To ask the Minister of Agriculture, Fisheries and Food what proposals he has to encourage young people to enter hill farming. [4127]

I have no plans to introduce measures specifically to encourage young people into hill farming. However, the Agricultural Tenancies Act 1995, which came into force on 1 September this year, will encourage landowners to let more land. This has been reinforced by 100 per cent. relief from inheritance tax for land in new tenancies granted on or after 1 September. As the market in let land is freed up, more opportunities will be created for new entrants generally.

I must tell the Minister that few young farmers will be cheered by his reply. The background to the Government's dealings with farmers in our hill country areas is that the livestock compensatory allowance has been cut or frozen over the last four years, grants in the less-favoured areas have been cut from 50 per cent. to 30 per cent., and farmers have less income than ever before. Instead of possibly making more land available, is not it time for the Government to do something to improve farmers' incomes, which have decreased in my own constituency and in other parts—

Order. We have questions to get through today. We do not want statements.

As to the first point about let land, what really troubles young farmers is the knowledge that the hon. Gentleman and the hon. Member for Edinburgh, East (Dr. Strang) introduced legislation in 1976 which did enormous damage to the ability of landowners to let land. They will have been shocked by the Labour party's decision to vote against the Agricultural Tenancies Act 1995, which has done an enormous amount to free up land.

Does my right hon. and learned Friend agree that the best way for young people to enter farming, whether it is hill farming or otherwise, is for them to have the opportunity to have their own tenancies? Does not the Minister find it extraordinary that the Labour party should therefore seek to oppose that very move?

My hon. Friend is entirely right. The 1995 legislation was agreed between all parts of the industry, and the Government would not have introduced it unless it had been so agreed. The Labour party defied informed opinion by voting against the legislation, and that was a disgrace.

Given that the land tenure situation in Northern Ireland is very different from that in Great Britain, does the Minister understand that the real concern of farmers in the hill areas of Northern Ireland has to do with the percentage of their net income that is at present derived from subsidies? What comfort can he give to those people over the long term?

I shall not refer directly to the question of farmers in Northern Ireland because I do not have the necessary expertise; that is more a matter for my right hon. and learned Friend the Secretary of State for Northern Ireland. I can say that, in 1995-96, the real value of farm incomes in the LFAs is expected to rise by 4 per cent. On the value of direct subsidies coming into LFAs in the United Kingdom, there has been a steady increase from 1993—and, it is anticipated, until 1996—in the real value of direct subsidies to livestock farmers. Incidentally, hill livestock compensatory allowances form only a relatively small part of the overall direct subsidies to livestock farmers.

To ask the Minister of Agriculture, Fisheries and Food what steps he is taking to promote British regional speciality foods. [4129]

As the Minister in the Department responsible for small businesses, I am especially concerned to assist this dynamic and growing sector of the food industry. We continue to support Food from Britain, which is broadening its active support for marketing groups and for individual businesses.

I thank my hon. Friend for that helpful answer. Is she aware that France's wonderful regional products are supported by forms of producer co-operatives? In my constituency, we have wonderful lamb from the Romney marshes, superb fish from the sea, and great cheeses and fruit. Can my hon. Friend assure me that we will have more publicity and help for regional speciality food groups?

Indeed, the regional food groups have been very successful in bringing together many smaller groups and individual businesses. We already have the well-established Taste of the West, Taste of Anglia and North West Fine Foods. My hon. Friend will be especially interested to know that, in January, two more groups will be launched—Middle England Fine Foods and Taste of the South East.

Is not it true, however, that British food is not being supported enough? We have a huge deficit of £6 billion in temperate foods that we could grow in this country. If we put some money into Food from Britain, instead of cutting back, and supported our farmers as the French do, we would have a real advantage in selling our food abroad.

I meet Food from Britain regularly and I frequently go abroad to support that organisation and British companies that are exporting quality, speciality British foods with great success. It is interesting that that particular sector of the food industry—speciality foods and small food companies—employs 20 per cent. of the work force employed in the food industry.

My hon. Friend has rightly mentioned Taste of the West. Does she agree that the success and the value added to all those products rests upon people such as George and Amanda Streatfeild—whom she knows—of Denhay Farms, who play such a remarkably virile role in Taste of the West?

Indeed. [HON. MEMBERS: "Who are they?"' I shall tell hon. Members who they are. They are farmers, a husband and wife team in Dorset, whom I have met. They have exhibited at many national and international exhibitions. Among their many excellent products, they produce air-dried ham, which the Italians think they are best at, but the Streatfeilds have beaten them to it in many awards.

To ask the Minister of Agriculture, Fisheries and Food if he will make it his policy to maintain the present levels of milk production. [4130]

Yes. The Government's policy is to resist any cuts in the UK's milk quota allocation.

Is the Minister aware that a number of milkmen, especially in the west midlands, are being put out of business, and that there will be a shortage of milkmen very soon, because the supermarkets are taking over the business? What does the Minister propose to do about that?

That is just competition in the marketplace, and nothing to do with EC milk quotas. At 26p for a four-pint poly-bottle of milk in our supermarkets, milk in the UK is cheaper than anywhere else in the European Community.

Can my hon. Friend set out the Government's view on the future of milk quotas?

Our ultimate objective is to get rid of milk quotas, because we are prevented from making the most of the UK's natural advantages for milk production by the EC quota system. So we wish to get rid of milk quotas.

Is the Minister aware that a recent survey by the Co-operative Wholesale Society showed that 11 to 16-year-old children are consuming far too little milk and other dairy produce? Instead of working to deprive our children of milk, does not the Minister think that it would help the milk industry and the health of our nation if he stopped treating the dietary needs of our schoolchildren with such contempt?

That really is over-hyping it. The take-up of the scheme varied greatly between local education authorities so the benefits were already spread unequally. Those benefits have never been targeted on the basis of need. We do not believe that the changes will have any effect on the health or nutrition of British teenagers.

To ask the Minister of Agriculture, Fisheries and Food what funding the United Kingdom will receive from the EU in 1995-96 towards the cost of milk in secondary schools and school catering. [4131]

We estimate that EU expenditure on the discretionary elements of the school milk scheme will amount to approximately £6.1 million in the United Kingdom in 1995-96. Doing away with the discretionary element will result in public expenditure savings of about £4 million.

Does the Minister accept that this subsidy, unlike much of the £3 billion subsidy to the dairy industry from the common agricultural policy, is an important and essential one? Will he take more notice of what nutritional experts say and make sure that this cut does not take place?

The scheme is neither important nor essential. We continue to subsidise milk for primary schools at a cost of about £12 million a year. As the Minister of State has just made plain, the take-up is extremely uneven: not all local authorities take up the scheme, and even in participating LEAs not all schools do so. There is no targeting of need, and the scheme is an inefficient use of resources.

Does my right hon. and learned Friend agree that it is worth reiterating that any change in policy will have no effect on primary schools, that milk will still be available to them, and that it is not the Government's objective to force-feed teenagers with milk?

rose—

It is surely up to parents to decide whether they want their children to drink milk, and they have some responsibility in that respect. Does my right hon. and learned Friend further agree that any reduction in milk consumption at schools will make more milk available for manufacturing, for adding value and for creating wealth?

I apologise to my hon. Friend for getting to my feet too soon. I should like to focus on two of his important points. He is right to draw attention to the fact that we subsidise the consumption of milk in primary schools. His second point is basic: it really is up to parents to encourage their children to drink milk, if that is what they deem right for them. Theirs is the responsibility; we must go on emphasising that kind of basic fact.

But surely the right hon. and learned Gentleman is aware that only two years ago a Minister of State in the Department was telling the House what a great scheme this was, and that we should encourage teenagers to drink milk in our schools—particularly young girls, to help reduce the risk of osteoporosis in later life. The Minister knows that the policy is wrong, and that we should be encouraging teenagers to drink more milk. Will he reconsider?

That is nonsense, and the hon. Gentleman knows it. What is more, it shows why the Labour party cannot be taken seriously when it talks about reducing expenditure and tax. The plain fact is that this is saving us £4 million which I can then spend on areas of greater priority in the agriculture budget. People should focus on schemes to determine whether they are good or bad. This one is not a good use of resources; that is why we have done away with it.

To ask the Minister of Agriculture, Fisheries and Food what steps he is taking to involve United Kingdom fishermen in discussions on future developments in the industry. [4132]

I regard dialogue and consultation with UK fishermen as imperative. I already hold regular consultations, meetings and pre-Council of Ministers briefing meetings with many of their representatives.

I appreciate and applaud all that my hon. Friend has done in this respect. Still, can he convince me and the House that Her Majesty's Government appreciate the depth of anger of our fishermen, especially in the south-west, about the fact that as from 1 January 40 Spanish vessels will be allowed into western waters? Moreover, our fishermen almost certainly face significant cuts in their quotas; and to rub salt in the wound, taxpayers will have to pay large sums in compensation to Spanish interests for the removal of those wretched flag-of-convenience vessels from our register. Can my hon. Friend tell me and my fishermen what future the fishing industry has?

First, it is important that the House recognises that the Factortame judgment has absolutely nothing to do with the fisheries policy. It is a judgment, in the Advocate General's opinion, on the freedom of business association for individuals in the European Union. It has nothing to do with fisheries policy. Indeed, if we were to leave the common fisheries policy, the Factortame judgment would still stand. I of course appreciate the UK fishing industry's concerns that it must have a long-term sustainable future, and every part of every policy that I take forward is bent on that end. Certainly at the Fisheries Council meeting next week I am determined to negotiate the best possible fishing opportunities for British fishermen, consistent with the scientific advice and the need to sustain stocks for the benefit of future generations of fishermen.

Is the Minister aware that the Government are always bragging about their opt-outs in the Common Market? Why do they not opt out of the common fisheries policy?

This House decided by a considerable majority in the early 1970s to join the European Community. In joining it, we signed up to the common fisheries policy. When the Labour party sought to re-negotiate our terms of entry, not a word was mentioned about fishing policy.

I thank my hon. Friend for taking time to meet representatives of Kent and Essex fishermen earlier in the year. Can he give us any further news on the non-sector quota? It is restricting the supply of fish to such traditional fisheries, to the point that—I am afraid—today they are sawing up their boats on the beach.

I am trying to see whether there are ways in which we can allocate more quota to the non-sector fishing industry. I appreciate my hon. Friend's points. The industry has very real concerns and I am trying to see whether there are ways in which we can meet them.

To ask the Minister of Agriculture, Fisheries and Food what action he has taken to work for an EU ban on the use of veal crates. [4133]

The Government have already achieved a review of directive 91/629 on the welfare of calves, bringing it forward from 1997. As a result, the Commission has obtained the advice of its Scientific Veterinary Committee and is on the point of putting proposals forward to the Council of Ministers. We shall press the Council for an end to the veal crate throughout the European Community and for changes to the unacceptable EU dietary requirements.

I thank my hon. Friend for that comprehensive answer. Is not the way forward for it not to be necessary for calves to be trans-shipped to Holland or wherever, and that the issue should be tackled by having a robust United Kingdom calf-rearing industry, which will meet the market's requirements? Is work not being done in that respect at the Rosemaund experimental husbandry unit near Hereford? Will my hon. Friend tell the House what progress is being made?

The launch of the Rosemaund experimental unit has attracted much interest. We have worked with the Meat and Livestock Commission to target interest in the catering industry especially, where much of the Dutch-reared veal is used; veal reared in those unacceptable crates. I assure my hon. Friend that the unit has proved very successful in introducing to people who are interested in raising welfare-friendly veal in the UK ways in which to go about it in the most welfare-friendly manner.

Have the Ministry and the Commission in Brussels never heard of the word subsidiarity? If they have heard of the doctrine of subsidiarity, why do not they apply it to the veal trade? Why does the Ministry not come forward with legislative proposals in this House to ban the export of veal under the present conditions and then wait to be challenged, if need be, in the European Court?

We took the decision in the House in 1990 unilaterally to ban the veal crate. I must say to the right hon. Gentleman that if we are seriously interested in the welfare of animals generally in the European Union, it should be as much a matter of concern to know that just over the channel those deplorable practices continue. We in this country have led the way with the banning of veal crates, and we hope that as a result of our actions—this year I have visited other Agriculture Ministers personally about the issue—other countries will understand that we did it not from an emotional viewpoint but from one of very clear science that shows that it is not in the animals' best interest. We want to see that policy applied throughout Europe—not in little England with the drawbridge drawn up.

May I congratulate my hon. Friend on the personal efforts that she has made to try to bring an end to a vile practice? We had hoped to see a ban imposed on the use of veal crates throughout the European Union by the end of the year. When does my hon. Friend think that a ban may be possible? I ask her and her departmental colleagues to seek to ensure that farm animal welfare has a proper place at the intergovernmental conference next year.

I can assure my hon. Friend that at the meeting of the Council of Ministers next week my right hon. and learned Friend the Minister will be seeking to hear the results of the Scientific Veterinary Committee. We are hopeful that our policy will be taken forward in Europe. The presidency has expressed its interest and concern that progress should be made, as have, interestingly, the Italians, who will take over the presidency in January. There is continuity in Europe to take forward the policy.

It has been the Government's policy to seek European-wide policies on animal welfare. But that is not the Labour party's approach. I shall share with the House a letter from a shadow Opposition spokesman. It was written only last month to Franz Weber. It reads:

"Thank you for your letter about the transportation of live animals across Europe. I strongly support your call for an end to the current legal provisions which allow the export and transport of live animals for slaughter."

Opposition Members should understand that the greater prize is to be concerned about the welfare of animals throughout the Community.

To ask the Minister of Agriculture, Fisheries and Food what plans he has to introduce a right to roam; and if he will make a statement. [4135]

As emphasised in the recent White Paper on rural England, we believe that a general right to roam is not acceptable.

Is my hon. Friend aware that there is already an excellent network of footpaths? Farmers have made much more effort to maintain those footpaths properly and consequently they have an excellent relationship with ramblers. Does my hon. Friend agree that a general right to roam would put at risk the present good relationship, break down trust and lead to quite of lot of environmental damage? Will he educate the Opposition? If they want to win votes in the countryside, they should drop the policy of a general right to roam.

My hon. Friend puts the matter in a nutshell. There is already a wide and satisfactory network of footpaths. We would not condone any failures to keep footpaths open. We believe that any imposed general right to roam beyond the present network of footpaths would elevate one interest above all others, institutionalise rights without obligations, upset rural communities and cause a great deal of damage.

Is the Minister aware that the hon. Member for North-West Norfolk (Mr. Bellingham) advocated introducing wolves into Scotland? It now appears that he wants to train them to attack people in cagoules walking across land. Surely there is a need to be reasonable. There are large areas of land that traditionally have been open. That was the position in the past. There has been access to them for generations. It is possible to have a right to roam that will not compromise crops or livestock. It would be balanced with the needs of the people generally and those of farmers. Let us have fewer smears in Government documents and more realism in understanding that a balance could be achieved.

The hon. Gentleman is right to the extent that freedom to roam in open country may be appropriate in certain circumstances. The vital ingredient that he omits is that of agreement. I know that it may come difficult given the Labour party's philosophy, but we think that agreement is the most important element. These issues are most appropriately decided by agreement between landowners and local people, as they conspicuously have been in many good examples.

Does my hon. Friend have any plans in the near future to meet representatives of the Ramblers Association? If he does, will he tell them that it is not necessarily sensible for them to appeal against every order made by a county council extinguishing or amending the route of a public footpath? Does my hon. Friend understand that many farmers are prepared to deal with the Ramblers Association and to maintain rights of way as long as they do not interfere with their farming practices?

I strongly agree with my hon. and learned Friend that megaphone diplomacy is most inappropriate in these instances. Last summer, we invited the ramblers to discuss with officials any specific cases under our access schemes where they considered that provision was unsatisfactory. I regret that to date the ramblers have not responded to our invitation. They would be welcome if they came forward. We would like to hear their views in detail on that basis.

To ask the Minister of Agriculture, Fisheries and Food when he last met representatives of the dairy industry to discuss problems facing the industry. [4136]

My right hon. and learned Friend the Minister and his ministerial colleagues regularly meet representatives of the dairy industry to discuss issues of importance to them.

When the Minister next meets representatives of the dairy industry, will he bring to their notice the scandal highlighted in The Observer involving at least two farms that recycle milk which is past its sell-by date, mix it with fresh milk and sell it through supermarkets to the general public? Furthermore, will he carry out a thoroughgoing investigation to ensure that there are not other examples in other parts of the country, and enforce the dairy hygiene regulations that were brought into law this year?

If there are any breaches of the regulations, and the breaches are known about, prosecutions follow. It is as straightforward as that.

During his discussions with dairy farmers, has my hon. Friend received any representations about the effect of bovine spongiform encephalopathy on dairy farm incomes? Does he agree that it is a touch inconsistent for the Labour party to complain that our schoolchildren are not being given enough milk to drink, when it considers it to be perfectly okay to ban beef in school canteens? Is it not about time that hon. Members on both sides of the House recognised that both the milk and the beef produced by farmers in this country are of very wholesome quality—the finest of any country in the European Union? The milk is safe to drink and the beef is safe to eat, and both should be available in all schools.

I just think that every local authority should calmly and quietly consider the chief medical officer's advice on the subject.

In view of those comments, will the Minister give us an assurance that the statement by the Parliamentary Secretary, the hon. Member for Tiverton (Mrs. Browning), to me in the debate in July—

"We have never ruled out categorically either vertical or horizontal transmission"—[Official Report, 13 July 1995; Vol. 263, c. 1186.]—

still represents the Government's position? What steps will he now take to reassure not only consumers but the many people in the livestock industry who are genuinely confused by the Government's advice, so that we can have some credible advice and guidance?

I do not think that there is any confusion whatever in Government advice. Any livestock farmer simply has to read the advice of the chief medical officer or the chief veterinary officer to see that there is no confusion. Any confusion simply comes from some sections of the media, and others who have a vested interest in causing confusion in that area. There is no confusion and no doubt; the message is clear from the best scientific reports by both the chief medical officer and the chief veterinary officer, and if people calmly and quietly read those, a sense of proportion will be brought back into the debate rather more speedily.

To ask the Minister of Agriculture, Fisheries and Food what assessment he has made of the relative efficiency of agriculture in the United Kingdom and in other major EU countries. [4137]

I believe that United Kingdom farmers can compete effectively with their counterparts in other major countries of the European Union.

I am grateful to my right hon. and learned Friend for confirming the efficiency of the British farming industry. However, does he agree that the nonsense of the CAP distorts the free market, and that its cost—the billions that it costs British taxpayers—enables less efficient foreign industries to compete unfairly with the United Kingdom industry?

There are indeed serious defects in the CAP, to some of which my hon. Friend has drawn attention. We have been forward in pressing the case for far-reaching reform of the CAP, and Commissioner Fischler has now produced a paper accepting that the status quo is not sustainable. I welcome that fact, and we shall push for substantial reform.

While we are talking about the efficiency of milk producers, if the Minister of State can really buy four pints of milk for 26p, will the right hon. and learned Gentleman advise his colleague to resign his seat and go into the milk business, to buy a milk tanker, take it round to his local supermarket and fill it up with milk in the half-gallon bottles that it sells, and then sell that milk to a farmer, so that the farmer can sell it on to a milk processor? If he did that, he would make a 100 per cent. profit.

It is quite plain that the hon. Gentleman was not listening to my hon. Friend the Minister of State. I should add that my hon. Friend has many talents, and I am sure that he would make a splendid milkman.

May I urge my right hon. and learned Friend to visit the three very efficient farms in Harrow, East? It is always an interesting phenomenon to visit urban farms. Will he confirm that one of the ways of enhancing the efficiency of Britain's farms would be to adopt the single currency, bearing it in mind that the National Farmers Union now endorses such a policy?

My hon. Friend has represented many interests in his time in the House of Commons, but I did not know that he was such a prominent spokesman for the agricultural community. I am delighted to hear that there are three farmers in Harrow, East. That community will be the easiest to meet in its totality.

I am glad that the Minister is keen to recognise the efficiency of our agriculture industry. Will he explain why this country currently has a trade deficit of £6 billion in food and drink, 63 per cent. of which is with countries that have no climatic advantage over the United Kingdom? Will he explain the compelling logic and virtue of agriculture policies that have seen imports from the EC increase by 20 per cent. since 1980 and exports decrease by 3 per cent.? If we have an efficient agriculture industry, what is the point of a policy that discourages Britain's ability to provide its own food?

There are two points to be made. First, the hon. Gentleman is enunciating a policy of fortress Britain, which—whatever else may be true about it—is incompatible with the policy of Opposition Front Benchers. Secondly, on a point of specific detail, if he contrasts food exports last September—the latest available figures—with the previous year, he will see that our exports have gone up by 10 per cent., whereas imports have gone up by 4 per cent. In other words, exports are doing rather well at the moment.

To ask the Minister of Agriculture, Fisheries and Food what efforts he has made to improve the marketing of British apples. [4138]

We have a range of assistance to help our growers. For example, we paid a marketing grant of £150,000 towards establishing the largest top fruit marketing group, and have seconded a leading horticulturist to boost exports. These complement the welcome efforts of the industry itself.

I welcome the Government's support for the marketing of apples because, as my hon. Friend knows, the best apples in Britain are grown in Kent. How does it help the marketing of those apples if massive subsidies are made for the production of apples on the continent? In particular, may I draw my hon. Friend's attention to the subsidy of FF240 million to French apple producers and the subsidy of 11.6 million Dutch guilders to Dutch producers? How do those subsidies help British producers get their excellent apples to the market?

Our help to the British apple industry and its exports and marketing is well targeted. Any assistance given by other member states to their producers—especially in areas of production and surplus—will be subject to the most rigorous scrutiny and, if necessary, will be referred to the European Commission.

Is it true that relations between the Deputy Prime Minister and the chairman of the Tory party have sunk so low that the Deputy Prime Minister has been reduced to eating an apple a day?

With great respect to the hon. Gentleman, I advise him to eat an apple a day—he will then feel a great deal better himself.

Given the general agreement in this country, on both sides of the House and in the industry that the present intervention system, particularly for apples, is quite intolerable—it is bad for the consumer, bad for the taxpayers and very bad for British apple growing—will my hon. Friend get a message to the Prime Minister in Madrid that we must not accept any deal that imposes for any length of time a continuation of that intolerable and unacceptable intervention system?

My hon. Friend has great knowledge of the apple industry, which is an important interest in his part of Kent. I agree that the intervention system is harmful. We are entirely opposed to it and we have registered that opinion with the Community. We look forward to continuing negotiations towards a satisfactory outcome that removes the difficulties, costs and wastefulness of the current system.

To ask the Minister of Agriculture, Fisheries and Food what is the total number of cases of BSE confirmed in the United Kingdom at the latest available date. [4139]

As at last Friday, 155,832 cases of BSE had been confirmed in the United Kingdom. I regularly meet industry representatives to discuss BSE.

Those are disconcerting figures. How can the Government conceivably hope to reassure the public when they are ordering redundancies at the Institute of Animal Health in Edinburgh, where scientists are working at the leading edge on BSE and its human equivalent? They have been told that they have until next Thursday to come up with redundancies in order to meet the Government's target. The Minister has an opportunity now to repudiate that policy and say that it will be reversed. It is appalling.

There are two points wrapped up in that question. The first relates to the statistics. The number of confirmed cases is declining. This time last year there were about 28,500 confirmed cases; this month there are about 16,500. In other words, we are seeing a decline of about 40 per cent. That is certainly encouraging.

On the substantive point, there are no financial restrictions on research. On the contrary, we have put another £1 million into research for next year. I asked Professor Pattison, the chairman of the independent advisory committee, whether he saw any financial restrictions on research and he said no.

In tackling the problem of BSE, does my right hon. and learned Friend accept that it is one thing to pass regulations on the content of feedstuffs and slaughterhouse procedures but a different thing to ensure 100 per cent. enforcement of those measures? What recent steps has my right hon. and learned Friend taken to increase enforcement?

It is important to stand back on the question of BSE. There are two important points to make: first, we do not believe that BSE in cattle can be transmitted to humans. The scientific evidence is reassuring on that point, although it does not enable us yet to prove that it cannot be transmitted. Against the possibility that we might be wrong, we have in place very rigorous regulations to prevent specified bovine offal—the material capable of carrying the infective agent—from getting into the food chain. I have given clear instructions to the Meat Hygiene Service to ensure 100 per cent. compliance with the regulations. I called in the slaughterhouse operators on 9 November to give them the same message.

Is the right hon. and learned Gentleman aware that we welcome the tightening of BSE controls announced today? Does he agree that it was unacceptable that the existing controls were not adequately enforced, for which the Government must accept their share of responsibility? Does he agree that we should err on the side of caution when it comes to BSE? Will the Minister announce today that he accepts the recommendation of the Agriculture Select Committee that we should ban the brains, spinal cords and other specified offal of cattle under six months from entering human food?

On matters of scientific evidence, I follow the advice of the independent advisory committee. We have done so throughout, which enables us to say with complete confidence that British beef is safe. On the first part of the hon. Gentleman's question, he is doing himself no credit. There are no party runs to be scored on the matter. If he tries to score them, he will simply make a clown of himself.

To ask the Minister of Agriculture, Fisheries and Food what steps he has taken to revitalise the agricultural tenanted sector. [4140]

The Agricultural Tenancies Act 1995, which came into force on 1 September, is designed to encourage landowners to let more land. The Act gives landlords and tenants much greater freedom to agree farm business tenancies that reflect their needs.

I thank my hon. Friend for that reply, but is not the aim that he described rarely realised in practice? When a smallish block of 60 or 70 acres comes on the market, the young farmer does not get it because he is outbid by a neighbouring larger enterprise. According to the aims of the 1995 Act, one would have expected the younger person to be able to take it on.

The Act has been in force for less than three months and it is early to assess its results, but the survey carried out by the Royal Institution of Chartered Surveyors, preparatory to the introduction of the Act, forecast that there would be increased opportunities generally, with a probability of a 10 per cent. overall uplift in the amount of land available for letting on tenancies of longer than a five-year term. I have every hope that, as the market settles down, there will be opportunities for new entrants.

To ask the Prime Minister if he will list his official engagements for Thursday 14 December. [4157]

I have been asked to reply.

My right hon. Friend the Prime Minister is in Paris signing the Dayton agreement on Bosnia.

Will the Deputy Prime Minister unequivocally condemn the remark made yesterday by his right hon. and learned Friend the Chancellor of the Exchequer, when he said:

"This bottom 10 per cent. always drive me up the wall"?

Will he further apologise to that bottom 10 per cent., who have seen a real fall of 17 per cent. in their living standards since the Conservative Government took office?

My right hon. and learned Friend the Chancellor of the Exchequer was referring to those people who have significant wealth but low incomes, which can give a wholly misleading idea of their overall position and the standard of living that they enjoy. The hon. Lady is giving a false impression of what he was saying.

Is my right hon. Friend aware that the best service that my right hon. and learned Friend the Chancellor can render to the lowest 10 per cent. and, indeed, the highest, is to reduce interest rates as much as possible and that his decision is much to be congratulated?

My right hon. and learned Friend the Chancellor is presiding over one of the most exciting periods of British economic potential. [Interruption.] I am sure that a wider audience will notice that Labour Members jeer at the fact that, for the 27th month in a row, unemployment fell. It was 20,000 less month on month and has been nearly 750,000 down over the 27 months. I should have thought that Labour Members would cheer on behalf of their constituents.

As the Prime Minister was unable to give any figure for the cost of rail privatisation at Question Time on Tuesday, will the Deputy Prime Minister confirm that the Government's figures, following the Budget, show that the long-term cost to the taxpayer will be £850 million per year?

The hon. Lady has the quotations wrong. Those quotations come from a Labour party press release. Like most Labour party press releases, they are unadulterated rubbish.

Will the Deputy Prime Minister therefore take the trouble to look at the sources of the figures in those documents, every one of which is a published Government source? Will he further look at the report of the Select Committee on Transport published today, which also shows that, if rail privatisation goes ahead, taxpayers will have to pay hundreds of millions of pounds extra to keep services as they are? Is not the message clear: rail privatisation is a waste of taxpayers' money?

If the hon. Lady and the Labour party are so against privatisation, why have they not got the guts to renationalise any of the industries that we have privatised? Why is it that every time we take the process a step further, they jeer and produce scare stories in advance, none of which stands up when we achieve the result?

I congratulate my right hon. Friend and the Government on the unemployment figures that he has just mentioned—8 per cent. and falling, whereas unemployment in France is 11.5 per cent. and rising. To what extent is that due to the franc fort policy and French membership of the exchange rate mechanism, while we have a free and floating pound?

My hon. Friend gives me the opportunity to pay tribute to all those industrialists in this country who have helped to create the jobs in the enterprise culture that we have designed as a Government. What I find extraordinary about the Labour party and the issue of unemployment is that last month, when there was a 200 increase in unemployment, the shadow Employment Secretary put out a press release in which he said that that recognised

"the final collapse of the Government's shuddering economic recovery."

The fact is that those figures have now been revised and we have discovered that last month, as in each of the past 27 months, unemployment fell. Why does not the Labour party recognise that far from a shuddering economic recovery, we have a buoyant economic attitude in this country which is creating wealth at one of the fastest rates in western Europe?

Have the Deputy Prime Minister and his colleagues considered the point of order made by my hon. Friend the Member for Liverpool, Mossley Hill (Mr. Alton) that it would be an outrage if social security regulations that could make 10,000 people homeless and destitute were to be implemented before Parliament had had a chance to debate them?

The right hon. Member raises an important question. I can assure him and the House that there will be an opportunity to debate these matters before they are implemented. I give that assurance.

Did my right hon. Friend notice in yesterday's Hansard a very good Bill on protecting those who wish to disclose information in the public interest? Has he further noticed that there are serious problems here in the House for those who might wish to do that? I particularly refer to members of the press corps who have been cajoled and coerced, I gather, by some strange people: a shadowy figure from Hartlepool and an ex-journalist from Today. Will he join me in encouraging them to break free from that and blow the whistle on that strange shadowy company over there?

My hon. Friend makes an important point. Conservative Members have raised it before but no answer comes. Is it the intention of the Labour party, if elected to power, to put Alastair Campbell as a civil servant into No. 10 Downing street to inject Labour party propaganda into the presentation of Government policy?

To ask the Prime Minister if he will list his official engagements for Thursday 14 December. [4158]

I have been asked to reply.

I refer the hon. Member to the answer I gave some moments ago.

Does the Deputy Prime Minister agree that the £850 million on-going cost of rail privatisation would be better spent on improvements to the west coast main line, which serves my constituency?

What I do believe is that offering the private sector the chance to provide the cash for the innovation and modernisation that we all want is much more likely to achieve the result than continuing with nationalisation, which I notice, significantly, has not achieved that result over the years.

Has my right hon. Friend noticed that of all the counties in England, Liberal and Labour-run Kent county council retains the largest share of its education budget at the centre? How does that sit with the oft-repeated complaints from the Opposition that too much is spent by the Government on administration?

It is wholly consistent with the theme of what the Opposition say. Most conspicuously, they will not say that they will put up taxes but they constantly talk about the need for increased expenditure. They want it all ways, which proves that the sums do not add up and that they are not fit to govern.

To ask the Prime Minister if he will list his official engagements for Thursday 14 December. [4159]

I have been asked to reply. I refer the hon. Member to the reply that I gave some moments ago.

Does the right hon. Gentleman understand my sense of shock this morning as I witnessed the evidence of wanton destruction and looting in central Brixton and parts of my Streatham constituency? Will he join me, my hon. Friend the Member for Vauxhall (Miss Hoey) and the vast majority of the local community in condemning those acts of violence? For the sake of Brixton's reputation and future, will the right hon. Gentleman also affirm that the acts that we witnessed yesterday evening were not a re-run of the events of 1981 and 1985, as has been portrayed, but the actions of a small criminal element? Finally, will he confirm that there is no intention of backtracking on the regeneration funding committed to the locality and that Brixton's future will be reassured, as is the will of the local people?

I unreservedly join the hon. Gentleman in condemning the violent minority who attacked police officers and property in Brixton last night. I wholeheartedly agree with the Commissioner of Police of the Metropolis, representatives of the local community and the hon. Member for Vauxhall (Miss Hoey), who spoke eloquently this morning in condemnation of those unacceptable acts of violence, which we all deplore. If we are to bring hope and opportunity to those urban communities, it is vital that they become attractive places for people to live, work and invest. All parties have made a massive attempt to bring that about in the past few years, and that process must continue.

Will my right hon. Friend confirm that neither he nor the Prime Minister would ever contemplate threatening the Union by introducing an elected Scottish Parliament? If they were ever tempted by such an idea, will he confirm that they certainly would not think of giving it tax-raising powers and then try to deceive the British people by saying that they would not use those powers?

It is extraordinary that Scottish Labour Members of Parliament are to contemplate a tartan tax to make taxes higher in Scotland than in the rest of the United Kingdom. I also find it extraordinary that English Labour Members of Parliament are prepared to give powers to their Scottish colleagues, which would be exercised by Scottish Members in England, while English Labour Members would have no such powers in Scotland.

To ask the Prime Minister if he will list his official engagements for Thursday 14 December. [4160]

I have been asked to reply. I refer the hon. Member to the reply that I gave some moments ago.

Does the Deputy Prime Minister recognise that it is not only with British Rail that privatisation has been taken too far? Is he aware of the anger and indignation felt by people in Britain at the appearance in an estate agent's brochure of the magnificent complex of buildings in Greenwich currently occupied by the Royal Naval college? Is he also aware that the Secretary of State for Defence refuses to reveal the organisations that are bidding to take over those magnificent buildings? As it comes hot on the heels of the fiasco of county hall, is it not clear that the nation's heritage is not safe in the Government's hands?

If the hon. Gentleman believes that, he will believe anything. As the Prime Minister and my right hon. Friend the Secretary of State made clear, the preservation of the buildings at Greenwich is of prime national importance and nothing will be done to prejudice it.

As unemployment has now been falling for 27 months in a row, has my right hon. Friend noticed the recent comments by the Director-General of the CBI, who said that a combination of increasing social regulations from Europe via the social chapter and a single currency would be "an employment-destroying disaster"? Does not that show the importance of the opt-out that we achieved at Maastricht and the hypocrisy of those who talk about creating jobs but then support policies such as the social chapter and European monetary union, as the Opposition do?

I shall have the opportunity tomorrow to lay the foundation stone of Siemens in the north-east. One of the reasons why a German company comes to invest and create jobs in this country is that we do not have the impost of the social chapter, whereas Germany has. I would have thought that Labour Members, whose constituencies have gained enormously from the inward investment coming to this country, would seek to enhance it, and not to destroy it.

To ask the Prime Minister if he will list his official engagements for Thursday 14 December. [4161]

I have been asked to reply. I refer the hon. Member to the answer I gave some moments ago.

Has the Deputy Prime Minister noted the good news from south Wales that Tower colliery in my constituency, which was bought by the workers a year ago, has made a pre-tax profit of £3.5 million in the first year? [Interruption.] That has been achieved despite the fact that the right hon. Gentleman told those workers that there was no market for their coal. Is not the lesson to be learnt that if the conditions are right—[HON. MEMBERS: "Privatisation."]

Order. The hon. Lady must be heard.

Is not the lesson to be learnt that if the conditions are right, and if workers are given control of the means of production—[Interruption.]

Order. Hear the hon. Lady out. [Interruption.] Order. Hear the hon. Lady out.

If the workers are given control of the means of production they can turn in profits, whereas the capitalists throw in the towel.

rose—

Order. Control yourselves.

I do not want to intrude on private grief, but perhaps the hon. Lady has not caught up with events. Those words have been deleted from the clause, although I realise that a large number of her right hon. and hon. Friends are just waiting their time to bring them back. The hon. Lady had better have a word with the hon. Member for Hartlepool (Mr. Mandelson) because she has got the language wrong—the soundbite does not fit with the language of those on the Opposition Front Bench. The real message behind what the hon. Lady has just said, the real triumph, is that it is privatisation that has made those profits possible.

I am very grateful to the Select Committee on Liaison for recommending that the House debates this estimate in so far as it relates to the very important topic of breast cancer services. I shall, of course, concentrate on the report published recently by the Select Committee on Health, which I have the honour to chair. The recommendations of the report were unanimous.

I should like to thank all my colleagues on the Committee for the very hard work that they put into the report, and for the very good spirit in which it was discussed. I should also particularly like to thank our specialist advisers, Professor Michael Baum of the Royal Marsden hospital and Professor Roger Blamey of Nottingham City hospital.

I shall begin by outlining the main conclusions and recommendations of the report, and the main points of the Government's response. There are a few questions that I should like to pursue with the Minister, which I hope he will be able to address in his speech.

Although the United Kingdom does not have a particularly high incidence of breast cancer—the disease is more prevalent in the United States of America, New Zealand, Canada and several other European countries, including France, Italy and Denmark—we have almost the highest recorded breast cancer mortality in the world. Breast cancer claims the lives of more than 13,000 women every year in England and Wales alone—more than any other cancer, and more than any disease other than heart attacks and strokes. None of our witnesses was able to offer any explanation of why breast cancer mortality should be so high in this country.

The Government's target, set out in 1990, is

"to reduce the number of breast cancer deaths among women invited for screening by at least 25 per cent. by the year 2000."

It is clear from the very wording of that target that the national health service breast screening programme is at the centre of the Government's plans to reduce breast cancer mortality. No reduction in breast cancer mortality from the programme is expected to be observed until around 1997, as there is a "lead time", which means that the full benefits of the programme will not be observed until those women who have benefited from the early detection of their breast cancer begin to enjoy additional life years. None the less, we were impressed by the fact that the programme has met or exceeded all its interim quality indicators so far, largely as a result of its excellent quality assurance programme, and especially the efforts of its national co-ordinator.

One of the great strengths of the quality assurance programme is that it operates not only in individual screening units but at district and regional health authority level. RHAs are responsible for purchasing quality assurance services and for the operation of the quality assurance reference centres in each region.

In 1992, the chief executive of the NHS management executive told the Public Accounts Committee that the standards laid down centrally for the programme were "non-negotiable", and said:

"If there are purchasers that want to try to step out of line"—

that is, to try to purchase a service that does not meet national specifications—

they must be brought back into line by the regions. That is the role of the region and we have made that extremely clear".

The national co-ordinator of the NHS breast screening programme also told us that she occasionally had problems with district health authorities which were trying to purchase services that did not meet national standards. That is why the quality assurance programme is so important to the screening programme. It ensures not only that the service provided matches the service for which it is contracted, but that the service for which it is contracted meets the national requirements in the first place. We recommend that the QAP should be preserved in something like its present form after the dissolution of the regional health authorities next April. That could be achieved either by central funding of the programme or by bottom slicing from district health authority allocations.

In their response, the Government said that they had issued guidance to the effect that

"it is vital that quality assurance systems should continue to be funded and operated in the future to the same high standards as at present."

The Government have also said, however, that they will move from the present system, under which RHAs are responsible for purchasing quality assurance, to a system of lead district purchasing, which will be funded through the common services levy.

I recognise the steps that the Department is taking to ensure that the QAP continues to operate at all three levels, but I should be grateful if my hon. Friend the Minister were able to assure us that the programme will not become simply a means for purchasers to check on provider units. We must continue to ensure that the service purchased meets the national standard.

The Select Committee on Health recommended, on the strength of the best evidence now available, that the upper age limit for inclusion in the call and recall system for screening should be extended from 65 years to 69, and that the Department of Health must ensure that women over that age are aware of their right to a three-yearly mammogram on request.

Professor Forrest's report, on the strength of which the NHS breast screening programme was originally established, suggested an upper age limit of 64, on the ground that there was lower acceptance of screening by women of older ages. It is difficult to understand what basis was used for that assertion, as the Swedish two counties study—one of the key pieces of clinical trial evidence on which the Forrest report drew—showed that 80 per cent. of women up to the age of 74 accepted invitations for screening.

There are two good reasons, I believe, for including older women in the screening programme. First, the risk of breast cancer increases with age. Secondly, the cancer detection rate among older women is much higher than among younger women.

Conversely, we found no evidence that extending screening to women under the age of 50 would be beneficial. None of our witnesses supported that proposal. Professor Martin Vessey of the advisory committee on breast screening explained to us that, apart from the lower incidence of breast cancer in women under the age of 50, it is also difficult to screen for breast cancer in pre-menopausal women, as

"the hormonal environment in the breast is different"

and the breast is much denser, making it more difficult to obtain accurate readable mammograms. The Committee was pleased to note the Government's response, which is to conduct clinical trials in screening older women.

The NHS breast screening programme is a model service. It has strong central co-ordination, a set of auditable national performance targets, and a quality assurance programme that has been praised by the National Audit Office. However good the screening programme, however, screening alone will not lead to a reduction in breast cancer mortality.

As we were completing our report, evidence emerged that breast cancer mortality was already beginning to fall in 1989. As I have said, such an effect could not have been generated after only two years of breast screening. It is probable that the welcome reduction in mortality is the result of improvements in the treatment of more advanced breast cancer.

There are ways in which treatment for women with both screen-detected and more advanced breast cancer could be improved. There was a wholehearted welcome for the Government's policy framework for commissioning cancer services. The Government's plan is that cancer services should be arranged into three tiers—primary care, designated cancer units and designated cancer centres.

The designated cancer unit will normally be a district hospital with a full range of support services for cancer patients. More importantly, however, it will have site-specific clinics for patients with the commoner cancers, led by a consultant specialist. Those will be clinics that deal with only one type of cancer, such as breast cancer or gastro-intestinal cancer.

In practice, that means that, where there are several hospitals in one area, purchasers and providers may agree between themselves that a unit for certain cancers or groups of cancers will be established at one hospital, and a unit for another cancer or group of cancers in another hospital. Such clinics would also treat patients with related non-malignant conditions—for example, women with non-malignant breast problems, which account for about 90 per cent. of all breast disease, would be seen in a specialist breast unit.

The cancer centre will be part of a large general hospital or a teaching hospital, and will offer the same range of services as the cancer unit. It will also offer specialist clinics for the less common forms of cancer, and a full range of support services for the local cancer units, including

"those treatment regimens which are too specialised, technically demanding or capital intensive to be provided by the cancer unit."

That could include radiotherapy, for example.

The most important point to make about the policy framework is that it is based on sub-specialisation. It is not acceptable that a woman with a serious life-threatening disease such as breast cancer should be treated by a general surgeon who might spend most of his or her time dealing with a muddle of other surgical conditions. In addition to a specialist breast surgeon, the specialist breast unit should have a multidisciplinary team of other specialists with specific training in the management of breast disease.

The advantages for patients in such units are manifold and great. Each unit will see enough patients to operate a dedicated clinic for new patients with breast problems each week—a one-stop shop, at which women can have all their diagnostic tests done at the same visit.

Rapid diagnosis is of the utmost importance. It allows women who have breast cancer to receive treatment at the earliest opportunity, and permits the timely reassurance of women who do not have cancer. Patients who have breast cancer will receive a high-quality package of care planned by a multidisciplinary team of specialists, rather than what the British Breast Group report, "Provision of breast services in the UK", described as

"ad hoc therapy being carried out by an individual acting without interaction with other members of a team".

More importantly, there is evidence that patients treated in such units have improved survival rates. A paper in The Lancet last spring showed that women treated by a consultant who sees more than 29 new cases of breast cancer each year have a 30 per cent. better survival rate than those treated by a consultant who sees fewer new patients.

The specialist unit also represents a very efficient way of treating breast cancer. Mr. Hugh Bishop, of the British Association of Surgical Oncology breast surgeons group told us:

"a specialist breast unit is actually more efficient. It does fewer benign breast operations, it does fewer unnecessary investigations … and processes people more efficiently and in a more kindly way."

That is the Government's vision for the future of breast cancer services in the United Kingdom, and it is a vision shared not only by the Select Committee but by organisations such as the British Breast Group, the British Association of Surgical Oncology breast surgeons group and the Cancer Relief Macmillan Fund.

While the Committee welcomed the Government's new initiative, we believe that it could be improved further. We believe that there must be some mechanism for ensuring that a hospital which is designated as a cancer unit or a cancer centre is providing the necessary services to the required standard. There is a real danger that every hospital with a consultant surgeon will simply hang out a sign saying "Specialist Breast Unit", and will designate itself as such, without having suitably trained specialist staff or the necessary critical mass of patients that is so vital to the good running of such a unit.

The British Breast Group recommends that a specialist breast unit should see a minimum of between 75 and 100 new cases of breast cancer each year. That serves to ensure both that the general level of expertise among the team is sustained and that the unit remains cost-effective. By issuing a set of national mandatory standards for specialist breast units, the Department could ensure that all women with breast cancer receive the highest standards of care.

During our inquiries, a definition of a specialist breast unit was produced by an ad hoc group consisting of representatives of various organisations involved in the management of breast disease, including several of the royal colleges. The Committee published the definition as an appendix to its minutes of evidence, and it can be found on page 191 of that volume. The same ad hoc group met again recently, and it has further revised the definition.

I have praised the mechanism which the NHS breast screening programme has in place to ensure that all screening and assessment units provide a high-quality level of service through its quality assurance programme. It is a Rolls-Royce among breast cancer services. Unfortunately, many women whose breast cancer is not detected by the screening programme receive a second-hand Trabant service. They might be referred to a general surgeon at a local hospital who has no special training in the management of breast cancer, does not work closely with a team of oncologists, radiologists and cytologists, sees only a few cases of breast cancer each year, and is not subject to any external mechanism of quality control.

In our report, we concluded that the QAP is one of the great strengths of the programme, as it operates at a level above individual purchasers and providers. We recommend that the remit of the national co-ordinator of the NHS breast screening programme and the regional quality assurance teams should be extended to cover the provision of services for women with symptomatic as well as screen-detected breast cancer.

Such an extension of the quality assurance programme would enable the Department of Health to ensure that all hospitals which were operating specialist breast units met the minimum mandatory standards. My noble Friend Lady Cumberlege and the chief medical officer told the Committee that they were worried that a mandatory service specification might stifle useful innovations at a local level. I fully appreciate their concern, but the mandatory requirements which the Committee proposed are the minimum requirements. There is no reason why they should prevent units from providing a higher level of service than is specified.

Perhaps I might draw an analogy with the patients charter. The charter lays down the minimum level of service that patients have the right to expect, but does nothing to prevent providing units from exceeding those standards. I am pleased that the Department of Health is working to develop service guidance for the common cancers, but I shall be grateful again if the Minister will assure the House that this will be sufficient to stop hospitals simply hanging out a sign.

Breast cancer is almost unique, in that a quality assurance system operating at national and regional level is already in place within the screening programme. The Select Committee believes that an extension of the functions of the quality assurance programme and the office of the national co-ordinator to include services for women with symptomatic breast disease could lead the way for other site-specific specialties. It is perhaps surprising that that proposal was supported by many of the doctors who gave evidence to us. They want their work to be subject to rigorous quality control.

Dr. Mike Richards of the British Breast Group told us that he would favour a national co-ordinator for all breast cancer services. Mr. Hugh Bishop of the British Association of Surgical Oncology told us that such a development was "absolutely essential". It is a pity that the Department is proving reluctant to build on the success of the screening programme in that way, but I await the Minister's response on the matter.

During our inquiry, the Committee learned that at least one regional health authority—North Thames—is extending the role of its regional quality assurance manager to encompass the provision of treatment for breast cancer patients. It told us:

"Women should be offered the same standard of care from the breast service in both screening and symptomatic investigation and treatment."

The Committee considered ways in which clinical research in breast cancer might be improved. Although our inquiry related primarily to breast cancer services, our recommendations on clinical research will inevitably have benefits for many researchers working in other fields. We heard from researchers and from the Department of Health that one of the obstacles to conducting good clinical research was disputes over who was to provide indemnity for the clinicians and trusts involved in that research. The present system of providing indemnity for clinicians and trusts engaged in research is ambiguous.

The Department of Health told us that NHS indemnity covered all NHS-provided health care professionals for negligent harm resulting from research undertaken as part of their NHS contract, and that the employing NHS body—for example a hospital trust—is expected to meet the entire cost of defending, and if necessary settling, a claim where negligence is alleged.

Ultimately, it is for the employing body to decide whether to allow research to proceed or not, and a trust may decide not to allow its employees to participate in a trial if it does not wish to provide indemnity for them. Mr. Richard Gray of the clinical trials service unit at the university of Oxford told us that many trusts refused to allow their doctors to take part in trials unless they received indemnity cover from the study sponsors.

In some cases, that has led to the absurd situation in which doctors have been permitted to use conventional treatments and new treatments of unproven effectiveness in an ad hoc manner, but have not been allowed randomly to assign patients to control and study groups in a way that would allow them to gain useful information about the effectiveness of the unproven treatment. That clearly militates against the Department's efforts to encourage the practice of evidence-based medicine, of which I am sure the whole House would approve.

Good clinical research is of benefit to the whole NHS, and the Select Committee did not think it fair that the indemnity cost of that research should be provided only by those NHS bodies which participated in it. We therefore recommended that indemnity for NHS bodies and their employees participating in research which is approved by the relevant research bodies—in the case of breast cancer research, the United Kingdom Co-ordinating Committee on Cancer Research—should be provided centrally by the Department of Health. The Committee was pleased to learn from the Department that it will be considering that option in its current review of research indemnity. I hope that the Minister will be able to report the latest progress of the review to the House today.

The Committee also recommended that the Department consider ways to streamline the system of ethics committees. Ethical review is an essential part of clinical research, but representatives of the UKCCCR told us that the present unwieldy structure of that committee system puts people off entering patients into trials. For a large multi-centre trial, the approval of as many as 40 local research ethics committees might have to be obtained.

There are a few good reasons why a research proposal might be allowed to go ahead in one area and not in another. The provision of information leaflets in ethnic minority languages for patients is liable to be an essential part of a trial conducted in some parts of the country, but not others. Likewise, some hospitals may have the appropriate facilities to participate in a trial and others may not.

The fundamental ethical considerations surrounding a research proposal, however, will not vary from one region to another. Breast cancer research is changing—moving towards the examination of smaller and smaller sub-groups of patients of different tumour types. It is therefore becoming necessary to involve more and more research centres in clinical trials.

I know that the Minister shares the Committee's concern about the unwieldy system of local ethics committees, and that the chief medical officer is considering ways of streamlining the system. Perhaps the Minister might be able to give the House a little more detail about that review this afternoon.

Finally, I should like to say a few words about the United Kingdom Co-ordinating Committee on Cancer Research and, in particular, its breast cancer trials and cancer screening sub-committee.

The UKCCCR consists of the Cancer Research Campaign, the Imperial Cancer Research Fund, the Medical Research Council and several other cancer research charities. It was originally chaired by Professor Sir Patrick Forrest, who was instrumental in establishing the NHS breast screening programme. The Department of Health and the Scottish Office Home and Health Department have observer status on the committee. The UKCCCR provides a forum for the exchange of information on the policies and plans of member bodies, recommends proposals for the co-ordination of policies, and offers advice to the member bodies on any matters that might come before it. Although the breast cancer trials co-ordinating sub-committee of the UKCCCR runs some trials of its own—such as those that are being conducted to examine the treatment of ductal carcinoma in situ and the use of tamoxifen—and endorses and co-ordinates large, multi-centre trials, it does not distribute the funds for such trials. After researchers have obtained approval from the UKCCCR, they must scrape around trying to find out where they can fund the research, going to committee after committee, at the mercy of the weakest of those committees, and all before they have to go through the system of local research ethics committees, which I have just described.

The UKCCCR breast cancer trials co-ordinating sub-committee can be seen as the parent body for breast cancer research, representing most of the main sources of research funding. The Select Committee believes that it would be a step forward if the UKCCCR were to have its own budget for funding trials, so that it could act as a one-stop shop for researchers wishing to undertake a trial.

We recommend that the Department of Health and the Medical Research Council identify their budgets for breast cancer research, and distribute the money through the UKCCCR in the expectation that that will provide an incentive for other research funding bodies to do likewise.

I understand that neither the Department nor the MRC has a specific budget for breast cancer research, but I cannot see why it would not be possible for them to identify the amount which they currently spend on breast cancer research, and devolve that amount to UKCCCR. The whole Committee agrees that that would be a welcome development, which would make it easier for researchers to gather vital information about the effectiveness of new treatments at the earliest possible opportunity.

I know that colleagues from the Select Committee wish to contribute to the debate, so I shall draw my remarks to a close. In my introduction, I have attempted to focus on the main conclusions of the Committee's report, but I look forward to hearing the views of other hon. Members, and, in due course, those of my hon. Friend the Minister.

I welcome the opportunity to take part in this important debate. Breast cancer services for women in the national health service are an important issue. As the Health Select Committee acknowledged in its report on breast cancer services, we have learnt that although England does not have a particularly high rate of breast cancer occurrence, it has almost the highest recorded breast cancer mortality rate in the world.

Currently, almost 30,000 women are diagnosed with the disease annually and around 14,000 die of it. It is responsible for about 5 per cent. of all women's deaths throughout the country. Understandably, breast cancer is an emotive issue. It is also a very real issue for the tens of thousands of women who have the disease and the thousands who die from it.

We must set this debate against the background from which it emerges—the increasing inequalities in public health. Since the Black report was published, socio-economic differences in health have increased. The difference in mortality rates between the deprived and the affluent has increased substantially. The recent widening of health inequalities mirrors the gross upward redistribution of wealth since 1979. It is vital that patients should have access to the same standards of health care throughout the country, irrespective of where they live or to what socio-economic class they belong. Inequalities in health should be targeted and eradicated.

In the Government's "The Health of the Nation", mortality rates for women suffering from breast cancer are targeted as a leading priority to be reduced in the long term. The Government have recognised the importance and significance of mortality rates for women suffering from breast cancer. They know that the figures are illustrative of the condition of the public health services.

In "The Health of the Nation", targets were set for a reduction in mortality of those screened for breast cancer. In progress reports on "The Health of the Nation", the Government are, I believe, complacent in stating:

"progress to date has been in the right direction".

Yet statistics from the House of Commons Library show that 60 per cent. of district health authorities are unlikely to meet those targets. Of the 112 district health authorities in England, 54 will fail to meet the target of a 25 per cent. reduction in mortality rates by the year 2000.

The Government's comments are therefore misleading and superficial. The Government's document on variation in health, in commenting on variations in breast cancer, stated:

"with respect to mortality there is relatively little variation around the England and Wales average".

"The Health of the Nation" dedicates only one page to regional variations but socio-economic variations show that, although the incidence of breast cancer is higher among the wealthier classes, the lower classes are more likely to die from the disease.

Leading health professionals are concerned that breast cancer services continue to vary considerably throughout the United Kingdom.

Will the hon. Gentleman give way?

No.

Department of Health public health common data showing regional and local mortality rates from breast cancer illustrate the huge variations between local health authorities and, on a wider and more significant level, large variations between regional health authorities.

I am particularly concerned about those alarming figures because they highlight the high rate of breast cancer mortality in and around my constituency. Although the registration rate for breast cancer in Doncaster is some 7 per cent. lower than the national rate, we have a disturbingly high mortality rate from breast cancer. For most of the past 11 years, the rate has been significantly higher than the national average. In 1993, it was 13 per cent. higher than the national average yet in neighbouring areas mortality rates from the disease have been consistently below the national average. The figures for North and West Yorkshire, for example, are significantly lower.

The House of Commons Library has analysed the progress made towards "The Health of the Nation" targets and assessed Doncaster as having made negative progress. Indeed, it is moving away from the targets set in 1990. A snapshot assessment of breast cancer mortality for women aged between 50 and 69 in 1993 puts the rate in Doncaster at 118 per 100,000 women, one of the highest rates in the country and the fourth worst for that year. The figures for 1994 are 82 per 100,000 women. Despite the reduction, Doncaster will still fail to meet the national standards set by the Government in their report. The Government are failing to meet their standards and failing badly the women of Doncaster.

Figures for the Trent authority show that, once again, there has been a higher than average mortality rate for the past 10 years. Let me compare those statistics with those of the neighbouring health authority. Northern and Yorkshire's statistics show a consistently below average mortality rate for each year in the past 10. The Government must recognise that those variations exist and begin to assess the local rates. They must set local targets rather than rely on a national target that could be set by a collection of varying mortality rates around the country, and seek to achieve those local targets. Perhaps they are too frightened to do so because local targets would emphasise what the Labour party has illustrated—that regional variations mean that many district health authorities would fail the Government's test.

As in any area of the health service, it is vital that women throughout the country receive the same standard of treatment wherever they happen to live. It is important that the Government make progress in meeting the targets that they have set. Why do not they publish local targets? Why has it been left to the Labour party to put those variations in the public domain? Are the Government too ashamed of the progress that has been made? We talk of statistics, but those represent people—in this case, women who suffer and die.

Access to health care and a chance of survival must not depend on where one happens to live. They must be accessible to people in all areas. The Government must monitor more effectively the progress towards their targets. They must deal with those regional variations in health care. We have shown that they have not dealt with those issues. They must now begin to do so.

I was appalled by the speech of the hon. Member for Doncaster, North (Mr. Hughes), who refused to accept an intervention when he was using statistics selectively. The Select Committee asked to see the regional differences in rates of breast cancer and those are published on page 239 of the Select Committee report.

In no area of health care can it be argued that an average figure will be the same for each area of the country. There is no reason why it should be. The population profile of each area differs and it is naive and ludicrous for the hon. Gentleman to think that all areas should conform to the norm. Each health authority should aim to bring about an improvement in the figures for its area, which is why it is important to publish figures and aim at a target. To pretend that differences show that the system is failing is wrong. As the hon. Gentleman said, although he did not pursue the point, breast cancer appears internationally to be a disease of affluence.

The hon. Gentleman referred to page 239 of the Select Committee report, which gives the regional figures. Those figures are for breast cancer incidence whereas my hon. Friend the Member for Doncaster, North (Mr. Hughes) said that, although the incidence may be higher in affluent areas, the mortality rate was higher in less affluent areas. Those figures do not reflect mortality rates.

I accept that the table contains incidence figures. If the hon. Gentleman wishes to provide me, after this debate, with figures for mortality in relation to incidence, I should be pleased to study them. I cannot look at figures that the hon. Member for Doncaster, North holds up on the opposite side of the Chamber. I am not complacent about the incidence of or death rate from breast cancer, but it is shameful to try to make party political capital out of this issue.

Disgraceful.

The disgrace is that Opposition Members are trying to make party political capital out of such an important issue.

Will the hon. Gentleman give way?

No, I shall not give way at this point. I want to make some progress.

The Select Committee carried out a useful inquiry into an issue that concerns many people, particularly women. Cancer in any shape or form is a disturbing disease that causes great anxiety and concern, and breast cancer probably causes more concern than most. It tends to strike younger women. Perhaps the most serious cause of concern is that it is often not identified until it is too late.

I said earlier that the incidence of breast cancer tends to be higher in wealthier countries. I would welcome more research into why that is so. The incidence of breast cancer is rising in the United Kingdom but, so far as I am aware from the Select Committee inquiry, no one could give substantive evidence as to why that is so. Perhaps we are simply getting better at diagnosing the disease, so we must take care when arguing about incidence.

The Select Committee was also advised that suddenly in 1989 the death rate started to decline, but nobody seems to know why. It cannot be because of screening because the programme had not started at that time. The importance of the Forrest report's recommendation to implement a screening programme has been acknowledged by all. That programme appears to have been successful, although more evaluation of the figures is necessary.

The United Kingdom was the first European Community country to introduce a national breast screening programme. It is acknowledged to have a good system of quality assurance, which ensures that it is implemented effectively. It was decided that all women between the ages of 50 and 64 should be screened regularly. The Committee received a great deal of evidence to suggest why that should be so. We were advised that screening has not been introduced for younger women because it has no particular impact on mortality; equally important, and more significant, there are difficulties in reading mammograms of pre-menopausal women. Members of the Committee were broadly prepared to accept that advice from the medical profession. There is far more controversy, understandably, about the decision not to screen regularly women above the age of 64. The Committee was advised that there would be a lower take-up by older women, and that there is a greater risk of older women dying from other diseases. The Committee was, frankly, unconvinced by those arguments. I was therefore pleased to support the Committee's recommendation that the screening programme should be extended to women aged 69.

It is particularly interesting to look at the relevant figures on breast cancer, which show that it is more common among older women. In 1989, 8,752 women between the ages of 50 and 64 died from breast cancer, and, 11,179 over the age of 64 died. Those figures reveal that more than 60 per cent. of breast cancer deaths occur in women over the age of 64. Surely that is a good reason for extending screening to include women up to the age of 69.

The Government argued that they had decided not to go ahead with breast screening for older women because they felt that it was not cost-effective. Does the hon. Gentleman agree that the evidence that we received suggests otherwise? The Government's response was a disappointment to many members of the Select Committee and to people throughout the country.

I am grateful to my hon. Friend for that intervention. If he had asked me that question half an hour ago I would have agreed with him entirely, but I have just happened to read in Hansardof 4 December that the Government have announced that, from 18 October, pilot schemes have been operating in the Northern and Yorkshire and South Thames regional health authorities to evaluate the effectiveness of extending breast screening to women up to the age of 69. I am a bit behind the times, and was unaware of that when I read the Government's response at the weekend. I welcome that announcement, and I am particularly pleased that I read about it just 15 minutes ago. I am sure that my hon. Friend the Member for Belfast, South (Rev. Martin Smyth) will be pleased about that announcement as well.

Screening is effective if it succeeds in identifying those women with breast cancer early enough so that they can be treated and prevented from dying. The hon. Member for Doncaster, North referred to the relevant figures, which reveal that in 1992, just under 14,000 women died from breast cancer, which is just under 5 per cent. of all female deaths. That is a staggering number of deaths from one particular disease—something that hon. Members on both sides of the House take seriously. Perhaps it is even more significant to note that breast cancer accounts for more deaths than any other form of cancer, including lung cancer. I find that pretty incredible.

A particular problem struck me as I was interviewing witnesses before the Select Committee about screening. The one problem with breast screening is that, apart from identifying those women with breast cancer, it generates a false positive. If a woman is recalled because there is something about which the doctors are concerned on her mammogram, she may have to wait a couple of weeks for an appointment. That woman is obviously subject to unnecessary worry and anxiety. The worst thing about any form of diagnosis is when the doctor says, "We think you have a problem, but we're not sure; we'll need to see you again in two to three weeks' time." That causes a great deal of anxiety.

The key point is revealed by the following figures. Since 1987, 5 million women—a staggering figure—have been screened. Of those, 270,000 have been recalled for further assessment. That does not mean that those 270,000 women had cancer, because just 20,000 of them were identified as suffering from it. I questioned witnesses in the Select Committee about those figures and drew to their attention the fact that that means that for every woman identified by screening as having breast cancer, a further 12 went through an awful lot of anxiety. The thing that surprised me was that a strange atmosphere then descended on the Committee, as though the witnesses had never heard of those figures before. I am concerned about that.

I understand the medical profession's proper desire to ensure that the screening programme works properly and succeeds in identifying those women suffering from cancer, thus preventing them from dying. That is a fantastic achievement, but I do not believe that the profession has paid enough attention to the flip side of the coin—the anxiety caused because the screening programme fails to reduce the number of false positives. That is an important issue.