To ask the Secretary of State for Health what recent consultations she has had concerning the provision of hospitals in south-west London. [22851]

Local health authorities, national health service trusts and general practitioners in south-west London are considering the future provision of hospital services in the area.

Does my hon. Friend accept that although the London borough of Merton does not have a general hospital within its boundaries, thanks to Government reforms it already has unrivalled access to three excellent national health service hospitals, St. George's hospital, St. Helier hospital and Kingston hospital? Does he agree that the picture would be completed by the exciting new plans to rebuild the Nelson hospital in Wimbledon, so that my constituents can have access to the highest quality day surgery and out-patient care?

My hon. Friend has been a staunch advocate of that proposal. It is intended that the review of specialist services, which is under way, will improve services across the area that serves my hon. Friend's constituency. I am sure that his points will be borne in mind by all concerned.

As London has half the number of health centres per person of other major cities in England and fewer GPs, health visitors and district nurses than it had in 1990, and as there has been a decrease of 2 per cent. in the number of GPs per head of the population in inner London in the past decade, how can the Minister claim to be presiding over a shift from hospital services to primary care? Surely he is getting rid of beds without providing alternative services.

As it is essential to provide excellent health care in London, combine specialist services, improve primary care and continue the Government's investment in primary care, such as the £210 million investment in the London implementation zone scheme, why do the hon. Gentleman and his party want to stop all that in its tracks and call for yet another review?

To ask the Secretary of State for Health if she will make a statement on the shortage of staff in consultant specialties in the health service. [22852]

In the five years to 1993, the number of hospital consultants in England increased by an average of 3 per cent. a year, well above the target of 2 per cent. set in 1987. Over the same period, the number of consultants in Northern Ireland increased by 12 per cent. The Government have established effective mechanisms to ensure that consultant numbers continue to expand to meet demand.

If the Government are controlling numbers to meet demand, why are there continuing shortages, particularly among anaesthetists and paediatricians, which mean that operations have been cancelled? Is someone in the Department using new maths and not counting correctly? Is it job protectionism, or are hospitals saving money at the cost of patient care?

I explained that there has been a substantial increase in the number of consultants, but there are always times when there is particular pressure on certain categories. That is why we have set up a working arrangement with the professions, whereby one committee can monitor and anticipate where there is particular pressure. The hon. Gentleman will be pleased to know that, for example, in paediatrics there was a 5.5 per cent. increase in consultants and in accident and emergency there was a 6.7 per cent. increase. The increase has been above average in both those specialisms.

Will my right hon. Friend confirm that the Government are committed to increasing the number of medical students and have taken on board the recommendations to that effect by the Medical Workforce Standing Advisory Committee? Will she also comment on the training of doctors? Can she say anything further about the implementation of the Calman changes?

I can indeed inform my hon. Friend that, having not only published the first report of the Medical Workforce Standing Advisory Committee but acted on it, we shall shortly produce the second standing advisory committee report. We train about 500 more medical students a year than we did 10 years ago and we anticipate further increases. My hon. Friend referred to the important Calman proposals to improve and accelerate specialist training. We are working on their detailed implementation, from which future generations of consultants will greatly benefit.

Is the Secretary of State aware of public alarm at the number of casualty departments being temporarily closed—including at least five in London? Is she further aware of concern that—

Order.

Order. The question has already been widened.

Is the Secretary of State aware that those closures might be due to staff shortages or, more likely, to the Government's policy of permanently closing casualty departments? What guarantee can she give London in particular that such closures will not recur?

The hon. Lady identifies an area of special focus—accident and emergency departments—in which there has been an 11.1 per cent. increase in consultant appointments because it is moving towards a consultant-led service. That is precisely what underpins the move to larger A and E departments associated with minor injury centres. Junior doctors will increasingly want to staff areas that offer an A and E service according to best practice—well staffed, well equipped and of significant size.

Does my right hon. Friend agree that consultant numbers have increased well ahead of target? Will she join me in congratulating North Hertfordshire NHS trust based at Lister hospital on the appointment of a new audiology consultant in September which, together with the new magnetic resonance imaging scanner later this month, will make a huge contribution to improved patient care for my constituents?

I join my hon. Friend in congratulating his trust, which is a classic example of how trusts have used the opportunities of their status to improve patient services and make them more responsive. I confirm that there have been an extra 300 consultants a year for the last four years. We intend to maintain and improve that impressive record.

To ask the Secretary of State for Health how many hospitals there were in England in 1979, April 1991 and December 1994. [22853]

In 1979 there were 2,023 hospitals in England, and in 1991 there were 1,624. For 1994, NHS Estates, using a different basis of calculation, has estimated the number at 1,440.

Have not 245 hospitals closed since 1990—one per week since Conservative health reforms were introduced? Does the Minister agree that as a result of record waiting lists, hospital closures and bed losses, the NHS is at breaking point in many parts of the country? Operations have been cancelled, specialist beds have been unavailable and there has been the unholy sight of many people on trolleys waiting hours in casualty departments.

If the hon. Gentleman were to look at his own constituency, he would see a different picture from that which he painted. In 1989–90, there were 560 waiters over two years; in 1995, there is none. In 1989–90, there were 214 two-year waiters; in 1995 there is none. Investment projects totalling £17 million are under way in the hon. Gentleman's constituency. Of course there have been a number of closures, but substantially better facilities have been put in their place. Why does not the hon. Gentleman recognise that when it is happening in his constituency?

Is my hon. Friend aware that people in my constituency have warmly welcomed the closure—regrettable though it is in some respects—of the oldest hospital in Britain, St. Bart's, and of All Saints hospital, the former workhouse? It is shortly to close, almost entirely owing to the large investment put into the Medway hospitals complex, which will provide unrivalled modern facilities. Does he agree that this counting of hospitals is meaningless?

My hon. Friend is quite right. The purpose of the health service reforms was to allow services to be provided closer to people. That is precisely what my hon. Friend points out in respect of the reconfiguration of services in his constituency.

Does the Minister accept that we are pleased to learn that he has found out some facts about hospitals, as it is not long since he told us that he did not know how to define one. I hope that that means that the questions that we table will in future be answered. Does he nevertheless accept that there is considerable concern in many parts of the country about the pace of change, and that when Ministers say, as they repeatedly do, that they do not know what is happening in terms of the provision of hospitals and do not know which hospitals or A and E departments are at risk, they add to that concern?

The right hon. Lady is well aware that these matters are decided locally. When they are disputed or objected to by community health councils, they come to Ministers for decision. Hence a tremendous amount of reconfiguration of service and change is going on around the country by local agreement.

To ask the Secretary of State for Health what guidance she offers to local authorities in assessing the means of persons in need of residential and nursing home care; and what plans she has to amend the figures on which such calculations are based. [22854]

Comprehensive guidance was issued to local authorities in December 1992 and is regularly updated.

At present, anyone with capital of more than £3,000 is expected to contribute towards the cost of his care, and anyone with more than £8,000 has to pay in full. Will my hon. Friend confirm that the figures were inherited in 1993 from the income support system and have not been altered since? In fact, they date back to 1990. Does he agree that they are perhaps due for review?

My hon. Friend's statement of the figures is correct. They were brought into line with income support figures in 1993, when the threshold was raised from £1,200 to £3,000. We do indeed keep the figures under review and will continue to do so.

Is the Minister aware that literally thousands of people are terrified that they will become so frail that they will be removed—forcibly, if need be—from an NHS bed and sent to a private home, leaving their families unable to make up the difference between the fees and the amounts available? That not only frightens large numbers of people but implies that the system is on the verge of breaking down.

I refer the hon. Lady to the guidance that we recently issued on continuing care and on discharge; and to one of the conditions of the special transitional grant—that there should be agreement between the social services and hospitals. There has been no change to the system for charging introduced in 1948 by the then Labour Government. This Government introduced the discretion and the requirement that the value of the house be ignored for spouses and other members of a family who may remain at home.

Will my hon. Friend publish the results of his review? As my hon. Friend the Member for Chislehurst (Mr. Sims) has made clear, in parts of outer London, such as my constituency of Ruislip-Northwood, a place in a residential nursing home can cost several hundred pounds a week, which can lead to a spouse eventually having to sell the family home, causing great distress over and above that of looking after the sick patient. Will my hon. Friend publish the review and re-examine the criteria?

There is no review as such. I said that we kept the matter under review. If we decide to make a change, we shall announce it. However, I can reassure my hon. Friend that, where a spouse remains at home, there is no question under this Government of that spouse being turned out of the family home. That is precisely the requirement that we put into law which was not there under the previous Labour Government. We have also given the discretion to enable that spouse to remain in the family home according to the standard of living to which he or she has been accustomed.

Does the Minister accept that people with on-going medical needs are being pressurised to move from hospitals into private nursing homes because of the in-built financial structure of the health care authority and its lack of beds? Surely anyone with an on-going medical need should be able to stay on in an NHS hospital.

The hon. Gentleman is correct. If someone is deemed by a doctor to have a continuing in-patient health care need, that should be provided by the NHS, whether in a hospital or a bed purchased by the NHS. It is only if doctors decide that there is no longer an in-patient health need that a patient will be discharged into the community where the community health services will continue to be free to that individual. However, as has been the case since 1948, the social care needs would be paid for by the individual unless that individual's income warrants support by previously the benefit and now the community care system.

Does my hon. Friend recognise that there is considerable concern among elderly people and their relatives that the family home, for which they have saved over many years, may well have to be sold? Will my hon. Friend urgently and radically consider proposals to exempt such homes?

My hon. Friend is correct to raise the concern of his constituents. I am happy to give him the assurance that we will continue to review the situation to ensure that the family is looked after. We already have in place assurances that we can give to families, and to spouses in particular, and now we must consider whether the figures that are in place are still adequate to meet the needs.

Does the Minister recall that one of the key objectives of the assessment process was the avoidance of unnecessary institutional care? Is it not a fact that many people are still being placed unnecessarily in care homes because of the requirement to spend the bulk of the community care grant in the private sector? Will the Minister make it clear which is more important—the proper assessment of individual needs or propping up the private care market?

Yet again, we see the naked hostility to the private sector that has been so apparent from the Labour party ever since we introduced the community care policy. It is clear that the assessment of the individual is central to community care. The individual takes part in that assessment and the individual and the individual's carers take part in discussions on how to meet the needs of that assessment.

To ask the Secretary of State for Health what proportion of elective surgery is now carried out on a day-case basis. [22855]

Half of all elective surgery is done on a day-care basis.

In the light of that excellent answer, will my hon. Friend pay tribute to Croydon's Mayday healthcare trust? More than half its non-urgent surgery is carried out on a day-care basis, and it has just opened a brand-new paediatric day-case unit. Does my hon. Friend realise that, if he had listened to the Opposition last week, all that would have been put in jeopardy? Is it not the Conservative party that is looking forward, and the Labour party that is looking backward?

I can confirm that 90 per cent. of cataract operations carried out at the Mayday hospital, 73 per cent. of arthroscopies and 54 per cent. of laparoscopies are performed on a day-case basis. That is good news for patients in my hon. Friend's constituency, and I am glad that he has endorsed and paid tribute to what has been a central policy in my Department.

When the Minister gives figures showing an increase in day-case surgery, does he take into account the extra work load for nurses? Does he not feel just a little ashamed of the fact that those who have made that increase possible are now balloting on whether to take industrial action?

Nurses do a wonderful job in day-case units, and it is right and fitting for their pay to reflect that.

To ask the Secretary of State for Health if she will make a statement on the provision of night time services by general practitioners. [22856]

Night-time services provided by family doctors are integral to British general practice. On 20 April, after discussions with general practitioner leaders, we proposed changes to strengthen services by increasing the support for local GPs working together to offer high-quality care to patients in their area.

No doubt my hon. Friend is aware that the number of night visits by GPs has more than doubled in the four years to last year. Is he fully satisfied that the proposals that the Department has put to the BMA—on which it will vote in the next few days—reflect that fact? How satisfied is he that the BMA will accept what is, on the face of it, a very reasonable proposition?

It is perhaps not surprising that, when the hours of night cover were extended some years ago, night fees and the number of night visits increased. About 50 per cent. of the increase in visits is attributable to that increase in hours of cover.

If the services are satisfactory, will the Minister condemn, and take steps to stamp out, the practice of hotels charging their residents for night-time visits when they are taken ill on the ground that national health service provision is inadequate and private doctors must be called in?

There is nothing to prevent anyone who is resident in either a hotel or private premises from making his or her own arrangements to seek emergency care.

Is my hon. Friend aware that there is, in general, great satisfaction in Wolverhampton about the way in which GPs provide night-time services? Will he pay a sincere compliment to the hon. Member for Wolverhampton, South-East (Mr. Turner)? For 20 years, in all his observations about matters connected with the health service, the hon. Gentleman has screamed that there is a crisis, and has said that the best way of dealing with that crisis is to spend a large amount of someone else's money. Is he not to be commended for the splendid consistency of his views?

His consistency is the equivalent of others who cry wolf too often and eventually get ignored. My hon. Friend makes a good, substantive point—that care in his constituency is good. The proposals for GP out-of-hours cover are designed to improve on that, to reduce the burden on medical practitioners who wish to undertake fewer night visits and to ensure that the quality of care for patients is improved during that important period when they need to call on medical services.

To ask the Secretary of State for Health what research her Department has undertaken into the administrative costs of general practitioner fundholding; and if she will make a statement. [22857]

The management costs of general practitioner fundholding are kept under regular review. In the first three years of the scheme, general practitioner management costs were about 2 per cent. of budgets, which represents excellent value for money for the very real benefits to patients resulting from the scheme.

I am sure that the Secretary of State is aware that the magazine Fundholding, which can hardly be said to be unsympathetic to fundholders, has estimated that the amount spent on setting up the scheme and on administration was £98 million, and that the average cost per fundholding practice is more than £80,000. There is also plenty of research to show that this is a much more expensive way of purchasing for district health authorities. Does not she think that the money should have been put into patient care and not into creating an expensive administrative system?

I do not agree with the hon. Gentleman. I believe, as does the King's Fund, that fundholding has been one of the most exciting aspects of our health service reforms. I recommend to the hon. Gentleman the words of the National Audit Office, the Organisation for Economic Co-operation and Development and Professor Howard Glennerster. They have all confirmed that fundholding has made care much more responsive to patients. The amount spent on management is modest compared with the substantial improvements in patient care and the better value for money that has been achieved by the scheme.

Is my right hon. Friend aware that in Lincolnshire well over 50 per cent. of patients are now treated by fundholding general practitioners? Is not that a remarkable tribute to the popularity of fundholding among GPs and patients, and does not it vindicate the Government's decision to go ahead with this proposal despite the consistent opposition of the Labour party?

I commend the example of Lincolnshire, but perhaps the most interesting example is to be found in Derbyshire. In Derby, South, 78 per cent. of the population have fundholders. That shows how persuasive is the Opposition spokesman on health with her local general practitioners, all of whom totally disregarded her words and decided that there were benefits for their patients by taking up the fundholding option.

Is the Secretary of State aware that managers in some parts of the country are said to be insisting that general practitioners become fundholders and are refusing to provide financial or administrative support to groups of GPs who want to become commissioning GPs although that is a much less expensive and more effective system? Those managers claim to be acting on instructions from the Department of Health. Why?

Let me make it clear that fundholding is and will remain voluntary. Undoubtedly, fundholding offers much more direct control to the general practitioner for securing, commissioning and monitoring services than joint commissioning. Joint commissioning clearly has a part to play, but in our view it is not as effective as proper GP fundholding. As the right hon. Lady will know, we have now set up 51 total fundholding projects which are being carefully evaluated to see what further lessons can be learned.

Does my right hon. Friend agree that GP fundholders are delivering a clear benefit to all patients in their areas? Does she further agree that the waiting time for the patients of GP fundholders tends to be shorter and that the opportunity for a better and more varied service in the surgery is greater?

I very much agree with my hon. Friend. I hope that he agrees that waiting time for all patients is shorter. Before the reforms there were 200,000 one-year waiters and he will know that there are now only 31,000. That affects all patients, irrespective of whether they have GP fundholders. It is right to say that the Opposition do not care. They do not want to know the facts because they might get in the way of the rhetoric. I agree not only with my hon. Friend but with the OECD that GP fundholders have been more prepared to challenge hospital practices and demand improvements. The National Audit Office states:

"the direct involvement of general practitioner fundholders in health care purchasing has led to improvements in the service provided for their patients".

To ask the Secretary of State for Health if she will make it her policy that the accident and emergency department of Broadgreen hospital will not be closed until adequate alternative facilities are made available. [22858]

It already is.

I am delighted to have that assurance. The Minister will be aware, however, that at the turn of the year the accident and emergency department has almost closed perforce due to lack of recruitment of qualified staff. He will also be aware of leaked reports that it was to be closed on 31 July when the contracts of staff recruited in crisis came to an end. Will he ensure that steps are in place to ensure that Broadgreen accident and emergency department is fully staffed to remain open after 31 July? Otherwise, my constituents in Knowsley, South will continue to live in fear and suspicion that the trust in which they have no trust is trying to engineer the closure of the department before adequate facilities are in place.

The hon. Gentleman's constituents can have trust in the trust. One has to consider only the brand new A and E department at Fazakerley hospital, the largest and best equipped not only in this country but in Europe, the £2.7 million extension to the Royal Liverpool University hospital A and E department, and the new £9 million critical care unit at St. Helens and Knowsley hospital, to be completed in April 1996. The pledge is there that the A and E department at Broadgreen hospital will not be phased out until those facilities are in place.

To ask the Secretary of State for Health when she last met the chairman of the National Blood Authority to discuss rationalisation proposals. [22859]

Ministers meet the chairman of the National Blood Authority regularly.

The Minister will be aware of the national blood transfusion service's continued difficulties consequent upon those rationalisation proposals, the latest of which is the purchase by the NBA of blood-testing kits which are regarded as inferior for HIV and hepatitis testing and are banned in many countries. In the past few months, the level of blood donations has decreased in this country, staff employed in the blood transfusion service have been completely demoralised, many skilled staff have left the service and, above all, there has been a complete loss of public confidence in that precious service. Will the Minister advise the chairman of the NBA to abandon the rationalisation proposals once and for all?

I am aware of a continuing attempt by the hon. Gentleman to make his political name by undermining the blood service—[Interruption.] He has continually claimed that blood donations are down, when they are holding at the level of last year. Demand for blood has gone up by 4 per cent. and donations have gone up by 5 per cent. As he knows, the plans to rationalise the blood service are to do with that fact that it has always been run regionally, so there is too much processing and too much testing. We must reduce those overheads on the service.

Does my hon. Friend agree that blood centres must be run for the benefit of the donors who give their blood freely and the teams who so devotedly serve them? Does he further agree that nothing whatever in the consultation document, or in anything that Sir Colin Walker has subsequently said, militates against that? Will he further emphasise his comment that the Opposition's political agitation is causing great dismay and is unnecessary?

I confirm that, whatever happens, specialist services, such as the anti-D donors, are being retained in Lancaster. My hon. Friend is right: the allegations have been attempts to be undermine the confidence of donors, but they have failed.

To ask the Secretary of State for Health what plans she has to change the way in which statistics are collected for publication on activities in the NHS. [22860]

There are no specific major changes in prospect, but each statistical return is reviewed at least once every three years, and every item is subjected to rigorous examination.

Many people will be disappointed with that reply because a strong case exists for radically overhauling NHS statistics. For instance, does the Minister agree that we should publish statistics on the readmission of patients to hospital so that we can measure the quality of the care that they receive there, the success of the treatment and the availability of good quality community care?

The hon. Gentleman is aware that in England we went over from deaths and discharges to a system of finished consultant episodes some years ago. Wales did not follow at that time, but it is now setting up a patient episode database which roughly mirrors our system. That is good news because the new Körner statistics are a proper measure of patient activity.

Does my hon. Friend accept that, however the figures are collated, there is strong evidence of a shortage of beds in London for the mentally ill, as was discussed in the Adjournment debate last Wednesday?

We are making considerable progress in the provision of intermediate beds and in all other areas of mental health. The Under-Secretary of State, my hon. Friend the Member for Battersea (Mr. Bowis), has replied to such debates on numerous occasions and has explained the plans that are in place to ensure that we improve mental health services everywhere in the country.

The Minister used statistics to defend the Secretary of State's reputation and to obscure the real information about patient care, which only goes to prove that Disraeli was right about statistics. Will the Minister now undertake to publish figures for the number of patients treated by the NHS and not what Ministers' jargon calls finished consultant episodes?

I begin by welcoming the hon. Lady to the Opposition Front Bench at Question Time. Unless we have reliable statistics which show the activity all over the health service, we do not know what is happening. There is no point in relying on individual incidents which are entirely unrepresentative of the health service, as the hon. Lady and her friends in the press continually do.

Is not the reality that the Opposition parties wish to change the way in which statistics are calculated because they are horrified at the number of additional patients being treated every year and appalled by the fact that waiting lists are falling and the only way they can achieve bad statistics is by changing the basis on which the statistics are collected? Can my hon. Friend confirm that in my constituency we have no patients waiting for more than 12 months for an operation? Is that not the statistic that really matters?

My hon. Friend is right. If one ignores the fact that 120 patients are being treated now for every 100 treated before the reforms, which is an embarrassing statistic for the Opposition, it is impossible to measure the success of the reforms.

To ask the Secretary of State for Health how many (a) hospital beds and (b) hospitals have been lost in London since 1990. [22861]

The number of acute hospital beds in greater London has been reduced by around 1,900 between 1990–91 and 1993–94. The equivalent figure for inner London, including the special health authorities, is around 1,000. Information on the hospitals that have closed is not held centrally.

Given that a ward has recently closed in Hornsey central hospital in my constituency without consultation and that waiting lists have increased by 7 per cent. in the Whittington hospital, which also covers my constituency, does the Minister now accept that, although the Government may have won the vote last week, they did not win the argument in the House or with the people in London or in the constituencies?

I will tell the hon. Lady what we did win last week and that was a vote for better health care in London, for bringing specialist medical care together on fewer sites, and obtaining better value for money and a better quality of health care. We made some progress towards improving London's health care in both the acute and primary care sectors and the Opposition want to call a halt to that progress.

Does my hon. Friend accept that for many of us what is important is not the number of hospitals or beds that are closed but the number of patients treated? In view of the extra primary care being offered, the number of day care patients being treated and the number of patients dealt with by general practitioners, would it not be extraordinary if the number of hospital beds stayed exactly the same?

My hon. Friend is quite right. The relevant statistic is the number of people treated. What is important is the amount of activity in the health service, not the simple number of beds. As for London, there is no bed target. It is up to individual health authorities to determine from time to time how many beds are necessary to provide care for the people living in their area. My hon. Friend is also right to point out that the Labour party is obsessed with the bricks and mortar of the health service, whereas we want to improve patient care.

To ask the Prime Minister if he will list his official engagements for Tuesday 16 May. [22881]

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

As the vast majority of the British public want to see the accounts of political parties open to maximum public scrutiny, will the Prime Minister join Labour in calling for the Nolan committee to examine all aspects of party political funding? Or what has he got to hide?

As the whole House knows, within the past 18 months the Home Affairs Select committee conducted a full inquiry, into these matters. Subsequent to that inquriy, the conservative party has implemented in full the code of practice drawn up by the Committee. The Labour party has refused to do so.

Will the Prime Minister take an early opportunity to point out to the public that almost every country in Europe has had to put up taxes to deal with the effect on deficits of the recession? Will he also point out that, every after recent tax increases, the tax burden in this country in the 1990s will be lower than it was in the 1980s, just as it was lower in the 1980s than in the 1970s, including deficits? Will my right hon. Friend also point out that, thanks to Conservative Governments, this country has by a long way one of the lowest tax burdens in Europe?

rose—[Interruption.] My right hon. Friend is entirely right—[Interruption.]

Order.

I commend to hon. Members opposite the excellent speech that my right hon. Friend made on this matter on Friday last week. As a result of the recovery, and despite the tax changes that we were compelled by the recession to make, households will actually be about £250 a year better off on average after tax and inflation this year.

Given the latest pay and perks scandal in the utilities at the weekend and today's massive rise in electricity profits, does the Prime Minister recognise that the utilities have degenerated into an unseemly racket and that the sooner he orders a thorough overhaul of their system of regulation the better? [Interruption.]

Order. I will have no more barracking from sedentary positions by individual Back Benchers. They will be named the next time.

Everyone wishes to see consumers protected. That is precisely why we have regulators to control prices and why, when necessary, the regulators have acted to control prices. Utility prices have fallen during the period of privatisation.

Will the Prime Minister confirm the following? Electricity prices in real terms for domestic households have risen since privatisation, as the House of Commons Library confirmed this morning; water charges have risen by more than 40 per cent. since privatisation; gas complaints are up by 150 per cent. in the past year—[Interruption.] He can cap rail fares only by promising an open-ended subsidy from the taxpayer to privatised operators. Why does he always stick up for the excess profits and the managers who make themselves into millionaires rather than the hard-pressed consumer, who is forced to use such monopoly services and is fed up with the way they are being run?

That was very well prepared, but almost entirely inaccurate. The reality is that the nationalised industries once cost the taxpayer £50 million a week and the privatised industries now yield £50 million a week. The average price of domestic electricity to households has fallen by 8.5 per cent. in real terms over the past two years; the price of gas has fallen by more than 20 per cent. in real terms since privatisation; BT's main prices have fallen by more than 35 per cent. in real terms since privatisation; Britain's water is now among the cleanest in Europe—[Interruption.] When those industries were all nationalised, prices went up year after year after year. The Opposition would like to control and regulate from the centre; they are determined to go back to when prices went up and not down year after year after year.

Will my right hon. Friend join me in welcoming yesterday's vote by the police, which showed that they do not wish routinely to carry arms? Does he feel, like me, that the best way in which to protect the police from those who carry arms is to increase the sentences that we can inflict on such people, and will he consider bringing back the death penalty for the murder of police officers?

I certainly very strongly support the decision not to carry firearms taken by the police in their ballot yesterday. That is wholly in tradition with policing in this country. I believe that it is the right decision and I warmly congratulate the police on having reached it. In recent years, we have increased the penalties for a large number of offences. I shall not retail them all at this moment, but I will willingly set them out in a parliamentary answer if my hon. Friend wishes me to do so. As my hon. Friend knows, I personally do not favour the return of capital punishment.

If the Conservative party has put its house in order on the question of funding, why will the Prime Minister not allow Lord Nolan to look into it? Does not the question of funding of all political parties go to the heart of the public's concern about trust in our political system? Does the Prime Minister not realise that, while he got high marks for establishing the Nolan committee, he will get no marks if he now seeks to turn what he told us was to be the public's bloodhound into the Prime Minister's poodle?

I do not think that anyone who has studied the membership of the Nolan committee or knows any of its members would remotely recognise the right hon. Gentleman's description of it. As he knows, there are only two ways of funding political parties in a free democracy. One is by subscription or donation freely given, and it is right in an open society that donors, if they wish, should preserve anonymity. [Interruption.] The other way is to fund political parties out of taxpayers' money. I do not favour that way and I hope that we shall not go in that direction. What is wrong about funding of political parties is when the funding of a party actually buys influence over its policy.[Interruption.] That is what is happening with the Opposition, where trade unions have 70 per cent. of the votes in Labour policy-making bodies, and even the proposal for dramatic reform would only diminish that to 50 per cent.

Does my right hon. Friend agree that, although the nuclear non-proliferation treaty has been signed there remains a serious threat of proliferation, and that the possession of a nuclear weapon is a measure of deterrence against those who would possess nuclear devices? Does he not find it absurd that Labour Front-Bench spokesmen say that they would hold Trident but would never use it? Does he think that that would deter anybody?

I suppose that there is a logical case for saying that one would scrap Trident—although I passionately disagree with that case, as I believe that Trident is necessary as a deterrent—but it is absolutely intellectually unsustainable to say that one would have Trident as a deterrent, but to tell those whom it is there to deter that one would never use it. If that is their position, the Opposition might as well take the money and pour it down the nearest drain.

To ask the Prime Minister if he will list his official engagements for Tuesday 16 May. [22882]

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

Can the Prime Minister confirm that there are now an extra 500,000 people, notably those on low incomes, paying tax, principally because of the cuts in the married person's allowance last month, and that, after 16 years of Tory government, there are a record 26.2 million people paying income tax? Is the message not clear: "Tory Governments damage your wallet"?

First I must tell the hon. Gentleman that, if we had retained the Labour tax regime, there would have been an extra 1 million people in tax today. As for his specific questions, there are two substantive reasons why more people are paying tax this year. One is wage drift upwards. The second is the number of people who were unemployed but who are now in work and paying taxes. I should have thought that the hon. Gentleman would welcome that drop in unemployment.

To ask the Prime Minister if he will list his official engagements for Tuesday 16 May. [22883]

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

Further to the notice that I have given my right hon. Friend, as we approach the 1996 intergovernmental conference in Europe, and more particularly as we approach the 'reflections' group meeting in the summer, will he undertake to publish the Government's contribution to that group? Is it not essential that the IGC should address not stories about square strawberries and straight bananas, but the real public anxieties about growing European Union power—anxieties which the Leader of the Opposition apparently does not share, as he would give away the veto? Like one of his predecessors, the right hon. Gentleman may be fit to become a European Commissioner one day, but he is unfit to lead this nation.

I am grateful to my hon. Friend for giving me notice of the matter that he proposed to raise. I certainly agree that the European Union needs to be more responsive to the views of its people, with less interference and less red tape. We shall enter the IGC with a positive agenda, providing for more intergovernmental co-operation in a Europe of nation states, including co-operation in foreign policy, in defence and in the international battle against crime.

To ask the Prime Minister if he will list his official engagements for Tuesday 16 May. [22884]

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

Does the Prime Minister agree with the statement of his Health Minister, Baroness Cumberlege, speaking to the Royal College of Nursing, that

"community care clearly isn't working"

I understand from my hon. and noble Friend—who is more familiar with the quotation than I am—that the hon. Gentleman has quoted the remark out of context.

To ask the Prime Minister if he will list his official engagements for Tuesday 16 May. [22885]

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

Does my right hon. Friend agree that a tax-raising legislative assembly in Edinburgh which fails to address the West Lothian question and the number of Members from Scotland in this House is bound to be unworkable and will be merely a stepping stone to separation?

I agree with my hon. Friend. It would be unworkable because some questions about it are unanswered and unanswerable. No one has yet explained why Scottish Members should be able to vote on English matters while English Members would not be able to vote on Scottish matters. There is silence from the Opposition on that. No one has yet explained why people who live in Scotland should pay more tax simply for the pleasure of being in Scotland. Again, there is silence from the Opposition. If the Opposition were serious about the constitution of Scotland, they would long ago have been able to answer a range of questions on the matter. Yet they still cannot answer them. Their policy is bad for Scotland, bad for the economy and bad for the United Kingdom.