue and will grow.

To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

I have been asked to reply.

On executive pay, will the Leader of the House answer the question of my right hon. Friend the Member for Kingston upon Hull, East (Mr. Prescott) and explain what the Government intend to do about it? What sort of Prime Minister says that he finds something distasteful but then says that he does not have the first idea of what he wants to do about it and simply leaves it to the CBI to tell him what Government policy should be? What sort of Government do that?

What the Government are going to do is what I have said at least twice this afternoon and what my right hon. Friend the Prime Minister has said on many other occasions: we will study the recommendations of the Greenbury committee with care and we will then decide what action to take, including the possibility of legislation if that seems appropriate.

Does my right hon. Friend agree that President Clinton's decision to meet Mr. Adams on Thursday and to allow Mr. Adams to raise funds on behalf of Sinn Fein-IRA is a grave blow to the United States' special relationship with this country, and indeed to the cherished links with the Republic of Ireland and the majority of the Irish people who are opposed to Mr. Adams's violence and terrorism?

My hon. Friend will know that my right hon. Friend the Prime Minister has made his views very clear to the President. The United States Administration are in no doubt about our views. I hope that everyone will now acknowledge that it is important to maintain pressure on Sinn Fein from all sides to engage in substantive constructive discussions along the lines that my right hon. and learned Friend the Secretary of State for Northern Ireland has indicated. I hope that the need for Mr. Adams to engage in such constructive and substantive discussions will be emphasised firmly and vigorously in any meetings with the United States Administration.

To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

I have been asked to reply.

In view of the fact that most independent jurists do not consider the courts of Singapore to be independent of the Executive and in view of the desire for a full judicial spotlight on the Barings affair in London, will the Leader of the House assure us that every effort is being made to extradite Mr. Nick Leeson from Germany so that he can stand trial in London?

The House will understand that I do not think it right to get drawn into commenting from the Dispatch Box on the legal position in other Commonwealth countries. The Government are determined to make every effort to ensure that the Barings events are properly and thoroughly investigated and that appropriate action is taken in the appropriate courts.

To ask the Prime Minister if he will list his official engagements for Tuesday 14 March.

I have been asked to reply.

Is my right hon. Friend aware of a letter of appreciation that I recently received from an Anglican clergyman in my constituency, who does not often support the Government's policies but who greatly appreciates the education that his daughter has received as a result of the assisted places scheme? He knows of many other low-income families in his parish whose children have benefited in the same way. How shall I respond to my constituent's request to learn whether the assisted places scheme has a future and whether it is safe?

I am sure that my hon. Friend is right that not only his constituent but many thousands of other parents throughout the country welcome the assisted places scheme, which has provided an excellent education in independent schools to many able pupils from low-income families. It has been outstandingly successful. The assurance I can give my hon. Friend and his constituent is that the assisted places scheme is safe under us. It is certainly not safe under the Opposition.