To ask the Secretary of State for Health what was the average life expectancy in 1979; and what it is currently. [13304]

Life expectancy in 1979 was 70.4 years for men and 76.5 years for women in England and Wales. By 1993, those figures had risen to 74 years and 79.3 years respectively.

Does my right hon. Friend agree that the blessing of a longer life results from two factors: first, Government policy, which has meant that an additional 1.5 million patients have been treated each year, 800 major building projects in hospitals have been brought on board, a greater range of treatments have become available and quality in hospitals has improved; and secondly, the skill and the dedication of nurses, doctors, carers and managers who operate hospitals?

My hon. Friend is precisely right. We have seen a dramatic improvement in life expectancy and the quality of life enjoyed by many citizens as a result of the success of the national health service. He is quite right to draw attention to that measure of its success, which is in the end the measure that matters to the patient.

Is the Minister not aware that life expectancy has improved in every decade this century? Since it improved less in the past decade than in some previous decades, what is so special about the figures?

I would have hoped that the hon. Gentleman, who has not only worked in the health service but espouses its cause, would have wanted to join an all-party celebration of the success of the NHS.

To ask the Secretary of State for Health what proportion of NHS patients are covered by general practitioner fundholders in the Northern and Yorkshire region. [13305]

Forty per cent. of the population in the Northern and Yorkshire region are registered with general practitioner fundholders. We expect that to rise to more than 50 per cent. in April.

Does my hon. Friend agree that fundholding has driven the way through and enabled greater emphasis on a primary care-led NHS, from which all patients benefit? Is he aware, for example, that one first-wave fundholding practice in my constituency has its own consultant clinic for neurology, which treats patients from other practices, whether fundholding or not? Does that not show just how good the NHS is becoming under the Government, and that the best way to secure it is to vote Conservative at the next election?

I disagree with my hon. Friend only in one respect. Voting Conservative is not the best way to secure fundholding GPs under the next Government: it is now the only way, because the Labour party is pledged to abolish fundholding.

Order. I must tell the Minister that his comments did not relate to the question. I may shortly have something to say about hon. Members and Ministers who stray far away from the questions on the Order Paper.

Does the Minister acknowledge that, in the Northern and Yorkshire region, a two-tier health system is operating? Will he confirm that the Central Sheffield Universities Hospitals trust provides conclusive evidence that there are two tiers? Cardiology patients of fundholders wait nine weeks, while those of non-fundholders wait 26 weeks. For hip replacements, patients of fundholders wait 12 weeks while those of non-fundholders wait 26 weeks. Can the Minister justify that, or is he saying that fair waiting lists and a one-nation health service have been abandoned for a two-tier health service—a fundamental part of the unacceptable face of Tory health policy?

No, I will not attempt to justify those figures, because they are wrong. Had the hon. Gentleman bothered to read his newspapers this week, he would have seen the purchasing authority's precise reply, which stated exactly what happens between fundholders and non-fundholders and in relation to waiting lists. I shall return to that topic in today's debate. The truth is that non-fundholders' patients are doing marginally better than those of fundholders, so the hon. Gentleman had better be careful when he peddles muddled facts.

Will my hon. Friend give the House an undertaking that he will not give funds to fundholders in the Northern and Yorkshire region, or anywhere else for that matter, towards the costs of surrogate motherhood on the NHS? Does he agree with me that, sad though the circumstances are surrounding the woman in question, the estimated cost of £15,000 would be better spent on other priorities?

I understand the point made by my hon. Friend. That matter raises difficult ethical issues. I can tell her that we shall carefully examine the issues which have been raised in the British Medical Association document and look at those which have been raised more widely.

To ask the Secretary of State for Health what estimate he has made of the growth in the private health market since 1979. [13306]

The value of the private acute health-care market has increased from an estimated £132 million in 1979 to more than £2 billion in 1994 according to Laing's "Review of Private Healthcare".

I cannot recall which party the Minister was in when Margaret Thatcher stood at the Dispatch Box and said that she wanted to make the NHS so good that no one would want to take up private medicine. However, that really has not come about—he has just told us of the enormous growth in the private medicine market. Since Tory reforms, about £1.5 billion has gone out of the NHS to pay for private treatment. Does the Minister accept that that is obscene when people who are waiting for operations can hear radio advertisements which tell them that, if they go private, they can get an operation, and, moreover, that they can borrow the money to pay for it under a finance arrangement? That is obscene, and the Minister should feel ashamed. He has not only let the people of this country down: he has betrayed the words of the blessed Margaret Thatcher.

I thought that, these days, the Labour party believed in choice. The hon. Gentleman said in today's Evening Standard that he would like to spend his money on skin toners and vitamins. Why are not other people allowed to make their choices and have waiting times cut and their surgery earlier?

Is my hon. Friend aware of the recent Institute of Fiscal Studies report which found that long waiting times for NHS treatments boost the take-up of private health assurance? Does he agree that the dramatic decrease in 12-month waits, from 20 per cent. of patients to only 2 per cent., is a stunning achievement which strengthens the NHS?

Those figures are absolutely right, and they reinforce the point that the hon. Member for Newham, North-West (Mr. Banks), who tabled the question, should have done his homework. He will find that the private sector is, in fact, getting extremely tough competition from the NHS for precisely those reasons.

To ask the Secretary of State for Health what estimates have been made of the savings resulting from the abolition of the regional health authorities; and if he will make a statement. [13307]

By 1997–98, total annual savings from the abolition of regional health authorities are expected to be around £100 million a year. A further £50 million a year has also been saved from the creation of single health authorities at local level. These substantial savings will be retained by the NHS and spent on improved patient care.

I thank my right hon. Friend for his reply, and warmly endorse his determination to remove an unnecessary tier of bureaucracy in the NHS. Will he reaffirm that Conservative Members believe—that the Government strongly believe—in putting patients first, in putting money into medical provision, and not into unnecessary bureaucracy?

Yes, my hon. Friend is right. We believe in an efficiently run health service, in which the administration function is subject to exactly the same efficiency scrutiny as that to which managers subject all the other activities of the NHS. It is because we are engaged in that activity that, over the next few years, an extra £300 million will be devoted to improving patient care in the NHS.

How can we rely on the figures that the Secretary of State has just given the House, given that he misled the House during the previous Health Question Time? Will he now admit that, contrary to what he said last time, no new beds have been opened in Consett, no new beds have been opened in Good Hope, no new beds have been opened in Newham general and no new beds have been opened in Chester? We believe in a Secretary of State who tells the truth about the national health service.

The hon. Lady is wrong on every one of the examples that she cited. What I told the House was exactly what happened—that, faced with an increase in the emergency work load, the managers in each of those hospitals provided extra bed space to ensure that it was dealt with. I should have thought that the hon. Lady would recognise that as good management delivering a good service to NHS patients.

Is my right hon. Friend aware that, as a result of changes in the regional structure, it was expected that some £11 million extra would be available for patient care in West Sussex? This is a matter of great importance to my constituency, because Worthing is the most underfunded district in the country-13 per cent. below capitation compared with 9 per cent. elsewhere. It now appears that a high percentage of that money will not go to reduce underfunding in the most underfunded district, but will go elsewhere. If the matter cannot be resolved, will my right hon. Friend receive a deputation?

Of course, I am always ready to receive a deputation led by my right hon. Friend, who has been a relentless and assiduous exponent of the interests of Worthing. I am sure that he will recognise that, as a result of last year's public expenditure survey settlement, West Sussex district health authority's allocation reflected a growth rate that is very much faster than the national average, reflecting the fact that Sussex is a below-target area. Worthing will benefit from that reallocation of resources in favour of Sussex, reflecting the operation of the weighted capitation formula, but I look forward to receiving my right hon. Friend's delegation.

To ask the Secretary of State for Health how many patients were transferred from the Royal Liverpool hospital to Broadgreen in the last six months. [13308]

Between 1 April and 31 December last year, the most recent period for which figures are available, the total was 483.

Is the Minister aware that since the closure of Broadgreen's accident and emergency centre—against the wishes of community health councils and, indeed, of the local communities which fought a long battle to retain that particular facility—all patients now have to go to the Royal Liverpool hospital for assessment before they are moved on? That includes stroke patients and those with heart problems. They have to ride in an ambulance from one side of the city of Liverpool to the other which, as anyone with any common sense will agree, puts them at risk. That is especially true of the type of patients to whom I referred. Is it not a fact that the Minister and the Government do not know what is going on in the national health service? They have abrogated responsibility for accountability. When will they tell us why the chief executive would not answer a very simple question—[Interruption.]

Order. The hon. Gentleman must resume his seat. This is not an Adjournment debate, but Question Time.

If I am allowed to say something, perhaps I could calm the hon. Gentleman down. We do know what is going on. The hon. Gentleman talked about the 483 people who were transferred between the two hospitals which are, after all, in the same trust. Only two were A and E transfers; 238 were being transferred to the recently opened rehabilitation unit at Broadgreen. I thought that the hon. Gentleman might have welcomed that, as well as the fact that, as a result of recent investment, the Royal Liverpool hospital's A and E capacity has increased from 80,000 to 120,000 patients a year.

To ask the Secretary of State for Health what steps he is taking to increase the speed at which those who suffer a cardiac arrest receive treatment. [13309]

The Department will continue to work with the national health service to find ways of speeding the delivery of treatment to patients.

What kind of national health service is it when a man collapses with a heart attack in the centre of one of our major cities, is refused by 12 or 14 hospitals, and has to be helicoptered to a far-off town to receive treatment? That is not an isolated incident, because, as the Minister knows, there is a lack of slack—that is what the British Medical Association calls it. There are not enough intensive care beds to deal with that kind of emergency, and there are not enough nurses to support the intensive care units. Last week's decision to give nurses a measly 2 per cent. will not help recruit many more.

I beg to differ from the hon. Gentleman. That incident was isolated, but important. Isolated incidents are vital for those involved, and I understand that the hon. Gentleman will meet my right hon. Friend the Secretary of State on 23 February to discuss that matter. Intensive care has grown rapidly in recent years, and the number of intensive care beds has risen by 100 since 1989. The number of nurses working in intensive care has increased by more than 1,000 since 1990. Other bodies of work are being undertaken by the Department of Health that will show us how we can better use the intensive care facilities that we have.

Will my hon. Friend send congratulations to the Lancashire Ambulance Service NHS trust, which I visited last year? It has invested a vast sum of money in a sophisticated tracking system so that it can deploy ambulances around that large county to ensure that they get to those patients who need ambulances most urgently.

Yes, I am happy to do that. My hon. Friend raises an important point about the need to provide care as quickly as possible to people who suffer from cardiac problems. Some of the essential components include improving response times—that is happening, as my hon. Friend points out—and putting paramedics in ambulance teams. The whole question of the provision of emergency care outwith the context of an acute hospital is being considered by the chief medical officer, who will report to Ministers in due course.

If there are no beds to receive patients, it does not matter how good the ambulance service is, because there is nowhere for the patients to go. Is not the difficulty that, since the NHS has been run as a business, new, lean-production techniques have abolished all the spare beds, so there is no capacity if sudden accidents or emergencies arise? Is not that the basic problem that is now emerging in our health service?

It is rather bizarre that the hon. Lady makes that point in the context of the number of intensive care beds rising steadily in recent years. She makes a false point. Much of the work that has to be done is to make better use of the facilities that are available. For example, following the Wells report, procedures have been set up to share intensive care beds in London. Sensible use of existing facilities can improve performance in an expanding service.

To ask the Secretary of State for Health if he will make a statement about the impact of the private finance initiative on the hospital building programme. [13310]

The NHS has so far seen schemes worth more than £200 million approved under the private finance initiative. The momentum is increasing, and is providing modern tools to NHS professional staff to allow them to deliver an ever-improving quality of health care to patients.

Is my right hon. Friend aware of the warm welcome that has been given in the South Buckinghamshire NHS trust, which I visited last week, to the £35 million rebuilding programme for High Wycombe and Amersham hospitals, announced under the private finance initiative late in 1995? Does my right hon. Friend agree that that welcome project will provide improved services for patients and better working conditions for NHS staff? Does he also agree that the project provides a telling contrast to the policy of savage cuts in hospital building that was imposed by the Labour party when it was in office?

My hon. Friend is precisely right on each count, and I shall add one more. The project to which my hon. Friend refers has commanded widespread support among the clinical fraternity working in the same hospital because they understand that the PFI route that has been chosen by the trust offers the best prospect for them to improve the quality of care provided to their patients.

The only one.

The hon. Gentleman says "the only one"—the Government have increased state-funded capital expenditure in the NHS by 80 per cent. in real terms over the figure that they inherited. We have further improved the prospect of capital investment by abolishing the controls that were the necessary concomitant of the old-fashioned means of capital planning.

Does the Secretary of State recognise that that sort of initiative is often not appropriate in many scattered and rural communities? Will the Secretary of State make it clear that public finance should be available where trusts start to adopt that policy and find that the necessary money is not available?

Public finance remains available to support the capital investment programme of the NHS. But we are looking for partnerships with the private sector to allow us to modernise the capital stock for NHS patients wherever they need their health care. I do not agree with the hon. Gentleman that there is any reason to sign rural patients out of that deal. The PFI offers the best prospect for improving the capital stock of the national health service wherever its patients need health care.

Does my right hon. Friend agree that the PFI is an excellent way to lever capital from the private sector into the health service? Could he rationalise the recent actions by the hon. Member for Peckham (Ms Harman) with her statement on the "Today" programme that the PFI provides a ramp for privatisation in the health service?

My hon. Friend is on to an important point. The Labour Front-Bench team seems to be in difficulties. The Leader of the Opposition said in the House that the PFI was "right in principle". The hon. Lady says on the "Today" programme that the PFI is a new trick to privatise the health service. Presumably they cannot both be right.

Are not clinicians in this country suspicious of the PFI and what is behind it? A few months ago, the Secretary of State said that clinical services would not be run by private companies. But clinical services are currently being privatised by the use of market testing. When will the Secretary of State stand up in the House and give a definition of clinical services? He knows, as I do, that many clinicians are suspicious that the measure is no more that a vehicle to privatise the national health service.

The hon. Gentleman is completely wrong. In my answer to the original question I referred to the fact that where a set of clinicians was presented with a specific proposal for the modernisation of its hospital, it did not simply accept it, it warmly embraced it because it saw an opportunity to improve the service available to its patients. As to the hon. Gentleman's question about what a clinical service is, and, indeed, what a clinical support service is—which the hon. Gentleman did not mention, although he might have done—they are both well-known terms of art within the health service. The scope of those terms is well defined.

My right hon. Friend will know from the county that we both represent that there have been tremendous improvements, both in terms of new building and rebuilding, at the major acute hospitals in Leicestershire: the Glenfield general, the Leicester general and the Royal infirmary. Will he confirm that he will do all in his power to influence the health trusts in that county to make use of the PFI further to improve the capital building project system in our county?

I can certainly assure my hon. and learned Friend that exactly the same opportunity is open to all the Leicestershire health trusts, as to every other trust throughout the national health service, to use access to both private capital and private management of health service facilities to give NHS clinicians the tools to improve the quality of care available to NHS patients. The PFI offers the national health service an escape from the bind in which it has been caught since the day it was established—short-term capital planning being dictated by short-term, Treasury-inspired horizons. We are now free of that as a result of the PFI, and I should like to have seen Labour Members celebrating that freedom.

To ask the Secretary of State for Health what recent assessment he has made of the provision of care to elderly people living in the community. [13311]

To ask the Secretary of State for Health what guidelines he has issued about the provision of care to elderly people living in the community. [13316]

Various guidelines have been issued to local and health authorities in relation to the care of elderly people.

Can the Minister confirm that 40,000 old people have had to sell their homes to finance their care in old age, and does he agree that, therefore, a whole generation has been betrayed, especially those who fought in the second world war, who were promised a better Britain and care from the cradle to the grave? They now find that they must pay twice for their care in old age; they have already paid once through their taxes, and now they must pay once again through private provision.

The people who fought through the war then lived through a Labour Government, and it was the Labour—[Interruption.] The hon. Gentleman may think that that is funny now, but many people remember that with horror.

Would that we had the welfare state that was introduced by Labour in 1945.

May I welcome the hon. and Scottish Lady to English Health questions? I suggest to her that, if Beveridge, Bevan and others were alive today, they would be astonished at the rates of investment by the taxpayer in the care of elderly people, and they would notice that, in the past six years, investment in personal social services has increased from £3.6 billion to £7.4 billion—I suspect, more than either of those two gentlemen would ever have dreamed of.

To ensure that the resources devoted to community care are used in the most cost-effective manner, should not local authorities be required to publish the true cost of care in residential homes run by local authorities, so that a comparison may be made with similar residential care provided in the private sector?

My hon. Friend makes an interesting and valid suggestion. When those who are interested in value-for-money reviews of social service provision—not least the Audit Commission and district auditors—seek to discover whether that value is being provided by a local authority, they need to be able to compare like with like. It is easy to see the price of residential care in the private or voluntary sectors; it is very difficult to see the price in the state sector. That is something that we shall certainly inquire into and which may emerge from our review of inspection regulation as a whole.

On the subject, not of residential care but, care in the community, does my hon. Friend agree that the social services budget has doubled in the past six years? Can there be any excuse for county councils such as Liberal-controlled Dorset increasing their charges for home care help and all other aspects of care in the community and spending the resulting funds on unrelated services? Is it not time to reconsider responsibility for social services? Is there not a strong case for social services to move over to community trusts, which are non-political and not manipulated by Liberals?

My hon. Friend makes a long-term suggestion of a solution. It is true that, in the county of Dorset, during the last six years resources have increased from £43 million to £93.8 million. Those resources are fair by anyone's standards.

By passing the buck to individual health authorities and allowing them to decide eligibility criteria for long-term care, have not the Government created a lottery in health provision for elderly people? Do not the care that elderly people receive and the price that they pay for it now depend on where they live? When will the Minister take responsibility for defining the boundaries between provided and paid-for care, so that once again we have a one-nation national health service where access to care is a matter of right and not a matter of chance?

The hon. Gentleman is right to point out the distinction between social care and health care, which was introduced by the Labour Government in 1948. We want a fair system and we shall be as open as possible about the definitions on either side of the dividing line. That is why we have introduced our guidance in that regard, which has been widely welcomed, and why authorities up and down the country have been consulting on the future eligibility criteria for those services.

I pay tribute to my hon. Friend's commitment to the care of the elderly in the community. However, does he accept that today many elderly people must pay for services which, until relatively recently, they received free under the national health service? Will my hon. Friend join me in campaigning for some form of assistance for those people—whether it is through fiscal means or other ways—which will help them to meet the cost that they must now pay for care that is essential for their health and well-being?

My hon. Friend is right: one of the great successes of our health service is that many people who would have spent their last days in geriatric wards are now able to have operations, receive treatment and take new medication which allows them to return home or to a homely setting. That is a triumph for the health service. Taxpayers—and the Government on their behalf—must now plan ahead to ensure that the cost is reasonable and affordable and that they make the necessary preparations to meet it. I believe that we have taken those steps through our various announcements, both before and in the Budget.

To ask the Secretary of State for Health what is his estimate of the average waiting time of accident and emergency visits at hospitals in London; and if he will make a statement. [13312]

Information is collected to monitor patients charter standards, which cover initial assessment and accident and emergency departments. Patients requiring emergency treatment are always treated immediately. National health service trusts and health authorities are working together to ensure that all patients attending accident and emergency departments are seen as quickly as possible.

Is the Minister aware that there is increasing concern all over London about the length of time that people spend in accident and emergency departments awaiting treatment? In view of last Friday's tragedy in east London, should not the Government reappraise the proposal to close Edgware accident and emergency department and consider reopening St. Bartholomew's accident and emergency department, so that Londoners may be secure in the knowledge that at least they will receive treatment at a nearby casualty unit, rather than being shuttled miles away in ambulances through a very congested city?

The accident and emergency and all other services performed magnificently in light of last Friday's tragedy, and I add my thanks to those that have been expressed already in the House.

Does my hon. Friend accept that we need no lectures from the Labour party on how to run a modern health service, as when the Labour party was last in power it closed or reduced 60 hospital units a year? Does he agree, however, that there are legitimate anxieties about future provision at Edgware general hospital, and that there is every reason to keep its accident and emergency facilities intact?

I understand that there are legitimate anxieties, but they have been discussed with my right hon. Friend and properly taken into account.

To ask the Secretary of State for Health if he will take measures to improve the morale of nurses in the national health service. [13314]

High-quality health care requires high-quality clinical staff. That is why NHS trusts have greater freedom than ever before to reflect and reward the valuable contribution of highly motivated and skilled nurses.

Is not the Government's commercial approach to the health service making the professional lives of nurses quite intolerable? Is it not time that the Secretary of State took action to help our nurses, who are now under great strain because of Government policies?

The hon. Gentleman says that it is time that the Government took action. The Government have taken quite a lot of action over the past 16 years to improve the lot of nurses in the national health service. If the average nurse were now paid what he or she was paid in 1979, he or she would be paid £186 a week. A nurse now receives £311 a week. On average, nurses in the national health service today are £125 a week better off at today's values than they were when the Labour party left power. That is a single proposition for every nurse in the national health service to think about this evening.

Does my right hon. Friend agree that nurses' pay was reduced by 23 per cent. in 1976? When that lot were last in power, not one hospital was opened in 1979, thanks to the National Union of Public Employees and the Confederation of Health Service Employees, and if a loved one died in 1979 we could not even get him or her buried? When that lot were last in power, the national health service was a total fiasco.

My hon. Friend, as ever, is accurate and rapierlike in his comments. Once again, he has underlined the central fact that, when nurses compare the records of the two parties, they will remember that the Labour Government cut nurses' pay and that the Conservative Government have increased the average earnings of a nurse in the national health service by £125 a week in real terms. Those are 125 reasons for supporting the Government in the development of the national health service.

The figures that the Secretary of State gave the House may be correct, but if two thirds of hospital trusts report difficulty in recruiting nurses, 75 per cent. of nurses regard staffing levels as too low to give adequate care to patients and 20 per cent. of nurses regard staffing levels as dangerously low, how will a below-inflation award of 2 per cent. assist either the recruitment of the additional nurses we need or the retention and morale of the nurses still in the NHS?

I have always thought that, like the Labour party, the hon. Gentleman and his party supported the principles of review bodies. The review body looked at exactly the case that the hon. Gentleman has set before the House—the proposition that there is a shortage of nurses in the NHS. It found there was not a generalised shortage, but isolated local shortages. The review body recommended in unambiguous terms that the right way to deal with the shortages was by locally negotiated pay in a national context. That recommendation has been accepted by the Government in full, and we are acting on it.

Will my right hon. Friend confirm that the worst thing for nurses' morale would be the election of a party that had no policy on NHS revenue funding, capital funding or primary health care?

My hon. Friend is exactly right. It becomes more and more obvious, week after week, that where there should be a national health service policy among Labour's Front Benchers, there is a vacuum.

To ask the Secretary of State for Health if he will make a statement about the provision of long-term residential beds for the elderly in the Cambridge and Huntingdon health authorities. [13315]

Cambridge and Huntingdon health authorities, in common with all others, have been consulting on and reviewing local provision for people with continuing health care needs.

Why will beds be lost at Brookfield and Chesterton hospitals in Cambridge, when there is already an estimated 1,350 shortage of nursing home and long-term residential beds? What will people in the Cambridge and Huntingdon health commission areas do if no alternative provision is made before those beds are lost?

People will be pleased to know that the local health commission has decided to invest a further £1 million in the area, and that the region is considering further support from the strategic charge levy fund—which will enable exactly that sort of planning.

To ask the Prime Minister if he will list his official engagements for Tuesday 13 February. [13333]

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

Will the Prime Minister accept from me that the national health service is holding together at this moment only because of the dedication and good will of its professional staff? In Wolverhampton, beds and wards have been closed, staff have been made redundant, and accident and emergency services have been closed dozens and dozens of times in recent months. May I assure the Prime Minister that the good people of Wolverhampton do not regard the health service as safe in his hands?

I am surprised that the hon. Gentleman chooses this day of all days to make that old charge. As was announced yesterday, the number of patients facing waiting times in excess of one year has fallen yet again. There are now only 20,000 people waiting more than 12 months. Five years ago, the figure was 187,000. People are getting treated quicker, better and more comprehensively at all levels in the health service than ever before. It is about time that Opposition Members—I do not mean only the hon. Gentleman—realised the tremendous advances made in the health service by doctors, nurses and administrators in the treatment of people from one end of this country to the other.

Is my right hon. Friend aware, from The Mail on Sunday, that the hon. Member for Dundee, East (Mr. McAllion) was persuaded to vote against the new clause IV relationship on the ground that it was only a change of words?

Oh.

Order. The hon. Gentleman must ask the Prime Minister a question on a matter for which he has responsibility.

Does my right hon. Friend agree that the change in words with which the hon. Member for Dundee, East disagreed was typical—[Hon. MEMBERS: "Order."] Does my right hon. Friend agree that a change in words often disguises a change in meaning?

I do not regard the hon. Member for Dundee, East as the only voice of the Labour party, but I am sure that my hon. Friend is correct: we are increasingly learning that we get a different Labour policy depending on which Labour Member writes it.

Will the Prime Minister agree to the request that has been made by Members of Parliament on both sides of the House—and now, very strongly, by Sir Richard Scott—that the Scott report be published at 2.30 pm rather than 3.30 pm on Thursday? Members of Parliament will then have an opportunity to study the report before commenting on it.

The right hon. Gentleman knows that that is not the way in which the Government, or our predecessors, have conducted business in the House. The proposed arrangements are in line with the usual practice of publishing a report and making it available to hon. Members at the same time. The Government have arranged for there to be a debate, in Government time, 10 days after the publication of the report. Hon. Members will therefore have time to absorb and to understand the report and will be able to speak to it with knowledge rather than with ignorance—which is what Labour Members have done for the past three years. There will be a full and open debate on the report.

The Prime Minister has relied on precedent. I suggest that a report containing 1,800 pages and of this complexity is almost without precedent. Ministers having a report for eight days before anyone else is also without precedent. The campaign to discredit the judge who conducted the inquiry—before the report has been published—is also without precedent. Will the Prime Minister reconsider the request? The refusal to allow Members of Parliament this facility, on the day that the report is published, effectively disables them and prevents them from holding the Executive to account and discharging their duty both to Parliament and to the country.

The right hon. Gentleman is quite mistaken, and he knows that. The Government will answer questions about the Scott report on the day that it is published, and we will debate it when all hon. Members have had time to study it. The right hon. Gentleman referred to a campaign to discredit the report before it is published. That campaign has come from the the hon. Member for Livingston (Mr. Cook) and the right hon. Member for Kingston upon Hull, East (Mr. Prescott), the deputy leader of the Labour party. Without a single scruple, time and time again, the Labour party has made it clear what it believes will be the outcome of a report that has only just been concluded. If anyone has prejudged the report, it is not the Government but the right hon. Gentleman and his colleagues—and the right hon. Gentleman knows that to be the case.

Does not what the Prime Minister has just said—in a ridiculous attempt to blame Opposition Members—underline why we should have the Scott report early, so that people can comment on it? In the interests of proper parliamentary democracy, will not the Prime Minister reconsider hon. Members' request, especially as it is backed by the inquiry judge?

As for the Government having had the report, the right hon. Gentleman knows that the House will expect my right hon. Friend the President of the Board of Trade to be at the Dispatch Box to answer questions, quite properly, put by the House when the report is published. That is why the Government have the report in advance. The right hon. Gentleman knows that that has been the position under both Conservative and Labour Governments for as far back as he may care to remember. He is trying to twist public opinion before the report is published, just as his hon. Friends have done for the past three years. The report will soon be published, and Labour Members will have to consider the issue on the basis of fact.

Is my right hon. Friend aware that the privatised utilities are such a good investment that, while slagging off British Gas and Yorkshire Water, a group of Labour councils in West Yorkshire—notably Leeds, led by the hon. Member for Hemsworth (Mr. Trickett)—were investing 170 million of their pensioners' money in those companies? Is that not a classic case of saying one thing and doing another?

I congratulate the unions on making a successful investment. I live in hope that the day will yet come when the Opposition recognise that, if they talk about the virtues of the market, they ought to support private ownership, not attack it on every conceivable occasion as they have been doing.

Leaving aside for a moment the interests of the House, will the Prime Minister at least consider the interests of his civil servants? How can it be right that Ministers, who can defend themselves in public, have eight days in which to read this 1,800-page report and prepare their defences, while civil servants who are criticised may not get even six hours?

Let me explain what has been agreed, so that I can remove the misunderstanding from the right hon. Gentleman's mind. At present, the report has been made available only to Ministers or civil servants who need to see it in order to help to prepare the Government's response to questions in the House—[Interruption.]

Order. The House must come to order and listen to the answers.

That is the fact of the matter. Other Ministers and former Ministers and civil servants have not had access to the report. That is how the matter has been dealt with; it is an entirely proper way to deal with the report—we have dealt with it entirely properly.

Will my right hon. Friend confirm that he has no plans to introduce a parliament in Edinburgh? It would leave Westminster Scottish Members with very little to do, because most of their business would be devolved; so they would become part-time, and should probably be paid part-time. They would also avoid paying the tartan tax, because they would be based in London.

My hon. Friend makes a sound point. The advocates of a Scottish Parliament among the Labour party who live in London would not themselves have to pay the extra tax that would be levied on everyone else living in Scotland. I can certainly confirm that we have no plans for such an assembly, or for such a tartan tax, or to allow Scottish Members to vote on matters in Scotland on which English Members cannot vote, and then to permit Scottish Members to come to the House and vote on similar matters for England, Wales and Northern Ireland. I can also confirm to my hon. Friend that, were anyone to introduce such plans, that would be the most blatant gerrymandering of the constitution that we have ever seen.

To ask the Prime Minister when he next plans to visit the royal docks. [13334]

I have at present no plans to do so.

When the Prime Minister does visit the royal docks, will he also visit the adjacent Silvertown fire station, whose crews joined their colleagues in Millwall on the Isle of Dogs at the tragic incident on Friday? Does he know that crews at both stations, not to mention the inhabitants of docklands, face the prospect of having the two appliances at each station reduced to one? Does he recall that his name appeared at the top of a successful motion at 10 o'clock last night, calling on local authorities to exercise their freedoms responsibly? If he were charged with denying them those freedoms, because of the policies of the Government towards the public services, what would he say?

Of course the hon. Gentleman is right to say that we require councils to exercise their freedoms and opportunities responsibly, but there must also be fallback powers for when that does not happen:

"we believe there must be fall-back powers to enable central government, in extreme circumstances, to protect council tax and business rate payers".

indicated dissent

I was quoting a Labour policy document, so I am sorry to see that the hon. Gentleman disagrees with it.

To ask the Prime Minister what recent analysis he has made of economic indicators and their effect on Lichfield; and if he will make a statement. [13335]

Lichfield has benefited fully from the Government's policies, which have given this country the lowest mortgage rates for 30 years, the lowest basic rate of tax for 50 years and the longest period of low inflation for 50 years. Unemployment in my hon. Friend's constituency has now fallen by some 40 per cent. from its peak.

Is my right hon. Friend aware that Lichfield is not only a beautiful cathedral town but a centre for light industry? Is he further aware that people in Lichfield will be heartened by the report in The Times today which showed that the average net take-home pay of production workers in France, Italy and Germany is now less than that in the United Kingdom? Is that not because we have consistently refused to enter into an agreement on the social chapter? Does my right hon. Friend agree that, under a Labour Government, workers would suffer, because the Labour party's idea of negotiating in Europe is rather like the Trustee Savings bank—it is the party that likes to say yes?

They certainly were very startling figures to set out what net take-home pay will purchase, which was the basis on which they were done. That stands in stark contrast to the claims of a sweatshop economy about which we so often hear from the Labour party. It is no coincidence that those figures were achieved. Business is attracted by flexible working practice and low cost—precisely the benefits that would be wrecked by the social chapter as it is and by the social chapter as it would be if any Government were to sign up to it in this country. This Government will not.