House Of Commons
Monday 3 July 1995
The House met at half-past Two o'clock
Prayers
[MADAM SPEAKER in the Chair]
Oral Answers To Questions
Transport
Network South Central
1.
To ask the Secretary of State for Transport what representations he has received from passengers regarding services on Network South Central. [30115]
My Department has received 28 representations this year about services on Network South Central.
I thank my right hon. Friend for his reply. Is he aware, however, that commuters in my Sutton and Cheam constituency are angry, frustrated and tired of the embarrassing service that they are receiving? They complain of delays, overcrowded trains and unintelligible announcements. When I spoke to the director of customer relations on their behalf, he would not accept my complaints. Has not the time come to privatise British Rail, and give commuters the service that they want?
I certainly agree with my hon. Friend's last point. I know that there have been difficulties on that line, and that my hon. Friend has—as is her wont—represented her constituents assiduously. I am aware that her constituents have also experienced difficulty in gaining access to proper information. As I think that she knows, I set great store by making as much detailed and accurate information as possible available to passengers.
Rail Franchises
2.
To ask the Secretary of State for Transport what is his Department's policy in relation to British Rail being invited to tender for rail franchises. [30116]
Under section 25 of the Railways Act 1993, the franchising director has the discretion to exclude the British Railways Board or any wholly owned subsidiary of the board from tendering for rail franchises.
The Prime Minister says that Conservative Members of Parliament should vote for his sound management, his years of experience and, above all, his track record. Why do those principles not apply to British Rail's tendering for franchises?
The franchising director has decided that British Rail should not be allowed to bid for the first three franchises. He fears that other bidders would be deterred if British Rail were allowed to bid. I emphasise, however, that British Rail management teams—to which I think that the hon. Gentleman was referring—will not be excluded. Indeed, a number of management and employee teams have expressed an interest in becoming franchisees.
Has not my hon. Friend made the exact point that, if British Rail is allowed to bid for each and every one of the franchises, the management teams will effectively be precluded from so doing—thus denying the possibility of innovative approaches?
My hon. Friend is entirely right.
Is it not a scandal that British Rail should be excluded from seeking franchises on political grounds? More important, does the Minister accept that his policy of ensuring that 51 per cent. of train operators held franchises by May is now in tatters? Will he concede that, having spent £1.25 billion on privatisation, the Government have not managed to bring any of the train operators into the private sector? When will the Minister give up this meaningless exercise—or must we wait until the Secretary of State has been moved to another Department before someone will have the guts to abandon this crazy, lunatic idea?
The answer to the last part of the question is never. I would never wish to abandon a policy that I believe would be of benefit to passengers and freight users. I must emphasise to the hon. Gentleman that there is no political involvement in those decisions. Indeed, my right hon. Friend the Secretary of State is specifically prevented from giving the franchising director objectives, instructions or guidance on the exercise of his powers under section 25 of the Railways Act 1993.
Northern Line
3.
To ask the Secretary of State for Transport if he will make a statement about investment in the Northern line of London Underground. [30117]
Prospects for the Northern line have rarely looked better. Angel station has been completely rebuilt at a cost of £72 million, and London Underground is currently renovating 10 stations at the southern end of the line. The entire fleet of trains is being replaced under the private finance initiative, with the first train entering service in the middle of next year.
I thank my hon. Friend for that answer and I look forward to having a glass of champagne with him on the first new train next year. Will he allow London Underground to discuss with private entrepreneurs the possibility of using the private finance initiative to improve signalling and the track, and to introduce automatic ticket barriers on the Northern line?
I congratulate my hon. Friend on his consistent and persistent support of the campaign to improve the Northern line on behalf of his constituents. He knows that I could not possibly help myself to a glass of his champagne as London Transport has a no alcohol policy, to which of course I would want to adhere. That notwithstanding, he is right. Now is the time that we should be considering how we can apply the principles of the private finance initiative to other sectors such as signalling and power supply, as well as the successful deal on trains.
I welcome the Minister's reply about the southern end the Northern line, but he must be aware that Hampstead is the deepest station in the whole network. When can we look for improvements at the northern end of the Northern line?
I shall not be doing anything to raise Hampstead station, if that is what the hon. Lady is implying. At the southern end, as she knows, we are improving stations that are not in a satisfactory condition. I welcome her support for the idea that we might get the private sector involved in some renovation work north of the Thames, as there is no doubt that that has proved an extremely lucrative way in which we can improve the system, for the benefit of passengers. I am delighted to have her support.
Transport Policy
4.
To ask the Secretary of State for Transport what proposals he has to encourage passenger and freight traffic to switch from road to rail. [30119]
Privatisation will bring improvements that will make railway passenger and freight services more attractive to customers.
I am grateful to my right hon. Friend for that answer. Does he agree that the past 45 years of the nationalised rail network have been years of decline in which freight has been deterred from using railways and pushed on to roads? Will he urge operators when they come forward to win back the business from the Royal Mail, the newspapers and innumerable other operators who send their freight by road instead of by rail because it has been so inefficient?
My hon. Friend is right that, in the past 40 years, there has been a relative decline in the amount of freight moved by train. In 1953, 24 per cent. of goods were moved by train; today the figure is 5 per cent. and falling, but my hon. Friend, and I suspect the whole House, will take encouragement from a survey recently conducted by the rail freight group, which considered current, former and potential rail freight users. It received 83 responses. Two thirds of those who responded expected to increase the use of railways for the moving of freight, and more than half of non-users thought that they were more likely to use rail now than in the past. Those are encouraging statistics and underline the importance of moving the freight railway from the public to the private sector.
Can the Secretary of State clear up a mystery? He will, I think, agree that one of the principal reasons, particularly at this time of year, for trying to reduce the amount of road traffic and to move it on to rail is to reduce atmospheric pollution, especially for the considerable number of asthma sufferers. During the debate on the Environment Bill, the Minister for the Environment and Countryside said that powers were available to the Secretary of State for Transport to reduce the amount of traffic, to reduce speeds and even to close roads where atmospheric pollution had reached a danger point for asthma sufferers. Will the Secretary of State confirm that he has such powers, explain how he intends to use them, and tell us what opportunities he would offer to local authorities to use such powers as well?
I think that the hon. Gentleman is referring to road safety regulations, which are very complex—certainly legally complex. I suspect that both of us think that there may be a case for trying to find an easier way through that particular issue, as quickly as possible.
If my right hon. Friend wants to move freight from road to rail, may I give him a piece of advice from my area? I suggest that he abandons the disastrous M62 relief road, which is causing havoc in my constituency, and where the management by his Department of the houses that it has acquired is little short of disgraceful. Will he abandon that scheme sooner rather than later?
I pay tribute to my hon. Friend, who is robust in defending the interests of his constituents, as they and he see them. He will note that a number of alternatives are being explored at the moment. I shall reflect on what he has said as we move forward with those investigations.
If the Secretary of State is serious about transferring freight from road to rail, should he not look urgently at an area of Government policy practised by the Ministry of Defence? At the beginning of the Tory period of Government, no fewer than 40 MOD depots had rail connections to the main line. Half of those connections have since been closed, including the Donington link in my constituency. Is that not a clear illustration of the MOD pursuing an obvious policy of transferring freight from rail to road, and what will the right hon. Gentleman do about it?
You will understand, Madam Speaker, that I do not have responsibility for the Ministry of Defence. However, I shall ensure that the hon. Gentleman's remarks are brought to the attention of my right hon. and learned Friend the Secretary of State for Defence.
Does my right hon. Friend agree that there is nothing more likely to discourage a move from road to rail than the annual threat of rail strikes? Does he have any idea whether future rail strikes are likely to have the support of the Opposition Front Bench?
I am sure that I am speaking for everyone—at least, all Conservative Members—in saying that any threat of industrial action on the railways cannot be in the interests of the passengers, the industry or those who work on the railways. I should have thought that everyone would have had enough experience of industrial disputes last year to use great caution in the contemplation of similar activities this year—which I sincerely hope will not take place.
Passenger transport in some areas of the country has not recovered from the negative effects of last year's strikes. We need a buoyant, viable rail service that will be attractive to passengers and there is certainly no way in which industrial disputes are likely to aid that process.We certainly hope that the right hon. Gentleman has learnt his lessons from what happened last year. What is the point of him launching a great debate on transport when there is to be no action at the end of it? How does he expect to achieve a major switch from road to rail when last year, for the first time since the war, there were no orders for new rolling stock, because of privatisation? Investment in the rail network as a whole plummeted by a third in one year to its lowest level for the past 50 years. When will the right hon. Gentleman realise that he is fast becoming the eunuch of the transport world—all talk and no follow through?—[Laughter.]
I am sorry, Madam Speaker; I know that I am not supposed to laugh out loud at the hon. Gentleman, but it is too great a temptation.
First, I did learn a lesson from last year's strikes—that if there is a strike in the public sector, we can always expect the Labour party to row in behind it. I hope that the hon. Gentleman will think very carefully before he repeats the foolish support that Labour Members gave to that damaging industrial dispute last year. Secondly, unlike the hon. Gentleman, virtually everyone else in the country—those who take transport seriously—has welcomed the debate. Indeed, I had the opportunity to talk to 700 people at the Sheldonian theatre in Oxford just a couple of weeks ago. I was told that, apart from graduation ceremonies, it was the largest event at the university in the whole of the academic year. People came together to study, debate, discuss and explore the possibilities of transport policy and transport strategy through to the next century. We know that the hon. Gentleman does not have a policy—he does not have one on railways, on roads or on aviation—so we understand his embarrassment. We are happy for him to continue to sit on the Labour Front Bench and make his rather silly remarks while the rest of us get on with developing a transport policy for the next century.Vehicle Excise Duty Fraud
5.
To ask the Secretary of State for Transport what measures are being taken to combat vehicle excise duty fraud. [30120]
The number of evaders penalised and revenue recovered from direct enforcement action has been increased in each of the last 10 years. Last year was the best yet, when £46.5 million was recovered from 458,000 evaders.
I am grateful to my hon. Friend for that answer. I congratulate him on the progress that has been made but remind him that there is still a great deal to be done. Constituents of mine regularly produce long lists of registration numbers of vehicles which they know to be untaxed. What is even worse is that when they take those lists to the police, they are told that nothing can be done. May I urge my hon. Friend to arrange constructive talks between his Department and the Home Office to ensure that the problem is cracked once and for all?
Yes, I shall certainly draw my hon. Friend's remarks to the attention of the Home Secretary because his point is very serious. We ought to be clear that evasion represents about 4 per cent. of potential revenue. None the less, it is an affront to all those law-abiding motorists who bother to get their VED, and such conduct is quite inexcusable. I am grateful to my hon. Friend for his remarks.
Why has the Minister not understood that it is a matter not only of tax evasion but of road safety? Is there not a close connection between the number of vehicles, especially heavy goods lorries, that are not only untaxed but unlicensed and the number that are uninsured and illegally operated? Indeed, that connection has been highlighted by the report of the traffic commissioners. When will he introduce powers to confiscate heavy goods vehicles, which are contributing to the cause of accidents? The Minister did not even take that into account in answering the hon. Member for Gloucester (Mr. French).
In the midst of all that, there was—I suppose—at least one semi-serious point, which I am happy to address.
How patronising!
It is difficult not to be patronising when faced with such inane contributions from the hon. Member for Oldham, West (Mr. Meacher) and his hon. Friends. The issue of some heavy goods vehicles not being covered by operators' licensing is very serious. I have undertaken, with the illegal operations working party, to look at the whole issue of confiscation. I agree with the hon. Member for Stoke-on-Trent, North (Ms Walley) to the extent that in some cases confiscation may be the only mechanism capable of deterring those for whom the normal framework of the law is clearly irrelevant.
A21
6.
To ask the Secretary of State for Transport what progress has been made on the plans to upgrade the A21. [30122]
Progress is being made. Preparation work is continuing on three schemes to improve the A21. We continue to keep the needs of the route as a whole under review.
I thank my hon. Friend for that reply, even though it will not relieve the distress among many communities along the A21. On Thursday evening, while driving through Lamberhurst, I noticed posters saying "Bypass Now". My constituents who work in Tonbridge Wells are concerned about the economic success of that town because of its poor communications, and Hastings has the 43rd highest level of unemployment in the country, largely due to appalling communications. Can my hon. Friend give any idea of how we will finally address the problem of upgrading the A21 to a reasonable standard?
I fully recognise the strategic and economic importance of improving the A21. My hon. Friend took the trouble to explain it to me fully when I visited Hastings earlier this year, when I met local business men. The three schemes being taken forward are the section between the Tonbridge bypass and Pembury bypass, the section between Kipping's Cross and Lamberhurst and the Lamberhurst bypass itself. For the section between Kipping's Cross and Lamberhurst, we are also considering whether interim measures can be taken as part of our network enhancement programme.
Travelcards (London)
7.
To ask the Secretary of State for Transport what is his policy in respect of the introduction of competing travelcards in London. [30124]
The existing London travelcard is a rightly popular form of ticketing and we are committed to its continued availability. Future developments in ticketing alongside the existing travelcard will primarily be a matter for the transport operators to pursue.
It is the latter part of the Minister's reply that worries me. Can he confirm now, once and for all, that there will be no establishment of competing travelcards in London, that there will be the maintenance of one travelcard which covers bus, underground and railway operations and that he will tell the rail franchising director that there should be no possibility of introducing any other form of travelcard which limits accessibility to, and interchange between, public transport in London? London's success depends on an integrated transport network and on an overall travelcard to facilitate that.
The hon. Gentleman is right. As I said, the travelcard is hugely important. He is also right to say that we would not want for a second to lose it. I hope that he will allow me to say, however, that the idea that we must assume that all ticketing technology is frozen in time is misleading and unhelpful. Stored value ticketing, for example, adds attractive opportunities for London Transport to appeal to people who do not need or want the present travelcard, which is time-limited, but who would like to have stored value in a ticket that they could carry with them to their great convenience. That is the kind of technical development that can sit alongside the travelcard. I say straightforwardly and on the record, because misleading information about the matter is frequently put forward, that we have no plans to water down the present travelcard for we hugely recognise the value that it has for millions of Londoners.
Crossrail
8.
To ask the Secretary of State for Transport when he expects to lay before the House an order under the Transport and Works Act 1992 to authorise a public inquiry into the crossrail project. [30125]
No firm date for an application under the Transport and Works Act has yet been set.
Given the acknowledgement by the Government, by local authorities along the length of the proposed crossrail route and by organisations such as London First and City Corporation, representing the City of London, that crossrail would bring enormous benefits to London and to the whole of the south-east, may I impress on my right hon. Friend the need for urgency in this project? Has he set a date by which the new review, which he has commissioned, of the feasibility of crossrail should be completed and the report given to him and his Cabinet colleagues?
It is a matter of record that my hon. Friend has taken a long, detailed and informed interest in the subject, and I pay tribute to him for that. He will be encouraged to know that the study that I have put in place is being carried out alongside the preparation of the application and I have asked for the study to be made available to me before the end of the year.
Does the Secretary of State recognise that the crossrail project, in principle, has cross-party and all-London support? This is not only because 61 of the 66 central London stations would be accessible from a crossrail route, but because the line would run from Heathrow through central London and possibly out to Stansted. Will he confirm that the review that he has commissioned will look at some of the proposals that were not used and that if the Bill procedure proves to be faster than the order procedure under the Transport and Works Act 1992, that procedure would not be entirely disregarded as the way forward?
I understand that there is cross-party support for the scheme and I am grateful to the hon. Gentleman for drawing attention to that fact. I believe that he would agree that we need to look carefully but quickly at the changed circumstances to ensure that any crossrail project that comes forward is well founded and well based. That is what we are seeking to do at the moment.
My right hon. Friend will know how important the crossrail project is to my constituency. Has he had an opportunity to look at the research that has been produced by the Centre for Economics and Business Research, which estimates that the project will create 20,000 long-term jobs and will add £1 billion to the gross national product? Can my right hon. Friend hasten the project, and make sure that it does not remain on paper but becomes a reality?
I must be careful in responding to my hon. Friend—whose points I well understand—because I will have a quasi-judicial role later in the process if crossrail proceeds. I understand the economic importance that is attached to the project. On the other hand, my hon. Friend will recognise that, if and when the project goes forward, it must do so on a solid basis so that we can look forward to crossrail adding the benefit and value that all of us would wish to see.
British Rail
9.
To ask the Secretary of State for Transport when he next expects to meet the European Commissioner for Transport to discuss European subsidies to British Rail. [30126]
There is no scheduled meeting to discuss subsidies.
Will the Minister confirm that the Government have been forced to repay the millions of pounds that they received from the European Union to implement major improvements in the British Rail network? Does he feel that obtaining money by that method is almost obtaining money by false pretences? Is that not another nail in the coffin of the privatisation of British Rail?
No, no and no.
If my hon. Friend meets the Commissioner to discuss the subject of subsidies, will he consider the importance of the midland main line to Leicester? Now that the channel tunnel rail link is to go to St. Pancras—extensive and expensive works are to take place there—has not the time come for a greater emphasis on the development of the midland main line, which is vital to all those who live in Leicestershire and beyond?
It is, of course, good news for Britain and the areas that have benefited in particular that the railways have obtained grants totalling £150 million during the past 10 years. My hon. Friend is right to say that the railways will still be eligible for such grant aid after privatisation. He will know that the channel tunnel rail link and the west coast main line upgrade are key projects identified by the Christophersen group for priority in funding the under-the-Thames programme. Perhaps consideration will be given in the future to the midland main line, as my hon. Friend suggests.
East London Line
10.
To ask the Secretary of State for Transport when he expects London Transport underground services to resume on the East London line. [30127]
London Underground has applied for listed building consent to strengthen and waterproof the tunnel carrying the East London line under the Thames between Rotherhithe and Wapping. The timing of the reopening of the line will depend on the progress of the application.
Is it not the case that the decision of the Secretary of State for National Heritage to list the tunnel the day after it was closed for refurbishment has meant that the application for listed building permission has had to be submitted? The Minister will be aware that the East London line is the only tiny connection that the people of south-east London have with the London underground network. Will the Minister—within the limitations of his powers—prevail upon the Secretary of State for the Environment to make the earliest possible decision on the listed building consent for the tunnel, so that those of us in south London can have what little of the underground network that we have restored to us?
I am happy to acknowledge the hon. Gentleman's campaign on behalf of his constituents, and the great interest that he has shown in the progress of the East London line. I am keen that my right hon. Friend the Secretary of State for the Environment should be aware that, above all, the East London line is a railway that connects people with jobs and families with families. That should not be forgotten while we discuss the merits and demerits of the listing application.
Cowden Crash Inquiry Recommendations
11.
To ask the Secretary of State for Transport what funding his Department intends to make available to enable British Rail and Railtrack to carry out the recommendations of the inquiry into the Cowden crash; and what estimate his Department has made of the cost of those recommendations to British Rail and Railtrack. [30128]
British Rail and Railtrack are evaluating the inspector's recommendations, some of which require programmes of research.
Since the Secretary of State—along with everything else that he is junking—has announced that he is not interested in progressing with the advanced train protection scheme, and since the inspector said specifically in the report that the installation of such a system would be a minimum requirement in all new trains, how can the Minister seriously come to the Dispatch Box and pretend that the Government are interested in the safety of those who use the railways?
On the contrary, my right hon. Friend announced in March that he had accepted in full the advice on ATP from the Health and Safety Executive and that British Rail and Railtrack would put in train further development work on alternatives to ATP, which could deliver some of its benefits. It was also accepted that ATP should be an integral feature of all high-speed lines and that careful consideration should be given to including it in any major resignalling. The hon. Lady is simply wrong.
Further to my hon. Friend's question, when will the Government implement the recommendations of the Cowden inquiry inspector and of the Hidden committee report on the Clapham crash six years before, that, as a minimum, all new high-speed railways should be fitted with some form of ATP? Is he aware that the installation of an ATP system covering the busiest 30 per cent. of the rail network, and thereby 80 per cent. of passenger miles, could have saved dozens of lives in the past five years, at a cost of less than half of what the Government spent in the same period on promoting rail privatisation? When are the Government going to be more interested in promoting rail safety than in partisan dogma?
The hon. Gentleman is as wrong as his hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody), both in his figures and his assertions. My right hon. Friend the Secretary of State will be receiving a progress report from the Health and Safety Executive on the development work being undertaken into systems to deliver some of the benefits of ATP. As I said in my reply to the hon. Lady's initial question, it is already accepted that advanced train protection will be an integral part of all new high-speed rail links, such as the channel tunnel and the west coast main line upgrade.
Transport Facilities (London)
12.
To ask the Secretary of State for Transport what proposals he has to improve transport facilities in London. [30129]
We shall continue to work in partnership with local government and the private sector in delivering the on-going programme of carefully targeted road improvements and traffic management measures, allied to very heavy investment in public transport.
One of the things that could be done to improve movement around London would be the greater co-ordination of all road works. Why are bridges still being closed without any apparent co-ordination? Can we have an assurance that, in the event of the Conservative leadership election going to a second round, there will be co-ordination of all road works associated with the installation of new telephone lines by British Telecommunications, so that the whole of Westminster is not turned into a large building site?
The trouble is that that question is long on rhetoric and short on specifics. The reality is that there is indeed a group to co-ordinate road works, and bridge works in particular. The hon. Gentleman is right in saying that bridges are vital, in the sense that they concentrate traffic into narrow corridors. Whenever there is the prospect of more than one bridge being repaired at any one time, there is an extensive programme of co-ordination.
I recently heard the figure of 30,000 utility diversions in one borough alone mentioned in respect of the huge number of utility adaptations, including cabling and so forth, which are very much in evidence at the moment. I share the hon. Gentleman's frustration, but all the boroughs and the Department take the matter very seriously.Granted that the reputation of the Department would stand even higher if there were greater stability and predictability for its public expenditure forecasts for London Transport, will my hon. Friend accept the gratitude of some London Members for the fact that the Department has begun to repair the investment deficiencies that occurred when London Transport was under the London county council and the Greater London council?
I am grateful to my right hon. Friend because he makes an extremely important point. On 1994 prices, investment rose above £150 million only in the mid-1980s and now stands at somewhere around £1 billion a year in London Transport infrastructure alone, along with a heavy programme of investment in railway and road infrastructure. My right hon. Friend is absolutely right to contrast that with the dismal record of previous Administrations. We need take no lessons from the Opposition on the amount that we have invested in transport infrastructure in London.
Air Service Agreement
13.
To ask the Secretary of State for Transport whether he will make a statement on progress in air service agreement talks between the United States of America and the United Kingdom. [30130]
The UK and US Governments reached agreement on 5 June on a package of new opportunities for UK and US airlines. We have already started work on the next stage of negotiations with the aim of opening up further opportunities.
May I tell my right hon. Friend how satisfactory it is that he was able to reach that agreement on 5 June? Will he make it clear to the House that he and Her Majesty's Government refuse to be browbeaten by Transport Commissioner Kinnock, who is attempting to bring European Court actions against nations that have rightly maintained their entitlement to negotiate independent national air service agreements with other countries?
I am grateful to my hon. Friend. Like him, we attach considerable importance to our bilateral negotiations with the United States over many years, which recently proved to be fruitful and on which we intend to build. I insisted at the last Transport Council meeting two weeks ago, before Commissioner Kinnock could carry forward his proposals, that the Council of Ministers' requirement dating back to 1993 should be carried out. It requires the Commission to undertake a study to demonstrate whether it can negotiate on behalf of member states and whether to do so would be advantageous to member states rather than to countries negotiating bilaterally. It also requires the Commission to establish common interest, which would be difficult given that the United Kingdom has 40 per cent. of transatlantic travel and Luxembourg has 0.02 per cent. I am sceptical about whether the Commission will be able to make speedy progress in that regard. In the meantime, I shall continue to defend and advance UK national interest in bilateral discussions with the United States.
Duchy Of Lancaster
Citizens Charters
28.
To ask the Chancellor of the Duchy of Lancaster what further charters, and in what areas, he is proposing; and if he will make a statement. [30146]
New charters for further and higher education in Northern Ireland will be published later this year, as well as revised charters for court users, people passing through customs points, and NHS patients in Wales. A revised charter for council tenants was published in June.
May I ask for a charter for council tenants and all council tax payers so that they have protection against councils like Ealing council, which is Labour-controlled, as you will know, Madam Speaker? If tenants and council tax payers owe council tax, Ealing council sends them reminders and within a week or a month of their having paid, they receive summonses and repeat summonses. Somebody who came to my surgery last Friday had had 10 summonses for taxes that had already been paid, and that person was over 90.
I assure my hon. Friend that the new council tenants charter sets out clearly the rights of council tenants, and tenants in Ealing should appeal if they feel that they are being disadvantaged. On the general performance of Ealing council, the indicators published by the Audit Commission will have revealed the position all too clearly.
The Minister will be aware that a number of charges have been made about charters being gimmicks. Is he aware that, by extending charters as he has announced this afternoon, he may further be accused of concentrating on gimmicks? Is he further aware that many people want a toughening of existing charters, for instance in the health service? Currently, no one appears on a waiting list until he or she meets a consultant. Would it not better reflect what is happening if the waiting list count were measured from the time that a person met his or her doctor? Given that the Duchy of Lancaster is providing short-term cover in Wales, will he introduce that system during the time that he is covering for the previous Secretary of State for Wales?
I am glad that the hon. Gentleman continued with the second half of his question because I thought for a moment that the Labour party was exercising yet another U-turn and backing off from its general support for charters. So far, it has been extremely helpful. I am encouraged by the toughness of the second part of the hon. Gentleman's remarks.
Science Education
29.
To ask the Chancellor of the Duchy of Lancaster what plans he has further to extend scientific education (a) for schoolchildren and (b) for the population at large—correcting the Table Office's typographical error, Madam Speaker. [30147]
I am always willing to discuss a wide and varied agenda with my hon. Friend, but I do draw the line at wide and varied gender.
The answer to the question of course is that we shall do whatever is necessary to capture the imagination of children and the population at large to the excitement of science, engineering and technology.I thank my right hon. Friend for that answer. The Table Office had erroneously tried to transfer that question to the Secretary of State for Education, as it did with the later question from my hon. Friend the Member for Stamford and Spalding (Mr. Davies), which I think explains what happened there. I thank my right hon. Friend for his—[HON. MEMBERS: "Get on with it."]
Order. The Table Office does not transfer questions; Ministers do. The hon. Gentleman should not attack Officers of the House who do not have a platform to answer back.
I am grateful for your guidance, but may I thank my right hon. Friend for the support that he is giving to scientific education? My right hon. Friend knows that I have a strong commitment to that because it is crucial—and I am sure that he agrees—that we are able to compete internationally. Unless the schoolchildren of the future have a very good scientific education, we shall be handicapped in competing with the Germans, the Japanese and the Americans.
I agree with my hon. Friend that that does revolve around competitiveness. That is why I was pleased, on 22 May, to publish, at the same time as the competitiveness White Paper, the technology foresight steering group report, which set out that we shall need to find the future scientists who will discover the cures for diseases to which there is as yet no solution or cure. They will have to find the motor vehicle of the future. Many exciting challenges lie ahead, and we must ensure that we are ready, willing and able to meet those challenges.
What a complacent response. Is the Minister aware that many 16-year-olds at school are turning their back on science, especially in England and Wales? Is he aware that degree applications for science subjects are down this year for this year's entrants—physics down 3 per cent., environmental sciences down 6 per cent., general engineering down 18 per cent. and electronic engineering down 74 per cent.? What will the Government actually do to sort out that science gap for 16 to 18-year-olds?
Would it not be timely to consider the model of the Scottish education system, for example, to introduce a broader curriculum for 16 to 18-year-olds to ensure that all youngsters throughout Britain have a better understanding of science and a chance to take science further?The hon. Gentleman ignores—I think that he acknowledged that indirectly—the fact that we have ensured that all children now study science up to the age of 16, under the national curriculum. As for 16 to 19-year-olds, he will be aware of Sir Ron Dearing's review, which is currently taking place.
Civil Servants
30.
To ask the Chancellor of the Duchy of Lancaster how many civil servants the Government or their agencies now employ; and what was the equivalent figure in 1979. [30148]
The number of civil servants is 516,100 today, and it was 735,400 in 1979—a reduction of 30 per cent.
May I congratulate my hon. Friend and the Government on the very substantial reduction in costs that that entails, but what is the next step for all the next steps agencies, which continue to employ a large number of people? Would it not be sensible, as they are market-tested, that, where they are successful, they are given the opportunity to transfer to the private sector and become businesses in their own right?
Lucky they don't market-test you lot.
The question of privatisation is considered when a next steps agency is set up. We then, under the existing procedures, have a period of five years before that question can be considered again. None the less, I can assure my hon. Friend that that timetable will be adhered to, and that any question of privatisation for a next steps agency will be thoroughly examined.
May I ask a question of which I have given notice to the Department?
How did my hon. Friend know that he was going to be called?
Tam Dalyell's charter.
I am sorry; this is a very precise question, which is worrying people in the Scottish Office. Is it quite proper that Mr. Gregor Mackay, an official of the Scottish Office, paid out of the public purse, should work in the office of one of the candidates for the leadership of a political party? Is there not some argument for having a code of conduct and making these things very precise?
I am grateful to the hon. Gentleman. Indeed, there is a great deal of point in having a code of conduct. There is, in fact, a code of conduct which makes it plain that people should not indulge in party political activities when they are paid from public funds. The gentleman about whom the hon. Gentleman is concerned is on leave at the moment.
Science Education
31.
To ask the Chancellor of the Duchy of Lancaster what plans he has to encourage more students to take science subjects at university and college. [30149]
We support initiatives to bring real life scientific challenges to the classroom.
Does my right hon. Friend share my concern that so many science graduates choose a career outside science and technology so that their talents and education are lost both to the advancement of knowledge and to the research and development effort, on which ultimately so much of our economic future depends? Do the Government have any specific ideas on how we can enhance the status and rewards and, therefore, the attraction of a career in science and technology?
I agree with my hon. Friend. We always seek to promote better career opportunities for scientists, engineers and technologists. I hope that everyone in the House will have the opportunity to visit the women in science exhibition in the Upper Waiting Hall, which my hon. Friend the Parliamentary Secretary, Office of Public Service and Science opened this morning, when he was able to announce that the Government are doubling their financial contribution towards the Dorothy Hodgkin fellowships.
Duchy Benevolent Fund
32.
To ask the Chancellor of the Duchy of Lancaster what financial resources will be available in the Duchy benevolent fund for distribution during the current year. [30151]
Approximately £215,000.
Does the Chancellor recognise that part of the money that is left by people who are intestate ultimately goes to the benevolent fund and part of it is used for running the magistracy in the county? Would it not be more appropriate for all the money to be used by the benevolent fund? As I am sure the right hon. Gentleman will be aware, there are many good purposes to which the money can be put.
I am not a trustee of the Duchy benevolent fund, but I know that the trustees donate all the income which is received from investments. Last year 88 per cent. of the money donated went to charitable causes in the Duchy. I recall that the hon. Gentleman wrote to me in April about help for the Burnley Alliance silver band. I am delighted to say that a grant of £800 was made to the junior section of the band for a purchase of a new flugelhorn. I am delighted on this occasion to blow the hon. Gentleman's trumpet for him.
May I ask my right hon. Friend to relay to those who run the Duchy benevolent fund the thanks of many thousands of people for the great care and attention to detail which they give to every application that is made to that excellent fund, which is special for the people of Lancashire?
I am delighted to hear the authentic voice of Lancashire. I shall convey to all those involved the praise of my hon. Friend.
Science Week 1996
33.
To ask the Chancellor of the Duchy of Lancaster what plans he has to encourage further involvement from broadcasters and the media in Science Week 1996. [30153]
I was delighted with the outstanding coverage of Science, Engineering and Technology Week 1995 and I am determined that the 1996 week should be even bigger and better.
I thank my right hon. Friend for his reply. Does he agree that science is vital to our national interest and is an exciting subject in itself? Will he continue to press the media, particularly the BBC, to put out more programmes on science and technology and to make them more exciting, fun and interesting for the general public?
Yes. I recently had a meeting with the BBC at which I met John Birt and Alan Yentob, both of whom were delighted with the success of the Science, Engineering and Technology Week 1995. They have already promised their full support for the 1996 week. I take the opportunity to congratulate "Tomorrow's World" on its 30th anniversary last month. It does a great deal to promote public understanding of science, engineering and technology.
I wonder how the right hon. Gentleman is at doing arithmetic. If somebody in the ballot tomorrow gets 190 votes and another gets 70, can he tell us whether the one who gets 190 votes will stand his ground and keep his job?
If I were to answer that mathematical hypothetical question, I would say quite clearly to the hon. Gentleman that my right hon. Friend the Prime Minister will have a decisive victory tomorrow. As for the other implication behind the hon. Gentleman's question, progress in arithmetic under this Government has improved considerably, and I know that, as a result of the past 10 years, even the hon. Gentleman can do joined-up handwriting.
Will my right hon. Friend congratulate those involved in the Science, Engineering and Technology Week? Looking forward to next year, will he assure the House that contributions to that event by local firms are as essential as those made by the media? What steps is he taking to develop further links with chambers of commerce so that they can plug in and make SET Week even more successful than it has been before?
I agree with my hon. Friend. If we are to make a great success of Science, Engineering and Technology Week 1996, we must involve small and medium-sized enterprises. In view of my hon. Friend's intervention, I shall consider how best to do that. I shall seek out chambers of commerce, training and enterprise councils and, through business links, all firms, so that they can play a positive part in SET 1996.
Citizens Charters
34.
To ask the Chancellor of the Duchy of Lancaster what plans he has to introduce further citizens charters during 1995; and if he will make a statement. [30154]
A number of new and revised charters have been issued this year. We are also encouraging the production of local charters. Thousands of organisations, including surgeries, hospitals and police forces, have already produced their own charters which reflect the needs of the local user.
Can the Minister confirm that citizens charters were originally introduced to give the voters more power over politicians and bureaucrats? Does he recognise that the unseemly battle taking place among 329 Conservative Members of Parliament to elect the next Prime Minister is a negation of all those charters' principles? Why does he not recognise that the people do not want any more charters but a general election now?
I am afraid that there are no charters that apply to activities inside the House; perhaps there should be.
If people do not recognise that charters are achieving something, why is it that the French, Germans and Americans are starting to copy our system? Why is it that the only people who knock the system are the Opposition? They do so only because they did not think of it first.
My hon. Friend makes a valid point. One of the first things that President Chirac did on taking office was to introduce a citizens charter. Well done, President Chirac.
Is not there a case for introducing charters for political and personal courage? If so, does the Minister agree that the ex-Secretary of State for Wales would receive that charter for having the guts to resign from the Cabinet in order to stand for the current leadership ballot? The President of the Board of Trade and the Employment Secretary, though they are desperate for the job at No. 10, simply do not have the guts to do what the right hon. Gentleman did.
I doubt whether that will influence many votes in that particular election.
35.
To ask the Chancellor of the Duchy of Lancaster by what mechanisms the Government measure the success of the citizens charters. [30155]
Various.
I thank my right hon. Friend for his splendid answer. Does he agree that one measure of success is the fact that there are more than 2,000 nominations for the charter mark currently in the pipeline, and which he is considering, supported by more than 4,000 individuals?
Yes. We were expecting 2,000 nominations, so to achieve double that number has been a great success, bearing in mind the fact that in 1992, 296 organisations were nominated; in 1993, 441 and in 1994, 523.
There is a charter that could be measured easily, and which would follow the greatest charter to be introduced, the initial set of charters introduced by the Chartists to extend the franchise. Why can we not have such a charter to deal with the current franchise, because between 3 million and 4 million names are missing from the electoral register? If we put that right there would be an easy way to measure our success, because the more people on the electoral register, the more that register would be judged a success by that particular charter.
That is why we strongly support all campaigns to urge people to register for voting and exercise that vote.
As my hon. Friend the Parliamentary Secretary said, many other countries across the world are following the Prime Minister's initiative of introducing a citizens charter. In May I was discussing this initiative with Vice-President Gore, who has already hailed it as an innovative idea.Does my right hon. Friend accept that one of the measures of success of the charters is national health service waiting times? Does he accept that, since the introduction of the patients charter in 1991, those waiting times have been dramatically reduced? Before he answers, will he bear it in mind that his right hon. Friend the Secretary of State for Health has just joined him on the Front Bench?
I commend my right hon. Friend the Secretary of State for Health and, indeed, the activities of the Welsh Office in Wales, in constantly taking forward the initiatives under the patients charter. I am delighted that, since the publication of the patients charter, there has been a dramatic reduction in NHS waiting times.
36.
To ask the Chancellor of the Duchy of Lancaster how many charters currently exist; and what plans he has to extend them into other areas. [30156]
There are currently 40 charters. New and revised charters are being introduced during the course of this year, and also many local charters.
Does not the Minister realise that when I was sitting, fuming, in a traffic jam the other day I realised that by far the greatest of the Prime Minister's achievements was not the charters, but the cones hotline? How much has the cones hotline cost? How many phone calls have there been to it? What great, new initiative will replace, challenge and equal the cones hotline if the Prime Minister is returned in the ballot tomorrow?
In tune with his forceful presentation of the subject, the hon. Gentleman should take a positive view of charters, not carp on about the minor, negative aspects.
Points Of Order
3.31 pm
On a point of order, Madam Speaker. Has the Secretary of State for Northern Ireland approached you about a statement on the release of Private Lee Clegg? If that is not so, could you give me some guidance? I am Private Clegg's constituency Member of Parliament, but I have not been informed of his release this morning. The Secretary of State for Northern Ireland assured me that Private Clegg would, rightly, be the first to know and, as his constituency Member of Parliament, I would be notified in due course. I understand that this morning other Members of Parliament were phoned individually to be told of Private Clegg's release and that the newspapers also had prior notification. As a Back-Bench Member of Parliament and Private Clegg's constituency Member of Parliament, I wonder if you, Madam Speaker, could help me.
I have not been informed that the Secretary of State for Northern Ireland is seeking to make a statement today, but he is a most courteous Minister and it seems that there may well have been an unintended oversight on the part of the Department. I am pleased that the hon. Gentleman has raised the matter in this way as a point of order and I am sure that those on the Treasury Bench will let the Northern Ireland Office know what has taken place. Perhaps an explanation will be given to the hon. Member for Bradford, South (Mr. Sutcliffe) who, as Private Clegg's constituency Member of Parliament, deserves to know what has happened.
Further to that point of order, Madam Speaker.
No.
It is extremely relevant —
That is the point—once I have dealt with a point of order, I do not take a further point of order on the subject. The hon. Gentleman's point of order cannot be relevant to the previous one as I have just dealt with it.
On a point of order, Madam Speaker. Have you had time to look at today's edition of The Guardian, which carries a report that the right hon. Member for Wokingham (Mr. Redwood) has retired to his newly acquired Back Bencher's Rooms in the House of Commons to hit the telephones? The implication is that the right hon. Gentleman is hitting the telephones to canvass support for the leadership election. I wonder whether you feel that that is an appropriate use of House of Commons facilities.
I am not prepared to comment from the Chair on newspaper reports. However, if it is a point of order for me, I shall look into the matter.
On a new point of order, Madam Speaker. You mentioned the courtesy of the Minister who deals with Northern Irish matters, but I wonder whether that is correct. I wrote to him on 31 January, 29 March and, again, on 25 May and I had no response to my comments on the guilt of Private Clegg until I received a letter off the Board as I came in this afternoon. It was very courteous of him. At the end, he says that when any further developments happen, he will let me know. A development has happened. I have not heard.
I stand by my original statement. The Secretary of State for Northern Ireland is a most courteous Minister, both in the duties that he carries out in Northern Ireland and in the way that he deals with hon. Members on both sides of the House. No doubt the Government Whip will make a report of the hon. Gentleman's point of order and some explanation will be given to him.
Opposition Day
[15TH ALLOTTED DAY[
Health Care
3.34 pm
I beg to move,
That this House shares with the public, with patients and with health care professionals, growing alarm at the incremental erosion of the public service ethos upon which the National Health Service was founded; rejects the drive to replace the cherished principles of public ownership, co-operation and fairness with private markets, excessive bureaucracy and inequity; calls for a slowing down of the passion for reorganisation; and urges that change in the NHS be based on health arguments, not financial considerations.
Order. I have selected the amendment standing in the name of the Prime Minister.
The debate is taking place at a time when Ministers have been squabbling among themselves, while in the country at large there is concern that the policies that the Government pursue are neither what the country needs nor what its people want. In no area of policy is that shown more clearly than in the health service, where there is growing alarm at the way in which co-operation and fairness in the delivery of health services are being displaced by competition and bureaucracy, and at the way in which the Government openly use the private finance initiative to privatise core clinical services.
There is little doubt that we shall again hear from the Secretary of State not only that the fears that we express are unfounded but that in holding them, the Labour party stands entirely alone. Unfortunately for the Secretary of State, our debate coincides with the annual conference of the British Medical Association. In a sermon on the eve of that meeting, the Bishop of Ripon attacked the Government's so-called reforms for fragmenting the health service and encouraging confrontation within it, and suggested that their dependence on the market and competition struck at the root of the principle of caring. This morning, Dr. Macara, the chairman of the BMA council, addressed the conference and spoke of theOver the weekend yet another senior clinician, the orthopaedic surgeon Professor Colton—who, like all too many doctors these days, is taking early retirement, in his case at the age of 55—said that many of the reforms had more to do with politics than with patient care. He pointed out that he had received a £20,000 bonus for treating fewer patients—in fact, for having had a children's clinic closed for four months because that closure meant that all his patients were treated in times that met the citizens charter targets. He was paid for seeing fewer people. That puts into context the barrage of statistics with which the Secretary of State will no doubt again bombard the House. Those are not the only voices raised in concern."dismantling of the NHS—and the creation of a grim game of winners and losers."
Will the right hon. Lady give way?
I shall give way in a moment. I am about to come to something very pertinent to the hon. Gentleman.
Some of the criticisms that we make, such as excessive bureaucracy, sweeping and sometimes ill-founded structural and organisational change, have been echoed in the ranks of the Government. The final words of our motion echo the words of the right hon. Member for Wokingham (Mr. Redwood)—and from before he left the Cabinet.Does the right hon. Lady really mean that she, in order to prove a point, would have been happy for patients' treatment to have been spread out through the year so that they would have had to wait longer? Surely it was in the interest of those patients to be seen early and well within the time scale that has been required by my right hon. Friend the Secretary of State for Health?
The hon. Gentleman has entirely missed the point. The professor was saying that his clinic was closed; he was not allowed to treat people. As a result of not treating people, the few people whom he did see were dealt with within the Secretary of State's target time. In consequence, he got a £20,000 bonus, which he thought was money misplaced. He saw fewer people than he could have seen had he been allowed to go on treating patients. That is what happens under the Government's reforms. It is not what is supposed to happen.
As the hon. Member for Gravesham (Mr. Arnold) contests the point, and as my right hon. Friend has raised an extremely interesting case, perhaps during the next four hours the Government could inquire about what happened and give us an explanation in the winding-up speech. We would all, including the hon. Member for Gravesham, like to know what happened.
I am confident that the Secretary of State will be able to explain it to us. It was announced at the weekend, so she will have had the opportunity to make her own inquiries.
I have no doubt, however, that the fundamental direction that the health service would take under the right hon. Member for Wokingham is exactly the policy followed by the Secretary of State. His policy is also privatisation, as he first made clear back in the 1970s when he spelt it out explicitly in a joint publication with Oliver Letwin, and it is a direction confirmed by his record in Wales. To be fair, the right hon. Gentleman was approaching the medium to long-term project of privatising the health service with rather more political subtlety than the Secretary of State. As he made clear to the Welsh Select Committee, he seems genuinely able to see something that the Secretary of State apparently cannot—that the Government's plans for the health service are going visibly wrong, and he has enough wit to say so. In the BMA News last August, the right hon. Member for Wokingham said—Will the right hon. Lady give way?
In a moment; I am in the middle of a sentence. The right hon. Gentleman said that he was
I now give way to the hon. Member for Lancaster (Dame E. Kellett-Bowman), who perhaps does not share that view."not mad keen to cut hospital beds. It's not politically popular".
Is the right hon. Lady aware that the ex-Secretary of State for Wales reduced the number of bureaucrats in the health service in Wales by only 340, which is a smaller proportion than that by which my right hon. Friend the Secretary of State for Health has reduced the number of bureaucrats in the health service in England?
I am grateful to the hon. Lady. If she will allow me to continue, I am pointing out that there is some contradiction between what the right hon. Gentleman said and what he has done.
Absolutely. Down with him.
I can without difficulty detect that the hon. Lady does not intend to offer her support to the right hon. Gentleman in the contest.
I was pointing out that the right hon. Gentleman has rather more sense than the Secretary of State for Health and knows when to keep quiet. Perhaps even more startling is his apparently unique perception among Cabinet Ministers that it would beThat is an insight which has so far escaped the Secretary of State for Health. The right hon. Gentleman can see that the Secretary of State's proposals for grand solutions and the closure of popular hospitals are deeply angering the public, something that she apparently cannot see. He is sharp enough to spot that the public are deeply disillusioned with Tory commitments that the NHS is safe in their hands. The Welsh NHS has not adopted the Secretary of State's star rating system now in place in England because the right hon. Member for Wokingham said that"important not to reduce the number of a beds to a point where there are not enough."
He also believes that tables are crude and simplistic. As I said, the right hon. Gentleman knows when to keep quiet especially if, by not doing so, he would jeopardise his long-term project, which is also that of the Secretary of State—privatisation of the NHS. Therefore, when the private sector bid for a new cardiac centre at the Morriston hospital in Swansea proved uncompetitive and the bid went to the in-house team, the right hon. Gentleman said nothing, refraining even from reporting the outcome to the House. In spring 1994, the then Secretary of State for Wales announced that the National Blood Transfusion Service would be market-tested and then, this year, he announced that, on the contrary, it would remain within the Welsh Health Common Services Authority. Sadly, the Secretary of State for Health does not know when she has gone too far. She knows neither when to keep quiet nor when to give way, gracefully or otherwise. Although the right hon. Gentleman can see when the Government are mishandling the NHS debate, there is no doubt that he shares the objective of privatisation, except that he would have undertaken it more quickly and more ruthlessly. The right hon. Gentleman has railed against the growing number and cost of non-clinical staff in the health service but appointed an accountant to chair the WHCSA. He supports performance-related pay, which would demoralise staff and set one against another. In Wales, as in England, NHS services have already been market-tested, including clinical services such as blood culture management, dental services, pathology and pharmacy. In most parts of Wales, NHS dentistry has been allowed to wither away as it has elsewhere in England and, while the right hon. Member for Wokingham believes that the Secretary of State should keep popular hospitals open in England, he has refused to support the reprieve of what I am told is Wales' most popular hospital—Cardiff royal infirmary—whose services are being run down. Since 1991, 6 per cent. of acute beds have been lost in Wales, the same percentage as have been lost in England. Since 1992 the number of managers in the Welsh health service has risen from 890 to 1,330. The right hon. Member for Wokingham claims that he would spend more on the NHS, but in 1993–94 the Welsh Office underspent on health to the tune of almost £30 million. In short the right hon. Member for Wokingham is a little less hamfisted in his public pronouncements than his colleagues at the Department of Health, but he is just as committed to the privatisation of the NHS—"quality is very important but it's harder to measure than factors such as numbers treated and cost."
The Secretary of State has said that she would work for him.
As my hon. Friend the Member for Bolsover (Mr. Skinner) says, no doubt that is why the Secretary of State has said that she would be happy to work with him.
Will the right hon. Lady give way?
No, I will not give way to the Minister. He will have plenty of time to speak later.
The right hon. Member for Wokingham is just as committed to privatisation as he is to the long-term project of ensuring that the NHS no longer provides comprehensive health care for all our people but will instead becomes a small core means-tested service for those who cannot afford any private health care. The Secretary of State and the right hon. Member for Wokingham are clearly at one. It appears that the Tory party is faced with no choice at all.It is all very well for the right hon. Lady to carp about the health services that are being provided by the Government, but has she set any standards for the number of patients that she would treat if the reforms were carried out? To what extent would waiting lists be reduced? Can the right hon. Lady quantify the result of her intended reforms compared with those that we have already made?
I am not aware that the Government have ever tried to quantify in advance the results of their changes. I and most people in the health service believe that if the policies that we advocate were adopted as opposed to the ones that the hon. Gentleman and his party support, NHS staff morale would be far better, services would be far better delivered, and patients would benefit as a result. When a Labour Government assess the delivery of health care, we shall certainly not count finished consultant episodes but we shall count what actually happens in the treatment of patients.
While the Tory party is apparently not faced with any choice, the British people have a stark choice—privatisation under the Conservatives or modernisation of the health service under Labour. Under the Conservatives there have been disasters such as the one described last week by at least one newspaper as a "bloody shambles". That of course refers to the shambles that was caused when operations were cancelled after 15 per cent. of the country's blood supplies were recalled by the National Blood Authority because of a fault in a number of blood bags. As the authority's minutes show, it made a policy decision to buy a proportion of its bags from a new supplier, first and specifically to get them at lower cost and, secondly, to introduce competition to the supply, a policy that the Government are always urging. The debacle that has followed is alarming in itself but it contains a number of striking ironies. For example, the fault was detected by staff at the centre in Oxford, which is threatened with closure in the reorganisation. Those donors who were called in to provide emergency supplies were called to centres such as that at Brentwood which are also threatened with closure because the National Blood Authority says it does not need them any more. Another irony, which I think is unintended, was contained in remarks by the authority's spokesperson, who said that the incident showed that the authority was right to bring in the new company because it was evidently dangerous to rely on one supplier. But the danger arose as a direct result of bringing in a new company, solely to lower costs and introduce competition. Last week's problems are not isolated examples. Blood stocks were already low: they had been below the safe recommended level for four days. Stocks of O-negative had been below the safe recommended level for 11 consecutive days. That was a result of the worry and the low morale in the service and among donors following the National Blood Authority's recent proposals. All those problems arose before the most recent problem caused the fresh destruction of stocks.There is clear evidence that, before any decision is made in the House, this quango will proceed with the appointment of a vast number of administrators. Instead of using its existing centres to continue and expand its service, it is causing chaos.
I share my hon. Friend's view. No doubt she, like me, hopes that the Secretary of State will come to the House before the summer recess to tell us what decisions have been made about the National Blood Authority's proposals, and what progress there has been—and also hopes that the suspicion that has arisen in the service that the Government intend to postpone any announcement until the House has risen for the recess will prove ill founded.
Operations have been cancelled as a result of the problems that we have identified, but that too is not an isolated occurrence. The most recent figures show that the number of cancelled operations rose by 22 per cent. in the last quarter of 1994–95, and that the number of patients not readmitted within a month rose by nearly 50 per cent. Those specific examples of more dramatic problems are only part of a general catalogue of difficulties in the service. Nor are the moves towards privatisation occurring in isolation. I wonder how many hon. Members have seen brochures such as the one from SMI, which advertises a conference to be held in September this year. The conference, entitled "Private Finance in Clinical Services", has been called to "assess" theThe brochure suggests that the private finance initiative"moves towards private finance in core and clinical services".
and states that"involves a complete culture change, creating entirely new markets",
I also have a copy of The Link, the staff newspaper for the Royal Hospitals NHS trust. It contains an article by the head of financial planning, one Mr. Sanford, who writes about the private finance initiative. He says:"Health authorities … are about to look increasingly to the private sector … to manage pathology and core health services".
"In all private finance deals the private sector partner will plan to earn enough income from the NHS to make a profit and cover the cost of its investment."
What a surprise.
It is not a surprise to us that the private sector will want to make a profit out of health care; that is why it exists. What we object to is that it should be making that profit, rather than our public and free national health service.
What may, or should, be of rather more interest to hon. Members who care about public finances is that Mr. Sanford also says:He goes on to suggest a number of ways in which the extra cost of borrowing from the private sector could be offset. His basic pitch is that, whether in laser surgery or pathology, the private sector will hope to cover the initial investment with income from the health service, and to make large profits out of the potential for private patient income. In the case of pathology, however, Mr. Sanford suggests that the private sector would gain through its profit on the sale of tests from a private sector service to NHS hospitals. So there we have it: a finance director and specialist explains that it may not be possible to demonstrate better value for money from the private finance initiatives being used for clinical services, although they will certainly be used to generate profits. That may be the Conservative party's project, but it is not what the health service needs or what the country wants. The Government try to pretend that their policies are right and successful, and that there is no alternative. None of those propositions is true. There is an alternative—in public health policy, for example. There appears at first to be some common ground between the Labour party and the Government, in our recognition of the importance of promoting good health rather than merely curing ill health; but, as always with this Government, the policy is flawed. Their first concentration is solely on the individual. It is up to him to eat sensibly, to keep warm in winter, and not to smoke, but the Government refuse to acknowledge their responsibility, the role of public policy, or the harmful effects on health—let alone on the ability of the individual to carry out those exhortations— of unemployment, bad housing, environmental pollution or poverty. Of course, when it comes to a choice between promoting good health by banning tobacco advertising, and the financial interests of the Conservative party, there is just no contest. A Labour Government would take action at national and local level to tackle such problems, insisting that Government Departments and local authorities alike assess and report on the impact of their policies on health. We propose alternatives too for health care itself—nothing less than the renewal of health care, national in scope and run as a modern public service, not as a set of individual private businesses. With Labour, the national health service would be a single organisation, its assets owned and its staff employed by the nation. We would replace competition with co-operation, and we see all engaged in the service as partners. Doctors, nurses, professions allied to medicine, accountants, staff, managers, the patients, the public, their representatives—all are or should be health partners in a new health service. The internal market depends on contracts and on competition. It is divisive, expensive and bureaucratic. We would replace it with a system in which funding came from the Department of Health to health authorities and, through them, to general practitioners and the organisations now known as trusts. That funding would flow to health authorities on the basis of weighted capitation. The new health authorities will be required to assess the health needs of the population whom they serve, commission care and monitor overall service delivery through comprehensive and long-term health care agreements, covering the range of services required to specified quality and volume within a fixed budget."So often it may be difficult to demonstrate better value for money through the private sector's involvement."
I may have misheard, but I think that I heard the right hon. Lady say that everyone in the national health service would be employed directly by the NHS. Does that mean that general practitioners would lose their self-employed status and become salaried family doctors?
No. What I am saying is that the staff who are employed in hospitals and other trusts would be employed within the NHS, not within individual businesses, as they are at present. I am sure that the hon. Gentleman understood that that was the proposal.
That is not what the right hon. Lady said.
If I can correct the hon. Gentleman, who is interrupting from a sedentary position—I am sorry but I have forgotten his constituency—[Interruption.] No, I am not worried about it: the hon. Member for Wyre (Mr. Mans) may not be representing it for long. What I said was that all staff will work within the NHS, which they all do.
As these new authorities will have a greater range of responsibilities than the individual bodies that they replace, and as we believe that they should give greater attention to the area and to the policies of public health, we do not believe that it is right for those authorities, as was the case with those that they will replace, directly to manage the services that deliver health care. Although the trusts would cease to be separate businesses, and their assets would be owned by a national health service, with Labour, hospital and other trust services would have day-to-day financial and managerial independence, and would be free to make day-to-day decisions about how they delivered the care commissioned. The authorities and services would have governing bodies reconstituted to reflect the interests of stakeholders, and within the guidelines of the Nolan committee. They would be reconstituted to include representatives of the health partners—staff, managers, the local community, service users and so on. The hon. Member for Eltham (Mr. Bottomley) raised the question of GPs. Again, the House will know that we opposed the creation of GP fundholding on the grounds that it fragmented the health service, added to costs and could lead to a two-tier system. All those concerns, I am sorry to say, proved to be well founded in practice. Fundholding is one end of a spectrum that we find unacceptable, but so is the extreme alternative: a system of health authority commissioning without any consultation or without the involvement of general practitioners or others in primary care. We find both of those extremes completely unacceptable, but between them there is a range of possibilities and models for GP commissioning that could be acceptable. In the policy document that we published last week, we identified a number of examples of such models being developed at the grass roots by GPs working in concert with their health authorities. We would find many of those varieties acceptable, but there is one absolutely clear bottom line that must be present in every scheme or model, but which is not present in the model proposed by the Government—that what is good about the provision of primary care must be available to every GP and, through him, to every patient. With Labour, GP fundholding will be replaced by a system aimed to benefit all patients, not just a few. Every GP will have the opportunity to take part in the commissioning of care. Every GP will have the freedom, at present exercised only by fundholders, to refer hispatient to whatever service and for whatever treatment he believes can best provide the necessary care. Those matters are essential to the provision of a renewed health service that will establish and stand by the principles that the British people expect. In our proposals for health care, we do not seek to turn back the clock—as the Secretary of State, on automatic pilot, automatically assumed and asserted. However, nor do we suggest that the health service can stay as it is, and certainly not that it should continue to head in its current direction towards privatisation. In our new document, we identify the stark choice before the British people. They can choose a truly national health service, available to all and based on need rather than ability to pay, or they can choose a fragmented collection of health businesses, increasingly dominated and driven by the interests of commerce. They can choose the competition of the marketplace or the co-operation of a single national health service. They can choose between a privatised health service under the Conservatives or a modernised health service with Labour. This week, the Conservative party is making a choice which is no choice, between two people bound to the same policies. We believe that it is time for Britain to choose and that that choice should be for a new Government and for a new health service in a new century.
4.2 pm
I beg to move, to leave out from "House" to the end of the Question and to add instead thereof:
We have just heard a speech of incoherence and emptiness, which was soporific most of the time and which did not adequately answer the questions that the public and the Conservative party wanted the right hon. Member for Derby, South (Mrs. Beckett) to answer."notes that since the introduction of the Government's health reforms, over one million more patients are treated in hospital every year and waiting times have fallen to the lowest on record; welcomes the Government's commitment to a strong and stable publicly-funded NHS where trusts and general practitioner fundholders are free to build further on these achievements; and condemns the inadequate, inconsistent and incoherent policies of Her Majesty's Opposition, which would destroy the key features of the new NHS, would undermine patients' interests and would throw into reverse the progress of recent years.".
My right hon. Friend is too generous.
I apologise for being far too generous.
There was a moment when I wondered whether the right hon. Lady's speech had been drafted in Cowley street, but we moved on from that point. The underlying theme of her speech, apart from her clear and profound discomfort about the health policy that has been foisted on her, was a real loathing of the private sector and the profit motive. The Conservative party knows that only by having a wealth-creating nation can we adequately fund a national health service. The difficulty for the Labour party is that it has never really understood wealth creation and job creation, which provide the fundamental key to a flourishing health service.rose—
I hope that you, Madam Speaker, will not mind if I make a little progress before giving way.
Last week, the Health Authorities Act gained Royal Assent. That landmark legislation completes the structural reforms for the national health service. It abolishes the regional health authorities and creates fewer, better, all-purpose health authorities at local level to plan the entire range of health services. The Act is the culmination of a long path of health reforms. The National Health Service and Community Care Act 1990 established the basic geography of the new health service—NHS trusts, general practitioner fundholders and the internal market, all aimed to achieve improvements in performance and efficiency. Underpinning the reforms is the principle that the decision should be taken as close as possible to patients. Underpinning the words of the right hon. Member for Derby, South is the principle of a command and control economy, with everything being decided in Whitehall. The regional health authorities had to go. They represented the last bastion of that old structure so favoured by the Labour party. National health service trusts have freedom to run their own affairs. They can control their assets, their organisation, and—increasingly—their greatest item of cost: pay. The Labour party claims with every passing soundbite that it does not want to turn the clock back, yet it would strip trusts of those powers. Trust freedoms are not simply abstract concepts: they work for patients. Since we liberated trusts from the straitjacket of central control, the number of patients treated every year has increased by well over 1 million. [Interruption.] It is very interesting that, whenever we talk about the numbers of patients treated, the Labour party loathes it. It dismisses fact and statistics. It simply likes to cobble together newspaper cuttings from the inevitable examples where, from time to time, things do not work as well as they should.I am grateful to the Secretary of State for allowing this intervention. Since she is referring to trusts and their work, will she address a situation on 7 June involving a constituent of mine? His doctor applied to admit him to Pinderfields general hospital in my constituency and was told that no beds were available. When a bed was arranged at Dewsbury district hospital, my constituent was told that no ambulances were available. How does the Secretary of State intend to deal with the situation under independent trusts? Will she hold an inquiry to find out why that incident was allowed to occur?
If the hon. Gentleman had wanted a detailed answer, he would have given me notice of the question. I shall, of course, come back to him on the detail of that particular case.
There is no health service anywhere in the world where from time to time individual cases are not treated less well than one would have hoped. Nearly always, behind the headlines so sought by the Labour party—food and drink to its debates—there are far more complex and detailed aspects, very often involving confidential information about patients or clinical staff. [HON. MEMBERS: "That is rubbish."] If I may, I shall take, for example, the case of Professor Colton raised in the debate. The House will have heard about Professor Colton and his decision to spend his time in the independent sector in Switzerland. It was the case that they decided at his clinic not to accept elective, non-urgent cases for a limited period. That was because, at that time, 242 out-patients were waiting a maximum of 56 weeks for treatment. At the end of that programme, 22 out-patients were waiting a maximum of four weeks, and they now offer an orthopaedic service for children, delivering a quality of care of which I, as Secretary of State, am happy to be an advocate. They were quite right to take that necessary short-term decision so that all patients could receive a standard of care. Labour simply does not care—rose—
No, I will not give way.
Labour does not care about the detail. It simply wants mischievous interpretation. That is only too clear because it is quite unable in any way to undermine evidence that the people of this country now receive a better service than at any stage in the history of the health service.rose—
I am not giving way. I have a short amount of time. [Interruption.] The debate is limited, and I gave strict undertakings to my hon. Friends not to over-speak.
Apart from the 1 million more patients treated every year since the reforms, we have also put into the hands of doctors, nurses, managers and staff working in hospitals the ability to slash waiting times overall. The average waiting time is now—On a point of order, Madam Speaker. Is it the procedure of the House, and therefore in order, to refuse interventions on the ground of undertakings given only to Members of one's own party?
As the hon. and learned Gentleman knows, it is up to the hon. Member who has the Floor to decide whether to give way. It is certainly up to the Secretary of State to determine whether she will take interventions. She appears to want not to do so, but to make some progress for the moment.
I have already taken interventions. I noticed that the right hon. Member for Derby, South refused to allow an intervention even from my hon. Friend the Minister for Health.
Will the Secretary of State give way?
Order. The hon. and learned Gentleman must not insist; the Secretary of State has made her position quite clear. I shall do my best to call the hon. and learned Gentleman; he may like to make his point then.
He is the only Liberal Democrat in the building.
True. I want to proceed with my speech, but I shall try to find time to give way when I have made a little more headway.
Waiting times have been slashed to the lowest levels ever recorded. Clinics that were previously open on a strictly nine-to-five basis now open in the evenings or at weekends. Requests for help that previously met with the slamming of glass partitions are now handled with courtesy and speed. Where once 20 people were given a 9 o'clock appointment and then had to wait all morning, individual appointment times are now the rule. I must make it clear to the House that survey after survey of the patients who use the NHS endorses their enthusiasm and appreciation of the service they have received, and shows that their confidence in the service is growing. I find it extraordinary that the Labour party, whenever the achievements of health service staff are pointed out, sneers at and denigrates that work.Will the right hon. Lady give way?
Even more achievements have been documented in the latest figures. In the year to March 1995, the number of patients waiting for more than a year for in-patient treatment fell by a half. That matters to patients. The new figures for out-patient waiting time show that 82 per cent. of patients were seen within 13 weeks, and that 95 per cent. were seen within 26 weeks. We are on course to meet the new patients charter target for out-patient waits that I announced earlier this year. That matters to patients and it is an achievement by the staff.
I can tell the right hon. Member for Derby, South that the league tables coming out later this month will again show that the NHS is becoming ever more efficient and responsive to patients. The Labour party sneers at and denigrates the remarkable document setting out the achievements throughout the country.Does the Secretary of State agree that what she has just said does not apply to the ambulance service, as is shown by the report from the Select Committee on Health? If, after nine debates:in the House, the ambulance service was not provided with what the Government eventually thought was necessary—they had given £5 million extra in 1991, and they gave £14 million extra last year—how can the Secretary of State say that the Government have calculated the real needs of the health service as a whole? If they got it wrong with the London ambulance service after nine debates in the House, how do we know that they will get it right for the country as a whole?
Our Government are committed to making information public and available. There has been a transformation in the amount of information that people have on the performance of ambulance trusts and health services throughout the country. It is precisely by making such information available that we can lever up standards.
The hon. Gentleman is, however, right about the London ambulance service; he and I have spoken at great length about that service, and about its long-standing management and trade union problems. My hon. Friends are only too well aware that the London ambulance service is not an NHS trust. It is a sign of old-style health services and not of the way in which we want to manage health services for the future. The Labour party claims that trusts would remain, but that they would be called local health services.Will the Secretary of State give way?
Is the Labour party really saying that all it has to show for five years of consultation, deliberation, effort and thought is simply a new name? Oh, no: the plan of the right hon. Member for Derby, South is much more sinister than that. She has already told the House that she thinks that trusts are an abomination. The truth behind her document is that NHS trusts would go. The right hon. Lady wants to take away their assets and freedoms. She aches to get back to the old regional health authorities with their web of committees, bureaucracy and grind. [Interruption.] The hon. Member for Bolsover (Mr. Skinner) agrees.
The Opposition voted against the Health Authorities Act at every stage, and they voted against the abolition of the regions that will save £150 million on administration to spend on patients. The difference between our parties is that the Labour party would pay the pen-pushers and bureaucrats, while we fund the front-line staff and the managers whom the Opposition never avoid denigrating. The right hon. Lady should be aware that we know the offence she has caused to many in her party who are public servants working in the NHS as managers, and the work of the right hon. Lady and the leaders of her party in constantly denigrating the achievements of those managers is a subject that every Government Front-Bench spokesman has heard time and time again. The right hon. Lady would have national pay, although someone—doubtless from the Leader of the Opposition's office—went over her head and inserted the meaningless words "with local flexibility". No wonder Bob Abberley, whose union Unison helps to pay the right hon. Lady's costs, welcomes her proposals. If the Labour party were ever in government again, it is clear that negotiations with the management side would be extremely difficult, as the management side would have one arm held behind its back by the very people for whose benefit it was negotiating. Until the Labour party renounces the sponsorships of its Front-Bench spokesmen by the health unions, it will never have any credibility. As for the Labour party's acceptance of research costs being paid for by the health unions, I think that that is an absolute outrage, and the public will increasingly think that also. One of the advantages of local pay is that it will take pay bargaining out of the national political arena and place it within trusts, closer to patients and focused on patient needs. Staff can and will benefit. Pay and conditions determined according to local circumstances can reinforce teams within trusts. Trusts can design packages for their staff to replace the bewildering array of national terms and conditions that currently exist. I was pleased that the Royal College of Nursing and the Royal College of Midwives last week accepted the principle of local pay, and they have agreed to start negotiating locally this year. I hope that other unions will see sense and follow their good example, so that we can put this unnecessary dispute behind us. I am tempted to speculate as to why we are having this debate. Is it the right hon. Lady's chance to put her spin on Labour policies? It must have been galling for the right hon. Lady on Thursday to see her policies being given the soft soap treatment by the Leader of the Opposition. Even as best supporting roles go, I think that the right hon. Lady will be pipped for an Oscar by my hon. and multi-coloured Friend the Member for Northampton, North (Mr. Marlow). Against a delicate pastel background, the Leader of the Opposition put his pastel spin on her policies, but green was closer to the colour with which I would associate the right hon. Lady. The Labour party has assured us that it will keep the good elements of the Conservative health reforms. Is it turning the clock back? Heavens, no. The Labour party believes in continuity, progress and—above all—nicking good Conservative policies. The Labour party would renationalise the NHS—a meaningless piece of rhetoric. The spectre of privatisation was, as ever, waved about as the last bullet in the Labour party's threadbare locker. The right hon. Lady made a performance on "Newsnight", where she snapped at the gentle Mr. Paxman that the market would definitely go, and that fundholding would not only go, but would be gone within the year. All day long, the Leader of the Opposition had been cuddling the NHS with his policies of continuity, but after he was tucked up with his Islington cocoa, the right hon. Lady was out of her cage to tear the whole thing apart. Let us be clear—the right hon. Lady does not think that there is anything good about our reforms. She has been forced into a wholly unconvincing and inconsistent compromise by the Leader of the Opposition. The result is:"Another fudge. These policies have not been properly thought through. They are spatchcock reactions, plundering what is newly popular while genuflecting to old vested interests".
Redwoodism.
The hon. Gentleman says Redwoodism, but those were not my words, or those of my right hon. Friend the Member for Wokingham (Mr. Redwood), but those of Melanie Phillips writing in syesterday's The Observer—neither noted for their unswerving support of Conservative causes. Dr. Vernon Coleman, in that other well-known propaganda newssheet for the Government, The People, said that the Labour party's proposals made him want to weep.
The right hon. Member for Derby, South is hopelessly trying to have it both ways. She says that she would keep the purchaser-provider system, but would abolish the internal market. Only Labour would try to ride a bicycle that had the right cogs in place, but no chain. What is the relationship between a health authority and a hospital, if it is not a managed and a market relationship? It is hard to find any precise answers in the document, because it promises armies of think tanks, consultation groups and even royal commissions for all the policies and details that the Opposition have been unable to clarify. The right hon. Member for Derby, South says that Labour wants to give power to general practitioners, but makes it clear that it would abolish within a year the single most effective means of giving them that power— fundholding. She says that Labour would cut bureaucracy, but in place of local, direct management, she wants commissioning committees, a new tier of regional administration, and enhanced powers for the centre to second-guess local decisions. That is not just turning the clock back, but taking it off the wall and jumping up and down on it. Patients would be the losers.May I raise with the right hon. Lady a question that is causing me much anguish? Last Friday, I attended a meeting in my constituency of parents whose children are unable to speak properly because of the absence of speech therapy. The meeting was deeply worrying, because teachers said that as many as 20 per cent. of children in schools in my constituency are unable to speak properly because of a row between the health authority and the county education provider.
Those children have a medical condition. Can someone bang heads together and get the local health authority to recognise that it has responsibilities? Those children will probably be disabled all their lives because of an argument that is going on now. The right hon. Lady has it within her power to get the health authority to do something about it.I hope that the House will bear with me if I do not give way to Labour Members again. The hon. Gentleman has a good case, and I will be more than happy to provide him with a detailed examination of it, but the issue is the health authority assessing the need and commissioning care on behalf of the local community, and working with education and often social service authorities.
The point of the reforms and the significance of the distinction between purchasing and provision is that it is being done so that there can be assessment of need and a collaborative approach with other agencies to meet it. I am more than happy to go into further detail, but I will not rehearse the great increase in the number of speech therapists and the improved training and arrangements—I will spare the House those statistics. The progress of the past few years has been formidable. The Opposition would throw it all into reverse. Fewer patients would be treated, and there would be longer waiting times as staff struggled—in a way that they have no wish to do—to come to terms with the ghastly new world of the right hon. Member for Derby, South, who has ignored the advice that she has received from many of her supporters.Those are not my words, but those of two health experts, one an adviser to the last Labour Government, writing in the June Fabian Review. Professors Brian Abel-Smith and Howard Glennester went on:."There is an obvious temptation for Labour to cash in on public concern and promise to undo every change the Tories have made … Such a gut reaction should be resisted."
"There is now overwhelming evidence that fund-holders are able to get a better deal for their patients. They can pick those hospitals or departments of hospitals which give their patients a better and more convenient service … They can bully specialists about waiting times. They can insist that test results come back quickly … Fund-holding represents a major transfer of power from specialists to GPs".
[Interruption.]
Disgrace. Apologise.
Order. I did not hear what the hon. Gentleman said.
I apologise to the House for any discourtesy. If you, Mr. Deputy Speaker, did not hear my remark, that is all for the best.
My objection was to the idea that GPs can send contracts for all their out-patients to one hospital, as happens in Bath, while the X-rays are in another hospital. Is that in patients' interests?The point was about the leverage that GP fundholders have within the system to deliver better care for their patients. It is for GPs to make those decisions.
Those are precisely the dynamics of the new NHS which the right hon. Member for Derby, South finds distasteful, because they work and deliver improvements for patients, and patients throughout the country know that. The 10,000 GPs or GP fundholders will make their message only too clear to the Opposition. Naturally, we are working to spread the benefits of fundholding to all GPs. We believe in levelling up, not levelling down, and have been listening to GPs' concerns. We shall make life easier for family doctors by cutting paperwork. We shall spell out the details of our plans shortly, but I can announce to the House today that an estimated 15 million forms a year will go. On out-of-hours payments, I remind the House that, as a result of our offer, a typical GP would receive an extra £800 a year for an average of six night visits a month. There can be no excuse for family doctors taking action that damages patients. I am, however, sympathetic to their concerns. The criticism or concern that they have raised about the patients charter—not the cynical reaction of the Opposition—relates to the extent to which we need to remind the public of the importance of using the service responsibly rather than calling out GPs inappropriately, keeping appointments and supporting health staff in their work. That is an area in which we can work together and make good progress. Our task is to realise the potential of the reforms. We must not turn the clock back and throw the whole system into upheaval. We believe in working with staff constructively and practically. We recently announced extra doctors and a 10 per cent. increase in new medical students. I set out many of those issues in a recent speech to the Royal Society of Medicine. I want to see the long-term perspective. On contracting, we need to develop more sophisticated purchasing patterns. Contracts should be drawn up with imagination and an eye on the future, and not simply replicate the patterns of the past. They should take account of quality, outcomes and how services will improve, not simply cost. The Opposition fail to understand that the information that we now have about health services, quality, cost and a number of other issues means that we can progressively fashion an innovative, pioneering and evidence-based service. Such a service will be developed on a research strategy, which is increasingly being acclaimed not only here but around the world, as is our "Health of the Nation" strategy. In her grudging and mean-spirited way, the right hon. Member for Derby, South talked about the importance of improving health, but did not say that we are now marking the third anniversary of our "Health of the Nation" strategy, which the World Health Organisation is using as a model and which the French Government and many health advisers around the world commend. Today, we launched the next phase—a new phase—in the "Health of the Nation" strategy, to target young people. We have much more work to do in that area. The Opposition simply wish to reorganise, turn the clock back and disrupt all that is taking place within the service. Change is necessary in the national health service, but that is change that is driven by new medicine—by new science. Day surgery, laser surgery, bio-pharmaceuticals, genetics, information technology: all those and more are stamping their mark on the evolving pattern of health services. But what does the Labour party do? It resists every closure, every change of use, because Labour frequently supports the patterns of the past, not the patterns of the future. The Opposition speak about the "public service ethos". Of course the national health service must remain publicly funded, but there is scope, as we see through the private finance initiative, to diversify and expand the range of provision without threatening that public service ethos.The Secretary of State speaks about the Government's record on reducing waiting times, and says that it is important that services for young people should be improved. What would she say to the boy in my constituency whose mother wrote to me to complain that he had waited 20 months for a first out-patient appointment for orthodontic treatment, which he has now had, but that, if he is to receive treatment, he will have to wait a further 24 months before he receives the orthodontic treatment he needs, for which his general practitioner has referred him to the hospital?
When will the Secretary of State provide the improvement in services for all people—not just young people—that the patients charter promises?That is another individual incident, which I am more than happy to investigate.
The Labour party appears unable to see the wood for the trees. We have a health service that provides everyone with everything, almost without the use of charges. We have some of the best medical research anywhere in the world. We pioneer new services which are comparable with services anywhere in the world. Our achievement on waiting times is formidable. We used to have 200,000 one-year waiters; we are now down to 32,000 one-year waiters. In the area of the hon. Member for York (Mr. Bayley), we used to have 7,000 two-year waiters when I first came to the Department, six years ago. Now, no one waits more than nine months in the west midlands. I believe that the hon. Gentleman should commend the fact that the west midlands has gone from 7,000 two-year waiters to a guarantee of nine months, albeit that, with the complexity of delivering the service that we are entrusted to deliver, there will always be aspects where there is more to do. [Interruption.] I apologise to the hon. Member with whom I momentarily confused the hon. Member for York. Be that as it may, I could offer him the figures—[Interruption.] Be that as it may, I shall spare him a similar comment about what is happening in York, except to say that the work taking place at the university on the dissemination of reviews—the service it provides and the interest that that is developing throughout the world—provides another example of the way in which we have made the service more fit to meet the future and to tackle the issues, not only of today, but of tomorrow. One will be able to achieve that only by embracing change—not, like the Labour party, by turning the clock back.There is no tomorrow for you.
I profoundly reject the Opposition's misleading motion. The NHS is not a business; it is not for profit; it is not for sale. It will remain a service for all the people to use, regardless of their ability to pay. It must be a health service, not only an illness service; a service focused on the individual patient, responding to their needs and influenced by their choices. It must be an innovative service, evidence-based at every level, and an efficient service, providing value for the taxpayer's money. It must be a service with a long-term view, and a public service with strong ethical foundations.
That is precisely what we are achieving by means of the changes that we have set in hand. The Labour party is stuck in the past, and, although it furiously tries to deny it, the health policies that it proposes show thatI say to the hon. Member for Hackney, South and Shoreditch (Mr. Sedgemore) that those are not my words, but those of the Financial Times. The Labour party would tear up the key elements of the reforms; it would inflict upheaval and uncertainty on staff; it would rob patients of the benefits they receive under the Government's policies. The choice is not between private markets and public health; it is between the Conservative party, which wants to modernise the national health service, and the Labour party, which wants to take it back to 1948."old Labour is far from dead and buried"./
4.34 pm
I am sorry that the Secretary of State has already fired off one set of statistics about the west midlands in the wrong place. I can explain to her that the west midlands is in a different part of the country from York, although it is a city that I know well.
I should like, with your permission, Mr. Deputy Speaker, to give one illustration of the way in which the national health service internal market has worked. It is from my constituency in Birmingham. It shows graphically how a bureaucratic nightmare has developed in which the buck is passed from manager to manager, trust to trust and authority to authority. The end result is delay upon delay in the development of new NHS facilities. The much-vaunted private finance initiative, which the Secretary of State mentioned in her speech, has only made matters worse. In my constituency there is a former psychiatric hospital campus called the Rubery-Hollymoor campus. It takes up about 200 acres of land. The hospitals have closed. The regional health authority, or NHS Executive West Midlands, as it will become, decided to sell off the land and develop it. There has been a great deal of controversy about to what extent local people would have a say in the development, and so on. I do not have time to go into that, but I recommend that hon. Members have a look at that story because it is fairly instructive in its own right. From the beginning it was said that local people would be able to get out of the development a primary health care centre—something that they had demanded for years. They were told that when the land was sold off, money would come into the health service from the sale. Whatever else happened on that land, they would have a primary health care centre. There was a fair amount of discussion—this is going back to about 1990—between people in the area and the South Birmingham health authority about what the primary health care centre should deal with. In 1994, the regional health authority published a new plan for health care in the west midlands. It had had some problems up to that point. It had become unpopular with its blueprint for health care in Birmingham. That even led to the resignation of the then chair of the regional health authority. In 1994 the authority published a new document called "Looking Forward". That document referred to a new preoccupation and emphasis in the west midlands on primary health care. It mentioned two flagship projects that would take place in Birmingham. One was a primary health care centre in a place called Quinton and another was a centre on the Rubery-Hollymoor site. I have to tell the Secretary of State and the House that even though the project was talked about back in 1990, guaranteed at that time, and even though it was proposed in the document in 1994, not one stone has been laid to construct that new primary health care centre. For the first year or so, even though we in the area became frustrated, we thought that the delay was due to the various delays in the development in general. Towards the end of last year I approached the regional health authority and asked what was happening about the development of the centre and why it appeared to be taking so long. The story that I got back was essentially that the main reason why no stone had been laid was that no one in the health service could decide whose responsibility it was to build the centre. The original initiative had come from South Birmingham health authority. It could not be responsible for building the health centre. Why? Because all that it did these days was purchase health care. It could not be involved in developing a facility. The land was owned by the regional health authority so I asked why it was not taking the project forward. The answer was that the RHA did not really do anything these days but merely monitored what other people did. It was not the RHA's responsibility to build the primary health care centre. I was told that it was the responsibility of the local trusts and that the local mental health trust would develop the primary health care centre. When I asked why it had not got on with the job, I was told that that trust had been in negotiation with the other trusts to try to work out how it would fund the centre. After all, that primary health care centre was designed to offer a range of different services, including community services, general practitioner services and chiropody. That was a great idea, so why had the mental health trust not got on with it? I was told that its negotiations with the other trusts had ground into the dust. It had asked the other trusts for the type of financial commitment that it felt it needed to develop the centre in the years to come, but they said that they could not make those financial commitments because, under the new NHS market, their financial regime operated just one year in advance. Those negotiations therefore produced no result and the project came to a halt. It was only when local councillors and I started to ask questions that the trusts decided that they had to get on with the centre. Earlier this year we were assured that the project would go ahead. I asked the trusts what they intended to do and they said that they now had to prepare a business case. I asked for whom and I was told that the project had to be considered under the private finance initiative. The project had, effectively, to be put out to tender. I argued that the project had first been approved way back before PFI was ever contemplated, but I was told that that did not matter and that the project now had to be governed by the rules of the PFI. When I asked what that meant, I was told that the trusts were getting on with the project but the plain fact was that it would be another two years before the health care centre saw the light of day. I was subsequently told by South Birmingham health authority that a notice for tender would be placed in the relevant journal in May 1995 and that pre-qualification submissions would be returned in early June. On 14 June pre-qualification tenders would be selected and an invitation to prepare an outline tender would be issued to between six and 10 companies. On 21 July, two preferred tenders would be short-listed and invited to prepare fully costed tenders. They are due to be returned on 8 September 1995 and on 3 October a finance committee, of the mental health trust I assume, will meet. The trust board will meet on 6 October and the full business case submission will be explored. That is what is due to happen in 1995—about five years after the health authorities agreed to the centre and almost one year after they had been chased up about why nothing had happened until then. Once the private tenders have been returned and it is decided to work on the basis of the PFI, does that mean that the health care centre will then be built? No, it does not, because it is only at that stage that the trusts can start to submit their planning applications. It is only at that stage that the trusts will talk to local people about what they want at that health care centre.The hon. Gentleman has offered us a long catalogue of tender procedures. Is he suggesting that such procedures should not be used and that the project should be given to one bidder only, who might just be the highest bidder? Would not that mean taking money away from patient care?
The project was given the go-ahead in early 1990s and had the support of local people. The health service then had a management structure that worked. The different parts of that service hung together and it would have been rather better if people had made the necessary decisions then. We would then never have reached the stage, as we did a year ago, where different trusts were unable to make a decision about who would fund the project, who would use it and who, indeed, would own it because it is always considered to be someone else's responsibility.
The hon. Member for Mid-Staffordshire (Mr. Fabricant) has implied that the PFI may offer better value for money to the health service. I am not too sure about that. I received a letter from South Birmingham health authority on 23 June, when I was updated on progress on the project. I was provided with the list of dates that I outlined a few moments ago. The health authority explained that taking the project through the PFI was a complicated exercise. It is so complicated that it appears that South Birmingham health authority, the trusts or even West Midlands regional health authority, cannot be expected to conduct it themselves. That is why I was told that, in order to pursue the PFI, the mental health trust had brought in outside help, Nexus Health Finance Ltd., to assist it to perform its task under the PFI regime. The trust, in order to obtain that finance, has had to commission and pay a private company to help it. That has happened on the back of the RHA's decision to call in Erdman Lewis company to help it market the land and another private firm to help it develop that land. Some questions must be asked about how much all that activity costs. The primary health care centre in south Birmingham is just one example from a catalogue of disasters, and it says a great deal about the way in which the health service operates. Any individual manager or health practitioner will have the interests of the patient at heart. It is most unreasonable for Conservative Members to say that the Opposition have attacked people working in the health service. Goodness, we spend our days listening to them and taking up their grievances. We articulate for them because they are often not allowed to do that. That demonstrates what is wrong with the way in which the health service is operating. It is clear that throughout the entire process in south Birmingham everyone has had the interests of the patient at heart, but when one puts the picture together and inserts the crucial mechanism of the market, the outcome is chaos. A decision was made that could never be carried through. The RHA wanted the health centre to be developed, but it never had the power to do that. In effect, the RHA took its eye off the ball. The trusts and provider units wanted the centre developed, but they could not reach the necessary agreement. That failure was not intentional, but they knew that the financial regime imposed upon them by the internal market forced them to expect of each other unrealistic financial demands. That led to delay and, finally, the much-vaunted PH. The only effect of that initiative on the proposed health centre in south Birmingham has been to create further delays and add to costs. At the end of the day, who knows—public money may be used to build that health centre. We know, however, that it will not be built for another two years. Let us go back to the start. It all arose from the sale of hospital land. We were told that that would raise money that could be put back into the health service. The one obvious project arising from that development, however, cannot be financed out of health service money. There is something radically wrong with the way in which the health service now operates. The market mechanism has not worked. It is because of that example in south Birmingham, and countless others throughout the country, that I welcome the new policy document issued by the Labour party. It is designed to bring to an end that disastrous market mechanism and, in a modern context, get back to the essential principles on which the health service is based. It will then serve the interests of people and patients, not bureaucrats and markets, and it will not be governed by an obsession with privatisation.4.48 pm
There is no doubt in my mind that the health service reforms were radical and bold. They are now nearly five years old and they have matured into an understanding of the need for strategic long-term relationships between purchasers and providers and, where appropriate, between providers themselves.
I remind the right hon. Member for Derby, South (Mrs. Beckett) that NHS trusts are NHS funded and NHS managed. But, of course, they will tender for services from public or private suppliers where it is advantageous in terms of improved quality and efficiency—for example, for cleaning and catering, and for patient transport. But the objective always remains the same: to secure improved services that are balanced and non-ideological. Competition stimulates innovation and improves efficiency; it also encourages new and better ways of providing health care. The NHS market is a public market, which is publicly accountable and publicly controlled. All purchasers, responding to the needs of the people they serve, seek to maintain good access to a comprehensive range of general hospital services. Those services will include all emergency treatment, which accounts for 35 to 40 per cent. of all expenditure. However, in some other services, planning needs to be undertaken jointly between purchasers and two or more providers. The implementation of the chief medical officer's recent important report on cancer services could not effectively be undertaken without joint work between trusts to ensure the highest-quality surgery, chemotherapy and radiotherapy—that requires strong links between cancer centres and local cancer services. In other services, the private sector may offer the best quality of care—but still funded by the NHS. Private psychiatric providers have specialist expertise for people with severe problems. Some purchasers are now obtaining much improved care at home for very dependent elderly people, such as quadriplegics, who need to receive customer-designed care, fitted to their needs, from specially and specifically trained carers. The private sector can often best provide such carers—funded and supervised by the NHS and social services together.If it is right that the private sector provides facilities—as well it might—for some areas that are better and give better value than the NHS, can the hon. Lady explain why, in some areas of medicine, the NHS is obtaining services from neither the private nor the public sector? For example, why is it so difficult to obtain medical treatment for anorexic teenagers in the NHS in London, so that some of them suffer for years, while those whose parents can afford to pay can be in a psychiatrist's chair within minutes?
I should draw the hon. and learned Gentleman's attention to the Select Committee's report on purchasing. If he reads the report in detail he will see that we considered those sorts of services that were not being provided in some areas, but found that such services were being provided in other areas and were certainly meeting the needs of the local population. I advise him to read that report in detail as he will see that his point is covered by it.
I am grateful to my hon. Friend for giving way because I wish to raise a point relating to the intervention by the hon. and learned Member for Montgomery (Mr. Carlile).
Is my hon. Friend aware that the family health services authority in Staffordshire produces a list of waiting times and availability of treatments for various types of disfunction? Is it not true that there is no reason why, if the fundholder is in London, the patient should necessarily have to be treated in London? If the treatment is not available, the patient could certainly easily be treated in areas surrounding London, where treatment is available.I take my hon. Friend's point but, again, the Committee's report shows that in some areas particular services are provided and are of a high quality.
The East Hertfordshire NHS trust, which covers my constituency, has established a deserved reputation as a prudent, well-operated organisation that has consistently met all its financial targets and contractual requirements, while placing key emphasis on developing new services for local people. In doing so, it has sought and benefited from private sector developments in just the sort of projects that provide benefits for patients first, for the trust second, and for the private sector third. Most importantly, services for national health service patients have been extended and introduced when that would not otherwise have been possible. For example, new and improved equipment has been introduced where private finance has improved the cost-effectiveness of services in a wide range of areas. The use of leased equipment has enabled vital advances while relieving the NHS of the burden of risk and cost. The East Hertfordshire NHS trust has been able to acquire more than £700,000 worth of essential equipment, ranging from image intensifiers, blood gas analysers and other critical medical equipment, as well as equipment that brings benefits to staff and patients, such as a new switchboard, new information systems and refurbished refreshment facilities within the main hospital. The trust has also developed improved diagnostic services through the provision of an on-site, state of the art, privately operated MRI scanner in a purpose-built unit. The Chase Farm Hospital NHS trust, which also covers my constituency, has a partnership with the private sector; the trust and its patients have benefited, both financially and by means of direct clinical care, through their partnership with BMI. There is a partnership arrangement with the Kings Oak private hospital, which is on the Chase Farm hospital site and which was built by the private sector on Chase Farm hospital trust land. That yields an immediate income of a minimum of £380,000 a year, with additional benefits. The benefits include: the sharing of expensive clinical equipment; training offered by the trust to the Kings Oak resident medical officer, with the trust in return receiving the funding for an additional doctor in its accident and emergency department; the ability to sell pharmacy, pathology and CTC scanning services to Kings Oak and generate income for the department involved; the opportunity for the doctors to undertake private practice on the Chase Farm site, thereby being easily accessible to the NHS when they are required; the ability jointly to develop new services such as mammography screening; and sports injury clinics. The Chase Farm trust has also worked closely with Broxbourne borough council, which was able to facilitate a land swap with the private sector, enabling the trust to re-provide Cheshunt community hospital with purpose-built premises in a central location in my constituency. In my constituency we are concerned about the grass roots delivery of an excellent health service, not about ideological rhetoric, where the word "private" has developed into an abusive term. Britain does not have to make a choice for the national health service between the public service or private markets. The key to maximising our resources and to providing the high-quality health care we need lies in creative and energetic partnerships between our national health service and the private sector. That is the way forward.4.58 Pm
It is now 16 years since the Government's political experiment with the national health service started. One would have thought that, by the end of 16 years, even by the standards of the right hon. Member for Wokingham (Mr. Redwood), the experiment would have come to fruition and would have achieved the panacea of the national health service that we had been promised. Listening to the hon. Member for Broxbourne (Mrs. Roe), one has the impression that the panacea has been delivered, at least in leafy Hertfordshire. If it applies in Broxbourne, it certainly does not apply all over the country.
The hon. Member for Mid-Staffordshire (Mr. Fabricant), who has temporarily left the Chamber, suggested in response to my earlier intervention that an anorexic teenager from London could be treated in Staffordshire. Are we really to believe that that is the recipe or prescription offered by the Government to people who are facing severe illness early in life? Where is the evidence that the national health service is meeting the acute needs of the great majority of the people? The reality behind what the hon. Member for Broxbourne described is that there has been a tenfold increase in the number of NHS administrators. Senior managers are earning over £63,000 a year on average, and the best employment offers in the jobs pages of the heavier newspapers are not for doctors, but for national health service administrators. Of course the national health service needs good, well-paid managers who can administer it well; what it does not need is a management structure which has overwhelmed the medical ethos of the service. It is all very well to talk about day surgery, laser surgery and technological changes; it is right that they should be embraced by the national health service. However, can we really be as satisfied—indeed, as self-satisfied and smug—as the Secretary of State and the hon. Member for Broxbourne when we hear, for example, the intervention by the hon. Member for Workington (Mr. Campbell-Savours) about speech therapy in Cumbria? It is not only in Cumbria that speech therapy is not available. There is a chronic shortage of speech therapists in rural Wales. Why have the Government failed to meet the need for speech therapists? Why is there a shortage of physiotherapists? Why does the training that paramedics who attend accidents receive vary greatly from one part of the country to another in a way that may critically affect outcomes? The Government ought to tell us what answer they have to the triple whammy which they have been given in the past two or three days by senior figures who have made comments about the national health service. The Secretary of State tried to rubbish the comments of Professor Colton, but she failed to deal with the comments of his chairman, Martin Suthers. He is the chairman of Queen's medical centre, Nottingham University Hospital NHS trust, and, one is told, a prominent Conservative. He said:What frustration was that? Perhaps the Government would care to explain it. I do not believe that Mr. Suthers is about to go to Switzerland to practise health in the private sector. He remains to try to pick up the pieces after the departure of Professor Colton, a leading paediatric surgeon, from Nottingham, and has been left to find somebody else to take over the children's clinic. What about the Bishop of Ripon, the Right Reverend David Young? The Minister may laugh at the notion that bishops have any right to say anything about what is going on in our society, but the fact is that bishops see a lot of what goes on through their diocesan work. Why is it that the Bishop of Ripon, despite the Minister's smug and dismissive smile, said:"I am sorry to see him go, but I understand his frustration."
He finds it difficult to see how competition can benefit patients. Then, of course, we have Dr. Macara, the chairman of the council of the BMA. That name brought from the Minister not a smile but a double raise of his eyebrows, probably because he cannot do them one at a time. I see that he can. He raised one eyebrow in response to that. Let us consider Dr. Macara for a moment. He is not a firebrand trade unionist; he has a long record of support for Conservative health policies. However, as chairman of the council of the BMA, this morning he described the regime under which the NHS now labours as "alien." He described the internal market as "an infernal bazaar". He has complained that there is neither equity nor integrity, and called the system whereby whistleblowers working in the NHS are under threat of losing their jobs "dedicated secrecy". Can the Government really, in the style that the Minister of State carries so well off-the-shoulder, shirk such criticisms? Can the Government really be satisfied with having lost the support of the medical profession? It simply will not do for the Secretary of State to say that general practitioners who are fundholders will fight to retain their fundholding status. She omitted to tell us that 60 per cent. of GPs have refused fundholding status. It is only the minority who are fundholders. There is some evidence that many of them regret it. The Nottingham fundholding commissioning group has received a lot of praise, both from the Labour party and from my party. In Nottingham, a very successful alternative has been found to GP fundholding. Part of the evidence is that fundholders have declared that they wish to join the Nottingham group. Why are the Government not prepared to give a fair run to fundholding groups such as that? Why do they insist on pressing the case for individual practice fundholding as their priority? Why are the Government not even prepared, as my party suggests, to test fundholders before they are given fundholding status, not on the basis of the size of the practice but by a strict system of accreditation, to ensure that they are fit to run the funds for their practices? When the Minister replies, I would ask him to explain why it is that, mysteriously, only a few days ago, the extremely able chief executive of the new joint Nottingham health commission, who has given great administrative support to the Nottingham fundholding commissioning group, resigned his job. Did that involve interference by the Government? Have there been subtle words to lever him out because he is doing rather too well and the Nottingham experiment is beginning to show great success? We deserve an answer."The increasingly competitive nature of health care is damaging."
Will the hon. and learned Gentleman give way?
I will gave way later, even though the Secretary of State refused to give way to me. I ask the Minister to find out the true explanation for the departure of the chief executive from his post. He should give an informed answer at the proper stage of the debate.
Is the hon. and learned Gentleman telling us that in Nottingham, for which the Minister is responsible but in respect of which he may or may not reply, there is a group of GPs who wish to avail themselves of advantages through some large-scale co-operative organisation, thus benefiting local citizens, but who are being prevented from so doing? If so, the Government must say why.
The Nottingham fundholders group is extremely well run, by some very good doctors. It is clear evidence that doctors can run important parts of the health service for themselves without large numbers of administrators. However, they have had a great deal of help from the chief executive of the Nottingham health commission, who sadly disappeared—I do not mean physically, but from his job, with very little notice, I understand, at the end of last week. If the Minister can give an informed explanation, I shall give way. I apprehended from his sedentary reaction that he was ready with one of his usual off-the-cuff ripostes rather than the true reasons.
The hon. and learned Gentleman asked two specific questions: had the Government engineered the chief executive's departure, and had the Government had any words? The answer to both is no, but I shall see whether there is any explanation that I can offer him. I cannot undertake to do so, but I shall certainly try. While I am on my feet, may I ask the hon. and learned Gentleman whether, as seems to be the case from what he said about fundholding, he shares the Labour party's view that it should be abolished?
I look forward to the Minister of State's informed reply to my inquiry about the chief executive in Nottingham. The Liberal Democrat view on fundholding is absolutely clear. We would encourage the development of joint commissioning groups. One has to be realistic, and it is not realistic to abolish all fundholding at a stroke. I do not believe that the Labour party would regard that as realistic, either.
The development of joint commissioning groups, as Nottingham has shown, would ensure that fundholding would wither on the vine. Indeed, fundholding has always been a kamikaze policy. It was always in the end bound to set doctor against doctor and patient against patient, and it was quite illogical from the start. It is the doctors in Nottingham and elsewhere who are saving the Government from the consequences of that policy. I welcome Labour's choice for a debate on the national health service. I hope that, as a result of the Labour party's measured approach to changing the NHS, we shall not return to the old phoney war of all public provision on the one side and possibly all private provision on the other. The NHS should cease to be a political and ideological battleground. It should rather be a service in which patients come first, and those who work in it come only slightly behind them. Like the hon. Member for Newcastle upon Tyne, East (Mr. Brown), who is a member of Labour's Front Bench, I was present at the annual dinner of the National Association of General Practitioner Co-operatives at the weekend. That is another organisation which has shown that doctors can run important parts of the national health service. For a change, I should like to hear the Government say that they will introduce initiatives to ensure that not so much of the management and administration of the health service is taken up by an exponential increase in administrators of only the managerial kind, but is done by doctors as far as possible. Although it provides a useful discipline, the internal market is desperately in need of reform. I accept the need to separate commissioners from providers, as it is a useful discipline which ensures that the best value and quality can be obtained. However, the creation of 400 to 500 separate hospital and community trusts, the fact that there are several trusts in some cities—there are four in Shrewsbury and three in Hereford—and that there is now a competitive market for nurses and auxiliaries, which means that continuity of care is not being provided in many areas, cannot be a sensible use of the internal market mechanism. In addition, the fragmentation of the national health service under the Government has meant that networking is extremely poor. When the hon. Member for Mid-Staffordshire made his absurd suggestion that anorexic teenagers from London should be shunted up to Staffordshire for out-patient appointments—rose—
It is clear what the hon. Gentleman meant. He has had his opportunity—
On a point of order, Mr. Deputy Speaker. Is it in order for an hon. Member to misquote me deliberately in order to mislead the House?
The hon. Gentleman will have the opportunity to make his point if he is fortunate enough to catch my eye.
The hon. Gentleman's facility for expressing what he means may not always work in tandem with his mind. However, we understood that he made the absurd suggestion that young people should be shunted—[Interruption.] It has happened. Psychiatric patients in London are being shunted to the north-east of London, away from their families, because one NHS health trust is not able to tell a neighbouring trust what beds are available. That is the reality, and it is only one small example of the chaos that the Government have created in many spheres of medicine—if only they had the courage to realise it.
5.14 pm
I am grateful to be called at this opportune moment, Mr. Deputy Speaker. If ever there was an example of the Liberal Democrats' woolly thinking and woolly hearing, the speech of the hon. and learned Member for Montgomery (Mr. Carlile) was it—as Hansard will clearly show.
The point that I was making, and which I shall make again later, is that the family health services authorities can provide lists of where people can receive treatment. To suggest for one moment that people from London would find it difficult to visit the surrounding counties is ridiculous. If the hon. and learned Member for Montgomery knew any geography, he would know that Staffordshire is nowhere near London. I was not saying that people from London should go to Staffordshire. We heard woolly criticism from the Liberal Democrats, but earlier we were graced by the right hon. Member for Derby, South (Mrs. Beckett), who criticised the Government but came up with no tangible suggestions as to what she intended to do. She merely provided a series of models—I believe that that is what she calls them.My hon. Friend was accused of supporting the idea that people should be moved from one part of the country to another, but is that not the reverse of our health reforms? More major operations now take place across the country so that people do not have to come to London. Yet we are criticised by the Opposition for tackling the problem.
As ever, my hon. Friend hits the nail on the head with great accuracy.
The right hon. Member for Derby, South talked about a number of different models for Labour party policy and alternative templates, but at the end of the day she came up with no tangible suggestions as to how the health service should be reformed. When I challenged her to say what her party's targets would be in terms of the number of treatments per year or by how much waiting lists should be reduced, she said that it was not her party's policy to set targets. All that we heard is that it is her party's policy to talk about centralism. You will know, Mr. Deputy Speaker, that before I was a Member of Parliament I used to travel a great deal to the former Soviet Union where people were experts in centralism. The Soviet state committee for planning—or Gosplan—used to come up with wonderful five-year plans.Is the hon. Gentleman aware that the Health Authorities Act 1995 removes a regional tier, thus giving more power to the Department of Health? Does he not consider that a centralising measure?
The hon. Gentleman clearly misunderstands the point of the Act, which is to decentralise the health service. He may be old enough—possibly not—to remember the original series of Dr. Finlay's Casebook". Although it may have presented an idealised vision of the health service, it dealt with local treatment. But in those days, of course, the health service was not funded nationally.
The right hon. Member for Derby, South maintains the myth that we no longer have a national health service by saying that, somehow or other, the trusts and fundholders are some form of private medicine. That is not the case, as the health service is funded nationally. Efficiency and the ability to say what is required locally—with clinicians making such decisions rather than a bunch of central bureaucrats trying to plan the health service as Gosplan tried to do in the Soviet Union—has to be admired. Just as the Soviet Union was damned and doomed, so was the national health service as we knew it. But it is still very much a national health service, and that is how it ought to be. I suspect that the only matter on which I agree with the right hon. Member for Derby, South and disagree with the Government relates to tobacco advertising. It is a strange anomaly that the Government rightly legislated in the Broadcasting Act 1990 to stop tobacco advertising on radio and television, but did not go the whole hog and ban it nationally in other media. That is a strange and inconsistent omission. There is much of which the Government can be proud. The Department of Health has produced a statistical bulletin that was prepared by the Government's statistical service. It shows that on 31 March this year 1,440,051 patients were waiting for treatment. However, more than 75 per cent. of those patients had been waiting for less than six months at that time and more than half of all patients had been waiting for less than three months. Those are significant achievements, but did we hear any recognition for them from Labour or the Liberal Democrats, whose spokesman, the hon. and learned Member for Montgomery has not even had the courtesy to stay for my speech, which followed his? There has been no recognition at all. When the Opposition were challenged to state what their targets would be, they came up with neither solutions nor targets. All they came up with were empty slogans and rhetoric. Of course, that is the authentic voice not of new Labour, but of socialism, and it speaks of central planning and slogans. The Opposition have no targets and no clear methodology as to how targets might be achieved. The statistical bulletin shows that the number of patients who had been waiting more than a year had fallen by 50 per cent. since March 1994. Of course people will always be able to quote individual cases. A number of Opposition Members intervened during the speech by my right hon. Friend the Secretary of State and spoke about individual cases which they thought should have had better or quicker treatment. However, none of them seems to have had the energy to write to the Secretary of State or the Minister of State to raise those problem cases—if they truly exist. The threat to scrap GP fundholders is worrying. Lichfield is witnessing the benefits of virtually all its doctors being fundholders. Fundholding is a clear example of how, for the first time since 1948, money is following the patients and not the other way round. That is an appropriate slogan because it summarises the position. The Victoria hospital in Lichfield has direct access surgery, evening radiology and physiotherapy services, additional orthopaedic, dermatological and gynaecological out-patient services and a new surgical wing, which I had the honour to open. All those services are being provided there for the first time and they are the direct result of the Government's strategy and policy. That hospital is ably run by Premier Health, whose managing director is a fully paid-up member of the Labour party. If he were here to speak to the right hon. Member for Derby, South he would probably have something to say about Labour's proposed reform of the trusts. If Labour's ideas were to be implemented not only would there be chaos, but there would be considerable delay in treating the people of Lichfield. In 1993–94, the out-patients department treated 11,346 people, but it now treats more than 15,500. That is a significant increase, and it is the result of the trusts and fundholders in Lichfield being able to say, "We want our patients to be treated locally." As I say, that is money following the patient and not the other way round. The Opposition's broad proposals, about which they do not go into any detail, would restore the disastrous situation prior to the reforms when patients were shunted all round the country for quite ordinary treatment. When I said that, for more complex treatments, people might have to travel a little distance, Opposition Members laughed. One of the great innovations by my FHSA in Staffordshire under the extremely able chairmanship of Mr. Philip Jones, who lives in Oulton Heath in Staffordshire, is a system by which all general practitioners, fundholders or not, receive every month a book which details against waiting lists the different types of treatment that are available in various parts of the country. Fundholders are able to say, "We can send our patients where treatment is most efficient, and to places with the shortest waiting lists." I hope that other counties will be able to emulate Staffordshire's flexibility.Will the hon. Gentleman give way?
I am happy to give way to the hon. Gentleman.
Will the hon. Gentleman not acknowledge that before the Conservative health reforms every GP was free to refer patients to any NHS hospital? But under the reforms most GPs can refer their patients only to hospitals with which their health authority has a contract. The hon. Gentleman is right to say that a GP fundholder can refer patients to any hospital—if that GP wishes to set up a contract—but that just means that some doctors are getting back the freedom of referral that they had before the reforms were introduced. Patients who are not with fundholders do not have the freedom of referral that used to exist.
Perhaps the hon. Gentleman is looking back through rose-coloured spectacles. Many of the NHS hospitals to which he refers did not perform the operations for which people are now referred. If the hon. Gentleman cares to look at the data more carefully, he will discover that. The hon. Gentleman shakes his head in disagreement. He represents a major city but my constituency contains Lichfield, which is the second smallest city in the country. Lichfield did not have access to consultants and patients had to be sent to Wolverhampton, Birmingham or Sutton Coldfield. But since the reforms, consultants from hospitals in those places have to come to Lichfield away from their hospitals and, dare I say it, away from their golf courses, too.
Will the hon. Gentleman give way?
Perhaps the right hon. Lady would allow me to finish dealing with the intervention by the hon. Member for York (Mr. Bayley) who, I think, was getting at the two-tier system. I should like to see a one-tier system and all doctors being fundholders.
I have borne, I hope with some patience, the hon. Gentleman's remarks. He seems to be entirely unaware, so may I gently point out to him, that the kind of improvements to which he refers result from GPs being involved in commissioning care and not from people being fundholders. Indeed, similar improvements have been achieved in cases where health authorities and GPs have worked together in GP commissioning of one form or another.
I am glad that I allowed the right hon. Lady to intervene because she displays an inordinate lack of understanding of how not only fundholders but non-fundholders work. Waiting lists are being shortened not only because hospitals are now being run more efficiently, but because fundholders are able to perform the little operations that formerly had to be done in hospital. Simple operations such as the removal of moles which, of course, could lead to sarcomas, can now be undertaken swiftly and efficiently in fundholders' surgeries. That could not be done before the reforms, and the right hon. Lady should accept that. The fact that she refuses to accept this major change clearly demonstrates that she does not have a clear grasp of her brief.
In June 1995, my right hon. Friend the Secretary of State announced that the intake of medical students had increased by some 10 per cent., and that the number will have increased by 5,000 a year at the turn of the century. That is another demonstration of the improvements that have been made in the health service, nationally and locally. The right hon. Member for Derby, South spoke of bureaucracy. Perhaps she would now care to tell me the actual number of people employed in NHS administration. She is constantly saying that the reforms have led to more bureaucracy; has she any idea of the percentage of health service employees who are administrators, and the cost involved? I shall be happy to give way to her.And I should be happy to give the hon. Gentleman the answer to his question, if the Government would publish it. However, they refuse to reveal the figures. According to our most recent estimates—which depend on some information about the finance spend—perhaps as many as 30,000 people are now employed in administration. As far as I am aware, it is not denied that the administrative costs of the health service have doubled since the Government carried out what the hon. Gentleman is pleased to describe as their reforms.
Again, I cannot follow the right hon. Lady's logic. First she says that she cannot gain access to the data; then she says, with great assurance, that the number has doubled. She is clearly talking off the top of her head. I can inform her—she may wish to make a note of this, and no doubt her hon. Friend the Member for Newcastle upon Tyne, East (Mr. Brown) will refer to it in his winding-up speech—that just 2.6 per cent. of total NHS spend is devoted to administration. That gives the lie to the claim that it is additional—[Interruption.] The right hon. Lady and the hon. Member for Newcastle upon Tyne, East say "Rubbish", although they have said that they do not have access to the data. The right hon. Lady now has time to find out the precise figures or to make an estimate, and I look forward to hearing that information when the hon. Gentleman winds up the debate.
The point is that the NHS is the largest organisation in Europe. It spends £110 million of taxpayers' money every day. What would the right hon. Lady do? She says, "We will not get rid of fundholders overnight; we will allow a year before we slash them"—and, no doubt, slash local people's chances of being treated locally. I wonder whether, if there had not been a Conservative Government, the Labour party would be enduring the same old health service that was set up in 1948. Does Labour not accept that demands on the service have changed substantially since then? Incidentally, Opposition Front Benchers keep coming up with the names of doctors who disapprove of the changes in the health service. Let me remind them that the British Medical Association—including consultants and other doctors—opposed the very changes that created the NHS. If we listened to every doctor who said, "We do not want change in the NHS; we want to exist in the same old way as before, although it will mean long waiting lists and will prevent us from treating people locally," no reforms would ever be made. We would never have had an NHS. For Opposition Members simply to sit there and say, "We will not make these reforms: we do not accept that reform is necessary," is a negation of their duty. It is almost as if, in their heart of hearts, they did not expect to be a party of government. If they were a party of government, it would not be a case of talking about templates and models; they would have to provide tangible policies and targets, which they consistently refuse to do. Even the Labour party admits that the situation cannot continue as it was. According to a Fabian Society report,I know some evil men in grey suits, but they are not in the NHS—"Dismay was expressed at the myth that NHS managers were evil men in grey suits"—
Those are not my words. At least the Fabian Society is the intellectual wing of the Labour party; at least it takes some pride in trying to evolve policy, rather than engaging in cheap point-scoring as Opposition Front Benchers do. They give us point-scoring and slogans, but no policy, no targets and, as ever, no clear idea of how they would resolve the problem of more patients needing more treatment. The right hon. Member for Derby, South spoke of bureaucracy, although she did not know the number of bureaucrats involved. She called for the abolition of GP fundholders, although that would result in a more bureaucratic system than that which currently exists. Labour wants the return of regional health authorities, and makes similar demands in its proposed reforms of local government. Who wants regional seats of government in England? No one except the Labour party. Who wants regional health authorities? No one except the Labour party. It is the party of central planning—Gosplan. It is the party of bureaucracy. Indeed, following the Monklands affair, it could be said that it is the party of jobs for the boys. All that is typical of where Labour would stand if—God forbid—it ever gained power. It is clear that Labour wants to turn back the clock. As Stephen Pollard of the Fabian Society has said,"and there was a plea for the Labour Party not to perpetuate this image … Comparisons were made with the tad old days', when nobody knew who managed the NHS … It was claimed that more and more nurses are taking up management positions, and that 45 per cent. are women … There were some really good things happening in NHS management, it was argued, and the Labour Party would be foolish to dismiss them out of hand"
Have we heard from new Labour today? No: we have heard the authentic voice of socialism."The whole issue of the future of the health service is, if you like, a classic test of old Labour against new Labour."
Real Labour.
There we have it. The Opposition Whip himself—the silent one—says that real Labour is the authentic voice of socialism. I hope that that message gets across to the right hon. Member for Sedgefield (Mr. Blair). In his heart of hearts, the right hon. Gentleman knows that the majority of the Labour party is real Labour—old Labour. The old socialists have not been changed, and the oldest socialist of them all sits on the Opposition Front Bench.
According to Mr. Pollard,As I have said, those are not my words but the words of Stephen Pollard of the Fabian Society, spoken in "On the Record". Once again we have heard the authentic voice of socialism which, we are told, is the voice of real Labour, which is new Labour—it is the same thing. We have heard a criticism of the national health service as run by the present Government; yet we have heard nothing about how the Labour party would run the service if it ever formed a Government. When challenged by me and by others, Labour Members do not answer the question, "What targets would you set for patient care? What targets would you set for ensuring that patients are"—"Old Labour … believed in sort of top-down state planning, the men in Whitehall know best about these things, which was typically characterised by the management of the National Health Service".
Order. The Chair has no views.
I was not referring to the Chair, Mr. Deputy Speaker, or indeed to the right hon. Member for Derby, South. I certainly would not point at the right hon. Lady.
When the hon. Gentleman says "you", he is addressing the Chair.
As always, Mr. Deputy Speaker, you are right. I bow to your superior experience. I ask your forgiveness as merely a new boy and unaccustomed as I am to public speaking.
The fact remains that real Labour—old Labour, the old socialists, the Gosplans and central planners of this world—has no central plan. Its members simply carp, criticise and come up with slogans. When asked to come up with targets, they answer, "We have no targets. We can provide no targets." The Government do provide a truly national health service in that the national health service should always be available free of charge to people who need it. Under this Government, it will always be nationally funded, but, whether it is the Soviet Union, which determined that central planning did not work, IBM, or any company in this country that knows that centralised planning never works—Will the hon. Gentleman give way?
I will give way to the hon. Gentleman. I was just about to conclude my speech and I know that he will be upsetting his Front-Bench team, but I am happy to give way to him.
The hon. Gentleman says that he is against massive bureaucracies, but does he not agree that, as part of Conservative reforms, two further tiers of bureaucracy have been introduced between the Department of Health and the national health service—the NHS management executive and, beneath it, the regional offices of that executive—and that both tiers are accountable upwards to the Secretary of State for Health rather than outwards and downwards to the service, which was the case with the old regional health authorities? Two layers of bureaucracy have been introduced to replace one.
The hon. Gentleman has studied his brief, is well aware of the facts and has stated correctly that those tiers exist, but he has failed to observe that the number of staff in those bureaucracies has been reduced fivefold. There must always be some overall control of matters such as epidemiology, which, incidentally, no Labour Member has—
Health planning.
Does the hon. Gentleman wish to intervene?
Order. We should be getting on with the debate.
I thought that the hon. Member for York was trying to say something. The whole point of the reforms, as the hon. Gentleman obviously knows from his own experience in York, where I know there are many fundholders, is that local fundholders can direct where patients should go and, for the first time, perform operations that they were previously unable to perform.
I remind the House that every doctor gets two degrees, not one. Any doctor who graduates in England or Wales gets a degree in medicine and a degree in surgery—he becomes a Bachelor of Medicine and a Bachelor of Surgery. That enables him to perform minor surgery in his local trusts. The hon. Gentleman will know that the reforms in York and those that my right hon. Friend the Secretary of State has made in channelling money northwards away from London enable his patients to be directed to local hospitals, which are run now by local people. That is local accountability. That is not centralism. That is a framework in which the NHS has clearly demonstrated that it can reduce the number of people on waiting lists and that the number of patients treated can be increased considerably. The hon. Member for York and his right hon. Friend the Member for Derby, South have come up with no proposals as to what they would do in office. All that they come up with is slogans. Here we have had it—the authentic voice of socialism: plus ça change, plus c'est la même chose.5.43 pm
In the short time since my election to this Chamber—three years—I have heard some nauseating nonsense from Conservative Members, but that takes the biscuit.
It is appropriate that we are having this debate today, which has again been initiated by the Labour party. In my three years here, I do not believe that the Government have initiated one debate on the national health service. It was appropriate to hold the debate today because it allowed the Secretary of State for Health to give her swan song—and what a swashbuckling attempt it was. I am sure that by the end of the week she will be looking for a new post. The debate is especially appropriate following the publication last week of Labour's policy document "Rebuilding the National Health Service", which was ably launched by my right hon. Friend the Member for Derby, South (Mrs. Beckett). The Secretary of State said that Labour would turn back the clock and return to a command-style national health service. Her criticisms were tongue in cheek and were levelled without foundation. Labour's plans will improve the service that the NHS can give patients, and secure the NHS as a public service for generations to come. The founding principles of the NHS have been utterly undermined by the Government's policies. Their reforms have introduced competition into the NHS. They have sabotaged the principle of treatment on the basis of clinical need and instead have introduced finance as the main factor that determines whether people receive care. The NHS was set up to ensure that payment would no longer be a condition of treatment, but the Government have reversed that. They have turned those principles upside down. The internal market has created a system of competing health businesses, each vying with each other for its own niche of the market. That has caused inflexibility, duplication and waste. It has also led to a secrecy and a lack of accountability that has been damaging the service overall, as well as the interests of patients. The ideology that the Conservatives have imposed on the NHS is totally at odds with its purpose. A collective, co-operative approach is needed to maximise efficiency. What is needed now is a commonsense approach to the NHS to rid the system of the commercialisation, fragmentation and privatisation that the internal market has caused. Labour will maintain managers' ability to manage at local and regional level to secure the most appropriate services for patients in their region. Services will be properly planned. Duplication and waste will not be tolerated under Labour. Patients must be treated, first and foremost, according to clinical need, but the Government's reforms have perverted that principle. Patients of fundholders may receive quicker treatment than some people whose care is paid for by the health authority, especially if its contract is nearing its end, as happens at the end of every financial year. We have heard stories—and we have checked them out and know them to be true—that, come the end of the financial year hospitals are told by general practitioner fundholders, as they are by different health authorities, not to carry out operations because they are running out of money. Charges for eye and dental check-ups were introduced and charges for prescriptions have spiralled over the 16 years of this Government. We know that one result is that people have been discouraged from taking eye tests. The number of tests fell dramatically when charges were introduced. We also know that NHS dentistry has been sabotaged by the Government's policies. In May 1995, the General Dental Practitioners Association reported that, since 1990, the proportion of dentistry carried out in the NHS had fallen by one third. I know from experience in my constituency of Doncaster, North that dentists have written to patients, saying that they will not treat any more NHS patients and offering them private cover. Patients are being told that they can wait months to see a consultant, or choose to pay £50 to see the same person privately the following week if they can stump up the money: for some people, that is some choice. With 1 million people on waiting lists, there is a real temptation for people to take that option, but, of course, not everyone can afford to, and the Government know that. Time after time, Government policy has undermined equal access to treatment and treatment based on clinical need, with the least well-off in our society the worst affected. Today, the British Medical Association chairman asked a question: where stands equity when the cash lottery dictates priority to patients with lesser need? At the same time as the market is skewing equal access, lower-income groups continue to suffer more ill health than the rest of society. With economic inequality on the increase, inequalities in health have become more marked. There is evidence that the service in deprived areas is lower than in other parts of the country, but the Government refuse to take account of deprivation through changes to the funding formula. As bureaucracy has spiralled, health care has suffered. Nationally, about 12 per cent. of the health budget is spent on administration. In Doncaster, administration costs increased by 48 per cent. following the introduction of the internal market, rising to £6 million. Management costs have spiralled even higher. The Government deny any problems. It is clear that Health Ministers do not read the newspapers and do not listen to either their Back Benchers or Labour Members. Patients are being flown miles across the country to find beds. People are waiting for hours on trolleys because there is no proper space for them in local hospitals. In Doncaster, a number of patients have been farmed out to other hospitals because no beds have been available. Those are real problems affecting real people, but the Government's response has been non-existent. Instead, they just get on with the job of upsetting health service staff by offering the nurses a pay award of just 1 per cent., by ending national pay, by lumbering them with more administration, by undervaluing their contribution and by failing to listen to their concerns. One trust in Doncaster has not paid the full 3 per cent. award—only 2.5 per cent., with a 0.5 per cent. top-up for this year. That means that in years to come nurses will be 0.5 per cent. worse off. With inflation currently at 3.4 per cent., that is little more than an insult to the people who run our NHS. Labour recognises that patients and staff are people, not units on a production line. They must all be treated with respect and their views listened to. The Government are failing to do that. The long-running dispute with dentists, the imposition of local pay and the dispute over out-of-hours work by general practitioners proves that. Patients need a voice too, and Labour will tackle the secrecy that the internal market has created, ensuring that both patients and staff have a say in their NHS. Labour will bolster the community health councils as advocates for patients. In "Rebuilding the National Health Service", Labour has comprehensively set out its vision for the national health service. It is a practical, effective recipe for improvement—a way of removing the worst excesses of the internal market and bringing some sanity back into the NHS—Will the hon. Gentleman give way?
No, many of my hon. Friends are waiting to speak and we are running out of time.
The Government say that the NHS is safe in their hands, but for those who have had to wait months for operations, for those whose operations have been cancelled—14,500 people in the first three months of this year alone—and for those denied services while others jump the queue, Labour has a more impressive agenda to offer. We will dispense with the policies that have left some unfortunate people with a second-rate service; we will introduce a system that can provide a service second to none, which is fair in its distribution of services and effective at meeting the demands of those in need. We have our agenda for change. The Government will not accept the need for change. The Government must go—and given the current shambles on the Conservative Benches that will be sooner rather than later.5.53 pm
The hon. Member for Doncaster, North (Mr. Hughes) made one true statement—that patients need a voice. How right he is, and that voice is coming from the Government. It has been passionately expressed by my right hon. Friend the Secretary of State for Health. I can think of no other person who has gone to greater lengths or shown greater commitment to giving patients a voice.
The Labour motion is a complete rag-bag of ideas. It focuses more on "growing alarm" than on any real care and concern, for the patient. Bearing in mind the fact that the Opposition tabled the motion, if they have so much care and concern, why are not their Benches full of Labour Members? Where are they? Their so-called concern for the patient is hypocrisy. The Government have worked hard for years to get a good deal for patients. Indeed, the evidence of that is clear in the Government's amendment, which points out thatWhy was the right hon. Member for Derby, South (Mrs. Beckett) incapable of paying tribute to those remarkable achievements? Why is she blind to progress? It strikes me that the Labour party is attempting to politicise the health service, rather than focus on patients. We kept hearing emotive words from the right hon. Lady, such as privatisation is an ogre and the private finance initiative is a dirty phrase. I can tell Labour Members that the PFI will give the NHS a boost and broaden its imagination in a way that has never happened before. I draw the attention of the House to an innovative programme that has been proposed in my constituency for a new Sutton medical campus, which will have the latest in technology and services for patients. How is that to be carried through successfully to the next century? It is by consulting and working with a private finance initiative. I have no doubt that patients throughout the south-west London area will benefit enormously. Another thought occurred to me when I was listening to the right hon. Lady. Among all her incoherence, she gave me the feeling that she had to alter the NHS just for the sake of it. I maintain, "If it ain't broke, don't mend it." Indeed, what is remarkable is that the NHS is providing a better service than ever before. The greatest evidence of that is that people are now living healthier lives and for much longer because of preventive care—[Interruption.] That does not happen by accident; it is a result of excellent treatment."over one million more patients are treated in hospital every year and waiting times have fallen to the lowest on record".
Is the hon. Lady satisfied with a situation in which poor people live, on average, eight years less than affluent people?
The whole point is that everybody has a different life style. If people choose an unhealthy life style, it is difficult to impose better habits on them.
They are poor people.
Yes, but does the hon. and learned Gentleman accept that the NHS helps everybody in the community, irrespective of income? With better preventive care than ever before, everyone in the community is leading a healthier life—[Interruption.] If people choose to smoke cigarettes, that is their choice—
So it is down to fags and chips then.
If people choose to eat an unhealthy diet, that is their choice. We can offer them the opportunity of a healthier life. There is no evidence that people on low incomes need necessarily live shorter lives. The hon. and learned Gentleman's comment was bogus.
Let us look at the broader picture in the health service today. It is remarkable that the health service is spending £110 million a day on patient care. Sadly, that message does not always get across. When talking to people in the street, I find that the responses are curiously paradoxical. I ask somebody, "How are you getting on?" They might say, "I am getting on very well, thank you." I ask, "Have you recently had any health treatment?" They say, "Oh, yes; I received wonderful service. My operation was carried out promptly, the doctors were dedicated, the nurses were marvellous and I am home, fit and well." I ask, "Why, therefore, are you and so many other people worried and fearful for the future of the health service?" The answer comes back over and over again, "It is what Labour says on television, what Labour says in the media, what Labour says through its politicians." There has been a very dangerous and irresponsible misinformation campaign. The Labour party is playing on people's fears; it is playing on the fears of elderly people, of young people, of young mothers. That is utterly wrong. Instead, we need to consider their experiences. In my constituency, the successful St. Helier NHS trust is treating more people every year. Operations are performed more promptly, waiting times are shorter and more out-patients are treated. The Royal Marsden hospital is also in our community. It has an excellent reputation throughout the world for the service that it provides and it is backed by the Institute of Cancer Research, whose research is second to none. More people are screened earlier for cancer, they are treated earlier and their survival rate has vastly improved. No longer do they suffer the fears that they had before. With modern technology and medical science, GPs are finding that the whole picture has changed. The concept of day surgery has changed the face of modern medicine. We no longer need the same number of acute beds. Day surgery has meant that people recover more quickly at home. They are back on their feet and back to work more quickly. Modern medicine with modern management has made all that possible. Waiting times have been a curse in the past, and it is interesting to note that, before our reforms, more than 200,000 people were waiting more than a year for hospital treatment. Today, the figure stands at only 31,600—the lowest since 1948. Indeed, over the past six years, the average waiting time has been cut in half. Half of all patients are seen right away—on the spot. The GP rings up, the appointment is made, the patient is seen; half the remainder are seen within five weeks. Nearly 75 per cent. are seen within three months and 98 per cent. are seen within a year. That leaves a tiny percentage of patients who have to wait for more than a year—the least urgent cases. Enormous progress is being made in our health service. Those improvements have been noted. A British social attitudes survey published in November 1994 showed that more people were satisfied than not. A survey conducted for the National Association of Health Authorities and Trusts in 1994 showed that nine out of 10 patients who attended hospital in 1993 found the NHS very good, good or average and that three out of four found the service very good or good. That is a tremendous improvement on the past. I shall turn briefly to the success of GP fundholding practices. I know that the Labour party is absolutely committed to sweeping away the independence of GP fundholders. Its deadly campaign against the independence of GP practices is very similar to what it tried to do to grant-maintained schools. It hates anybody or any authority having the ability to think and manage for themselves. It wants to drag people willy-nilly back under its centralised control and management—politicised management at that. Meddlesome Labour Members cannot let go and cannot stop interfering with other people's lives. Even Labour party advisers have recognised the dangers of the interventionism that it advocates. Professor Julian Le Grand, founder of the Socialist Philosophy group, has described the health service as "the biggest success story" and noted that GP fundholding isProfessor Brian Abel-Smith, vice-president of the Fabian Society, co-authored a recent article which said:"now widely thought to be at the cutting edge of the reforms".
The success of fundholding has also been highlighted and praised by the Organisation for Economic Co-operation and Development, the National Audit Office, the King's Fund Research Institute and a four-year independent evaluation into GP fundholding in Scotland carried out by Professor John Howie and his team at Edinburgh university. Why should the patient believe that the Labour party holds out any hope for progress or improvement? As an NHS patient, like anybody else in my constituency, I fear the Labour party's doctrinarian ideology. I fear the fact that Labour wants to bring politics into clinicians' decision making, undermining their work. I fear that patients will be faced with the gobbledegook of the Labour party. When the Labour party talks of comprehensive health care agreements, it means interference and meddling. The Labour party will try to destroy incentives for hospitals to improve health care. I cannot see how that will benefit the patient."There is now overwhelming evidence that fund-holders are able to get a better deal for their patients from hospitals … Fund-holding represents a major transfer of power from specialists to GPs".
Will the hon. Lady give way?
I am sorry, but I shall continue with my speech because I know that other hon. Members want to speak. At least one Labour Member wants to speak after me—at least I hope that he does; otherwise, it would show the paucity of Labour representation in this debate.
The Labour party is committed to abolishing compulsory competitive tendering, which will divert £100 million from patient care. I cannot see how that would benefit the individual. It is also going to persist with the minimum wage, which will cost the NHS £500 million. How will that help the patient? Surely we should concentrate all available resources on the patient himself. The patient now faces a nightmare scenario. If this country ever decides to go down a socialist route, the patient will find that he comes second to confused, left-wing ideologies. I believe firmly that when patients look to their own interests, they will realise that there is only one way forward—the Conservative way.6.9 pm
It is always a pleasure to follow the hon. Member for Sutton and Cheam (Lady Olga Maitland). When she looks at the Conservative central office brief, she should study the articles from which she takes her selective quotations. If she looks at the article by Brian Abel-Smith, to which she referred, she will find that there are references to some of the shortcomings of the fundholding system. Indeed, the article concludes that the Labour party should consider putting substantial extra funds into services in poorer areas. The hon. Lady was asked earlier about the health of poorer people, but she completely ignored the question. There are grave inequities in health care in our present system and it is important that they are corrected.
The hon. Member for Sutton and Cheam was wrong in some of the factual points she made. A constituent wrote to me recently saying that following a first appointment, she was told that she would be on a 78-week waiting list. Her back condition meant that she could not carry on with her work, so she was forced to seek private assistance; she could not wait 78 weeks to get back to work. Another case concerns an 84-year-old lady who required an urgent bladder operation. Her sons were able to pay for her to have the operation and did so. They did not, however, take her off the waiting list because they were interested to find out just how long it would take for her to have the operation under the NHS. It was two years later that she was told that she could have the operation for which her sons had paid two years previously. That 84-year-old would have had an inordinate wait which she should not have had to suffer. There are real concerns which the hon. Member for Sutton and Cheam simply ignores because she sees the NHS through rose-coloured spectacles. Perhaps Sutton and Cheam is very different from the areas that other hon. Members on both sides represent. The Secretary of State was a little petulant in her opening speech. I am sure that she has seen the Labour party paper, "Rebuilding the National Health Service", to which my hon. Friend the Member for Doncaster, North (Mr. Hughes) referred. She must have been able to see that it was a constructive paper. It was also obvious that the hon. Member for Mid-Staffordshire (Mr. Fabricant) had not read the paper because most of what he said about it was completely wrong. The Secretary of State and the Minister of State no doubt expected a wrecking paper. They find, however, a paper that is constructive in its approach to the NHS. It makes it clear that the reforms already in place will evolve. Some practices will be jettisoned because they cannot conform to the principles that we espouse for the health service. On the whole, however, the reforms will evolve to meet our principles and without any worsening of patient care or of the service given by GPs. It is obvious that our proposals will be welcomed by patients, by health professionals and by health authorities. Under the present system, health authorities could find themselves in conflict. The reforms recently introduced would reduce the significance of the health authorities and reduce their health promotion and health purchasing roles. I am convinced that the reforms that we will put in place and the transformation that we will bring will benefit the health service and the British public. It is clear that our first principle is that of a national health service. We do not believe in a service that is an oligarchy, as suggested by the hon. Member for Mid-Staffordshire, in which all power is centralised. We believe in a service in which regional power and local power exist. We clearly state that we intend to ensure that at the local level, the people who operate the health authorities have a degree of local accountability and that accountability becomes a much more important word. Through the changes that we shall make, we shall reduce the inequities in the service and restore the accountability of the service. We shall make our changes on the basis of the minimum disruption to patient care. The hon. Member for Sutton and Cheam also suggested that the wording of the motion was inappropriate at almost every point. The motion is clearly worded to show that we have a choice between an increasingly privatised service and a service that returns to being a truly public service. It is important that we consider that point now, when the level of privatisation in the health service is about to increase considerably, if the Conservatives remain in power. In the early years of the reforms of the health service, the Government did not find it easy to progress privatisation. The market that they set up was not a real but a bogus or quasi-market. Both purchasers and providers depended on public finance. Although in their roles as purchasers and providers they entered into contracts and although money was transferred on the basis of episodes of patient care, the money was almost always public money which was transferred from one body to another. The market was often self-consciously not a market in terms of the normal market mechanisms that the Conservative party espouses. As members of Leeds Health Care—the Leeds health authority—we were given strict instructions when the authority was set up about the two major hospitals in Leeds. Whatever prices we arrived at through the contracting procedures—one of the hospitals appeared for most purposes to be more expensive than the other—it was regarded as important that each of the hospitals remained viable and in existence. I entirely supported that view. Leeds clearly needs both the Leeds general infirmary and St. James's University hospital. A current review of Leeds health services will, I hope, start from the basis that each hospital is needed. I understood, therefore, why the market mechanism was not a normal market mechanism, but one in which there were priorities other than simply accepting the lowest tender. It has been difficult for the Conservatives to progress their privatisation proposals as they wish. There is abhorrence in this country at the idea of making money out of people's ailments. There are other societies where that is not the case. Having lived in the United States for eight years, I am well aware that one can enter a completely different system in which one can feel vulnerable. I felt vulnerable when I took children to the United States, as one child developed pneumonia—a condition not covered by insurance. He had experienced that condition in the year before going to America. In those circumstances, one recognises the great strength of the NHS. Despite what the hon Member for Mid-Staffordshire asserted, the NHS is now not free at the point of delivery. There are charges to pay at many different points of delivery, as the hon. Gentleman and other hon. Members well know. Nevertheless, the NHS provides a level of support that is absent in what one might call the more traditional financial market in health care. The Government have been slow to develop the private market in health care in the NHS. The debate comes at a critical point, because it is clear that a number of initiatives are progressing apace. One specific area that has been developing since the introduction of the Community Care (Residential Accommodation) Act 1992 is the provision of private nursing care. We are aware that many hospitals seem to have a mechanism whereby people move rapidly from hospital care to private care. Highlighted in The Independent recently was the work of Michael Fallon, a former Member of the House who lost his seat to my hon. Friend the Member for Darlington (Mr. Milburn). Mr. Fallon, who made it clear that he was developing "Quality Care", a private nursing home group, was a member of the Government's deregulation task force and an adviser on the private finance initiative. Mr. Fallon suggested that it was important to take the initiative forward, and he looked forward to a time when companies which are at present operating nursing care will be allowed to run entire hospitals, including the employment of doctors and nurses, on behalf of NHS trusts. The private finance initiative is currently concerned with the various ways in which money can be made through the NHS. I do not think that the NHS has yet created any individual millionaires through the initiative, but that is seen to be a possibility for the future. The Opposition have never taken the view that there are no appropriate ways in which the public and private sectors could work together, but there remains a suspicion of the direct involvement of the private sector in making profits out of health care. Two other aspects have been highlighted recently. One is the increasing use of NHS facilities—in particular hospital facilities—to assist private patients. An article in the same edition of The Independent referred to the Royal Surrey county hospital at Guildford, which will be well known to the Secretary of State, and talked about its provision of facilities for private patients. The article stated that those covered by private care—some 11 per cent. of the population—accounted for one in five of all those on the waiting lists for surgery. The facilities are being made available to the private sector because the income is extremely important to the trust, and the article made it clear just how important. It is clear that there is preferential treatment as far as the receipt of surgery is concerned, which suggests that we have not a two-tier but a three-tier system. Those in the private sector have the best care, with those who are being treated by GP fundholders next on the list. The patients being treated by non-fundholders are at a lower stage. Dr. John Yates has made a study of consultants and the incomes that they are receiving from private sector consultancies. He is concerned about the level of that private sector work in comparison with their public sector work. There will be a big increase in the level of privatisation in the service if the present Government remain in control, and that could well be to the loss of many people who rely on the health service in all circumstances. It is important that people see that the Labour party's proposals in our recent document are constructive. In relation to GPs, we are proposing not to sweep away fundholding but to introduce a system of local commissioning on a wider scale so that the choice which is available currently to fundholders becomes available to non-fundholders too. I have seen examples in Leeds where operations were denied to non-fundholders because the contract was used up, and people wanting certain types of surgery have had to wait until the next financial year. It is important that there is equality at GP level and that all GPs have similar access to hospitals and to hospital care. Far from being rigid, the pronouncements in our document make it clear that there will be many different forms of local commissioning and that we will encourage experimentation in that commissioning. Our proposals are extremely constructive on trusts. The Secretary of State referred to trusts and their record of producing patient episodes, but what is not clear is the gain that trusts receive from being the owners of the hospital and from having a property management role. Our paper refers to hospitals, which makes a difference from most of the papers that we see nowadays. It is right that those hospitals are clearly publicly and communally owned, and not owned by individual trusts.Is the hon. Gentleman advocating political involvement in health trusts, and that councillors should take decisions over the heads of clinicians? All the evidence that the Labour party has given suggests exactly that. I cannot see how a patient would in any way benefit from such a system.
The hon. Lady ought to read the paper, and she will see that that is not the case. Of course, there may be a role for some members of a council. We have suggested, for example, that it may be constructive for the chair of a social services committee to be a member of the health authority. I was the chairman of a social services committee in Leeds and a member of the health authority, and it was possible to assist in getting those two bodies to work together. But we are not suggesting that all the people involved should be elected members. There should be a valid local reason for such a person to be a member of a health authority. We are not suggesting that they should all be elected members, but it is important to have some link with the local authority. Nor are we suggesting a lack of involvement on the part of professionals in the health service. Indeed, our proposals make it clear that there will be a wider role for them and that consultation with them will be an important factor in decision making.
The health service is at a crucial stage. A change of control is vital for the future of the service and, therefore, I very much look forward to the time when my right hon. Friend the Member for Derby, South (Mrs. Beckett) takes charge.6.30 pm
This debate has certainly drawn out the philosophical differences between the two political parties. The Opposition believe in a national health service based on the public service ethos, and the Conservatives believe in fragmented private markets.
As our motion makes clear, it is our fear that the public service ethos that underpins the NHS is being eroded. My hon. Friend the Member for Doncaster, North (Mr. Hughes) said that a doctor's first duty is to the patient—a point of view that is unexceptional on the Opposition side of the House. Mr. Roy Lilley, a leading Conservative thinker on such matters, and a man who is regarded as being in the vanguard of the Secretary of State's reforms, said recently that a doctor's first duty should be not to his patients, but to the employer. Every patient should carefully note that point of view, which comes from the Conservative side of the House. The public service ethos of the national health service is undermined by the Conservative party's trusts. They are inserting gagging clauses in staff contracts, bringing a cult of Stalinism into the NHS, and preventing clinicians from speaking out. Recently, the Conservatives had the nerve to accuse us of wanting a command-and-control national health service, but it is they, not the Opposition, who have just renationalised functions that used to be carried out at the regional level of the NHS, but which are now being taken in-house, under the Secretary of State's direct control. On the ground of commercial confidentiality, the Secretary of State is allowing national health service trusts—apparently still publicly owned—secrecy over their affairs. Commercial confidentiality in a public service—those two concepts do not sit happily together. The Nolan committee expressed concern at the appointment procedures used for the boards of NHS quangos. The chairman of the British Medical Association said today that the national health service isThose concerns are echoed by the clergy. Last year, the Bishop of Birmingham described the reforms as"not so much an internal market as an infernal bazaar, in which considerations of cost reign supreme, whilst concerns for value and values are relegated to second place."
This year, the Bishop of Ripon denounced the internal market, and pointed out that it leads to a "lack of patient choice". The Government defend what they have done on the ground that it has brought about efficiency savings that have benefited patients. We can see that they have brought about a substantial increase in NHS bureaucracy. It is harder to demonstrate that that has been to the benefit of patients. Until the reforms were introduced, administrative spending in Britain's health service was among the lowest in the world. At the moment, for every £10 spent in the health service, £1 is spent on administration. In 1989–90, it was £1 in every £20. That is a substantial increase. The administrative costs of GP fundholding average £80,000 per practice, and trusts have spent around £117 million on conveyancing and image building. Every trust was given a one-off payment of £300,000 towards set-up costs. Increasing bureaucracy has made patient admissions to hospital more complicated. It is a time-consuming paper-chase, and it was condemned in an article in the journal of the Institute of Economic Affairs, in June—a right-wing institute and not one associated with the Labour party. It described the red-tape nightmare in today's national health service thus:"distressing, unchristian and morally wrong."
The institute concludes:"The very act of getting a patient on to a waiting list and then admitted has become a bureaucratic obstacle course for clinicians. The patient's postcode must be matched to their DHA. The GP must be identified in case they are fundholding. The procedure must be checked to see if it is chargeable to the GP or the DHA. The contract must be scrutinised to ensure it covers the proper operation … Sending the patient for admission requires many more hurdles to clear. An audit of one unit's admission process found 24 different steps were now required before the patient could be sent for."
That quotation is from a right-wing institute, not the Labour party. Recently, the Select Committee on Health studied the London ambulance service to find out how well the Secretary of State's reforms were doing. I attempted to intervene on the Secretary of State, but she did not let me, and it will be pretty clear why when I read this passage from the report. That all-party Committee, which commands great authority in this place, had this to say about Ministers:"It is difficult to reconcile this with the White Paper's assertion that the 'reforms will make it easier for consultants and their colleagues to get on with the job of treating patients'."
We will wait and see what that turns out to mean in practice. The Government's reforms have been accompanied by cost cutting on patient care. The recent scandal over the National Blood Authority purchasing cheap blood bags, which have turned out to be defective, has caused widespread public concern, as well it might. Running parallel—this might almost stand as a vignette for the entire NHS—to that scandal, which has relied so much on public good will to help sort it out, there has been a change in the structure of the key management of the service. Where previously one director and a small staff would do, there are now 23 key managers, including 11 regional chief executives, some of whom are paid more than £100,000 per year, as well as getting a nice new leased car. The public look at the bloated management and the failing service, and draw their own conclusions. In debate after debate—all initiated by the Opposition, as my hon. Friend the Member for Doncaster, North rightly pointed out—we have heard of wards running at dangerously high capacity because of the relentless, management-led drive to get rid of beds. We have heard of casualty departments shutting their doors to new admissions—for almost 40 hours at the Homerton hospital, which is a case in point. We have heard of patients being driven and flown hundreds of miles to find an available specialist bed. The situation is especially serious in intensive care, sometimes with fatal results. More and more patients are having their operations cancelled at the last minute before admission because of bed shortages. Psychiatric departments in inner London hospitals are regularly running at capacities of as much as 120 per cent., with the result that seriously mentally ill people, who are in need of treatment, are being turned away. The Secretary of State must be proud that new wards are being named after her, even if they are only corridors with trolleys parked up in them."We do not think that Ministers can be absolved of blame for the sorry record of the LAS. Ministers represent the final link in the chain of accountability. Had the political will existed at Ministerial level, the problems of the LAS might have been effectively addressed years ago. We are heartened by recent assurances that the political will does now exist."
Cheap.
That is exactly the point—it is cheap. The hon. Lady is right. That is our criticism of what is being done. The money should be spent on patient care, rather than on a burgeoning bureaucracy.
The service is over-reliant on junior doctors. We have the worst patient-to-consultant ratio of many our European neighbours. We over-use bank and agency nurses to drive down the staff bill. The only area where NHS trusts are not attempting to keep the wages bill down is that of senior managers' pay. In 1993–94, the remuneration of trust chief executives rose by an average of 6.6 per cent., which is particularly remarkable given that there was a public sector pay limit of 1.5 per cent. for that year. Perhaps managers no longer regard themselves as part of the public sector. Local pay is designed to push down wages and terms and conditions of employment. Apparently, it is now intended that it will apply to junior doctors as well as to nursing staff, with individual trusts instead of regional authorities holding their contracts. I presume that that is a prelude to local pay bargaining for junior doctors as well. No wonder staff morale is at rock bottom. A survey in Doctor magazine found that 75 per cent. of doctors would leave the national health service if they could. The number of consultants taking early retirement has increased by 212 per cent. since 1988. The range of national health service employers are finding recruitment more and more difficult. The position is particularly bad for nurses and junior doctors, and it is difficult to get GPs to serve in deprived inner-city areas. It is exactly that emphasis on primary care that is the Government's justification for removing secondary services, particularly hospital beds. The Government's amendment boasts thatAs a number of hon. Members have mentioned, Dr. Christopher Colton had something to tell us about that over the weekend. He says that the way in which he was ordered not to exceed his targets meant that he had to close his children's clinic for about four months and have no referrals. As he points out, it logically followed that he was seeing so few people that another target, that nobody should wait for more than 30 minutes, was 100 per cent. successful and he was rewarded with a £20,000 bonus. If a service is shut and the number of people who use it is thinned out, naturally one achieves that target, but it is a reprehensible way to run a public service. We believe in a unified public service, as my hon. Friend the Member for Morley and Leeds, South (Mr. Gunnell) pointed out. The Under-Secretary of State said recently that he sees no reason in principle why the private sector should not run entire hospitals on contract to the national health service. Expenditure on purchasing care from the private sector has increased by some 80 per cent. between 1992–93. My hon. Friend the Member for Birmingham, Northfield (Mr. Burden) referred to the private finance initiative, which transfers risk to the public sector and profits to the private sector, and referred to its failings in his constituency. Market testing in the national health service is progressing apace. Thirty clinical services have already been market-tested for privatisation and 1,100 private companies are on a Department of Health market testing database. The privatisation agenda is clear from a recent directive issued by the national health service executive, which expresses its concern that"waiting times have fallen to the lowest on record".
I presume that that means private health care firms. The Labour party believes that there should be no entry of other organisations, and that both purchasers and providers should be publicly owned. It is interesting that the Government's motion does not refer to the public ownership of those who have the provider functions. It"Collusion between providers and purchasers may prevent the entry of other organisations"—
but does not go on to say that the trusts and general practitioners will be in the public sector. The implication of the Government's amendment is that that will not be the case. The Conservative party has been in government for a long time. Perhaps power brings a complacency of its own. Let me tell Conservative Members what a former leader of the Conservative party, Disraeli, had to say when the Conservatives had been in opposition for 19 years:"welcomes the Government's commitment to a strong and stable publicly-funded NHS"
The modern Conservative party, before its 19 years in opposition, clearly believes that the followers must not be afraid to dismiss the leader. The only thing that can be said with certainty about the last 10 days' events is that Mr. Hugh Grant has done his chances of getting elected leader of the Conservative party no good. Today's BMA conference, perhaps anticipating the outcome of tomorrow's vote, has heard Dr. Sandy Macara say:"A leader should not be afraid to dismiss his followers."
The present Secretary of State is apparently willing to do so. Her statement that she is willing to serve in a Redwood Government—we have not been told that she has been asked to serve in such a Government—may say something about the likelihood of her services being retained by the present regime. I do not understand how the Government can come before the House with a motion boasting of success, when the whole world knows that the architect of that success is about to be fired. I do not see how the Secretary of State for Health can offer to serve under Mr. Redwood when their views are so obviously at variance. She will no doubt double cross that bridge when she comes to it. Mr. Redwood—"We are labouring under an alien regime".
Order. I remind the hon. Gentleman of the convention that hon. Members do not refer to colleagues by name.
My problem is that it is difficult to keep up with the resignations, and I was not sure how far the right hon. Member for Wokingham (Mr. Redwood) had gone.
In his manifesto and recent speeches, the right hon. Member for Wokingham, as he is at the time of speaking, has offered to keep local hospitals—he describes them as "cherished institutions"—and to recruit more medical staff. He boasts that he will spend up to £114 million on the national health service in Wales next year. He also offers to cut taxes by £5 billion. Those policies are clearly the product of a great mind. He is right to want to breathe life back into the national health service, but combined with his tax cuts it will clearly be "life, John; but not as we know it." While the Opposition deplore Mr. Redwood's drive towards the privatisation of public service—Order. The hon. Gentleman has forgotten my previous admonition. He must refer to the right hon. Member for Wokingham (Mr. Redwood).
Yes, Madam Deputy Speaker. We deplore the drive towards privatisation of the hon. Member for Wokingham —
Right honourable.
The hon. Lady is right.
Order. Those matters may safely be left to me.
I think so too, Madam Deputy Speaker. I was certain that the Prime Minister would not have deprived the right hon. Member for Wokingham of his membership of the Privy Council.
The right hon. Member for Wokingham has spoken ofour motion speaks of "the cherished principles". The right hon. Gentleman has condemned excessive bureaucracy; our motion condemns excessive bureaucracy. Our motion calls for"the shining principles of the national health service";
We lifted that phrase word for word from the right hon. Gentleman's speech. Our motion calls for change in the national health service to"a slowing down of the passion for reorganisation".
The right hon. Gentleman said that change in the national health service"be based on health arguments, not financial considerations."
just as our motion says. Clearly, the right hon. Gentleman's advice to Conservative Members is, "Save your seats." I must tell them, "Vote for Labour's motion." May I add some helpful advice of my own to those Conservative Members who really want to save their seats at the next election: the very best chance they have is to stand as a Labour candidate."must be based on the health arguments, not financial considerations"—
6.48 pm
I shall resist the temptation placed before me by the hon. Member for Newcastle upon Tyne, East (Mr. Brown) to follow him down his road of puns instead of discussing the substance of the debate. It has been an extraordinary debate, because it afforded an opportunity for the Labour party to set out with some clarity what lay behind its paper, so recently published, about the future of the health service.
Straining at the speeches of the right hon. Member for Derby, South (Mrs. Beckett) and her Opposition friends, it was obvious to me that what was certain about that document was that there was a change of philosophy. It is a centralist philosophy, concentrating power in an old-fashioned health service whose time has gone. It was a philosophy of replacing bureaucracy, recently abolished, and it was a philosophy of taking away from clinicians the discretion that they have been given by the Government—no more so than in GP fundholding. The debate was typified, again and again, by the myths and scares that we so often hear from the Labour party. I felt the same frustration during the debate that I once felt when I was in the "Today" studios at Radio 4 in the morning, when, having set out the facts of the matter, I was greeted with the astonished and pathetic plea, "The facts are all very well, Minister, but?" That is the Labour party's approach throughout: the facts are all very well, but. I turn to a matter that was mentioned by the right hon. Member for Derby, South specifically, when she spoke about facts. She constantly tells the House—rose—
I will not give way; I have been given very little time.
The right hon. Lady constantly tells the House that we skew the figures. She and her hon. Friends always pray in aid the fact that we use finished consultant episodes to organise and describe the activity that takes place in the national health service. Let me take the opportunity to tell the House the basis for those figures, and perhaps to surprise the right hon. Lady by reminding her that the figures had their genesis in the royal commission appointed by the last Labour Government in 1976, which, when it reported, said that there was no satisfactory basis of measuring activity in the NHS. As a result, a group was eventually set up under the chairmanship of Edith Körner, who was then vice-chairman of the South-Western regional health authority. The aim of its investigations was to find a system that would accurately reflect the information needed by management to perform complex tasks of efficient administration, effective planning and genuine accountability. That steering group's ultimate report said that, if the work done by individual consultants as specialty groups is to be accurately recorded, each consultant episode must be separately identified. That was the basis on which the change was made. It is astonishing that, between 1979 and 1989, when the changes were made, not only did the Labour party make no criticism of that change, but it called for the more rapid introduction of the changes. I have consulted the Official Report, and there—lo and behold—over the years, and as recently as 1988, is the hon. Member for Holborn and St. Pancras (Mr. Dobson), urging the Government, in question after question, to get on with it. What were the Government afraid of? Were they afraid that those statistics would cause them a problem? The simple truth—which the whole House should always remember when the Labour party makes those accusations in the way it does—is that the figures were a fine stick with which to beat the Government when the Labour party believed that it would suit its purpose, but, when it became clear that the activity in the national health service, as measured by those new and well-founded statistics, was not going to fit its arguments, it started to criticise them. It is important that as those figures, described as "mere statistics" by the—rose—
I have told the hon. Gentleman that I shall not give way.
The truth is that those are important facts, determined using the best methodology that is available. The House should know that, and I have pleasure in placing it firmly on the record. I turn to several of the arguments that were made in the debate. The hon. Member for Birmingham, Northfield (Mr. Burden) expressed unease about the private finance initiative as it affected his constituency. The whole purpose of the PFI is to secure better care of patients and best value for money for the taxpayer. There is a transfer of risk, often away from the public sector to the private sector. That is the intention, and it benefits the national health service. As far as the constituency of the hon. Member for Northfield is concerned, I would remind him that the reforms have served it well. No Birmingham in-patient or day case now waits longer than nine months for treatment. All Birmingham health authorities are signed up to a target of having no in-patient or day care patient case waiting more than six months by March 1996. If the hon. Member does not believe that that is good, and a vindication of the reforms in his constituents' eyes, I believe that they feel very differently. My hon. Friend the Member for Broxbourne (Mrs. Roe), as always, made an important speech.Will the hon. Gentleman give way?
I am not giving way to the hon. Gentleman.
My hon. Friend emphasised the benefits of partnership with the private sector. I agree with her entirely. It is important that we are not—as the Labour party is—purblind to the benefits that others can bring to the health service. Partnership brings in extra funds and extra activity. That is to be welcomed. The hon. and learned Member for Montgomery (Mr. Carlile) made two specific inquiries. He queried why the chief executive of Nottingham Healthcare is leaving, and he suggested, rather strangely, that he did not want any "off-the-shoulder" remarks from me. I do not quite know what that means. I believe that he meant "shooting from the hip." He has been watching too many Versace dresses in the papers recently, and he is getting his analogies mixed up. I can tell the hon. and learned Gentleman what the background is. I repeat what I said to him; there certainly has been no interference from Government. Dr. Reynolds is leaving on 10 October 1995 to take up a new post in the private hospital sector. I understand that Dr. Reynolds has a background in the pharmaceutical industry, and that he joined Nottingham Healthcare only on the understanding that at some time he would return to the private sector. The hon. Member for Doncaster, North (Mr. Hughes) gave some general support to Labour party policy, but he was unable in any sense to say how much better health would be under those policies. Something was markedly absent from the debate—very much the dog that did not bark. The Labour party has published a document, and I believed that the debate might give us an opportunity to hear the answer to the following question. How much money is the Labour party prepared to add to the national health service if it intends to bring about those great changes? What will its commitment be? I say to the right hon. Member for Derby, South, if she is saying that there will be more commitment—every implication of what she says at that Dispatch Box and in the House is that more funding will be needed—what will the level of funding be? Will she tell the House tonight that she would at least do as well as the Government have done since they came into office and during the present Parliament, in increasing resources in real terms year on year? The right hon. Lady will not answer, and she is pretending that she does not hear what I am saying by being in deep conversation with her hon. Friends. There we are, Madam Deputy Speaker. We hear that there is absolutely no commitment—no attempt to put us right on that issue. We have had a typical debate from the Labour party, in which Labour Members have bad-mouthed a series of things that are happening in the NHS. They bad-mouthed management, as my right hon. Friend the Secretary of State says continually. It is a disgrace to bad-mouth management, who have delivered so much in the NHS. In the NHS, fewer people are now involved in management, as compared with patient care, than 12 years ago. Sixty per cent. of people were involved in patient care about 12 years ago; now 66 per cent. are. That is an improvement, and it is a benchmark by which the Government are prepared to be judged. Labour Members lose no opportunity, do they, to raise scares that are unfounded? I return to an argument that the right hon. Member for Derby, South made in the previous debate about health, when she made certain accusations about events that were going on in my constituency, concerning a patient who had not received proper treatment. It is a disgrace that, even when given the opportunity to retract, she has not done so. The right hon. Lady has managed to get herself in the position in which not only am I pretty cross about her making unfounded accusations about a hospital in my constituency, but the chairman of the trade union group in that hospital has urged her to make a formal apology, and she has not. It takes quite something for me to forge an alliance in my constituency with that gentleman. We have heard yet another debate in which Labour Members have made sterile arguments. We have heard the Labour party's philosophy of taking the health service back into central hands, abolishing GP fundholding and ruining the discretion of trusts—trusts that are developing unparalleled levels and quality of health care. The Labour party would destroy the health service that we have created. It has been in our hands for longer than it has been in the Labour party's hands. It will continue to improve in our hands. That is what its future will be.Question put, That the original words stand part of the Question:—
The House divided: Ayes 218, Noes 288.
Division No. 189]
| [7.00 pm
|
AYES
| |
| Abbott, Ms Diane | Dafis, Cynog |
| Adams, Mrs Irene | Dalyell, Tam |
| Ainger, Nick | Darling, Alistair |
| Ainsworth, Robert (Cov'try NE) | Davidson, Ian |
| Allen, Graham | Davies, Bryan (Oldham C'tral) |
| Alton, David | Davies, Rt Hon Denzil (Llanelli) |
| Ashdown, Rt Hon Paddy | Davies, Ron (Caerphilly) |
| Ashton, Joe | Davis, Terry (B'ham, H'dge H'l) |
| Banks, Tony (Newham NW) | Dewar, Donald |
| Barnes, Harry | Dixon, Don |
| Barron, Kevin | Dobson, Frank |
| Battle, John | Donohoe, Brian H |
| Bayley, Hugh | Dowd, Jim |
| Beckett, Rt Hon Margaret | Dunnachie, Jimmy |
| Bell, Stuart | Dunwoody, Mrs Gwyneth |
| Benn, Rt Hon Tony | Eagle, Ms Angela |
| Benton, Joe | Eastham, Ken |
| Bermingham, Gerald | Etherington, Bill |
| Berry, Roger | Evans, John (St Helens N) |
| Betts, Clive | Fatchett, Derek |
| Blunkett, David | Faulds, Andrew |
| Bray, Dr Jeremy | Field, Frank (Birkenhead) |
| Brown, N (N'c'tle upon Tyne E) | Fisher, Mark |
| Burden, Richard | Flynn, Paul |
| Byers, Stephen | Foster, Rt Hon Derek |
| Caborn, Richard | Foster, Don (Bath) |
| Callaghan, Jim | Foulkes, George |
| Campbell, Mrs Anne (C'bridge) | Fraser, John |
| Campbell, Menzies (Fife NE) | Fyfe, Maria |
| Campbell, Ronnie (Blyth V) | Galloway, George |
| Campbell-Savours, D N | Garrett, John |
| Cann, Jamie | Godman, Dr Norman A |
| Carlile, Alexander (Montgomery) | Godsiff, Roger |
| Chisholm, Malcolm | Golding, Mrs Llin |
| Church, Judith | Gordon, Mildred |
| Clapham, Michael | Grant, Bernie (Tottenham) |
| Clark, Dr David (South Shields) | Griffiths, Win (Bridgend) |
| Clarke, Eric (Midlothian) | Grocott, Bruce |
| Clarke, Tom (Monklands W) | Gunnell, John |
| Clelland, David | Hain, Peter |
| Clwyd, Mrs Ann | Hall, Mike |
| Coffey, Ann | Hanson, David |
| Cohen, Harry | Hattersley, Rt Hon Roy |
| Corbett, Robin | Henderson, Doug |
| Corbyn, Jeremy | Hill, Keith (Streatham) |
| Corston, Jean | Hodge, Margaret |
| Cummings, John | Hoey, Kate |
| Cunningham, Jim (Covy SE) | Hogg, Norman (Cumbernauld) |
| Hood, Jimmy | Orme, Rt Hon Stanley |
| Hoon, Geoffrey | Pearson, Ian |
| Howarth, George (Knowsley North) | Pike, Peter L |
| Howells, Dr. Kim (Pontypridd) | Powell, Ray (Ogmore) |
| Hoyle, Doug | Prentice, Bridget (Lew'm E) |
| Hughes, Kevin (Doncaster N) | Prentice, Gordon (Pendle) |
| Hughes, Robert (Aberdeen N) | Prescott, Rt Hon John |
| Hughes, Roy (Newport E) | Primarolo, Dawn |
| Hughes, Simon (Southwark) | Purchase, Ken |
| Hutton, John | Quin, Ms Joyce |
| Illsley, Eric | Radice, Giles |
| Ingram, Adam | Randall, Stuart |
| Jackson, Glenda (H'stead) | Raynsford, Nick |
| Jamieson, David | Reid, Dr John |
| Janner, Greville | Rendel, David |
| Jones, Barry (Alyn and D'side) | Robertson, George (Hamilton) |
| Jones, Lynne (B'ham S O) | Robinson, Geoffrey (Co'try NW) |
| Jones, Marlyn (Clwyd, SW) | Rogers, Allan |
| Jowell, Tessa | Rooker, Jeff |
| Khabra, Piara S | Rooney, Terry |
| Kitfoyle, Peter | Ruddock, Joan |
| Lestor, Joan (Eccles) | Sedgemore, Brian |
| Lewis, Terry | Sheerman, Barry |
| Liddell, Mrs Helen | Sheldon, Rt Hon Robert |
| Litherland, Robert | Short, Clare |
| Livingstone, Ken | Skinner, Dennis |
| Lloyd, Tony (Stretford) | Smith, Andrew (Oxford E) |
| Loyden, Eddie | Smith, Chris (lsl'ton S & F'sbury) |
| Lynne, Ms Liz | Smith, Llew (Blaenau Gwent) |
| McAllion, John | Snape, Peter |
| McAvoy, Thomas | Soley, Clive |
| Macdonald, Calum | Spearing, Nigel |
| McFall, John | Spellar, John |
| McKelvey, William | Squire, Rachel (Dunfermline W) |
| McLeish, Henry | Steel, Rt Hon Sir David |
| McMaster, Gordon | Steinberg, Gerry |
| MacShane, Denis | Stevenson, George |
| McWilliam, John | Straw, Jack |
| Madden, Max | Sutcliffe, Gerry |
| Marshall, David (Shettleston) | Taylor, Mrs Ann (Dewsbury) |
| Marshall, Jim (Leicester, S) | Taylor, Matthew (Truro) |
| Martin, Michael J (Spingburn) | Timms, Stephen |
| Martlew, Eric | Tipping, Paddy |
| Maxton, John | Turner, Dennis |
| Meacher, Michael | Tyler, Paul |
| Meale, Alan | Vaz, Keith |
| Michie, Bill (Sheffield Heeley) | Walley, Joan |
| Michie, Mrs Ray (Argyll & Bute) | Wardell, Gareth (Gower) |
| Milburn, Alan | Wareing, Robert N |
| Miller, Andrew | Watson, Mike |
| Mitchell, Austin (Gt Grimsby) | Welsh, Andrew |
| Moonie, Dr Lewis | Wicks, Malcolm |
| Morgan, Rhodri | Williams, Rt Hon Alan (Sw'n W) |
| Morris, Estelle (B'ham Yardley) | Williams, Alan W (Carmarthen) |
| Morris, Rt Hon John (Aberavon) | Winnick, David |
| Mudie, George | Worthington, Tony |
| Mullin, Chris | Wray, Jimmy |
| Murphy, Paul | Wright, Dr Tony |
| Oakes, Rt Hon Gordon | Young, David (Bolton SE) |
| O'Brien, Mike (N W'kshire) | |
| O'Brien, William (Normanton) | Tellers for the Ayes: |
| Olner, Bill | Mr. Jon Owen Jones and
|
| O'Neill, Martin | Mrs. Barbara Roche.
|
NOES
| |
| Ainsworth, Peter (East Surrey) | Atkinson, David (Bour'mouth E) |
| Alexander, Richard | Atkinson, Peter (Hexham) |
| Alison, Rt Hon Michael (Selby) | Baker, Rt Hon Kenneth (Mole V) |
| Allason, Rupert (Torbay) | Baker, Nicholas (North Dorset) |
| Amess, David | Baldry, Tony |
| Ancram, Michael | Banks, Matthew (Southport) |
| Arbuthnot, James | Bates, Michael |
| Arnold, Jacques (Gravesham) | Batiste, Spencer |
| Arnold, Sir Thomas (Hazel Grv) | Bellingham, Henry |
| Ashby, David | Bendall, Vivian |
| Atkins, Rt Hon Robert | Beresford, Sir Paul |
| Biffen, Rt Hon John | Garnier, Edward |
| Bonsor, Sir Nicholas | Gill, Christopher |
| Booth, Hartley | Gillan, Cheryl |
| Boswell, Tim | Goodson-Wickes, Dr Charles |
| Bottomley, Peter (Eltham) | Gorman, Mrs Teresa |
| Bottomley, Rt Hon Virginia | Gorst, Sir John |
| Bowden, Sir Andrew | Grant, Sir A (SW Cambs) |
| Bowis, John | Greenway, Harry (Ealing N) |
| Boyson, Rt Hon Sir Rhodes | Greenway, John (Ryedale) |
| Brandreth, Gyles | Griffiths, Peter (Portsmouth, N) |
| Brazier, Julian | Grylls, Sir Michael |
| Bright, Sir Graham | Gummer, Rt Hon John Selwyn |
| Brooke, Rt Hon Peter | Hague, William |
| Brown, M (Brigg & Cl'thorpes) | Hamilton, Rt Hon Sir Archibald |
| Browning, Mrs Angela | Hamilton, Neil (Tatton) |
| Bruce, Ian (Dorset) | Hampson, Dr Keith |
| Budgen, Nicholas | Hannam, Sir John |
| Burns, Simon | Hargreaves, Andrew |
| Burt, Alistair | Haselhurst, Sir Alan |
| Butcher, John | Hawkins, Nick |
| Butler, Peter | Hawksley, Warren |
| Butterfill, John | Hayes, Jerry |
| Carlisle, John (Luton North) | Heald, Oliver |
| Carlisle, Sir Kenneth (Lincoln) | Heath, RI Hon Sir Edward |
| Carrington, Matthew | Hendry, Charles |
| Carttiss, Michael | Heseltine, RI Hon Michael |
| Cash, William | Hicks, Robert |
| Channon, RI Hon Paul | Higgins, Rt Hon Sir Terence |
| Churchill, Mr | Hogg, Rt Hon Douglas (G'tham) |
| Clappison, James | Horam, John |
| Clarke, Rt Hon Kenneth (Ru'clif) | Hordern, Rt Hon Sir Peter |
| Coe, Sebastian | Howard, Rt Hon Michael |
| Colvin, Michael | Howarth, Alan (Strat'rd-on-A) |
| Congdon, David | Howell, Sir Ralph (N Norfolk) |
| Conway, Derek | Hughes, Robert G (Harrow W) |
| Coombs, Anthony (Wyre Forst) | Hunt, Rt Hon David (Wirral W) |
| Cope, Rt Hon Sir John | Hunt, Sir John (Ravensbourne) |
| Cormack, Sir Patrick | Hunter, Andrew |
| Couchman, James | Hurd, Rt Hon Douglas |
| Cran, James | Jack, Michael |
| Curry, David (Skipton & Ripon) | Jackson, Robert (Wantage) |
| Davies, Quentin (Stamford) | Jenkin, Bernard |
| Davis, David (Booth ferry) | Jessel, Toby |
| Day, Stephen | Johnson Smith, Sir Geoffrey |
| Deva, Nirj Joseph | Jones, Gwityrn (Cardiff N) |
| Devlin, Tim | Jones, Robert B (W Hertfdshr) |
| Dicks, Terry | Kellett-Bowman, Dame Elaine |
| Dorrell, Rt Hon Stephen | Key, Robert |
| Douglas-Hamilton, Lord James | king, Rt Hon Tom |
| Duncan, Alan | Kirkhope, Timothy |
| Duncan-Smith, Iain | Knapman, Roger |
| Dunn, Bob | Knight, Mrs Angela (Erewash) |
| Durant, Sir Anthony | Knight, Greg (Derby N) |
| Dykes, Hugh | Knight, Dame Jill (Bir'm E'st'n) |
| Eggar, Rt Hon Tim | Knox, Sir David |
| Evans, David (Welwyn Hatfield) | Kynoch, George (Kincardine) |
| Evans, Jonathan (Brecon) | Lait, Mrs Jacqui |
| Evans, Nigel (Ribble Valley) | Lamont, Rt Hon Norman |
| Evans, Roger (Monmouth) | Lang, Rt Hon Ian |
| Evennett, David | Lawrence, Sir Ivan |
| Faber, David | Legg, Barry |
| Fabricant, Michael | Leigh, Edward |
| Fenner, Dame Peggy | Lennox-Boyd, Sir Mark |
| Held, Barry (Isle of Wight) | Lidington, David |
| Fishburn, Dudley | Lltley, RI Hon Peter |
| Forman, Nigel | Lloyd, Rt Hon Sir Peter (Fareham) |
| Forsyth, Rt Hon Michael (Stirling) | Lord, Michael |
| Forth, Eric | Luff, Peter |
| Fowler, Rt Hon Sir Norman | MacKay, Andrew |
| Fox, Dr Liam (Woodspring) | Maclean, Rt Hon David |
| Fox, Sir Marcus (Shipley) | McLoughlin, Patrick |
| Freeman, Rt Hon Roger | McNair-Wilson, Sir Patrick |
| French, Douglas | Madel, Sir David |
| Gale, Roger | Maitland, Lady Olga |
| Gardiner, Sir George | Major, Rt Hon John |
| Garel-Jones, RI Hon Tristan | Malone, Gerald |
| Mans, Keith | Rifkind, Rt Hon Malcolm |
| Marland, Paul | Robathan, Andrew |
| Marlow, Tony | Roberts, Rt Hon Sir Wyn |
| Marshall, John (Hendon S) | Robertson, Raymond(Ad'd'nS) |
| Martin, David (Portsmouth S) | Robinson, Mark(Somerton) |
| Mates, Michael | Roe, Mrs Marion (Broxbourne) |
| Mawhinney, Rt Hon Dr Brian | Rowe, Andrew (Mid Kent) |
| Mellor, Rt Hon David | Rumbold, Hon Dame Angela |
| Merchant, Piers | Ryder, Rt Hon Richard |
| Mills, Iain | Sackville, Tom |
| Mitchell, Andrew (Gedling) | Scott, Rt Hon Sir Nicholas |
| Moate, Sir Roger | Shaw, David (Dover) |
| Montgomery, Sir Fergus | Shaw Sir Giles (Pudsey) |
| Nelson, Anthony | Shaw Rt Hon Gillian |
| Neubert, Sir Michael | Shephard, Colin (Hereford) |
| Newton, Rt Hon Tony | Shepherd, Richard (Aldridge) |
| Nicholls, Patrick | Shersby, Sir Michael |
| Nicholson, David (Taunton) | Sims, Roger |
| Nicholson, Emma (Devon West) | Sims, Tim (Beaconsfield) |
| Norris, Steve | Soames, Nicholas |
| Onslow, Rt Hon Sir Cranley | Spencer, Sir Derek |
| Oppenheim, Phillip | Spicer, Sir James(W Dorset) |
| Ottaway, Richard | Spicer, Michael(S Worcs) |
| Page, Richard | Spink, Dr Robert |
| Paice, James | Spring, Richard |
| Patnick, Sir Irvine | Sproat, Iain |
| Pattie, Rt Hon Sir Geoffrey | Squire, Robin(Hornchurch) |
| Pawsey, James | Steen, Anthony |
| Peacock, Mrs Elizabeth | Stephen, Michael |
| Pickles, Eric | Stern, Micheal |
| Porter, Barry (Wirral S) | Stewart, Allan |
| Porter, David (Waveney) | Streeter, Gary |
| Portillo, Rt Hon Michael | Sumberg, David |
| Powell, William (Corby) | Sweeney, Walter |
| Rathbone, Tim | Sykes, John |
| Redwood, Rt Hon John | Tapsell, Sir peter |
| Renton, Rt Hon Tim | Taylor, Ian (Esher) |
| Richards, Rod | Taylor, John M (Solihull) |
| Riddick, Graham | Taylor, Sir Teddy(Southend, E) |
| Temple-Morris, Peter | Watts, John |
| Thompson, Sir Donald (C'er V) | Wells, Bowen |
| Thompson, Patrick (Norwich N) | Wheeler, Rt Hon Sir John |
| Thornton, Sir Malcolm | Whitney, Ray |
| Thurnham, Peter | Whittingdale, John |
| Townend, John (Bridlington) | Widdecombe, Ann |
| Townsend, Cyril D (Bexl'yh'th) | Wiggin, Sir Jerry |
| Tracey, Richard | Wilkinson, John |
| Tredinnick, David | Willetts, David |
| Trend, Michael | Wilshire, David |
| Trotter, Neville | Winterton, Mrs Ann (Congleton) |
| Twinn, Dr Ian | Winterton, Nicholas (Macc'f'ld) |
| Vaughan, Sir Gerard | Wolfson, Mark |
| Viggers, Peter | Wood, Timothy |
| Walden, George | Yeo, Tim |
| Walker, Bill (N Tayside) | Young, Rt Hon Sir George |
| Waller, Gary | |
| Ward, John | Tellers for the Noes:
|
| Wardle, Charles (Bexhill) | Mr. David Lightbown and
|
| Waterson, Nigel | Mr. Sydney Chapman.
|
Question accordingly negatived.
Question, That the proposed words be there added, put forthwith pursuant to Standing Order No. 30 (Questions on amendments) and agreed to.
MADAM DEPUTY SPEAKER forthwith declared the main Question, as amended, to be agreed to.
Resolved,
That this House notes that since the introduction of the Government's health reforms, over one million more patients are treated in hospital every year and waiting times have fallen to the lowest on record; welcomes the Government's commitment to a strong and stable publicly-funded NHS where trusts and general practitioner fundholders are free to build further on these achievements; and condemns the inadequate, inconsistent and incoherent policies of Her Majesty's Opposition, which would destroy the key features of the new NHS, would undermine patients' interests and would throw into reverse the progress of recent years.
Private Business
Queen Mary And Westfield College Bill (By Order)
Order for Third Reading read—Queen's consent, on behalf of the Crown, signified.
7.13 pm
The right hon. Member for Bethnal Green and Stepney (Mr. Shore), who moved the Bill's Second Reading, is abroad on parliamentary business and is therefore unable to be present tonight.
The Bill is promoted by three colleges of the university of London, of whose council I am a member, an interest which I declare. In the era of the ultra cautious, I should perhaps add that my mother, who is entitled as a noble Baroness to sit in another place, has been an honorary fellow of Westfield, and I learnt to play tennis upon its courts. One of the colleges, St. Bartholomew's hospital medical college, is in my constituency. The Bill is designed to bring about the merger of those three colleges. Two of them, Bart's and the London hospital medical college, are medical colleges, the third, Queen Mary and Westfield, is a multi-faculty institution. It is the fourth largest college of the university of London. The Bill is designed to bring those three colleges together into one institution in line with developments across London, which are integrating medical and dental education and research within multi-faculty institutions. Those developments enjoy the widest measure of support in the academic and medical worlds. The Bill received overwhelming support on Second Reading after a speech of great length and admirably consistent relevance by the hon. Member for Hackney, South and Shoreditch (Mr. Sedgemore). It has passed its Committee stage and I hope that hon. Members will support its Third Reading. It is now some five years since the three colleges joined together in the City and East London Confederation for Medicine and Dentistry, when the pre-clinical departments from the two medical colleges were transferred to Queen Mary and Westfield college. This has been successful, but it is now agreed that the process needs to be taken further. To be able to educate those medical and dental students with the widest curricular opportunities; to give them a much fuller experience of being educated alongside students of other subjects; and to strengthen research both within medicine and across disciplinary boundaries, that union of the colleges is imperative. Is the Bill needed for that purpose? The answer is an unequivocal yes. The colleges have powers to co-operate and collaborate. They could create a joint school of medicine and dentistry, but without the Bill they cannot come together as a single institution with one governing body and single administrative, financial, managerial and academic structures. No misuse of the royal prerogative is involved: only legislation can bring about the full legal merger of the colleges. A number of consequential changes are then needed to the statutes of Queen Mary and Westfield college, which require the approval of the Privy Council. Those amendments will not come into force until the Bill is enacted. How do the Bill and the merger proposals relate to St. Bartholomew's hospital? Hon. Members will be aware of my views about the decisions relating to St. Bartholomew's hospital to transfer its activities to the Royal London hospital at Whitechapel. The three colleges each concluded, prior to the decisions on the future of St. Bartholomew's hospital, that their merger and the creation of a new school of medicine and dentistry was unquestionably the right thing to do. It is the right thing to do even if St. Bartholomew's hospital were to remain. The new school of medicine and dentistry would then teach its students and conduct its research at the Royal London hospital at Whitechapel and St. Bartholomew's hospital in West Smithfield in the City. If Bart's closes, teaching and research will have to take place elsewhere. I still entertain the hope that, despite the decision earlier this year, Bart's will escape closure. If that is so, the new college and medical school will take full advantage of the facilities and activities at West Smithfield. If the hospital ceases its activities, it is absolutely vital that the new unified school is brought into being and the education of students and medical and dental research are able to carry on unimpeded elsewhere. Does the Bill involve the destruction of Bart's medical college, as was alleged on Second Reading? Saving the grace of my parliamentary neighbour, the hon. Member for Hackney, South and Shoreditch, it does not. A medical school or, indeed, any other academic institution, is not just the physical buildings in which it operates. It is, above all else, people working in an environment which has, over the years, developed certain characteristics, reputation and ethos. St. Bartholomew's hospital medical college, like the London hospital medical college, will certainly undergo change in the process of amalgamation. But the same number of medical and dental students will be educated, at least the same amount of research will be prosecuted, all the staff will continue to be employed and, overall, the facilities and opportunities secured by the merger should be greater. The process of bringing together three separate institutions such as this is not without its difficulties and the process is a challenging one for all involved. But opportunities are offered here, and all three college councils are convinced that it is the right way forward. The Bill is important for London and for medical education generally. As can be seen from the Second Reading debate, no coherent arguments can be advanced against it. The proposal even enjoys the support of The Times Higher Education Supplement, although some might think that that is a poisoned chalice. I commend the Bill to the House.7.20 pm
I am delighted to follow the right hon. Member for City of London and Westminster, South (Mr. Brooke), who spoke with his usual charm, grace and conciseness—perhaps that will be a lesson to me as I spoke for two and a quarter hours in the previous debate on the subject. I shall not do that tonight. The right hon. Member for City of London and Westminster, South certainly draws the short straw. Only a week ago he was introducing in the House a private Bill that he apparently found so disdainful that he never pressed it to a vote.
My right hon. Friend the Member for Bethnal Green and Stepney (Mr. Shore), who moved the Second Reading of the Bill, has found it such a poisoned chalice that he has this evening absented himself on a parliamentary visit. I wonder what procedural device the right hon. Member for City of London and Westminster, South will use to block the Bill tonight.Order. Perhaps the hon. Gentleman would come to the subject of the debate.
Of course, I shall, Madam Deputy Speaker. I was trying to give a charming and easy introduction to put everyone at ease.
We meet on a tumultuous evening, with historic events about to take place tomorrow. People are naturally asking me what the link is between the Queen Mary and Westfield College Bill and the election of the leader of the Conservative party. I imagine that it is precisely because there is a link that the Chairman of Ways and Means has tabled the Bill for debate tonight. There is such a disruptive campaign taking place that we all expect an election, probably by Christmas—by spring at the latest—which, of course, the Labour party will win. That means that St. Bartholomew's hospital will be saved. After the hospital has been saved, we shall look again at the position of the medical colleges of St. Bartholomew's hospital and the London hospital. I am told that there is only one unifying force in the extraordinarily disruptive campaign involving the Prime Minister, the right hon. Members for Wokingham (Mr. Redwood), for Enfield, Southgate (Mr. Portillo) and for Henley (Mr. Heseltine). If we look at the list of proposed Cabinets, we see that the Secretary of State for Health does not appear in any of them. That makes a difference to us because perhaps after this week we shall be able to discuss the future of St. Bartholomew's hospital and its medical college in rational terms—something which we have not been able to do. I wish to make a plea to two sets of people tonight. First, I wish to ask Conservative Members to vote down the Bill. Secondly, I wish to make a plea to peers of the realm in another place. Should the Bill receive a Third Reading in the House, I ask them to block it, delay it and vote it down when it comes to its Second Reading in the other place. I ask Conservative Members to think back to that great Conservative philosopher, Edmund Burke—perhaps the greatest Tory philosopher there has ever been. Edmund Burke based his theory on the virtues of custom, tradition, stability, continuity, renewal and excellence. St. Bartholomew's hospital and its medical college stand for all those virtues. I could understand it if the Labour party in the 1960s proposed to abolish St. Bartholomew's hospital and to merge its medical college with the Royal London hospital. I cannot understand how the Conservative party in the 1990s should be advancing that proposal. I ask Conservative Members to stand back, think of the great Conservative philosopher and reject barmy 18th century notions of classical liberalism that appear to form the theory driving the two proposals. I suppose that it may be impertinent for a mere commoner, dressed in a shabby lounge suit, to tell peers of the realm what to do. However, I ask them to come to London and vote down the Bill on its Second Reading in the Lords, should it go through the House tonight. I make that plea not just to life peers, but to hereditary peers—the squirearchy of England. I ask all 1,200 them to come down here, if necessary with their footmen, livery men, maids, and perhaps even mistresses, to vote the Bill down. They will be defending the greatest medical college in the world. It only needs one peer to block a Bill in the House of Lords. Whom shall we choose? We know that the Duke of Gloucester spoke on the subject of St. Bartholomew's hospital in the House of Lords, damned the Secretary of State to eternity—and did so beautifully. Perhaps he can do it; if not him, perhaps another peer will. Stopping the Bill is an important matter. Not so long ago—not even a week ago—I went to a ball organised by St. Bartholomew's college. I shall let the House into a secret: the right hon. Member for City of London and Westminster, South went to the same ball; we sat at the same table. His wife and I exchanged views that were so confidential that I dare not talk about them in the House.But the hon. Gentleman will.
Not at all.
While I was moving around the ball I was stopped by consultant after consultant who told me that every week and every month that I hold up the Bill, I am doing St. Bartholomew's hospital a good turn. Notwithstanding what the right hon. Member for City of London and Westminster, South said about the enthusiasm with which St. Bartholomew's hospital supports the Bill, not one of those whom I met at the ball told me that it would be helpful if I stopped what I was doing because I was making a nuisance of myself. No—I received 100 per cent. support. It is ironic that, in politics, one can use balls instead of the corridors of Westminster as a good way of conducting research into important issues such as those that we are now discussing. I said that St. Bartholomew's was a place of excellence. I was looking through the exam results from 1988 to 1993. There are nine London medical colleges and I see that, in 1988 St. Bartholomew's ranked second overall in pass rates, first in 1989, third in 1990, first in 1991, first in 1992 and third in 1993. We should surely not abolish a place that produces excellence, but in terms of distinctions, the college came second in 1988, first in 1989, first in 1990, first in 1991, third in 1992 and first in 1993. I looked at the latest results for 1994 and found that, in terms of distinctions, 33 per cent. of those who took the exam at St. Bartholomew's received distinctions and the college was ranked first. At the London hospital, 21 per cent. of those who took the exam received distinctions and the medical school ranked fourth. At University College hospital—the place of greatest excellence—17 per cent. received distinctions and the college ranked ninth. There should be no doubt about it—we are talking about a medical college of great academic distinction. I wish to answer the points made by the right hon. Member for City of London and Westminster, South and by my right hon. Friend the Member for Bethnal Green and Stepney, who say that there is agreement about the Bill. There is not. I know that it looks odd because St. Bartholomew's hospital is one of the Bill's supporters. That is what everyone finds difficult to understand. This afternoon, I looked through the annual reports of the medical colleges and found that in 1985, 1986 and 1987 there were great criticisms of the proposal when Dr. Kelsey Fry was the dean. I see also that there was a judicial review and that the merger between St. Bartholomew's and the London medical college was dropped in favour of the City and East London Confederation for Medicine and Dentistry to which the right hon. Member for City of London and Westminster, South referred. The confederation has worked perfectly happily ever since and, in my view, could still. In 1992, the Tomlinson report recommended first, the closure of the hospital and secondly, the complete merger, both pre-clinical and clinical, of the two medical colleges. Professor Lesley Rees, currently the dean of St. Bartholomew's medical college and someone who, presumably, knows as much as anybody about the matter, is a superstar if ever I have met one. When the Tomlinson report came out in 1992, she wrote in the Christmas 1992Barts Journal:The current dean of St. Bartholomew's medical college says that there is no added advantage. If there are hon. Members with the ability to contradict Professor Rees, I should like to hear them. Of course, she may have changed her mind since then but in the annual report of the medical college in 1993, Professor Rees said:"As far as the Medical College is concerned the Tomlinson Report recommends a merger with The London Hospital Medical College and Queen Mary and Westfield College. I believe that the City and East London Confederation for Medicine and Dentistry (CELC) provides the optimum link between the two Medical Colleges and Queen Mary and Westfield College. The Faculty of Basic Medical Sciences at QMW has largely met the claims made for medicine being placed within a multi-faculty college of the University. Cementing further the CELC arrangement will provide no added advantage that I can see in a medical faculty structure for teaching and research. Indeed with activities on at least three major sites such a Faculty structure would be unlikely to create economies of scale."
"This has been a momentous year in the fortunes of the College and for our hospitals.
I repeat that she says "we were required". Members of Parliament are versed in the subtleties of what people have to do by force majeure and what they do voluntarily. When the dean of a medical college writes "we were required" to do something and finds no higher words of praise than that, one must take it that the dean is saying that something that the college does not want to be done is being forced on it. That is the truth. This is not a private Bill and never has been. It is a public Bill; it was whipped on Second Reading and is to be whipped again tonight. That is why I am going to keep my speech short. There is no point arguing against the force majeure of votes in the House. When the Bill's Second Reading was moved, my right hon. Friend the Member for Bethnal Green and Stepney said:In line with Government Policy we were required to inform the Higher Education Funding Council for England (HEFCE) by the 1st October 1993, of our intention to merge with the London Hospital Medical College and Queen Mary and Westfield College."
In favour of his argument, he went on:"My second reason for claiming that this Bill should be largely uncontroversial is that the merger is an agreed measure … In no sense is it a takeover bid, either by the London medical college for Bart's medical college or by Queen Mary and Westfield medical college for the other two."
I can tell right hon. and hon. Members that the warden of the new medical college is Sir Colin Berry. His so-called deputy is Professor Lesley Rees from Bart's. The principal of the medical college, Professor Zellick, wrote to me in connection with the Bill and blocking motion saying that it was not a takeover and that Sir Colin Berry from the London was the warden—selected before the Bill had had a Second Reading, an odd way of going about creating a new institution which has no parliamentary approval of any kind. Never mind, we know that Professor Zellick has contempt for Parliament because he had to apologise through his agent at the Bill's unopposed Committee stage, which I personally attended. He also said that Lesley Rees had the offer to be the dean of clinical medicine. What could be fairer than that? I sent his letter to Professor Rees for her comments. They are very brief. In a letter dated 12 April 1995, she said:"As for personnel, the warden of the new school of medicine and dentistry will come from the London, and all those concerned want his deputy and successor to come from Bart's."—[Official Report, 19 April 1995; Vol. 258, c. 277.]
"I made it quite clear to Professor Zellick that my application was for the Wardenship only and that I was not interested in the position of Dean of Clinical Medicine. The 'package' he mentions was never publicised or discussed with me before or during the interview. In fact, the intention at the time was to advertise for the position of Dean of Clinical Medicine.
We have Professor Zellick telling my right hon. Friend the Member for Bethnal Green and Stepney, who moved the Bill's Second Reading, and writing to me, giving information which misleads us, in the hope presumably that we will mislead the House. I had the good sense to check it. That is the truth of the matter, so let us not say that there is massive agreement and that it is no sense any kind of takeover. Indeed, as regards personnel I give credit to the right hon. Member for City of London and Westminster, South who, in one of our more general debates on Bart's hospital, first raised the point about the number of people at the medical college who were leaving because of the uncertainty that had been created. A lot of the personnel do not want the merger. To bring matters right up to 1995, there is my research last week at the ball, where all the consultants were saying to me, "Keep it up Sedgemore. For the first time in your life, you are doing a bit of practical good in Parliament." If the House is to support an institution, the institution has to be able to show that it has acted in good faith. It gives me no pleasure to say this, but the college lost a wonderful opportunity when it turned down Professor Rees as warden and appointed Sir Colin Berry before, as I said, Second Reading. It was bizarre that Eastman dental hospital, which is not part of the new institution, had a vote on who should be the warden of the medical college. That struck me as extraordinary. But the choice of Sir Colin Berry suggests that it is not the sort of institution to which the House should give its approval. Clive Priestley, who is lay vice-president of St. Bartholomew's medical college, said to me in the presence of Professor Zellick, that he had asked before the warden was appointed whether it would be in order for him to ask one of the candidates whether there was anything to that candidate's detriment that might damage the college. That seems a perfectly reasonable question—the sort of question asked at all kinds of interviews. However, Professor Zellick ruled the question out of order. I have never heard of a principal of a college ruling out of order a question that could discover whether a person who might be about to be appointed has some skeleton in the locker that could damage the college. In this case, we know that the warden, as a pathologist, had in fact misdiagnosed two women whose breasts were cut off, and we know that there had been a vote of no confidence in him by some staff. Even the general and fat controller at the Royal Hospitals NHS trust, Sir Derek Boorman and Gerry Green, realise that it has all been a terrible mistake. Perhaps my point is laboured because I understand that the Government may be prepared to bail out Queen Mary and Westfield college. There is a real chance, I am told, that none of the people there will ratify the appointment of Sir Colin Berry as warden. The Government now realise that he is so useless that they could make him chair of a quango and therefore satisfy everyone. The medical college at St. Bartholomew's hospital has existed almost from the time of the hospital itself. It was founded in 1123 by Rahere, an Augustinian monk, and was linked to the priory at St. Bartholomew's hospital. Soon, there were apprentices who worked with the doctors and they, in effect, were the first students at the medical college. I think that Conservatives should recognise that, down the centuries, it has fought off a number of tremendous attempts to close it, and it is ironic that they who should be the creatures of custom, tradition, excellence and renewal in the style of Edmund Burke are now about to change all that. Henry VIII desperately tried to close the college. He wanted to dissolve the monasteries and introduced the Acts of Dissolution 1536 and 1539. The college refused to close itself and eventually Thomas Vicary, who had trained at Bart's and who was Henry VIII's surgeon, persuaded the king to grant it a royal charter in 1546. A hospital that fought off Henry VIII cannot survive the modern House of Commons. In September 1666, the great fire of London did its worst and tried to destroy the hospital and the medical college. On that occasion, God and the weather came to the aid of the medical college, and I very much hope that tonight God will come to its aid again.I also made it abundantly clear to Professor Zellick and to many others that in the event I was not appointed as Warden, I would not be an applicant for the post of Dean of Clinical Medicine."
The hon. Gentleman knows that he and I are shoulder to shoulder on some aspects of the matter, although we are on opposite sides on the Bill. He has in his narrative relating to the hospital, omitted one of my favourite passages which is that the index of the history refers to "English Civil War (Effect on the Parish)". An institution has to be pretty self-confident to make that its single reference to the English civil war.
The right hon. Gentleman—I was about to call him my right hon. Friend because we are so close on this matter—shows how great and self-confident one can be. I think Balliol college, Oxford, used to call it the unconscious realisation of effortless superiority, which is something that St. Bartholomew's as well as Balliol college had. Certainly, I doubt that it is something that the Minister will have when he replies. However, we shall see.
The medical college did not entirely escape the ravages of the great fire of London. Much of Bart's property was destroyed, and it was calculated that it lost income of £2,000 a year. It was a huge sum but Bart's quickly recovered. Therefore, the medical college survived Henry VIII and the great fire of London, but it cannot apparently survive the House of Commons in 1995. In the war, Hitler's bombers tried to destroy the hospital and the medical college. On 23 and 24 September 1940, they bombed the medical college and, in October that year, they bombed Charterhouse square, which is mentioned in one of the clauses. Shortly after the war, and as a result of all the bombing, the Department of Health said that it should perhaps close the hospital. Perhaps it was that niggle which entered the psyche of the Department of Health as long ago as 1945 which has found fruition 50 years later and led to the suggestion that the hospital be shut and the medical college wound up. Sometimes the bureaucrats never give up. I speak as someone who worked in the civil service—I know the way its mind works. In any event, the college beat Henry VIII, the great fire of London and Hitler's bombers, but we cannot beat the Conservatives in the House of Commons in 1995. I shall draw my remarks to a close, but many people, past and present, will be saddened by what we are doing. They include the eminent surgeon Percival Pott, who was one of the first people to act as a real professor at the medical college; John Abernethy, who effectively formalised teaching at the hospital and who is usually regarded as its founder in the 18th century; Lord Horder, Sir Archibald Garrod and William Marsden, who was ultimately responsible for the foundation of the Royal Marsden hospital in 1851. Last but not least I must mention the great W. G. If anyone knows who the great W. G. is, it will be the right hon. Member for City of London and Westminster, South. I am sure that all hon. Members know that I am referring to Dr. W. G. Grace, the greatest Englishman who ever lived and one of the finest batsmen the world has ever known. W. G. qualified as a doctor at St. Bartholomew's hospital and he will be turning in his grave tonight. There is no better reason to oppose the Bill than to let W. G. rest in peace. I believe that the hospital can be saved; then we can look again at the medical college. That would be the wisest and best thing that we could do. I hope that hon. Members will oppose the Bill.7.44 pm
I support my right hon. Friend the Member for City of London and Westminster, South (Mr. Brooke). In doing so, I must, in deference to Mr. Justice Nolan, declare an interest in that Queen Mary college conferred an honorary degree on me. That fact is listed in all publications and is well known throughout the country. I received no remuneration although I was given one free meal. Having established that, I can say that I strongly agree with what my right hon. Friend said.
I am amazed at the contribution by the hon. Member for Hackney, South and Shoreditch (Mr. Sedgemore). I have heard him make a serious and persuasive speech, but that was certainly not the case tonight. The frivolity with which he treated the matter is deplorable. To begin by saying that the Bill was to be debated at this time because of a party leadership election shows that he is living in a world of fantasy. As for the hon. Gentleman's arguments, my right hon. Friend the Member for City of London and Westminster, South dealt with them. I share my right hon. Friend's view that the decision taken about Bart's was and is a mistake. The Tomlinson committee considered every technical and physical development of the hospitals; the only matter that it did not consider was the people. It is for that reason that the decision was a mistake, quite apart from Bart's great history. Although we had an interesting history lesson this evening, the fact that Handel played the organ at Bart's was omitted—that is perhaps the most important thing of all. My right hon. Friend the Member for City of London and Westminster, South said that there was no reason why the change suggested in the Bill should not go ahead. We have been given no real reasons against that. I accept what my right hon. Friend said and the advice that I have received. Most unusually from an Opposition Member, we heard a quotation from Edmund Burke. Burke also said:I have endeavoured over the past 45 years to contribute some industry; now I contribute my judgment, which is that my right hon. Friend is absolutely right."Your representative owes you, not his industry only, but his judgment".
7.46 pm
It is a pleasure to follow my right hon. Friend the Member for Old Bexley and Sidcup (Sir E. Heath), who made some cogent remarks. I, too, was interested in the alliances forged by the hon. Member for Hackney, South and Shoreditch (Mr. Sedgemore). He called on forces beyond the grave in the shape of Dr. Grace and attempted to forge what was, to my mind, a rather unusual alliance with the other place. The thought of him leading the combined forces of that other place on any subject is indeed an interesting one. However, I am not sure that he did his case much good by referring to the peers of the realm as the squirearchy. That will perhaps set back his cause to some extent. In any event, it was an interesting notion.
The House is well aware of the fact—I shall, nevertheless restate the convention—that my purpose in such debates is to give a broad outline of the Government's position. I greatly welcome the arguments that my right hon. Friend the Member for City of London and Westminster, South (Mr. Brooke) has put before us in the case for the merger of the medical schools within the Queen Mary and Westfield college. I am happy once more to state the Government's broad position in welcoming the Bill and the opportunities that it presents for developing a continuing partnership between medical education, research and clinical services in east London. As the right hon. Member for Bethnal Green and Stepney (Mr. Shore) made clear on Second Reading, and as my right hon. Friend reiterated this evening, the Bill has the support of the institutions involved. The principles supporting the case for the merger of the colleges have been laid before the House and, I believe, stand firmly on their own merits. To put it in context, the Bill is one of a number introduced over the past 20 years or so to unite medical colleges within multi-faculty colleges of the university of London. It will strengthen the institutions concerned and develop important links with departments of life sciences. It will also ensure that the tradition of excellence in medical teaching and research in that part of London will continue from a strong academic base. My Department and the Department for Education welcome the Bill. It will contribute to securing London's leading position in these fields as well as securing a medical and dental school of great distinction in east London to match those that are being established in other parts of the capital. I congratulate my right hon. Friend the Member for City of London and Westminster, South on putting the case for the merger so concisely and well. I hope that the Bill can now proceed quickly for consideration in another place, perhaps free of the cohorts that the hon. Member for Hackney, South and Shoreditch hoped to bring as legions to oppose it. The Bill deserves to be placed on the statute book as quickly as possible, and the Government confirm their broad support for the measure.Question put, That the Bill be now read the Third time:—
The House divided: Ayes 213, Noes 56.
Division No. 190]
| [7.50 pm
|
AYES
| |
| Ainsworth, Peter (East Surrey) | Coe, Sebastian |
| Alexander, Richard | Colvin, Michael |
| Allason, Rupert (Torbay) | Congdon, David |
| Alton, David | Conway, Derek |
| Amess, David | Coombs, Anthony (Wyre For'st) |
| Ancram, Michael | Cope, Rt Hon Sir John |
| Arbuthnot, James | Cormack, Sir Patrick |
| Arnold, Jacques (Gravesham) | Couchman, James |
| Ashby, David | Curry, David (Skipton & Ripon) |
| Atkins, Rt Hon Robert | Dalyell, Tam |
| Atkinson, David (Bour'mouth E) | Davies, Quentin (Stamford) |
| Atkinson, Peter (Hexham) | Day, Stephen |
| Baker, Nicholas (North Dorset) | Deva, Nirj Joseph |
| Baldry, Tony | Dicks, Terry |
| Banks, Matthew (Southport) | Dorrell, Rt Hon Stephen |
| Bates, Michael | Douglas-Hamilton, Lord James |
| Bellingham, Henry | Dover, Den |
| Bendall, Vivian | Duncan, Alan |
| Beresford, Sir Paul | Dunn, Bob |
| Biffen, Rt Hon John | Durant, Sir Anthony |
| Bonsor, Sir Nicholas | Dykes, Hugh |
| Booth, Hartley | Eggar, Rt Hon Tim |
| Boswell, Tim | Evans, David (Welwyn Hatfield) |
| Bowden, Sir Andrew | Evans, Nigel (Ribble Valley) |
| Bowis, John | Evans, Roger (Monmouth) |
| Boyson, Rt Hon Sir Rhodes | Evennett, David |
| Brandreth, Gyles | Fabricant, Michael |
| Brazier, Julian | Fenner, Dame Peggy |
| Bright, Sir Graham | Field, Barry (lsle of Wight) |
| Browning, Mrs Angela | Fishburn, Dudley |
| Burns, Simon | Forsyth, Rt Hon Michael (Stirling) |
| Burt, Alistair | Forth, Eric |
| Butcher, John | Fox, Dr Liam (Woodspring) |
| Butler, Peter | Fox, Sir Marcus (Shipley) |
| Campbell, Menzies (Fife NE) | Freeman, Rt Hon Roger |
| Carlile, Alexander (Montgomery) | French, Douglas |
| Carlisle, John (Luton North) | Gale, Roger |
| Carrington, Matthew | Gardiner, Sir George |
| Cash, William | Garel-Jones, Rt Hon Tristan |
| Channon, Rt Hon Paul | Garnier, Edward |
| Chapman, Sydney | Goodson-Wickes, Dr Charles |
| Clappison, James | Gorst, Sir John |
| Greenway, Harry (Ealing N) | Marshall, John (Hendon S) |
| Griffiths, Peter (Portsmouth, N) | Merchant, Piers |
| Gummer, Rt Hon John Selwyn | Michie, Mrs Ray (Argyll & Bute) |
| Hague, William | Mills, Iain |
| Hamilton, Rt Hon Sir Archibald | Mitchell, Andrew (Gedling) |
| Hannam, Sir John | Nelson, Anthony |
| Hargreaves, Andrew | Neubert, Sir Michael |
| Hawkins, Nick | Newton, Rt Hon Tony |
| Hawksley, Warren | Nicholson, David (Taunton) |
| Hayes, Jerry | Nicholson, Emma (Devon West) |
| Heald, Oliver | Norris, Steve |
| Heath, Rt Hon Sir Edward | Onslow, Rt Hon Sir Cranley |
| Hendry, Charles | Oppenheim, Phillip |
| Hill, James (Southampton Test) | Ottaway, Richard |
| Howard, Rt Hon Michael | Page, Richard |
| Howell, Sir Ralph (N Norfolk) | Paice, James |
| Hughes, Robert G (Harrow W) | Patnick, Sir Irvine |
| Hughes, Roy (Newport E) | Pattie, Rt Hon Sir Geoffrey |
| Hunter, Andrew | Pawsey, James |
| Jack, Michael | Peacock, Mrs Elizabeth |
| Jenkin, Bernard | Pickles, Eric |
| Jessel, Toby | Porter, David (Waveney) |
| Johnson Smith, Sir Geoffrey | Prentice, Bridget (Lew'm E) |
| Jones, Barry (Alyn and D'side) | Rathbone, Tim |
| Jones, Gwilym (Cardiff N) | Rendel, David |
| Jones, Robert B (W Hertfdshr) | Richards, Rod |
| Key, Robert | Rifkind, Rt Hon Malcolm |
| King, Rt Hon Tom | Robathan, Andrew |
| Kirkhope, Timothy | Robinson, Mark (Somerton) |
| Knapman, Roger | Scott, Rt Hon Sir Nicholas |
| Knight, Mrs Angela (Erewash) | Shaw, David (Dover) |
| Knight, Greg (Derby N) | Shaw, Sir Giles (Pudsey) |
| Knight, Dame Jill (Bir'm E'st'n) | Shephard, Rt Hon Gillian |
| Knox, Sir David | Shepherd, Richard (Aldridge) |
| Kynoch, George (Kincardine) | Shersby, Sir Michael |
| Lait, Mrs Jacqui | Smith, Tim (Beaconsfield) |
| Lamont, Rt Hon Norman | Spicer, Michael (S worcs) |
| Lang, Rt Hon Ian | Spink, Dr Robert |
| Lawrence, Sir Ivan | Squie, Robin (Hornchurch) |
| Lidington, David | Stephen, Michael |
| Lightbown, David | Stern, Michael |
| Lilley, Rt Hon Peter | Stewart, Allan |
| Lloyd, Rt Hon Sir Peter (Fareham) | Streeter, Gary |
| Lynne, Ms Liz | Sweeney, Walter |
| MacKay, Andrew | Sykes, John |
| Maclean, Rt Hon David | Taylor, Ian (Esher) |
| McLoughlin, Patrick | Taylor, John M (Solihull) |
| Maitland, Lady Olga | Taylor, Matthew (Truro) |
| Malone, Gerald | Taylor, Sir Teddy (Southend, E) |
| Mans, Keith | Temple-Morris, Peter |
| Marland, Paul | Thornton, Sir Malcolm |
| Marlow, Tony | Thurnham, Peter |
| Townsend, John (Bridlington) | Whitney, Ray |
| Townsend, Cyril D (Bexl'yh'th) | Whittingdale, John |
| Trotter, Neville | Widdecombe, Ann |
| Twinn, Dr Ian | Wiggin, Sir Jerry |
| Tyler, Paul | Wilkinson, John |
| Walker, Bill (N Tayside) | Willetts, David |
| Waller, Gary | Wilshire, David |
| Ward, John | Winterton, Mrs Ann (Congleton) |
| Wardell, Gareth (Gower) | Wolfson, Mark |
| Wardle, Charles (Bexhill) | Wood, Timothy |
| Waterson, Nigel | Young, Rt Hon Sir George |
| Watts, John | Tellers for the Ayes:
|
| Wells, Bowen | Mr. Peter Brooke and
|
| Wheeler, Rt Hon Sir John | Mr. Michael Lord.
|
NOES
| |
| Adams, Mrs lrene | Loyden, Eddie |
| Banks, Tony (Newham NW) | McAvoy, Thomas |
| Barnes, Harry | McKelvey, William |
| Bermingham, Gerald | Marshall, David (Shettleston) |
| Burden, Richard | Maxtor, John |
| Caborn, Richard | Meale, Alan |
| Campbell, Ronnie (Blyth V) | Michie, Bill (Sheffield Heeley) |
| Cann, Jamie | Miller, Andrew |
| Chisholm, Malcolm | Mitchell, Austin (Gt Grimsby) |
| Clwyd, Mrs Ann | Mullin, Chris |
| Cummings, John | Oakes, Rt Hon Gordon |
| Cunningham, Jim (Covy SE) | O'Brien, Mike (N W'kshire) |
| Dafis, Cynog | Olner, Bill |
| Donohoe, Brian H | Pike, Peter L |
| Dunnachie, Jimmy | Purchase, Ken |
| Evans, John (St Helens N) | Sedgemore, Brian |
| Galloway, George | Simpson, Alan |
| Godman, Dr Norman A | Skinner, Dennis |
| Godsiff, Roger | Smith, Llew (Blaenau Gwent) |
| Golding, Mrs Lin | Spearing, Nigel |
| Grant Bernie (Tottenham) | Squire, Rachel (Dunfermline W) |
| Hanson, David | Steinberg, Gerry |
| Hill, Keith (Streatham) | Wareing, Robert N |
| Hogg, Norman (Cumbernauld) | Welsh, Andrew |
| Hood, Jimmy | Wray, Jimmy |
| Hughes, Kevin (Doncaster N) | Young, David (Bolton SE) |
| Jamieson, David | |
| Jones, Lynne (B'ham S O) | Tellers for the Noes:
|
| Lewis, Terry | Mr. Harry Cohen and
|
| Livingstone, Ken | Mr. D. N. Campbell-Savours
|
Question accordingly agreed to.
Bill read the Third time and passed.
Orders Of The Day
Education
8.3 pm
I beg to move,
As hon. Members will know, we introduced the assisted places scheme in 1981 because we are committed to choice and diversity and because we wish to encourage high standards in education, wherever they are to be found. We want parents to be able to choose the education that they think best for their children, regardless of income. The scheme has opened up educational opportunities for many thousands of able children from less well-off families, and continues to be an outstanding success. Under the present Government, it is here to stay. Our best independent schools have a long tradition of academic excellence, of which they are rightly proud; but schooling is not just about achieving good results on paper. Schools in the scheme take a justifiable pride in developing their pupils as individuals, and equipping them in every way to make a full and valuable contribution to society. Independent schools are also here to stay. We believe that the range of opportunities that they offer should not be restricted to those who can afford to pay for them. Independent schools have a long history of providing bursaries and scholarships for less well-off pupils, and the Government welcome that, but there is a limit to what the independent schools can do themselves. The assisted places scheme builds on and extends the schools' own contributions. It not only expands opportunities for children from lower-income families, but helps to widen the social mix and create greater awareness and understanding across communities. In short, the scheme is an academic success: assisted pupils, on average, achieve better GCSE and A-level results than their peers in independent and maintained schools, and have high entry rates into further and higher education. The scheme is successful in the wider opportunities and experiences that it provides in sport, the arts and other aspects of personal development, and it is successful in giving all those opportunities to children who could not otherwise have afforded them. Over 40 per cent. qualify for a totally free place, and 80 per cent. of their families have incomes below the national average. The regulations governing the scheme were last consolidated in 1989. Amendments have been made in each year since then, mainly to uprate the parental contribution tables that set out the amounts that parents must pay towards their children's assisted places. The House is considering new consolidated regulations, whose effects I shall explain shortly. Consolidation is essentially good housekeeping, to bring all the previous changes into a single document, update some detailed aspects of the rules and remove redundant wording. The consolidated regulations include this year's parental contribution uprating. There are no radical changes in the operation of the scheme. If approved, the regulations will come into force on 25 August, for the school year 1995–96. Part I of the draft regulations—that is, regulations 1 and 2—deals with citation, commencement and application and with the interpretation of expressions used throughout the text. The main changes here are in connection with the definition of "parents" for the purpose of income assessments under the scheme, and with the use of the term "European Economic Area" with regard to the residence of applicants for assisted places. The definition of "parents" in regulation 2 has been revised to take account of provisions in the Children Act 1989 and subsequent developments, and to limit the definition to the person or persons with whom the child normally lives. There have been no major changes of substance, but the wording has been clarified. In the usual case, the "parents" are of course the natural mother and father, and both must make a declaration of their joint incomes to be eligible for assistance under the scheme. The regulations also cater for adoptive parents, those who are guardians or foster parents and those who, although not the natural parents, have custody or care and control of the child. Part II of the draft regulations—regulations 3 to 8—deals with eligibility for an assisted place. The wording of regulation 3 has been made clearer, and the requirement that parents and child applying for an assisted place must fulfil all the conditions specified is strengthened. Draft regulation 4 sets out the residence requirements. The vast majority of assisted pupils will, of course, satisfy the requirement that they should be ordinarily resident in the British islands for at least two calendar years before taking up the assisted place. In addition, there have always been conditions applicable to children who have been living in European Community countries and have been nationals of those countries. Those conditions have been revised in the draft regulations to take account of the European Economic Area agreement, and to reflect our legal obligations to provide access to free or subsidised tuition for children of migrant workers on the same basis as for British residents. By the same token, the requirement that a child from a member state of the European Community be resident in the British islands on 1 January before taking up an assisted place is removed. The conditions as to age in draft regulation 5 remain largely the same. The only exception is that the somewhat anomalous requirement that a child should have attained the age of 11—the scheme's minimum age—by 31 July following his admission to an assisted place is now amended, so that the child concerned must have reached the specified minimum age by 31 August, the conventional end of the school year. There have been some minor technical amendments and drafting changes in part III of the draft regulations—regulations 9 to 15—dealing with remission of fees. Cross-references in footnotes to other relevant legislation have been updated. Draft regulation 11 provides for an allowance to be made for each dependent child, other than the assisted place holder, against parents' total income when calculating their contribution towards school fees. This year, the allowance is raised from £1,140 to £1,165, in line with inflation, and will maintain the help for families with more than one child. Draft regulation 15 refers to the scales of fee remission in schedule 2 which, in turn, sets out the income bands used for assessing parents' contribution to fees for the school year 1995–96. I announced those to the House on 26 January last. Like the dependant's allowance, those bands have been uprated in line with the 2.4 per cent. movement in the retail prices index over the 12 months to October last year. The income threshold at or below which parents pay nothing towards fees is raised from £9,352 to £9,572 a year. There are corresponding increases in the thresholds for the higher income bands. The effect is that parents whose relevant income has risen by no more than inflation will continue to contribute the same proportion of that income, and indeed the same amount in real terms. Parents whose incomes have risen by less than inflation will pay less. All those adjustments help to achieve the objective of targeting assistance on those who need it most. The provisions of the remaining parts of the draft regulations cover the administrative arrangements and miscellaneous requirements of the scheme. They remain essentially unchanged. Draft regulation 19, for example, lies at the heart of the scheme and requires participating schools to recruit at least 60 per cent. of their assisted pupils from publicly maintained schools.That the draft Education (Assisted Places) Regulations 1995, which were laid before this House on 26th June, be approved.
Does my hon. Friend agree that what he has just said reinforces yet again the fact that the only remaining people who disapprove of the assisted places scheme, which has already benefited 70,000 children over the years since its introduction, are Opposition Members who are still peddling the politics of envy? Does he agree that it is noticeable that people, such as a gentleman in my constituency, are resigning from the Labour party when their children have benefited from assisted places because they recognise the poverty and hypocrisy of the Opposition's ideology, which is based on, "We're all right Jack, knock away the ladder"? No fewer than seven members of the shadow Cabinet have benefited.
Order. I think that the hon. Gentleman knows full well my view that interventions should be short. That was getting very long.
The intervention of my hon. Friend the Member for Blackpool, South (Mr. Hawkins) was enjoyable, however, at least from where I was sitting. I congratulate him on what he said, which is well known not just in the House, but, I am pleased to hear from his comments, among a growing number of erstwhile supporters of the Labour party.
The scheme is not intended for those who would have sent their children to independent schools in any event, but a small number of assisted place holders were attending private preparatory schools before taking up their secondary school place and have been awarded assisted places on the ground of hardship.Will the Minister tell me how many pupils in Wales are currently on an assisted places scheme and what percentage that is of the overall school population in Wales?
I have that information, but I do not have it immediately to hand. Will the hon. Gentleman allow me to cope with that in my concluding comments rather than give him an estimate and then, in a sense, have to correct that estimate?
I ask the same question in relation to Scotland. Will the Minister give us the figures for Scotland?
The regulations do not affect Scotland. They cover purely England and Wales, so whether or not I can find the figures for Wales, those for Scotland are not affected by the regulations.
Finally, the technical arrangements for the computation of parents' income in schedule 1 to the draft regulations have been updated and amended, mainly as a result of various Finance Acts brought into force in the intervening years since 1989.Will the Minister give way?
I am anxious to make progress, but I shall give way to the hon. Lady.
There is of course a great deal of alarm and concern among parents about the falling school budget. What would the Minister say to the head teacher of my local sixth form college, who has written to me and recently published a press release saying:
as that head teacher has been allocated to teach his pupils?"Governors, staff, students and parents therefore want to know why recent parliamentary answers suggest that the Government allocates up to twice as much per student to buy an assisted place in an independent school"
Several answers would accurately sum up the position and give useful information to the head teacher to whom the hon. Lady referred. The first and most obvious point is that the fees paid under assisted places to private independent schools cover not merely revenue expenditure, but capital, whereas the allocation under the standard spending assessment covers only revenue items. Secondly, although I hope that she would not expect me to run through the figures on 109 SSAs, she will find that, even taking that into account, the amount allocated to some local education authorities per pupil under the SSA for the current year is greater than the average allocated in relation to the scheme.
I have some figures here. In 1994–95, funding for 16 to 19-year-old students, including capital, at my local colleges in Cambridge—funded of course through the Further Education Funding Council—was £2,823 per year. I have not had the exact figures, but I know that the sum at a school such as Leys school in Cambridge approaches £5,000 a year. As I said earlier, the figure is almost double for such schools.
The hon. Lady has made her local point. I repeat that, considering the full range of schools within the assisted places scheme, and, separately, the amount advanced by the standard spending assessment annually, there is an enormous range of figures. In particular, the other thing the hon. Lady will know is that the whole funding of sixth forms, be it sixth form colleges or sixth forms as part of schools, displays significant variances as well.
I congratulate my hon. Friend on the admirable answers that he has given to the hon. Member for Cambridge (Mrs. Campbell), which I am certain will entirely satisfy her. Some disquiet is being expressed about the assisted places scheme. The disquiet that I have heard is that the Government may not be firmly committed to it. I would therefore be grateful if my hon. Friend would put those rumours to rest and nail the Government's colours firmly to the mast of the scheme.
I am delighted to give my hon. Friend the utter and complete assurance that the Government are committed to the assisted places scheme. We see its continuing advantages and we have no plans to cut it, let alone to abolish it.
I hope that I have explained to the satisfaction of the House the purpose behind the laying of these draft consolidated regulations, and that I have covered the main areas where some minor changes have been made. Whatever Opposition Members may feel about the assisted places scheme as a whole, I am confident that the House will welcome both the tidying-up that we have undertaken in the regulations and, of course, the annual uprating to preserve its value. I commend the regulations to the House.8.17 pm
We will vote tonight against the regulations and we will do so simply because we are against the whole scheme in principle. I shall explain why, but before I do, may I enlighten the Under-Secretary and tell him that in Wales approximately 720 pupils are on the assisted places scheme?
There are three principal reasons for opposing the assisted places scheme. First, it is unfair and inefficient to penalise the many to advantage the few, yet that, effectively, is what the scheme does. Secondly, in the main, schools select the most academically able through the scheme, distorting the academic profile of children in the maintained sector and inflating the image of academic excellence projected by many independent schools. Finally, it is a totally unwarranted subsidy by the state of the private sector. The Government would have us believe that the scheme is an unqualified success, but they regularly refuse to make more detailed information available. My hon. Friends have regularly tabled questions to the Department for Education so that a clearer picture might emerge, but it has all been to no avail. On 17 January, my hon. Friend the Member for Wolverhampton, North-East (Mr. Purchase) sought information as to which local education authorities had a concentration of assisted places, but he was told that the data were not broken down by local education authority. Later that year, on 2 March, my hon. Friend the Member for Cunninghame, South (Mr. Donohoe) attempted to find out how many families using the scheme could have afforded private education anyway—something to which the Under-Secretary referred earlier. He was told that that would apply to very few. How can the Government possibly know that without the relevant data—which, from their own evidence, they do not collect? The Scottish Office told my hon. Friend:At least the Welsh Office was honest when, on 4 March last year, it told my hon. Friend:"The number of such pupils is impossible to assess accurately but they must be very few."—[Official Report, 7 March 1994; Vol. 239, c. 54.]
The truth is that the Government neither know nor care because the scheme is motivated by ideology and they do not want it to be scrutinised too closely."No such assessment has been made."—[Official Report, 4 March 1994; Vol. 238, c. 906.]
While on the subject of provision of information, does the hon. Gentleman agree that no fewer than seven of his Front-Bench colleagues have been beneficiaries of the sort of schools that his opposition to the regulations would damage?
I would not have a clue about to whom the hon. Gentleman is referring. Perhaps I am one of them because I went to a direct grant school that eventually opted for the independent sector. There is hardly a case to be made against hon. Members who, at the age of 11, were arbitrarily selected by a system that they neither understood nor in which they participated.
The Under-Secretary has been party to the smokescreen around the assisted places scheme. When my hon. Friend the Member for Sheffield, Hillsborough (Mrs. Jackson) asked how many households with children on the assisted places scheme were in the bottom tenth of disposable income levels under Department of Social Security statistics, he obfuscated by saying that the information was not available in the form requested. That lack of information and clarity does not, in any shape or form, prevent the Department for Education from making odd claims about the scheme. Last week, at my request, it faxed me its view of the scheme and made four principal claims, which have been echoed tonight by the Under-Secretary—that it widens opportunity to the poor; it extends choice to those who would not have it; it justifies the intake as otherwise not choosing the private sector; and it claimsThe argument that the scheme widens opportunity lacks any conviction. Despite 100 per cent. take-up of first-year places, it consistently involves between 0.8 and 0.9 per cent. of the total number of secondary pupils. That obviously implies that more than 99 per cent. of our pupils do not cut the mustard academically to qualify for the scheme. The second argument, of extension of choice to those who otherwise would not have it, again denies choice to 99 per cent. of the population by virtue of the narrowness of the take-up. It reinforces our view that the whole notion of choice in education is chimerical, at least for the vast majority of people. At best, preference is exercised, not choice. The third argument is a very odd claim as it is predicated on the statement that almost 70 per cent. of assisted pupils have come from maintained primary schools. Given that the Prime Minister and the Chancellor both sent their children to state primary schools and then on to independent schools—as have thousands of parents—that appears to be a spurious deduction to make. On the contrary, I would be more concerned with the 30 per cent. plus who have gone from independent primary schools to independent secondary schools at the taxpayers' expense. The Department for Education will continue to laud the achievement of children on the scheme, as the Under-Secretary has done this evening. Of course those children will do well academically—that is why they are creamed off from the maintained sector to inflate the otherwise dubious academic records of many of the schools in the scheme—295 in England alone."295 good independent schools in the scheme (in England)."
rose—
Before the hon. Gentleman intervenes I will accept that many of those schools are good schools and have always been good schools in their own right. I argue against the assertion that all of them are good schools that could stand alone without the infusion of fresh blood—fresh academic talent—being brought in from the maintained sector.
Is it any wonder that organisations such as the Independent Schools Information Service use the scheme as propaganda for their own promotion? For example, is it a coincidence that in the autumn edition of its publication, under a banner headline about Labour party policy and the assisted places scheme, it makes great play of the academic success of independent schools? The implication was clear—that independent schools add value to the fewer than 1 per cent. of pupils who are creamed off. Is not it the 1 per cent. who add value to the schools, not only academically but by propping them up financially? In an open market, many of those schools would have collapsed long ago. The Department for Education claims the scheme is good value for money and that the total cost is justified by a significant increase in opportunities and an extension of choice. I am afraid that such outlandish statements are far from the truth.The hon. Gentleman suggested that some schools would have collapsed long ago without the benefit of the assisted places scheme. Will he improve on the example given a year ago by the hon. Member for Bath (Mr. Foster), speaking for the Liberal Democrats, who could submit only the name of Dulwich college as a school that would have collapsed? Perhaps the hon. Gentleman could give a better example.
The four schools out of the top 50 which the DFE says take more than £1 million a year from the public purse in subsidy, and may even have in excess of 40 per cent. of their pupils on the assisted places scheme, could hardly find it easy to exist without the material support of the students or the huge sums of money that they are given.
Between 1989 and 1995, the cost of the scheme rose from £50.9 million to £102 million—a 100 per cent. increase. Can the Under-Secretary explain why, during the same period, the number of places increased by only 2.6 per cent., from 33,280 to 34,139? Where did the money go? Obviously, the Under-Secretary either does not wish or is unable to tell us where it has gone. My hon. Friend the Member for Bridgend (Mr. Griffiths) referred to the position in Wales, where the average budget per pupil in the maintained sector is £2,373. In the independent sector, the grant per head for the assisted places scheme is £3,790 for the 720 pupils to whom I referred. In England, the position is even worse. According to the House of Commons Library, the average per head in the maintained sector is £2,250, but for places under the APS the average grant per place is £4,110. Where is the value for money between the two? In my county of Merseyside, five schools are in the top 50 recipients of money under the scheme. Between them, they receive £3.5 million a year. Other schools in the county also take money under the scheme. If we assess the cost of a teacher at £20,000—a figure off the top of my head—that £3.5 million would pay for an additional 175 teachers for schools in the county. What would that do to raise standards for all our pupils in all our schools? How many other savings could be made—for example, filling surplus places that we are busy taking out of the system, which is costing a fortune both centrally and locally?Does my hon. Friend agree that the Government are buying something that is, perhaps, not very good value for money? The college that I mentioned earlier—Hills road sixth form college, which is just outside my constituency—gets £2,800 per year per pupil. However, it consistently comes in the top 10 schools, including the public schools. It is the one state school that gets on to that list and consistently gets a high proportion of its pupils into Oxford and Cambridge. Schools that get twice as much money do not come anywhere near it in their results.
It is absolutely true to say that the Government are using and abusing the maintained sector to maintain an ideological position on the assisted places scheme. The school, that takes in more pupils under the assisted places scheme than any other, is, as I recall, not a million miles from Cambridge: Wisbech grammar school. Several schools take nearly as many pupils on the scheme.
The Minister might argue that the scheme is an egalitarian measure, pointing out that around 40 per cent. of pupils pay nothing, going entirely free to these grand schools. But what of the 60 per cent. who are being subsidised in one way or another together with the schools? I note that the schools chosen by other members of the Cabinet, such as the Foreign Secretary and the Home Secretary—the Etons, the Harrows and the Marlboroughs—do not figure at all in any of the parliamentary answers. Winchester is an exception, creeping into the list of schools taking up the scheme, but it is certainly not one of the top 50 schools. If anything, it has a token involvement in the scheme. Perhaps its sense of noblesse oblige does not quite square with the parvenu erstwhile direct grant schools, which are trying to gain status from the scheme rather than anything else.I shall try not to interrupt the hon. Gentleman excessively, but he partly answers his own point. As he knows, the origins of the scheme lay in the old direct grant schools and their efforts. It would be surprising if a significant number of other schools were brought in—not least since there is a waiting list of other schools trying to get on the assisted places scheme.
In fact the Under-Secretary reinforces my point. The scheme is ideologically driven to enable the old direct grant schools to continue a selective, elitist approach to education by creaming off the best from the maintained sector. In government, the Labour party will without doubt abolish this scheme.
Like grant-maintained schools?
The hon. Gentleman refers to grant-maintained schools. Although they are not particularly relevant to this debate, his intervention warrants an answer. We propose to narrow down six categories of schools into three. He will not be surprised to find that that proposal is receiving an increasingly favourable response from head teachers, governors and parents involved in all areas of the maintained sector.
I am obliged to the hon. Gentleman for rising like a particularly plump fish to my intervention.
A plump trout.
All right, rising like a trout. Is the hon. Gentleman able to say that his party, if elected to government, would abolish the grant-maintained sector in its entirety?
Order. I must remind the House that we are debating the assisted places scheme. We must return to that subject.
I may be able to answer within the remit of this debate by saying that when the Labour party goes into government, Labour Members intend to look after the interests of all our children, in all our schools, regardless of the school they may attend.
The Labour party in government will abolish the scheme—not in any way which will damage the progress of the pupils currently studying under the scheme, but by halting new places under it. I hasten to add that Labour Members recognise that there are—as there have always been—cases which require support. Only last week I met the admirable Mr. Tom Juckes, the chairman of the Lord Wandsworth Foundation, which, as the Minister may know, is an umbrella charity for a number of other worthy causes and deals with children in particular educational, social, psychiatric and financial need. We believe that, where appropriate, help can be offered to people who, like those helped by the foundation, use the assisted places scheme. At one time, in local government circles, such help was known as the Martin Rules, which were certainly catered for in section 81B of the Education Act 1944, if the Minister cares to check it out. I fail to see why the assisted places scheme has been subverted to provide places which are already catered for—unless it is for ideological reasons. We will not perpetuate the wholly unacceptable practice of hiving off a few to the disadvantage of the many, to prop up schools which wish to remain elitist and which ignore their wider educational responsibilities to their communities. The Minister's alarm bells ought to be ringing because our new structure, catering for all schools, is looking increasingly attractive to former direct grant schools, which are aware that the future Labour Government will remove any advantages under the assisted places scheme. Indeed, they have already suffered under the pressures of the second great recession since the Conservative party took office since 1979. Labour Members will most certainly and happily vote against the regulations.8.34 pm
I was a little surprised to discover that this draft statutory instrument is being opposed. I say that quite eliberately, notwithstanding what the hon. Member for Liverpool, Walton (Mr. Kilfoyle) has said, because Labour Members are now coming around to the wholesale adoption of Conservative education policies. For example, they are coming around to the acceptance of league tables. They have discovered virtue in them. They have discovered virtue in the national curriculum and even in testing. In short, they are beginning to adopt many Government policies. They have found excellence, and it is excellence that this motion is all about.
The motion makes a contribution to parental choice. It enables parents to select schools and it broadens children's horizons. It enables a child from an ordinary family to share in some of the benefits and the advantages which spring from the independent sector. The scheme helps those parents who, while appreciating the benefits of independent schools, would simply not be able to afford them. It enhances available diversity and choice, which Labour Members are coming around to accepting. If Labour Members believe in diversity and choice, let them tonight withdraw their ill-founded and spiteful opposition to the assisted places scheme. The scheme positively helps children who may be socially disadvantaged; it helps children from single-parent families; it helps children who come from the inner cities. [Interruption.] Does the hon. Member for Walton want me to give way? I thought that he wanted to intervene. Since he does not, I shall continue. All those laudable objectives should not receive the spiteful attention of Labour Members. We are seeing the old egalitarian enmity of Labour: old Labour dressed up as new. It takes more than a smiling leader to change the mind of the hard-nosed municipal socialist. The popularity of the assisted places scheme can be seen from the fact that about 30,000 pupils hold assisted places at almost 300 participating schools. That is an overall take-up of about 90 per cent. and I have to remind the hon. Member for Walton that 100 per cent. of the new places made available each year are now being taken up. The hon. Member for Walton referred to polls. Interestingly, a MORI poll undertaken on behalf of the Independent Schools Information Service shows that the number of parents coming from the C2 group amounts to almost 40 per cent. That is the answer to the question that the hon. Gentleman put to my hon. Friend the Under-Secretary. Almost 40 per cent. is about 12,000 children. Among APS parents, 80 per cent. have relevant incomes below the average household income of about £12,750. Even more to the point, 40 per cent. of parents have incomes below the scheme's school's threshold of £9,352 per year, which will be uprated to £9,570 in the coming year. Children from those families qualify for free places at APS schools. I need hardly remind Opposition Members that many of those parents voted Labour in the past, as my hon. Friend the Member for Blackpool, South (Mr. Hawkins) said. [Interruption.] Does the hon. Member for Walton wish me to give way this time?The hon. Gentleman has quoted figures. Are they for income before it is adjusted or afterwards? Can he tell us what elements are taken out before the base figure of £9,000-plus is reached?
I am sure that those detailed figures will be given by my hon. Friend the Minister when he winds up the debate. I can, however, quote from an admirable document given to me by the Department for Education. Indeed, I will quote it in full for the benefit of the hon. Gentleman and his colleagues. The document says:
as I have mentioned already—"80 per cent. of APS parents have relevant incomes of less than the national average household income of £18,760 … over 40 per cent. of parents have incomes below the scheme's threshold of £9,352 pa (to be uprated)"—
Does that satisfy the hon. Gentleman? I take it from his silence that it does, and I am delighted. The House will recall that the scheme has been in operation for about 15 years. Indeed, I served on the Standing Committee which considered the Bill that became the Education Act 1980. I have to compare the debates which took place at that time with our recent debates. Fifteen years ago, Opposition Front-Bench spokesmen would speak with passion and commitment, but that has all dissolved and drained away. Increasingly, Opposition Members are coming to accept the education reforms that we have introduced, at times painfully and always in the teeth of ill-considered opposition from Labour Members. The assisted places scheme is now an accepted and integral part of the education scene. As my hon. Friend the Member for Blackpool, South said, it provides an admirable ladder of opportunity for a great many children. However, I must tell my hon. Friend the Minister that my cheerful demeanour is qualified. There is at least one aspect of the scheme that genuinely disappoints me—the small percentage of APS parents of African, Asian and Caribbean origin. The figure is only 7 per cent. I say to my hon. Friend in all seriousness that we should do a great deal more to promote the scheme to those parents. I should like to see many more parents from ethnic communities taking advantage of the scheme. I urge my hon. Friend the Minister, therefore, to introduce measures specifically designed to encourage more children from those groups to apply for assisted places. I do not believe that the scheme should be seen as being intended principally for the white Anglo-Saxon Protestant child. It has a much wider appeal and I should like many more children from ethnic groups to take advantage of the scheme. As I said earlier, I believe that the scheme should reach out to all parts and all members of our national community. I ask my hon. Friend the Minister, when he winds up the debate, to advise the House of more measures which might be taken to widen the assisted places scheme to bring in more children from the ethnic minorities."and their children qualify for free places at these schools".
Does the hon. Gentleman appreciate that the assisted places scheme currently costs us £102 million a year? If the scheme were abolished, the money could be used to benefit all members of society—ethnic minorities, children from working-class backgrounds, and so on. My authority would benefit by an extra £1 million a year, which would do a great deal to make good the appalling cuts imposed by the Government this year.
Unlike the hon. Lady, I come from a working-class background. I was born in the working class and educated in the working class, and I am proud of that. I say to her gently that I need no lectures from her on what she believes the working class requires. I want the maximum choice and diversity. It might be argued that grammar schools, for example, cost more. Is that why the hon. Lady would like to see them abolished? Is that why Labour Members would like to see grant-maintained schools abolished? Are we bringing everything down to mere money? [Interruption.] The reaction of Labour Members is to laugh. For them, the education of our children is something to laugh about. Those of us who have our children educated within the state sector do not share that light-hearted view. We take the matter seriously.
Will the hon. Gentleman give way?
It is a great pleasure to give way to the hon. Gentleman, whom I regard as a cheerful friend.
The hon. Gentleman is trying to ruin my reputation with my hon. Friends. I have a simple question for him. If the answer is mere money, why is the same amount of mere money not given to children in the maintained sector as is given under the assisted places scheme?
I have no doubt that as the economy strengthens, more funds will be made available for education. I see my right hon. Friend the Secretary of State for Education sitting in her place in this debate. Where is the hon. Member for Sheffield, Brightside (Mr. Blunkett), the hon. Gentleman's leading education spokesman? He is not in the Chamber listening to what is being said. The fact that my right hon. Friend is present to hear this debate is a clear sign of her commitment to education discussions generally.
Perhaps my hon. Friend the Member for Sheffield, Brightside (Mr. Blunkett) has more faith.
I can reassure the hon. Gentleman that my right hon. Friend the Secretary of State for Education has faith. Under her guidance, the education of the nation's children will continue to flourish.
Criticism has also been levelled at the geographical spread of the assisted places scheme. Again, that matter should be urgently addressed. If the participating school is some distance away from the family home, parents will be deterred from applying for an assisted place. Conservative Members at least know how expensive it is to get children to school and we know of the importance of school transport. That point is not lost on Opposition Members whose colleagues in Essex are taking away free transport for children who attend grammar schools. In those remarks, I include the hon. Member for Southwark and Bermondsey (Mr. Hughes), who occasionally leads for the Liberal Democrats on Education. Earlier, we listened with a sense of déjà vu to what the hon. Member for Walton said. His speech was entirely predictable. In some ways, it reminded me of the earlier comments made by him and his colleagues about grant-maintained schools. I suspect that it will probably take an application by the right hon. Member for Sedgefield (Mr. Blair) for an assisted place for his son to make this measure acceptable to his colleagues.It might help.
My right hon. Friend makes an interesting intervention. She is right; clearly it would help. If the right hon. Member for Sedgefield applied, it would immediately stamp the scheme with the seal of new Labour. At a stroke, Labour Members would fall into line and would immediately see virtue in the APS that had previously eluded them. Like St. Paul on the way to Damascus, the right hon. Member for Sedgefield sees a blinding light which illuminates Conservative education policies and he seeks at once to make them his own. He believes that the light will show him the way to Downing street. Opposition Members will need to do a lot more than simply pinch our policies to get themselves into Downing street.
I commend the regulations, especially to Opposition Members and particularly to the right hon. Member for Sedgefield. I very much hope that Labour's ill-considered opposition will be withdrawn.8.48 pm
Unlike the hon. Member for Rugby and Kenilworth (Mr. Pawsey), I was not here for the first year of this debate and I was not a member of the Committee that considered the Bill which became the Education Act 1980, although I have been here for 12 such debates and have taken part in several of them. Fundamentally, the arguments have not changed.
Some of the evidence has changed, but the arguments have not. My party's position has also been consistent throughout, and it will remain consistent tonight. We shall oppose the regulations because they are not justified, and the Minister tonight—as with other Ministers in the past—has not made a case to justify them. The case for assisted places has never been made in a way that justifies it as a logical way of spending the relevant amount of public money. The Minister accepts that the assisted places scheme provides opportunities for a few. There is no debate about that, as we are talking about around 30,000 assisted places pupils. If one argues that the few should be treated in a particular way, one must ask whether that way is justified. Let me make two preliminary points clear. First, there are some cases for treating a few in a particular way and for particular reasons, the most obvious of which is special needs. If special needs provision, for example, is not arranged locally through county or borough schools, it is often purchased elsewhere. That is perfectly justifiable. Secondly, we must ask if the debate about the scheme is to do with the validity of independent schools per se. I do not oppose the existence of independent schools, and I would regard as very unsatisfactory a nation in which there were only public authority schools. If one is trying to have diversity in education, it is very important that there is diversity in the school providers. I am not arguing for one species of schooling, as a case could not be made for maintained schools or Church schools if that were so. If we ask the principal question—whether the assisted places scheme is justified—we must then ask the following five questions. First, does the scheme fundamentally change things? I would argue that it does not, because it brings assisted places to so few pupils. Therefore, it does not make a fundamental difference to the educational provision of the nation. Secondly, is it good value for money? We have heard the regular debate tonight, and the figures vary from year to year. They are far from conclusive. Thirdly, does the scheme provide a better product for public money than we could get elsewhere? That is at least arguable, and it has never been proven. The research has never concluded that the scheme is the best way of spending a limited amount of public money. The scheme clearly has implications of the type which were alluded to by the hon. Member for Cambridge (Mrs. Campbell) in her intervention. If we take a certain amount of money to buy places for a few and we spend roughly twice as much on doing that as we would need to spend to educate the same number of pupils in the maintained or public sector—the capital costs having already been paid in those sectors—the number of people we are assisting is therefore fewer. In doing that, we are at the same time depriving others of the advantages that they would have received from the extra money. That is a very obvious point. In an age when there is a general complaint—the Secretary of State knows this as well as anybody—from nearly all local education authorities that their real terms cash is being cut and class sizes are going up, it is clearly not to their advantage or to the advantage of the much larger number of children in those schools that such a funding system applies. If the money were used for a different purpose, more money would go to the other schools and the class sizes would not be so big. The education of others is being hindered by that money going elsewhere. Fourthly, does the scheme reach the parts that it is intended to reach? The hon. Member for Rugby and Kenilworth referred to an undisputed piece of survey research about what percentage of assisted places goes to which category in terms of population, economic and social categories. The hon. Gentleman made a criticism in passing that very few places go to ethnic minority children. The research has made it clear that, in the 15 years of the scheme, assisted places have not gone mainly to the sort of children for whom they were intended. They have gone to some of those children and they may now go to more, but the evidence suggests that it is the children of parents who would otherwise have benefited the most from the education system who have been the beneficiaries. They, of course, have an interest in the scheme continuing, as the lottery has come up with a good result for them. It would be difficult to abolish the scheme as far as they are concerned, but it is not providing a fundamentally large social change. We are not identifying only the most needy families and taking them out of a system which gives them the worst schools. Fifthly, is the scheme consistent? The Secretary of State and the Minister are right to say that educational standards have gone up in recent years. So they should, and they still need to go up hugely in many parts of the country. If educational standards in county and borough schools and the maintained sector are going up, do we not need the assisted places scheme less? Surely now we do not have such a great need to take pupils out of the normal education system and to place them elsewhere. I wish to deal with two other matters which were raised. The Minister referred to my hon. Friend the Member for Bath (Mr. Foster), and I want to put on record in my hon. Friend's defence the context in which he referred to Dulwich college. My hon. Friend cannot be here this evening because he is on his way to Littleborough and Saddleworth. He referred in a previous debate to an article that had appeared in The Sunday Times which pointed out that a number of independent schools were pegging their fees because they were finding it difficult to attract pupils. My hon. Friend said that the schools were holding down their fee levels in an attempt to reverse the drift away by parents who were struggling to pay their bills. One of the schools mentioned in the article was Dulwich college, which the previous year received the largest amount of assisted places money—£1.3 million. Dulwich college is a school in my borough, which is also the borough of the Minister for Transport in London, who is in his place. My hon. Friend was not arguing that Dulwich college could not do without assisted places, but he made the case that there were a small number of schools which benefited, with a much smaller number of schools which received a disproportionate benefit. The hon. Member for Liverpool, Walton (Mr. Kilfoyle) made the point that Wisbech grammar school gets more than 49 per cent. of its pupils through the assisted places scheme.I will not labour the point, but, as the hon. Gentleman's quotation demonstrated, the reference to Dulwich college and the fact that it received the highest amount followed immediately after a reference by his hon. Friend the Member for Bath (Mr. Foster) to the fact that
If it was not meant to be read together, why did he follow the first comment with the second?"a number of independent schools … find themselves in increasing difficulties."—[Official Report, 19 July 1994; Vol. 247, c. 269.]
I do not want to go into a detailed analysis. The point is that a relatively small number of schools benefit. Clearly, the scheme is a relevant consideration and is financially helpful for them. I am not arguing that the Government keep the scheme in operation to keep certain schools in being. Coincidentally, it may have that advantage. However, if I were running an independent school that was dependent on fees, I would certainly regard it as helpful if I could get the local authority to pay for a certain number of places.
Finally, the hon. Member for Rugby and Kenilworth mentioned a subject that is tangential to the debate, but which must be dealt with. When counties such as Essex, which happens to be under a joint Liberal Democrat and Labour administration, decide that they cannot continue funding travel out of area, they do so on budgetary grounds. Like every other education authority at a time of Government restraint on their funds, they have to look for money savings. That is not an invalid criticism. The Secretary of State and Ministers keep on telling education authorities that they must shepherd their resources properly—excuse the pun—as they must, and that was the reason for the cut. It was not an ideological attack on a certain type of schooling as such travel represented a considerable budget cost. The cut has resulted in considerable savings, which have gone to other mainstream school activities.Is the hon. Gentleman saying that it is purely coincidence that children whose schools happen to be attacked by both his party and members of the Labour party were selected? If he is saying that, I must point out, very gently, that I am not entirely persuaded that it is accurate.
My colleagues voted to reduce the budget in that sector and transfer the money elsewhere, not for ideological but for cost reasons. The hon. Gentleman can believe it or not as he chooses. It is a perfectly valid ground for the decision and it is the one that they chose.
There is all the difference in the world between accepting the continuing existence of the independent sector and working with it, and buying places for a few pupils, which clearly gives them an advantage that the majority do not get. My hon. Friends and I will oppose the regulations this year, as we have opposed them in previous years, because of the failure to attain any of the objectives and the lack of evidence that the scheme is succeeding in what it was intended to do or fundamentally changes anything and, above all, the lack of evidence that it is the best way to spend what will always be limited public resources. We would not continue with assisted places. Of course, we would not prejudice those who currently enjoy them, but in the future we would look for better ways to use public money, to ensure that co-operation, where appropriate, was delivered. I believe that the public would find that considerably more acceptable.9.1 pm
I want to use the opportunity of this debate to refer briefly to a practical example in my constituency, which clearly demonstrates how this modest, low-cost but great value-for-money assisted places scheme is helping those whom it is designed to help, by providing greater opportunities for able pupils from less well-off families, who would be cruelly affected if Labour were ever given the opportunity to abolish it, as the hon. Member for Liverpool, Walton (Mr. Kilfoyle) confirmed tonight.
Earlier this year, I received a letter from Rev. Godfrey Taylor, the vicar at St. John's Anglican church in Boscombe, which is in my constituency. I am sure that he will not mind my mentioning his name because, as he reminds me in his letter, some of his previous correspondence with me has been critical of Government policies. In this letter, however, he tells me how much his family have appreciated the assisted places scheme for children from families such as his, where money is tight. He is a Church of England clergyman on a very low income, with four children to educate, one of whom has been able to benefit from the scheme by going to an excellent independent girls' school in the constituency of my hon. Friend the Member for Bournemouth, West (Mr. Butterfill)—Talbot Heath. He certainly could never have afforded to send her there on his income, regardless of any personal sacrifice that he and his family were prepared to make. In addition to his experience, my constituent tells me that he knows of many other families in his parish who have found this scheme of equally great assistance to them. In no way can those families—my constituents—on low incomes be described asto quote the hon. Member for Sheffield, Brightside (Mr. Blunkett) in his article in The Daily Telegraph on 28 November 1994. My constituent has not always supported the Government but has taken the trouble to commend them on the assisted places scheme. He hopes that it will be safe in the future and, in so doing, is clearly not alone among my constituents. On their behalf, may I welcome the assurance given by my hon. Friend the Minister, which he has since confirmed to my hon. Friend the Member for Rugby and Kenilworth (Mr. Pawsey): that the scheme, and independent schools, will be safe in the Government's hands? As we now know from both Opposition spokesmen, it will be safe only in the Government's hands."creating a self-perpetuating elite whose grasp of the profound economic and social changes taking place is minuscule",
9.4 pm
It is usually my lot in education debates to follow the hon. Member for Rugby and Kenilworth (Mr. Pawsey): tonight is an exception, I am pleased to say. He said that the Secretary of State had entered the Chamber due to her interest in this matter. She came in only during the hon. Gentleman's speech and I suggest that it was not out of her natural interest in the debate but simply to hear his eloquence. Given how he performed tonight, I suspect that we might see his name tossed forward on Wednesday for even higher office.
The hon. Member for Rugby and Kenilworth said that tonight's debate was about excellence. It is not about excellence; it is about division. He said that the assisted places scheme gave children from inner cities an opportunity to benefit from private education. But that applies only if they are bright. Does he accept that children from inner cities and other deprived areas, who are of average or below-average intelligence, could also benefit from the assisted places scheme? I take it from his silence that he does not accept that.The hon. Gentleman clearly listened to the first part of my remarks. Had he concentrated with equal intensity on their latter part, he would have heard me say that I am anxious to see the scheme reach down—for example, into the ethnic communities. I want more young people to attend those schools from all strata of society. [Interruption.] I cannot speak over the barracking nonsense from the Labour Back Benches. The hon. Gentleman may remember my saying that I was keen on ensuring that the scheme did not apply simply to white Anglo-Saxon Protestants. I want it to have a much broader base.
I am grateful to the hon. Gentleman for reaffirming what I already believed: that he believes that the scheme should be open only for bright children and does not accept that children of average, just above average or just below average ability should benefit from it.
I shall not repeat the points that were made ably by my hon. Friend the Member for Liverpool, Walton (Mr. Kilfoyle). It is interesting that we should have this debate a week or so after a debate on the capping orders. Those orders cut the budget of my authority of Devon by £9 million, which is having profound effects on children in my area. In that debate it was argued that the funding provided for children in my area and other capped areas was sufficient. Let us contrast that argument, which we heard but a week ago, with those that we are hearing tonight from the Minister and his apologists on the Conservative Back Benches. Last year the assisted places scheme received £102 million for just 32,000 children. I do not want to trouble the Minister with too much arithmetic because I know that it gives him difficulties. May I assist him by explaining that, in a local authority secondary school—even a grant-maintained secondary school where capital is included—the average amount spent is £2,200 per pupil. Yet if the Minister works out what is spent on each place in the assisted places scheme, he will see that it is at least £3,300 per pupil. If he then adds the parental contribution, he will find that we are giving about twice as much funding to children in private schools as we are to those in local education authority schools. Decent. ordinary people throughout the country are asking: if that funding can be made available to private schools, why cannot it be made available for our children in local education authority-funded schools? If we need extra funding to create smaller classes in private and independent schools, why cannot that money be available to local education authority schools? Like many other matters, such as the double funding of grant-maintained schools and the massive extra amounts that have been given to city technology colleges, it is simply intended to prop up the failed dogma of the Tories. The Minister says that the purpose of the regulations is to give choice to parents. Why does not he give all parents the choice of their children, whatever school they attend, benefiting from twice as much funding as at present? Many other arguments have been advanced in the debate, but I shall not go into them all. The hon. Member for Blackpool, South (Mr. Hawkins)—who is not in his place at the moment—said that the Opposition were displaying the politics of envy. I can tell him that people in my part of the country do not understand the politics of envy, but they do understand the politics of fairness. There is a difference between private and independent schools and local education authority schools, and it is to do with accountability. For years, the Government have made great play of accountability, the national curriculum, the standard assessment tasks and the compulsory Office of Standards in Education report, some of which we support. However, I should like the Minister to answer the following question: why does he not expect the same accountability in those private and independent schools that receive £102 million under the assisted places scheme? The taxpayer also pays more than £130 million into private and independent schools through the service boarding scheme. For the Minister's assistance, I calculate that slightly more than £0.25 billion of taxpayers' money is being poured into private and independent schools, which are not properly accountable in the ways that local education authority schools have been made accountable. One or two of those schools have had Ofsted reports. Under the law as it stands, not only does an LEA school have to meet the parents, governors and the inspectors and provide to all parents a summary of the Ofsted report, but it has to make the full report available to all those parents who want it: contrast that with the schools that receive money from the taxpayer under the assisted places scheme. I refer the Minister to a letter that I received from the then Under-Secretary of State, the hon. Member for Mid-Worcestershire (Mr. Forth), on 17 February 1994. He said, on the subject of independent schools:none of that sending it to all parents. It is not, "make the report available to all parents", but"Any … school which is the subject of a published report is supplied with copies which it can distribute as it sees fit"—
One way in which a school might distribute that report is to distribute it around the head's study and ensure that it got no further than the boundaries of the school. The then Under-Secretary of State said in the final sentence of the letter:"distribute as it sees fit".
I refer the Minister to an example of a school that I have dealt with in the past year or so, a private school that receives substantial amounts of taxpayers' money—Finborough school in Suffolk. It is not in the assisted places scheme, but it is a private school. In March 1994, the head teacher wrote to the parents of the school, as follows:"The onus is on the school to distribute the report to interested parties or to advise them where reports can be obtained."
the Ofsted report—"We have not obtained copies of the Report"
and then he goes on to list all the reasons why parents cannot have the Ofsted report. I suggest to the Minister, and to his right hon. Friend the Secretary of State, that if we are to place £102 million of taxpayers' money into private and independent schools, the least that we should expect of them is the accountability that we expect of local education authority schools."for parents because"
9.14 pm
We have had an interesting debate. If nothing else, I can assure Opposition Members that any doubts that they may have about the assisted places scheme are not shared by the many parents on modest incomes whose children have benefited from it in the past, who continue to benefit from it now and who hope to participate in it in the future. My hon. Friend the Member for Bournemouth, East (Mr. Atkinson) made that point well in his good speech.
The assisted places scheme is plainly achieving its objective of giving access to some of the best independent schools for children who would not otherwise have been able to contemplate them. Conservative Members believe that it can be only to the pupils' and the nation's advantage. We believe that the scheme has a vital continuing contribution to make. That is why we have introduced the draft regulations. Hon. Members raised detailed points, which I shall deal with briefly. The hon. Member for Liverpool, Walton (Mr. Kilfoyle) leads for the Opposition on these matters. He must have enjoyed being able to made an education speech in which for once he was able, root and branch, to oppose a Conservative reform. As my hon. Friend the Member for Rugby and Kenilworth (Mr. Pawsey) so tellingly reminded us, a litany of reforms introduced in the past 10 years or so were fought tooth and nail by Labour Members only for us to find, particularly in the past couple of years, that suddenly the penny had dropped, the light shone and all the things that we had said about testing, publicising results and so on—I will not go through the whole list now—were accepted as a significant contribution to improving standards in this country, as of course they are. The hon. Member for Walton found a subject tonight on which his party was able to unite. I find it a strange subject on which it unites. Let me go into the detail of some of the points that he made. He and several hon. Members, including the hon. Members for Cambridge (Mrs. Campbell), for Southwark and Bermondsey (Mr. Hughes) and for Plymouth, Devonport (Mr. Jamieson), made great play of the alleged extra cost of the assisted places scheme. I covered part of the point in my immediate response to the hon. Member for Cambridge, but let me say a little more. The most obvious point is that any suggestion that the abolition of the scheme would save more than £100 million a year is obviously untrue. If the scheme were abolished, the great majority of assisted pupils would have to be accommodated in the maintained sector because their parents simply would not be able to afford full fees in the independent sector. Moreover, the figures quoted by some Opposition Members were misleading. That possibly even includes the hon. Member for Devonport, whose grasp of some of the figures may be just a little shaky. There is little difference between the average cost of an assisted place and that of a maintained school place when all relevant factors are taken into account. It is misleading to contrast the average net cost per assisted pupil—about £3,700 in the current financial year—with the standard spending assessment unit cost of maintained secondary schooling, for example—currently more than £2,600 pre-16 and more than £3,600 post-16. That is not comparing like with like. First, the assisted places scheme has a greater proportion of sixth form places, which, as the House will be aware, are more expensive to provide. Moreover—Will the Minister give way?
No. I was generous in giving way earlier, as I know the hon. Lady will concede. I am anxious to answer the points raised in the debate.
The scheme's overall unit costs include elements for capital and other overheads not counted in SSAs. There are wide variations in SSAs between different local authorities. Some of them, for example, in inner London, are higher than the cost of the average assisted place, even without making the adjustments that I have just mentioned. Above all, the assisted places scheme offers good value for money. It produces better GCSE and A-level results than the maintained sector, as well as choice and diversity. The hon. Members for Walton and for Southwark and Bermondsey, who speaks for the Liberal Democrats, asked about targeting. I do not want to drown the House in figures, but the simplest way to demonstrate how the scheme continues to reach those on low incomes is to compare figures on the average income of parents with children on the assisted places scheme in 1984–85 with the average national income and the figures nine years later in 1992–93—the latest year for which I have the full figures. In that time the proportion of parents on average income with children on assisted places has fallen from 69.3 per cent. to 58.5 per cent. In other words, as average national incomes have grown, the average income of parents with children on the assisted places scheme has not increased at the same rate.The Minister has moved sharply from costs to targeting. I remind him of one of my earlier questions. To put it simply, if the cost of the scheme between 1989 and 1994 has gone up 100 per cent., from £50.9 million to £102 million, can he explain why the actual expansion of places available has gone up by only 2.6 per cent. and the take-up by just 6 per cent? Where has the money gone?
The simplest answer to the hon. Gentleman is to look gently at how the costs in education have grown in that time. He will note a significantly similar movement in the figures. He can by all means pursue the subject on a future occasion, but I suggest that that is where the answer lies.
The hon. Member for Southwark and Bermondsey spoke about targeting. The Government do not claim, nor have they ever done so, that the assisted places scheme alone will meet our educational needs. The scheme should be seen as part, albeit an important one, of the Government's overall strategy to improve the education of all pupils in the maintained or independent sector. As my hon. Friend the Member for Rugby and Kenilworth said in a telling intervention, if one were to run through each and every aspect of diversity in education—which the Government endorse and applaud—the hon. Member for Southwark and Bermondsey could pick off grammar schools and a range of other measures and subject them to exactly the same schedule. The hon. Member for Bridgend (Mr. Griffiths) asked about Wales. I confirm that 700 pupils have assisted places in schools in Wales. I cannot give a precise figure for the percentage that that represents of the total pupil population in Wales, but I do not believe that it will be different from the corresponding figure in England of about 0.5 per cent. The number of assisted places in Wales reflects the number of schools that wish to participate—eight—and the demand from parents for places. My hon. Friend the Member for Rugby and Kenilworth, whose speech I have already praised, made an important point about the use made by ethnic minorities of the assisted places scheme. I take his point, but the proportion of such children on the scheme is broadly in line with the population as a whole. I will, however, certainly consider what further steps the Government and schools might take to ensure that ethnic minority families are fully informed about the scheme and given every encouragement to seek places on it. The hon. Member for Devonport rehearsed his argument about the accountability, real or imagined, of independent schools to Ofsted. I am inclined to repeat what the Minister of State said to him 12 months ago: he should take the matter up with Ofsted because it is an independent body which is not in any way controlled by the Government.rose
No, let me finish. Hon. Members have had a good run and I have given way quite a lot. I believe that I have covered all the points raised in the debate.
Despite the current user-friendly style that the Labour party leadership tries to throw over all its policies, the Opposition remain at heart opposed to real parental choice. That was demonstrated in their recent education policy statement. Nothing better underlines that attitude than their continuing opposition to APS. We point out tonight, and on every occasion that we can, that the Labour party, led incidentally by someone who was educated at Scotland's premier private school, no longer has time for bright children from poorer backgrounds. There was a time when the Labour party would have emphasised enhanced opportunities for such children. Now, those children and their parents must look to the Conservative Government to fight their cause. We shall not let them down.Question put:—
The House divided: Ayes 243, Noes 169.
Division No. 191]
| [9.25 pm
|
AYES
| |
| Ainsworth, Peter (East Surrey) | Dorrell Rt Hon Stephen |
| Alexander, Richard | Douglas-Hamilton, Lord James |
| Alison, Rt Hon Michael (Selby) | Duncan, Alan |
| Allason, Rupert (Torbay) | Duncan-Smith, Iain |
| Amess, David | Dunn, Bob |
| Ancram, Michael | Durant, Sir Anthony |
| Arbuthnot, James | Eggar, Rt Hon Tim |
| Arnold, Jacques (Gravesham) | Evans, Nigel (Ribble Valley) |
| Arnold, Sir Thomas (Hazel Grv) | Evans, Roger (Monmouth) |
| Ashby, David | Evennett, David |
| Atkins, Rt Hon Robert | Fabricant, Michael |
| Atkinson, David (Bour'mouth E) | Fenner, Dame Peggy |
| Atkinson, Peter (Hexham) | Fishburn, Dudley |
| Baker, Rt Hon Kenneth (Mole V) | Forman, Nigel |
| Baker, Nicholas (North Dorset) | Forsyth, Rt Hon Michael (Stirling) |
| Baldry, Tony | Forth, Eric |
| Banks, Matthew (Southport) | Fowler, Rt Hon Sir Norman |
| Bates, Michael | Fox, Dr Liam (Woodspring) |
| Bellingham, Henry | Fox, Sir Marcus (Shipley) |
| Bendall, Vivian | Freeman, Rt Hon Roger |
| Beresford, Sir Paul | French, Douglas |
| Biffen, Rt Hon John | Gale, Roger |
| Body, Sir Richard | Gardnier, Sir George |
| Bonsor, Sir Nicholas | Garel-Jones, Rt Hon Tristan |
| Booth, Hartley | Garnier, Edward |
| Boswell, Tim | Gillen, Cheryl |
| Bottomley, Peter (Eltham) | Goodson-Wickes, Dr Charles |
| Bowden, Sir Andrew | Gorman, Mrs Teresa |
| Bowis, John | Greenway, Harry (Ealing N) |
| Boyson, RI Hon Sir Rhodes | Greenway, John (Ryedale) |
| Brandreth, Gyles | Griffiths, Peter (Portsmouth, N) |
| Brazier, Julian | Grylls, Sir Michael |
| Bright, Sir Graham | Hague, William |
| Brooke, Rt Hon Peter | Hamilton, Rt Hon Sir Archibald |
| Browning, Mrs Angela | Hampson, Dr Keith |
| Budgen, Nicholas | Hannam, Sir John |
| Burt, Alistair | Hargreaves, Andrew |
| Butcher, John | Haselhurst, Sir Alan |
| Butler, Peter | Hawkins, Nick |
| Carlisle, John (Luton North) | Hawksley, Warren |
| Carlisle, Sir Kenneth (Lincoln) | Hayes, Jerry |
| Carrington, Matthew | Heald, Oliver |
| Carttiss, Michael | Hendry, Charles |
| Cash, William | Higgins, Rt Hon Sir Terence |
| Channon, Rt Hon Paul | Hill, James (Southampton Test) |
| Chapman, Sydney | Hordern, Rt Hon Sir Peter |
| Churchill, Mr | Howard, RI Hon Michael |
| Clappison, James | Howell, Sir Ralph (N Norfolk) |
| Coe, Sebastian | Hughes, Robert G (Harrow W) |
| Colvin, Michael | Hunt, Sir John (Ravensbourne) |
| Congdon, David | Hunter, Andrew |
| Conway, Derek | Hurd, Rt Hon Douglas |
| Coombs, Anthony (Wyre For'st) | Jack, Michael |
| Cope, Rt Hon Sir John | Jackson, Robert (Wantage) |
| Corrnack, Sir Patrick | Jessel, Toby |
| Couchman, James | Johnson Smith, Sir Geoffrey |
| Cran, James | Jones, Gwilym (Cardiff N) |
| Curry, David (Skipton & Ripon) | Jones, Robert B (W Hertfdshr) |
| Davies, Quentin (Stamford) | Key, Robert |
| Davis, David (Boothferry) | King, Rt Hon Tom |
| Day, Stephen | Kirkhope, Timothy |
| Deva, Nirj Joseph | Knight, Mrs Angela (Erewash) |
| Devlin, Tim | Knight, Greg (Derby N) |
| Dicks, Terry | Knight, Dame Jill (Bir'm E'st'n) |
| Knox, Sir David | Ryder, Rt Hon Richard |
| Kynoch, George (Kincardine) | Sackville, Tom |
| Lait, Mrs Jacqui | Scott, Rt Hon Sir Nicholas |
| Lamont, Rt Hon Norman | Shaw, David (Dover) |
| Lang, Rt Hon Ian | Shaw, Sir Giles (Pudsey) |
| Lawrence, Sir Ivan | Shephard, Rt Hon Gillian |
| Legg, Barry | Shepherd, Colin (Hereford) |
| Leigh, Edward | Shepherd, Richard (Aldridge) |
| Lidington, David | Shersby, Sir Michael |
| Lightbown, David | Sims, Roger |
| Lilley, Rt Hon Peter | Smith, Tim (Beaconsfield) |
| Lloyd, Rt Hon Sir Peter (Fareham) | Spencer, Sir Derek |
| Lord, Michael | Spicer, Sir James (W Dorset) |
| Luff, Peter | Spicer, Michael (S Worcs) |
| MacKay, Andrew | Spink, Dr Robert |
| Maclean, Rt Hon David | Squire, Robin (Hornchurch) |
| McLoughlin, Patrick | Steen, Anthony |
| McNair-Wilson, Sir Patrick | Stephen, Michael |
| Maitland, Lady Olga | Stern, Michael |
| Major, Rt Hon John | Stewart, Allan |
| Malone, Gerald | Streeter, Gary |
| Mans, Keith | Sweeney, Walter |
| Marland, Paul | Sykes, John |
| Marlow, Tony | Tapsell, Sir Peter |
| Marshall, John (Hendon S) | Taylor, Ian (Esher) |
| Martin, David (Portsmouth S) | Taylor, John M (Solihull) |
| Merchant, Piers | Taylor, Sir Teddy (Southend, E) |
| Mills, Iain | Temple-Morris, Peter |
| Mitchell, Andrew (Gedling) | Thompson, Sir Donald (C'er V) |
| Nelson, Anthony | Thompson, Patrick (Norwich N) |
| Neubert, Sir Michael | Thornton, Sir Malcolm |
| Newton, Rt Hon Tony | Thurnham, Peter |
| Nicholls, Patrick | Townend, John (Bridlington) |
| Nicholson, David (Taunton) | Townsend, Cyril D (Bexl'yh'th) |
| Nicholson, Emma (Devon West) | Twinn, Dr Ian |
| Norris, Steve | Viggers, Peter |
| Onslow, Rt Hon Sir Cranley | Walden, George |
| Oppenheim, Phillip | Walker, Bill (N Tayside) |
| Ottaway, Richard | Waller, Gary |
| Page, Richard | Ward, John |
| Paice, James | Wardle, Charles (Bexhill) |
| Patnick, Sir Irvine | Waterson, Nigel |
| Pattie, Rt Hon Sir Geoffrey | Watts, John |
| Pawsey, James | Wells, Bowen |
| Peacock, Mrs Elizabeth | Wheeler, Rt Hon Sir John |
| Pickles, Eric | Whitney, Ray |
| Porter, David (Waveney) | Whitfingdale, John |
| Powell, William (Corby) | Widdecombe, Ann |
| Rathbone, Tim | Wiggin, Sir Jerry |
| Redwood, Rt Hon John | Wilkinson, John |
| Renton, Rt Hon Tim | Winterton, Mrs Ann (Congleton) |
| Richards, Rod | Winterton, Nicholas (Macc'f'ld) |
| Riddick, Graham | Wolfson, Mark |
| Rifkind, Rt Hon Malcolm | Wood, Timothy |
| Roberts, Rt Hon Sir Wyn | Yeo, Tim |
| Robinson, Mark (Somerton) | Young, Rt Hon Sir George |
| Roe, Mrs Marion (Broxbourne) | Tellers for the Ayes:
|
| Rowe, Andrew (Mid Kent) | Mr. Simon Burns and
|
| Rumbold, Rt Hon Dame Angela | Mr. David Willetts.
|
NOES
| |
| Adams, Mrs Irene | Byers, Stephen |
| Ainger, Nick | Caborn, Richard |
| Ashton, Joe | Callaghan, Jim |
| Banks, Tony (Newham NW) | Campbell, Mrs Anne (C'bridge) |
| Barnes, Harry | Campbell, Menzies (Fife NE) |
| Battle, John | Campbell, Ronnie (Blyth V) |
| Bayley, Hugh | Campbell-Savours, D N |
| Beckett, Rt Hon Margaret | Cann, Jamie |
| Bermingham, Gerald | Carlile, Alexander (Montgomery) |
| Berry, Roger | Chisholm, Malcolm |
| Betts, Clive | Clapham, Michael |
| Blunkett, David | Clark, Dr David (South Shields) |
| Brown, N (N'c'tle upon Tyne E) | Clarke, Eric (Midlothian) |
| Burden, Richard | Clarke, Tom (Monklands W) |
| Clelland, David | Marshall, David (Shettleston) |
| Clwyd, Mrs Ann | Martin, Michael J (Springburn) |
| Coffey, Ann | Martlew, Eric |
| Cohen, Harry | Maxton, John |
| Corbyn, Jeremy | Meale, Alan |
| Cummings, John | Michie, Bill (Sheffield Heeley) |
| Cunningham, Jim (Covy SE) | Michie, Mrs Ray (Argyll & Bute) |
| Dalyell, Tam | Milburn, Alan |
| Davies, Bryan (Oldham C'tral) | Miller, Andrew |
| Davies, Ron (Caerphilly) | Mitchell, Austin (Gt Grimsby) |
| Davis, Terry (B'ham, H'dge H'l) | Morgan, Rhodri |
| Denham, John | Morris, Estelle (B'ham Yardley) |
| Dewar, Donald | Mudie, George |
| Dixon, Don | Mullin, Chris |
| Donohoe, Brian H | Murphy, Paul |
| Dowd, Jim | Oakes, Rt Hon Gordon |
| Dunnachie, Jimmy | O'Brien, Mike (N W'kshire) |
| Dunwoody, Mrs Gwyneth | O'Brien, William (Normanton) |
| Eagle, Ms Angela | Olner, Bill |
| Eastham, Ken | Pike, Peter L |
| Etherington, Bill | Powell, Ray (Ogmore) |
| Evans, John (St Helens N) | Prentice, Bridget (Lew'm E) |
| Flynn, Paul | Prentice, Gordon (Pendle) |
| Foster, Rt Hon Derek | Prescott, Rt Hon John |
| Fyfe, Maria | Primarolo, Dawn |
| Galloway, George | Purchase, Ken |
| Godman, Dr Norman A | Quin, Ms Joyce |
| Godsiff, Roger | Raynsford, Nick |
| Golding, Mrs Llin | Reid, Dr John |
| Gordon, Mildred | Rendel, David |
| Grant, Bernie (Tottenham) | Robertson, George (Hamilton) |
| Griffiths, Win (Bridgend) | Robinson, Geoffrey (Co'try NW) |
| Grocott, Bruce | Roche, Mrs Barbara |
| Gunnell, John | Rooker, Jeff |
| Hall, Mike | Ruddcok, Joan |
| Hanson, David | Sedgemore, Brian |
| Hattersley, Rt Hon Roy | Sheerman, Barry |
| Henderson, Doug | Short, Clare |
| Hill, Keith (Streatham) | Simpson, Alan |
| Hinchliffe, David | Skinner, Dennis |
| Hoey, Kate | Smith, Andrew (Oxford E) |
| Hogg, Norman (Cumbemauld) | Smith, Chris (Islton S & F'sbury) |
| Hood, Jimmy | Smith, Llew (Blaenau Gwent) |
| Howarth, George (Knowsley North) | Snape, Peter |
| Hoyle, Doug | Soley, Clive |
| Hughes, Kevin (Doncaster N) | Spearing, Nigel |
| Hughes, Robert (Aberdeen N) | Spellar, John |
| Hughes, Roy (Newport E) | Squire, Rachel (Dunfermline W) |
| Hughes, Simon (Southwark) | Steinberg, Gerry |
| Hutton, John | Stevenson, George |
| Illsley, Eric | Sutcliffe, Gerry |
| Jamieson, David | Taylor, Mrs Ann (Dewsbury) |
| Jones, Barry (Alyn and D'side) | Taylor, Matthew (Truro) |
| Jones, Lynne (B'ham S O) | Tipping, Paddy |
| Jones, Marlyn (Clwyd, SW) | Turner, Dennis |
| Jowell, Tessa | Tyler, Paul |
| Khabra, Piara S | Wallace, James |
| Kilfoyle, Peter | Walley, Joan |
| Lestor, Joan (Eccles) | Wardell, Gareth (Gower) |
| Lewis, Terry | Wareing, Robert N |
| Livingstone, Ken | Watson, Mike |
| Lloyd, Tony (Stretford) | Wicks, Malcolm |
| Loyden, Eddie | Wigley, Dafydd |
| McAllion, John | Williams, Alan W (Carmarthen) |
| McAvoy, Thomas | Winnick, David |
| Macdonald, Calum | Worthington, Tony |
| McFall, John | Wray, Jimmy |
| McKelvey, William | Wright, Dr Tony |
| McLeish, Henry | Young, David (Bolton SE) |
| McMaster, Gordon | Tellers for the Noes:
|
| McWilliam, John | Mr. Joe Benton and
|
| Madden, Max | Mr. Jon Owen Jones.
|
Questions accordingly agreed to.
Resolved,
That the draft Education (Assisted Places) Regulations 1995, which were laid before this House on 26th June, be approed.
Wroxham-Hoveton Bypass
Motion made, and Question proposed, That this House do now adjourn.— [Dr. Liam Fox.]
9.37 pm
I am most grateful to have been granted this Adjournment debate, which gives me the opportunity to bring before the House the worst case of its kind that I have come across in my 12 years as a Member of Parliament.
My constituents, Mr. and Mrs. Balchin, have had their lives completely ruined through no fault of their own. Their misfortune is entirely due to the heavy-handed, unsympathetic and, I have to say, incompetent treatment that they have received at the hands of the authorities responsible for building a bypass beside their home. I am delighted to see my hon. Friend the Minister for Transport in London in his place, although he is not personally responsible for the events that I shall describe. If I use strong language, I trust that he will understand. I am not aiming at him, but I trust that, by the time I have finished, he will entirely understand why I use it. Mr. and Mrs. Balchin were living happily in their house called Swan's Harbour until along came Norfolk county council, aided and abetted by the Department of Transport, with plans to build the A1151 Wroxham-Hoveton bypass just 32 yd from their property. The result of the exercise was that Swan's Harbour became unsaleable and valueless. The security that the house had given to Mr. Balchin's business was removed, and the business collapsed. It no longer exists, and the house stands deserted. Huge debts are owed to both bank and building society, and Mr. and Mrs. Balchin have had to stand helplessly by while all this happened. Before granting planning permission for the bypass, the Department of Transport clearly indicated that it expected Norfolk county council, which is responsible for the scheme, to take care of Mr. and Mrs. Balchin. The council refused to do so. The result has been the loss of their home, the loss of their business and eight years of misery, with no one prepared to accept responsibility for what has happened. The bypass was first proposed by Norfolk county council in 1984, and a public inquiry was held in 1990. The case first came to my attention in 1992, when Mr. and Mrs. Balchin, having been forced to leave their home, came to live in my constituency. The decision by the Secretary of State to allow the bypass to go ahead was conveyed to Norfolk county council in a letter signed by Mr. J. W. Horton, dated 3 June 1992. In a moment, I shall read a couple of extracts from that letter to Norfolk county council, but before I do, I should state that Mr. and Mrs. Balchin's house was worth £375,000 and had been sold for that sum before the news of the bypass drove the potential purchaser away. I shall quote from a letter to Mr. Balchin from William H. Browne, a well-known and reputable estate agent:Overnight, a £375,000 house with a potential purchaser became unsaleable and the Balchins' world started to collapse. Was that foreseeable? Of course it was. The minutes of Norfolk county council's planning and transportation committee as far back as 17 December 1987 state:"Due to the very close proximity of the proposed, and now confirmed, route of the Wroxham bypass, the proximity of the proposed flyover and underpass being so close and intrusive, I consider that at this particular moment in time the property is unsaleable on the open market. The prospect of the construction work and ultimate usage of the bypass would, without doubt, dissuade any potential purchaser".
One interesting note in the minutes states:"the value of the property is considerably reduced by the proposed bypass. And Mr. Balchin uses the property as security for business loans. He claims that the decrease in value, due to the bypass, will reduce the amount he can borrow, and he believes this will adversely affect his business as a property developer. The bypass, when built, would completely alter the character of the house. If the Council does purchase, the price could be in the region of £325,000 to £375,000".
I remind the House that, so far, Mr. and Mrs. Balchin have not seen a single penny from Norfolk county council or from anyone else, and have spent a fortune in time and money trying to defend themselves. The final recommendation of Norfolk county council's planning and transportation committee on that day states:"if the Council does not purchase Swan's Harbour, the owner will only be entitled to claim for depreciation due to physical factors. It is difficult to assess the extent of these in advance, but it is unlikely that more than £50,000 in current values will be payable".
I ask the House to remember that date—17 December 1987—because it was the date on which Norfolk county council set its face against doing what was right, and it has stubbornly, and against all sense of natural justice, clung to that decision ever since. I now turn to the Department of Transport's letter dated 3 June 1992, informing Norfolk county council of the Secretary of State's decision to allow the bypass to be built. For the sake of clarity and the record, I shall quote one or two sections from that letter. In the section dealing with the objector's case, paragraph 24 states:"As the owner has no statutory rights to insist on the property being acquired, Members are recommended not to agree to this purchase".
Under the heading "Inspector's Conclusions and Recommendations", paragraph 44 states:"Swan's Harbour will be particularly affected, being so physically dominated by the route that no countermeasures could reduce the impact. Searches in 1984 did not reveal a proposed bypass and Swan's Harbour has been substantially improved since then. The property is unsaleable and your Council refuses to buy it. The effects of the proposal have been devastating on the owners. The Council should be directed to purchase all the properties seriously affected by the proposals."
When it comes to conclusions, under paragraph 50, after saying that the eastern bypass should be constructed, the letter recognises all the disadvantages that the route will have—particularly for people—but also recognises that those disadvantages can be mitigated to some extent by compensation. Paragraph 51 states:"The proposals will have an adverse effect on the general ambiance of the high-quality Beech Road residential area and on Timberley Lodge, Swan's Harbour and Copperbeech Cottage. Whilst your Council has given adequate assurances in relation to construction and other problems at Timberley Lodge, the same cannot be said for Swan's Harbour and Copperbeech Cottage. The road would overpower these properties despite the effects of any countermeasures. If a decision is made in favour of this route, adequate compensation arrangements should be made urgently in respect of Swan's Harbour, particularly in view of the owners' financial situation."
Crucially, under the heading "The Secretary of State's Decision", in paragraph 62 appears the following:"sympathetic consideration should be given to the particular adverse effects that confirmation of an Eastern route would have on Swan's Harbour and Copperbeech Cottage and the plight of the owners".
At the end comes the sting in the tail:"It is noted that the Inspector has drawn particular attention in his conclusions at Paragraph 11.47 to certain matters arising from his consideration of the Orders and Bridge scheme. He called for `sympathetic consideration' by your Council of the plight of the owners of Swan's Harbour and Copperbeech Cottage. And finally, he said that whilst they are not for his consideration here, the Secretary of State is confident that your Council will give these matters early consideration".
Having said that he hopes that Norfolk county council will take steps to look after Mr. and Mrs. Balchin as a matter of urgency, the Secretary of State fails to take the one step that would have guaranteed their protection: the withholding of his consent to the scheme until the different parties concerned had arrived at a fair settlement. I suppose that, in some ways, it was not unreasonable for the Secretary of State to think that Norfolk county council might behave as he wished—with reason, fairness and a little compassion; but I am afraid that he was gravely mistaken. Norfolk county council hid behind the letter of the law, and refused to help. I remind the House again of the recommendation that its officers had made, which was endorsed by elected members:"Details of compensation arising in consequence of the confirmation of these Orders are for negotiation with the acquiring authority, not with the Secretary of State."
In the hope that I might persuade someone on Norfolk county council to realise just how unfair the council had been, I wrote to the leaders of the three main political groups—Mrs. Cameron, Mrs. King and Mr. Revell—explaining Mr. and Mrs. Balchin's distress and urging them to look at the case again. I received a reply from Mr. Barry Capon, Norfolk county council's chief executive and clerk. The final paragraph stated:"As the owner has no statutory rights to insist on the property being acquired, Members are recommended not to agree to this purchase".
I can only say that I hope that those ladies and gentlemen are able to sleep soundly in their beds at night—in their unblighted homes—and that they do not call to mind too often the way in which they have destroyed one family. For a number of years, I have been a member of the Select Committee on the Parliamentary Commissioner for Administration—in other words, the parliamentary ombudsman. Over those years, I have seen many cases of this kind. As Mr. and Mrs. Balchin's case was the worst that I had ever seen, I was more than happy to refer it to the ombudsman in January 1994. In December 1994, I received the report on the case, in which—while accepting all the facts set out by Mr. and Mrs. Balchin and all the harm they had suffered—the ombudsman failed to find maladministration on the part of the Department of Transport. As a member of the Select Committee, I am well aware of how carefully Mr. Reid, the ombudsman, goes about these matters, so it was only after thinking the matter through most carefully and consulting widely that I asked him to reconsider the matter, and had a meeting with him to discuss it. He felt unable at that stage to alter his report or its findings. Mr. and Mrs. Balchin are currently seeking leave to challenge the ombudsman's decision in the courts. I remain convinced that maladministration has occurred. Both the inspector who conducted the public inquiry and the Secretary of State recognised and accepted that unacceptable harm would be caused to the Balchins' property by the construction of the bypass. Those are more than adequate grounds to refuse to confirm the order for the bypass until the necessary arrangements had been put in place. These are administrative measures, and they were mishandled. What can be more maladministrative than that? What is the purpose of a public inquiry, an inspector's report and the Secretary of State's scrutiny if it is not to ensure that mistakes—and this is a huge mistake—do not happen? If it is not maladministration in the sense that I have described it, as I believe it is, then it is maladministration as clearly defined for the ombudsman Select Committee by the Minister of State, Treasury, when he appeared before the Committee on 2 November 1994, and by Sir Patrick Brown, on behalf of the Department of Transport, giving evidence to the same Committee on 1 March 1995. Again for the record, I want to quote directly from the minutes of evidence taken before the ombudsman Select Committee on 1 March 1995. In questioning Sir Patrick Brown, I quoted the Minister of State, Treasury as having said, when he appeared before us in November 1994:"The decision not to purchase Mr. Balchin's house was taken without dissent, by agreement across all parties, and they do not see any good and sufficient reason to raise the matter again".
I asked Sir Patrick Brown to confirm that, and he said:"failure to mitigate the effects of strict adherence to the letter of law, where this produces manifestly inequitable treatment, that will now be an example of maladministration".
I then said:"Yes, Mr. Nelson was speaking for the government".
Sir Patrick Brown replied:"What we are really saying is that, even where everything has been done precisely by the law of the land, and is defensible in that sense, where that produces clearly distress and problems, then maladministration may well be shown to have occurred".
There we have it. If this is not maladministration in one form, it is maladministration in another. I trust that, before too long, that will be conceded. Although Mr. and Mrs. Balchin's case is the worst that I have seen, they are not alone in their difficulty. A Lieutenant Colonel David Owen has recently taken on the Department of Transport because of the proposed Cirencester bypass, which is planned to run 150 m from his home. He was refused compensation, but the Court of Appeal found that he was entitled to be bought out, because his home had lost value as a result of the road. The Appeal Court judges described the existing guidelines on compensation as "a shambles". Colonel Owen's home was 150 m away from the bypass; Mr. and Mrs. Balchin's is 32 m. It seems likely, as a result of that case, that new guidelines will be drawn up, but Mr. and Mrs. Balchin cannot wait for that. In recent weeks, I have had meetings with the Secretary of State to plead the Balchins' case yet again. He listened sympathetically, but insisted that the Government were unable to help. This sort of inhuman treatment, dealt out to innocent citizens by the authorities, whoever they may be, might be understandable in some lawless banana republic, but surely not in this country in 1995. I have already said that I do not hold the Minister present tonight responsible for what has happened in the past, but I will hold him responsible, with others, for what happens in future. His Department cannot simply wash its hands of this case. Tonight, I want to hear not Pontius Pilate platitudes from the Minister but proposals for a sensible solution. At first sight, it may seem that the Government are not to blame, or at least not wholly to blame, for what has occurred, but no one can deny that the Government were involved in the procedures that caused the problem, or that the Department of Transport, in the power it had not to sanction the bypass, was a crucial link in the chain of events that did the damage. In a chain, one link is as important as the whole chain. When the link is as important as the Government's power in this matter, it becomes absolutely crucial. I believe that those of us who are so very concerned about the case are entitled, both morally and legally, to say that the Government have a considerable responsibility for what has happened. In the time that Mr. and Mrs. Balchin have been suffering, the Government have introduced citizens charters of all sorts, and we continually talk about proper consultation and people's rights. If all the new initiatives are to mean anything, to me, to Mr. and Mrs. Balchin or to anyone else in this country, something must be done about the case. What is absolutely clear in all the evidence—and it has never been denied by the Government—is that it was acknowledged that harm would be done to Mr. and Mrs. Balchin and their property. It was also acknowledged that someone had to look after them. The Department of Transport, which had the power to ensure that that was done before allowing the bypass proposals to proceed, singularly failed to take the steps that could have turned a pious hope into a fair and reassuring reality. The Balchins' plight is desperate. They have no money, and their health is suffering. A solution must be found, and found quickly."That is the current arrangement for dealing with cases of this sort."
9.56 pm
I congratulate my hon. Friend the Member for Suffolk, Central (Mr. Lord) on his assiduity in pursuing this case on behalf of his constituents, Mr. and Mrs. Balchin. I know that my right hon. Friend the Parliamentary Secretary to the Treasury, the right hon. Member for Mid-Norfolk (Mr. Ryder)—who cannot speak in the House—is also concerned about the case. I see that my hon. Friend the Member for Great Yarmouth (Mr. Carttiss) is here, and I know that he is concerned, too.
It is a difficult case, and, on the facts outlined by my hon. Friend the Member for Suffolk, Central, any reasonable person would have a great deal of sympathy with Mr. and Mrs. Balchin. It might be helpful if I outline how the Department views the facts of the case, and where they lead. My hon. Friend has been a good friend for the past 12 or 13 years in this House, but perhaps I could tell him that, in his enthusiasm to prosecute the case on behalf of his constituents, he should not be drawn into an examination of the Owen case. I have studied that case and been involved in it for some time, and I can assure my hon. Friend that the basis for that case is very different from the facts that have been adduced in my hon. Friend's case. My hon. Friend must recognise that the most important point of all is that there is a difference between a national road scheme, which is promoted by the Department, and a local highway authority scheme, where the county council is the highway authority. As my hon. Friend pointed out, the Wroxham-Hoveton bypass is being promoted by Norfolk, in its role as the local highway authority. In February 1990, it submitted a statutory bridge scheme and orders for confirmation by the Secretary of State for Transport. Because of the number of objections to the proposals, my right hon. Friend convened local public inquiries into the bridge scheme and orders, which opened in October of that year. The inspector submitted his report on the inquiries, for consideration by the Secretary of State, in March of the following year. In his report—and I do not think that there is any difference between my hon. Friend and me on this—the inspector drew attention to the especially adverse effect the bypass would have on Mr. and Mrs. Balchin's property, called Swan's Harbour, and on the neighbouring property Copper Beech Cottage, owned by a Mr. Evans. Although neither property was required for the bypass, in the words of the inspector it would, in the case of the Balchins' property,In recommending confirmation of the bridge scheme and orders, the inspector therefore expressed the hope that the plight of the owners of Swan's Harbour and Copper Beech Cottage would be looked on sympathetically by the county council. Those sentiments were reflected in the letter of my right hon. Friend the Secretary of State for Transport, confirming the bridge scheme and orders issued in June 1992, in which he expressed his confidence that the county council would give the matter early consideration. That letter also pointed out—this really is important, and I am sure that, when he considers the point, my hon. Friend the Member for Suffolk, Central will recognise its strength—that matters of compensation arising as a consequence from the confirmation of orders were for negotiation with the acquiring authority and not with the Secretary of State—"have a somewhat overpowering effect".
It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.
Motion made, and Question proposed, That this House do now adjourn.— [Dr. Liam Fox.]
Following the issue of the Secretary of State's decision letter, an application to quash the bridge scheme and orders was made in the High Court in August 1992 by a group calling itself the Alternative Bypass Group. Although that challenge subsequently proved unsuccessful, the delay caused in the implementation of the scheme resulted in the expiry of the county council's planning permission for the project, and planning permission for the bypass is therefore being re-sought by the county council.
As my hon. Friend the Member for Suffolk, Central has said, in the interim he lodged on behalf of Mr. and Mrs. Balchin a complaint with the Parliamentary Commissioner for Administration, based on counsel's advice that the Secretary of State should have assured that adequate compensation would be payable to the Balchins before confirming the bridge schemes and orders. In his report of December 1994, the commissioner found the complaint to be not made out, and that matters of compensation arising from a road scheme were for the highway authority and outside his jurisdiction. It is there, I submit to my hon. Friend, that the Secretary of State's quasi-judicial involvement in the scheme ends. As my hon. Friend the Member for Suffolk, Central is aware from the correspondence that he and I have had, I fully sympathise with the predicament in which the Balchins find themselves. However, as the ombudsman made clear, matters of compensation arising from a local highway authority road scheme lie outside the jurisdiction of Ministers. Indeed, at the specific request of my right hon. Friend the Secretary of State, I looked carefully at the issue of compensation. I have concluded, after careful examination, that there are no powers whatever available to my right hon. Friend to provide compensation in this case or to secure the provision of compensation by the local authority. When Parliament gives the power of decision over a matter to the local authority, responsibility and accountability lie with that local authority. There is no general power which allows central Government simply to override a decision by a local authority. With respect to my hon. Friend, he knows that that way would lie chaos. Indeed, in the absence of any proper power, it would be quite improper, and probably counter-productive for a Minister to attempt in some way to exercise pressure on a local authority on the way in which it exercises its power.I know that my hon. Friend is answering the points that I have made in great detail. In such circumstances, what frequently happens is that the Secretary of State says that he will not grant permission for a particular development until the parties concerned have got together and satisfied him that questions of compensation—or whatever has to be ironed out—will be ironed out. The parties go away, sort things out, agree the compensation, and then the Secretary of State says, "Okay, now you can go ahead." This case was an example of the Secretary of State saying that something must be done, yet not taking the practical steps to ensure that it was done.
No, I am sorry: on that point, and with the greatest respect, my hon. Friend is simply wrong. In this case, my hon. Friend's complaint to the ombudsman was that the Secretary of State ought to have sought a resolution of the issue of compensation before he confirmed the orders.
The Secretary of State submitted that in this case, he simply did not have the power to refuse to make the order until the matter had been resolved, because that resolution was in the hands of the local highway authority. That does not imply that he welcomed the local authority's decision, as I shall explain, but it makes it clear that he does not have the power to refuse to make the order. With the greatest respect, I say to my hon. Friend that he can make the point as many times as he likes. He can imply that Ministers have the right to sweep their arms, to sweep away the rights of local authorities and to impose their interests in the matter, but he knows that that is simply not the case, and I am rather grateful for that fact.I know that Adjournment debates are not normally prolonged, but I must ask my hon. Friend a question. What, then, is the point of the Secretary of State's scrutiny of these matters? I am sure that I can produce for my hon. Friend, not tonight but on a future occasion, numerous examples in which the Secretary of State has not been satisfied that matters have been properly organised, and has therefore simply held back permission until such time as they have been organised.
My hon. Friend is right to say that we do not have the time, or, I suspect, the legal advice, to be able to debate this point at any length. I make it clear, however, to my hon. Friend—I am sure he knows this—that, in the exercise of his quasi-judicial function in terms of confirmation of an order sought by a local authority, the Secretary of State has to satisfy himself that the powers that the local authority seeks are properly sought; that they are within the vires of the authority; that the orders have been correctly made; that the procedures have been correctly followed; and that the local authority has acquired thereby the right to take the steps that it seeks in the order.
The Secretary of State is not thereby given the right to determine that he does not like the proposal put forward by the local authority, that he will sweep away the right of the local authority, conveyed by Parliament, to exercise discretion, and that he will substitute his own discretion. A Minister might find the matter as frustrating as my hon. Friend does, but my hon. Friend will appreciate that it is not enough to be frustrated in these matters. One must be clear where the legal remedies lie. I offer my hon. Friend some thoughts that need not stop me attempting to explain as far as I can, on the basis of the correspondence available to me, the specific position that has now been reached in the Balchin case. I believe that I may have something useful to offer my hon. Friend. The problems in this case, and the problems of the others affected by the planned bypass, stem from Norfolk county council's decision not to use advance discretionary purchase powers, which are given to all highway authorities by section 62 of the Planning and Compensation Act 1991, which inserted section 246(2A) in the Highways Act 1980. The county council has adduced in correspondence a number of factors as underlying the decision not to use advance discretionary purchase powers. The council considered, for example, that the depreciation of Swan's Harbour owed more to the general decline in property prices than to the existence of the bypass proposals. I note that my hon. Friend smiles. I observe only that that may be a plausible assessment of part of the reason for the reduction in value of the property. There is, after all, no doubt that the property will have suffered from the recession, as did others. My hon. Friend may, however, conclude that that is not the whole story. It also appears that the council did not operate a discretionary scheme to implement section 246(2A). The council referred to general tightness of funds as one of the reasons why it had decided not to operate such a scheme. It concluded that the right way in which to deal with the situation faced by the Balchins was not to acquire their property, but to compensate them for the loss of its value due to the road one year after the new road was opened, using the powers of the Land Compensation Act 1973—assuming, of course, that they were still eligible claimants at that time. It is not for me to override the judgment of the council. Any redress that remains for the Balchins will be for the courts, or, if there is any question of maladministration, the local government ombudsman, to decide, rather than the parliamentary commissioner. In recent years, the courts—through mechanisms which include judicial review—have not been slow to defend the interests of citizens who may have suffered from decisions of public authorities which may lack satisfactory justification. It is not for me to obtain legal advice in this case, but there may be a question about whether the decision not to operate a discretionary scheme for which statutory provision has been made by Parliament can be justified. I emphasise that those matters are ultimately to be considered by lawyers. Certainly, if this case had occurred in relation to a national roads scheme promoted by the Department, I—as the Minister charged by the Secretary of State with dealing with cases of discretionary purchase—would have looked carefully at the option of advance purchase. Mr. Balchin had, after all, no foreknowledge of the scheme before he purchased the property, which falls within the distance limits defined by the Department's discretionary scheme. We would also have considered hardship, and the need to realise the proper value of the property under our scheme. The valuation would have been based on what the value of the property would have been in the absence only of the road scheme at the appropriate time. It cannot be appropriate for the acquiring authority—Norfolk county council in this case—to compensate the Balchins for the general decline in property values, which the council observed may have been just as significant as the road in this case. I hope that my hon. Friend will read this debate carefully, because I believe that I have offered him an avenue which he may care to examine, which offers a realistic prospect of pursuing the case on behalf of his constituents. I hope that he will also gather that I have a great deal of personal sympathy for the Balchins. My hon. Friend graphically described their plight, and I know how strongly he feels about the case. I hope my hon. Friend understands that no Member of this House—certainly not my right hon. Friend the Secretary of State nor I—would wish to stand by and see an injustice occur were it within our power to correct it. I have offered my hon. Friend the best advice possible in the circumstances, and I hope that he will find my remarks helpful in taking the case forward.Question put and agreed to.
Adjourned accordingly at twelve minutes past Ten o'clock.