I express my appreciation and that of members of the current Select Committee on Health for the opportunity to debate in detail the reports produced in the previous Parliament on children's health. I particularly thank those hon. Members who, like me, have been up all night for their presence at the debate. It is a tribute to their commitment to the issues that we shall be discussing.

I find myself in the unusual position of introducing a debate on four reports produced by a Committee of which I was neither the Chair nor a member. Therefore, my introduction will be somewhat general. However, I am delighted to see in the Chamber two Committee members from the previous Parliament: the former Chair, the hon. Member for Broxbourne (Mrs. Roe), and my hon. Friend the Member for Preston (Audrey Wise), who devotes great energy to this issue. I know that they will address in detail many of the points picked up by the Committee.

For the record, the Health Committee's inquiry ran from February 1996 until March 1997—just before the general election. It received some 500 submissions and conducted 19 oral evidence sessions. It is fair to say that it was a very thorough inquiry; the hon. Members involved deserve our congratulations on considering serious concerns in depth. The Committee issued four reports. The first two were published on 27 February 1997, and the final two were published on 18 and 26 March 1997. In an effort to conclude the inquiry, the Committee met 29 times in a four-month session shortly before the general election.

The reports from the 1996–97 Session covered a range of areas. The Committee's second report addressed the specific health needs of children and young persons; the third report dealt with home and school; the fourth report addressed mental health services; the fifth report considered hospital services. In introducing the debate, it is obviously important to stress that the contents of the reports refer to the policies of the previous Government. I pay tribute to Ministers in the new Government for the way in which they have picked up many issues raised by the Committee.

Last July, my hon. Friend the Member for Preston and I met the Minister of State, Baroness Jay, and had detailed discussions with her in the Department of Health. We are also grateful for the formal response that the Government gave in November to the recommendations in the reports.

As a background to the debate, I particularly welcome the efforts of the Select Committee in the previous Parliament. I welcome also the chance to discuss the contents of its reports. It has been my long-standing concern that Parliament rarely gives detailed consideration to child welfare and children's health. There are few debates on those subjects, so it is commendable that we have the chance this morning—I hope that we shall have more chances in due course—to examine an area that is much neglected.

It is said that children should be seen and not heard, and I believe that that saying typifies the attitudes to children's issues that have prevailed in this place—certainly during my time as a Member—until very recently. For generations, little consideration was given to the key concerns of children and young people.

One reason for that attitude is that, until recently, the overwhelming majority of Members of Parliament were male. Some of the male membership wrongly held the view that child care is a women's issue rather than an issue for men and women; but that attitude is changing. During my time in Parliament—and at 5 o'clock this morning, when we were discussing corporal punishment—I have been struck by the number of hon. Members, especially Conservative Members, who still place their children in private boarding schools. They probably have less contact with their children in term time and less knowledge of their children's concerns than I have. I am generalising. I accept that that does not apply to all Conservative Members, but a significant number of them have dispatched their children to school. Parenting at home has perhaps been second hand, because nannies have taken the bulk of the responsibility for the care of the children.

I welcome the radical changes that have occurred since the general election, such as the great increase, certainly on the Labour Benches, in the number of women Members of Parliament. The impact of that will be far greater consideration of wider issues of family policy, and of the health and well-being of children and young people.

Perhaps it is because I have reached middle age or beyond, but I also welcome the radical reduction in the average age of Members, which will afford us far more opportunities to discuss the concerns of children and young people. It is a particular delight that several of my female colleagues have just had or are expecting babies. That is healthy for Parliament, because their experiences of the health service and of caring for young children will be brought to bear in debates. In the past, opportunities to debate a huge area of policy have been missed because the vast majority of hon. Members, because of their age or background, had no direct experience of children's and young people's issues.

The changes have resulted in a radical sea change in attitudes. About 10 years ago, I was attempting to persuade the Whips Office that I needed time off to be present at the birth of my second child. There was a good deal of resistance, because the poll tax was coming through. I was told that there would be rebellions by Conservative Members, and that I had to be at the House. My daughter's arrival was delayed, and I was able to be present at the birth. My discussions with female colleagues who have recently been through those experiences suggest that there has been a radical change in the views of parliamentary business managers, which bodes well for future discussions about children and young people.

Members of the Select Committee will reinforce the fact that the overall picture of children's health and well-being is encouraging. The figures in the reports show falling mortality rates and marked improvements in the ability to treat children with diseases and to reduce the extent of those diseases in a range of ways. From our different perspectives, we all welcome those advances, which have been delivered relatively recently.

Nevertheless, the Select Committee has identified several key anxieties that relate to wider policy areas outside those for which my hon. Friend the Minister for Public Health is responsible. For example, the number of children who are killed and injured in road traffic accidents is alarming. That tragedy should be urgently addressed, and we must consider our personal transport habits. There has been a rapid increase in childhood asthma. I regularly visit schools in my constituency, and virtually every classroom has a supply of inhalers. It is tragic that such young children have been affected by problems that, in many areas, are directly related to traffic levels and pollution.

Transport policy must be reappraised radically if we are to have an effect on the health of young people, and I welcome the fact that the Government are soon to publish a White Paper on it. With regard to respiratory problems and asthma, I also welcome the steps that the Government are taking to reduce smoking. I look forward to the White Paper on smoking. As the Minister knows only too well, the Select Committee has produced but one report on tobacco so far in this Parliament. We feel strongly that urgent and radical steps must be taken to deal with the effect that passive smoking has on the lives of children and young people.

The Select Committee identified the mental health problems of children and young people as a key anxiety, and wider issues such as the increased incidence of family breakdown must be considered when addressing them. I urge my hon. Friend to discuss with her colleagues the apparent conflict between policies introduced by the previous Government, such as that between the Children Act 1989, which had cross-party support, and the operation of the Child Support Agency. The 1989 Act is underpinned by the welfare principle—the welfare of the child should prevail in relationships with the state and the natural family—but the CSA operates in such a way that children's welfare is the last thing to be considered. I see that too often in my constituency: CSA interventions often cause conflicts that damage children's welfare, and there is a knock-on effect on their well-being.

My personal anxiety about the mental health problems of children and young people is that we increasingly place far more pressures and stresses on them than we did when I was a youngster. Children do not have anywhere near as much freedom to enjoy childhood as I had. We make them grow up a great deal sooner, which is directly connected to the sad increase in mental health problems.

Eating disorders, especially among teenage girls, are a consequence of body image and the way in which the media reinforce what is expected of girls and, to a lesser extent, boys. The drug and alcohol culture has developed beyond that of the 1960s and 1970s, when I grew up.

The Select Committee rightly highlighted areas for specific action which my hon. Friend the Member for Preston and the hon. Member for Broxbourne will want to mention. It identified the lack of comparable data on children's health, which is discussed by the Acheson report on health inequalities. Although Government adult health figures can be compared, a comparison of children's health is not possible. I hope that the Government will rectify that through the health inequalities initiative on which Sir Donald Acheson will report.

The way in which children's services are fragmented over a range of professionals and agencies was emphasised. I had never heard of the children's community nurse service; as far as I know, it does not operate in my area. I was interested to discuss with my hon. Friend the Member for Preston the services that it offers. There are also health visitors, the school nursing service, social services and education services. The Committee is considering the divide between health and social services, and has rightly drawn attention to the fragmented provision and to how problems sometimes slip between the various agencies and professionals.

People in my area recently experienced the problem of the dreaded head lice, which caused great distress to many parents who look after their children and attend to their welfare. That problem arises throughout Britain, and it is difficult to decide who is responsible. Does responsibility lie with the school, the district nurse or the family? We need to consider carefully how to address this distressing, if not serious, problem.

It is obvious from the reports that, in the past, the health service has failed to recognise the separate needs of children. The report on hospital services emphasised that many hospitals do not take account of the specific needs and problems of children and young people.

I have my own interpretation of the Committee's conclusions, but other members of the Committee may take a different view. In my view, the Committee has clearly identified the need for much greater strategic vision in relation to provision for the health of children and young people. The Minister was a member of the Committee, and knows that there is a Cabinet Sub-Committee on Women's Issues. Perhaps we should consider a similar arrangement to oversee children's health and issues pertaining to them.

Perhaps the Minister will give us some information about collaboration between Departments. I served with the Minister, as a shadow Minister. She will remember that, at that time, we had a shadow Minister for children. There is a strong argument for a Minister with specific responsibility for children's issues who can span Departments and draw initiatives together.

Perhaps the Select Committee will consider the issue of a children's rights commission, which has been debated for a long time. It was raised in a recent inquiry into children who are being looked after. I welcome the Government's initiatives on children's health and their willingness to consider the issues that the Committee identified. I appreciate that wider policy changes, in particular the abolition of the internal market, will have a direct impact on the health of children. The expertise in commissioning children's services was discussed in the Select Committee.

I welcome the suggestions in the NHS White Paper on primary care, because they will certainly bring together community services that are currently fragmented. The Budget positively discriminates in favour of poorer families, and we know that there is a direct connection between poverty and the ill health not just of adults but of children.

The Committee's report on children who are being looked after was initiated in the previous Parliament and, because of its importance, was picked up by the new Committee. I hope that the House will debate that report soon. I also hope that this debate will be the first of many that will reflect a new political agenda for children and young people.

I am pleased to be called to speak in this important debate, and to have the opportunity to comment on the four reports on children's health; the inquiries took place when I was Chairman of the Select Committee on Health in the previous Parliament. I thank the hon. Member for Wakefield (Mr. Hinchliffe) for bringing those reports to the Chamber, and for his kind comments. I pay tribute to all my colleagues on that Committee for their constant support and commitment to our work.

It was the first time that the Select Committee had held an inquiry into services for children and young people. Twenty years had passed since the publication of the last comprehensive Government review of children's services—the Court report, "Fit for the Future"—and there had been no major parliamentary inquiry into the subject. That may surprise some people, because media hype about children easily lulls us into the trap of thinking that children, who comprise about a quarter of the population, receive excellent health provision that is specifically designed to meet their needs.

As the hon. Member for Wakefield has said, there is no doubt that the overall epidemiological picture is encouraging. Childhood mortality rates have been falling steadily for more than 100 years and are lower in the UK than in many comparable developed countries. There have also been significant improvements in the incidence and severity of childhood illnesses. However, areas of significant concern remain, and although the number of deaths and injuries from road traffic accidents have declined steeply in recent years, they remain high in absolute terms. There is considerable scope for further improvement, as there is for accidents generally.

There are still problems with respiratory and infectious diseases, and asthma, in particular, appears to have increased over recent decades, for reasons that are imperfectly understood. Mental health problems among children and adolescents may be increasing. Finally, there are the problems of success. Children who, in the past, would have died now survive with varying degrees of disability or need for care.

Unfortunately, the Committee's inquiry also identified areas of major concern and revealed that the specific needs of children were commonly ignored in the NHS. Our overall terms of reference were to consider

"The specific health needs of children and adolescents, and the extent to which those needs are adequately met by the National Health Service".

We identified several major themes that were common whichever aspects of services for young people and children were studied. I hope that the new Committee will utilise the findings of the four reports to undertake further inquiries on individual aspects of care. I am pleased to note that the new Committee has resumed and completed the inquiry of major importance, "Children Looked After By Local Authorities". I look forward to seeing its report.

It is crucial that the inquiry's findings are not ignored because of the change of Parliament. As Chairman of the previous Committee, I urge the new Committee to be vigilant and to ensure that that does not happen. I hope that it will require the Department of Health to provide regular reports on its progress relating to the inquiry.

In their response issued in November, the Government

"Healthy children are much more likely to become healthy adults and we must make sure that we are investing in the future".

They also agreed with the Committee that

"The health needs of children are significantly different from those of adults, that they are a particularly vulnerable group, and that the provision of effective health services for children depends upon a thorough understanding of their special needs."

The Government's response states:

"The Department of Health will be discussing the future structure and development of health services for children with the service, the professions, users and their representatives. The Committee's reports will inform the debate about the specific policies of the new Government, and will help set the agenda for the future. Accordingly, we are not yet able to offer the Committee a substantive reply on many of their recommendations."

Although I accept that any new Government have many issues with which to contend, I have seen little evidence of activity either specifically relating to our conclusions or recommendations, or in the involvement of professions, users and their representatives. It appears that the Department of Health has no intention of consulting anyone other than its own civil servants. That must be rectified. I for one do not intend to let all the work on the four reports following that first inquiry into children's services be ignored.

The Committee recognised and welcomed the undoubted improvements in some areas of children's health in recent decades, but that should not lead to complacency or to an under-estimation of the importance of a change in attitude, leading to child care that is more child centred. Many factors have contributed to those improvements: immunisation, health education, improved nutrition and housing are just a few. I welcome the Government's acknowledgment that the reports echoed the fundamental philosophy of their public health initiative and the fact that they are carrying forward the public health initiatives to which the previous Government gave such serious attention.

The rewards of good health care in childhood, especially health promotion and preventive interventions, are unique, because the benefits may last a lifetime and may be passed on to future generations. We all recognise that. Therefore, it seems incredible that health visiting and school nursing posts are being dramatically reduced. That group of health professionals has played such an important role in keeping children healthy.

The Committee received an enormous volume of evidence across a wide range of topics, but several themes were prominent in every aspect of health services for children and young people. The first theme we identified was that, at present, services for children do not always consider the specific needs of children. Too often, they are based on traditional customs and practices or on professional self-interest. Children's health services must be needs-led, not based on historical patterns or the self-interest of provider groups.

That was obvious in myriad examples, some practical and involving few, if any, additional resources, such as grouping children together in out-patient clinics, rather than mixing children and adults together. Another example was of information wholly designed for adults being sent to child patients. How can a mother feel confident that her small child's needs will be met when the information that is sent refers to refraining for a defined period from returning to work or resuming sexual intercourse? We would not appreciate information advising us that we should not attend nursery school or be permitted to play boisterous games such as football. Children have as much right as adults to receive information that is appropriate to their needs.

On a more serious note, it is worrying that many of our witnesses felt that, some six years after the purchaser-provider split, purchasers still did not have the necessary commitment to, or expertise in, purchasing services that focus on the specific needs of children. Department of Health policies relating to children's services rarely appeared to have been considered by the commissioners.

Some commissioners appeared to limit specific services for children to immunisation and health surveillance. The needs of children who were ill appeared to be completely subsumed within services for adults. We therefore recommended that hospital services for children should be purchased as part of an overall package of services for children. To rectify the problem, we also recommended that each purchasing authority should appoint a lead commissioner for child health services. The Government's response was:

"We agree that health authorities could benefit from having an individual who has a lead role in the commissioning of child health services".

That lacks commitment. Again, children's specific needs are given less attention than those of adults.

A basic tenet of all Governments since 1959 has been that children should be nursed in children's wards among their own age group, with appropriate facilities for parents, play, leisure and educational activities, and that staff providing care should have undertaken specific training in children's needs, yet many witnesses gave examples of children being put in adult wards—even when there were empty beds in the children's ward— with no contact with specifically trained staff. That situation was often referred to as "surgeon's shoe leather syndrome." Some surgeons do not want to walk down the corridor to the children's ward from the adult ward in which the majority of their patients are placed.

That was clearly an example of the recurrent theme that services were too often based on traditional custom and practice or professional self-interest, and not in the best interests of the child. The Committee therefore recommended that the percentage of children admitted to adult wards should be included as a performance indicator in the Department of Health's annual hospital performance league tables. That would focus the minds of hospital managers, clinicians and purchasers on the importance of meeting that target. We also recommended that all the standards that are set out in the "Charter for Children and Young People" should be monitored.

I am sure that I was not the only member of the Committee to be staggered by the Government's response, which stated that their evidence was contrary to all that the Committee had received, as only 1.2 per cent. of children admissions are to a hospital without a children's ward. As a paediatric nurse said to me, the only reason for such a response is that the Department is being extremely economical with the truth, or deliberately obtuse, or it is completely ignorant of the reality of the situation in acute hospitals.

In reply to the Government's response to our reports, a Royal College of Nursing press release stated:

"We believe that the Government had simply failed to understand the situation. The problem is widespread in hospitals which do have children's wards and it is the reality which the Government has failed to address."

The RCN's paediatric nurse managers forum has recently completed a survey of hospitals with a children's ward. It showed that the third commonest cause of concern of paediatric nurse managers was children in adult wards.

I was pleased to note in the Government's response that they were considering whether care of a child outside a children's ward should be a centrally returned quality indicator. I should be grateful if the Minister would inform me whether a decision has been made and, if so, what it is. If no decision has been made, when will it be made, and will she assure me that her decision will be announced in the House?

The care of children in accident and emergency departments provided evidence of similar lack of implementation of well-established good practice guidelines. More children attend A and E departments during a year than are admitted to hospital. Children comprise almost one third of A and E attendees. It is reasonable to expect that high priority should be given to children's needs in those departments. The Secretary of State for Health has properly drawn attention to the violence that is now common in A and E departments. What must it be like for young children to witness such events?

The 1996 Audit Commission report "By Accident or Design" showed that even separate waiting areas for children, recommended since 1959, were uncommon. The Department's response ignores our conclusions and recommendations. I specifically ask the Minister personally to consider children in A and E departments.

Another of the "cardinal principles" stemming from 1959 is that children should be admitted to hospital only if the care that they require cannot be provided as well at

home, in a day clinic or on a day basis in hospital. To facilitate that, community children's nursing services must be rapidly expanded.

The Committee was unanimous in its concern in discovering that in 1997, almost 40 years after the expansion of community children's nurses was recommended, only 50 per cent. of the country had such a service. Only 10 per cent. provided a 24-hour service. The Department of Health report on the evaluation of the pilot projects between 1992 and 1997, published last month, concluded that

"community children's nurses make a vast difference to these families."

We would all agree that, whenever possible, children should be nursed at home. We were interested to learn how children's community nursing teams enable parents to care not only for children following a short acute illness or surgery, but for children who require long-term care due to major chronic illness and/or disability. That included children requiring special feeding techniques or ventilators to assist with their breathing.

Will the hon. Lady give way?

No. I have so much to cover and time is limited. The hon. Lady will forgive me, but I still have some important points to put on the record.

Only a few years ago, such children, if they had survived, would have spent their whole lives in an institutional setting. Now, if community children's nursing and appropriate social care are available, not only can such children live at home with their families, but they can participate in activities of the local community and be integrated back into school—some into mainstream schools.

We were most concerned to hear that, despite continual Government recommendations to expand services, the Department has paid so little attention to their provision. Our recommendations for the rapid expansion of community children's nursing services are clearly set out in our reports. For many years, such a nursing service has been available to all adults in their own homes. We consider that, as a matter of principle, sick children need and deserve no less. It is another example of the needs of children being given less consideration than those of adults.

We all recognise that children's health needs are different from those of adults. Children become more ill more quickly and more seriously than adults do, even those with the same condition. Safety margins are much narrower and, due to their stage of development, children have difficulty in telling us what is wrong, particularly when they are ill.

Like my fellow Select Committee members, I had always assumed that health professionals, particularly those for whom children are the focus of their work, would be required to have undertaken specific training. That is not so, yet staff caring for adults undertake long training focused on the needs of adults. How strange it is that children receive an inferior service.

Clinical effectiveness is of concern to us all, yet we received evidence from surgeons that a considerable number of operations are being performed on children unnecessarily. In 1996, the Royal College of Paediatrics and Child Health, in association with other royal colleges, issued a report entitled "Children's Surgical Services", which sets out the principles for those services. We recommended that the Department should issue explicit guidance to all those involved, reminding them of the good practice guidance and the need to monitor implementation.

While welcoming such reports from professional bodies, the Government's response is that they will consider how to encourage everyone to comply with them. That is not satisfactory. Successive Governments seem to spend considerable time "considering"; it is about time that action was required. I am waiting to see whether any action will be taken or whether such an announcement will prove to be no more than rhetoric.

An aspect of care that gave serious cause for concern—so we devoted an entire report to it—was child and adolescent mental health. Even the Department of Health witnesses agreed that current provision is inadequate in quality, quantity and geographical spread. In recent years, the House has rightly heard much about unsatisfactory mental health services, but our debates have been almost totally confined to services for adults.

Child and adolescent mental health services seem to feature at the bottom of the agenda in both mental health and child health services, and there is little public sympathy either for the children and young people concerned or for their parents.

Prevention is by far a cheaper option than treatment at a later date, when a plethora of problems have arisen, and health, social services, education and the youth justice system are involved. How many of those in prison, costing the country millions of pounds, would have become involved in criminal behaviour if their mental health difficulties had been addressed earlier? The paucity of services results in difficulty of access.

Successive Governments have devoted attention to the waiting time for surgery, but no such targets or the resources to meet them are available for child and mental health services. Only last week, the Select Committee's adviser informed me that his waiting list for an appointment is now 12 months. It is very difficult for those of us who have not had to experience the trauma associated with a mentally disturbed child or teenager to imagine what it must be like to have to wait at least 12 months for an appointment unless the child attempts suicide.

In common with consumer and professional groups, I was extremely disappointed that the Government response stated that they had no plans to set up a committee on children and young people. In Scotland and Wales, Ministers with responsibility for children review, develop and co-ordinate Government policy and strategy for children.

The House has a responsibility to represent all our constituents, particularly the most vulnerable. I was not fully conversant with how orientated our services are towards adults and so often ignore the needs of children, who represent 25 per cent. of the population and our future. Children are a vulnerable group. They have no political vote and cannot lobby Members of Parliament, yet they are not even to have parity with women by being given a Cabinet Sub-Committee. Surely that cannot be right.

The Government's response stated that they have a children's strategy group, which includes representatives of all the main Government Departments concerned with children, thus co-ordinating their activities. That does not convince me that fragmentation will be reduced. It was obvious from the evidence of Government witnesses that there was much about the services of which they appeared to have little knowledge and no mechanism for obtaining it. That is not good enough.

I remind the House that children are our future. The first inquiry into service for children and young people identified the serious lack of action by successive Governments on policies that were agreed by the House, consumers and voluntary bodies. It is about time that action rather than rhetoric was forthcoming. Why are our health services so focused on the needs of adults? Surely, as the 20th century nears its end, the needs of children should receive the same attention as those of adults. A notable achievement for the millennium would be in 2000 for the Secretary of State, backed by the facts, to confirm that all the principles of health care for children and young people had been implemented.

I congratulate the hon. Member for Broxbourne (Mrs. Roe) on chairing the Select Committee during the inquiry. It was a long inquiry. My hon. Friend the Member for Wakefield (Mr. Hinchliffe) said that it started in February 1996. However, terms of reference and an appeal for evidence were published back in summer 1995, so we gave those in the field an ample opportunity to prepare evidence. The whole process has resulted in a substantial report of no less than eight volumes—four volumes of reports and four volumes of evidence to back up their conclusions.

One of the main and best characteristics of the work of the Select Committee is the publication of the evidence. I am pleased that, in their interim response, the Government have said that that substantial body of work would inform the debate. My only worry about the report is that it costs £131.60 to buy the whole of it, so I fear that its circulation is unlikely to be as wide as its contents merit. Like the hon. Member for Broxbourne, I have noted that the Government's response is an interim one; I must advise the Minister, in the friendliest possible way, that I have carefully annotated the Government's responses, paragraph by paragraph, and will seek out suitable opportunities to pursue each one. Never let anyone think that a promise by the Government to "consider" something will be allowed to die the death: it will not.

One of the good features of the new Government's policies on health is their emphasis on the baleful effect of inequality. The Committee said:

"We were surprised to hear from the Department of Health that there was no readily accessible data on variations in child health by region and social class. It is our understanding that there is a considerable body of evidence going back to Sir Douglas Black's report in 1980, 'Inequalities in Health', and before, which deals specifically with this topic. We welcome the Department of Health's announcement that further research into the nature and extent of variations will shortly be commissioned".

The Government's response states:

"the Secretary of State for Health has asked Sir Donald Acheson to report to him on social, geographical, ethnic and sex inequalities of health … The health of children is likely to be a key component of this report."

I am not sure that that sufficiently meets the case. I hope that the Government will convey to Sir Donald the firm idea that the health of children must be a key component of his report; otherwise, his report will not be the valuable document that we need.

The Committee looked first into whether children need any special attention. Are they not simply miniature adults? This view, although perhaps not entertained in theory, has been prevalent in practice. Thus, children being prepared for surgery are prepared just as though they are adults. That can be harmful, because, as we learned, children's physiology is different, and all their body processes work faster. In short, they are very different from adults. I will not dwell on all the differences, because the hon. Member for Broxbourne covered them competently.

Another difference between children and adults is that children must be considered in context. A doctor can treat an adult for a particular problem—we think ourselves quite lucky if the doctor treats us as a whole person. I do not mean any offence to the hon. Member for Isle of Wight (Dr. Brand), who is sitting directly opposite me—I hope that he will not take my strictures personally. As I was saying, we feel lucky if we are considered as a whole person rather than, say, a walking stomach.

With a child, it is not enough to say, "This is a whole person." One cannot sensibly deal with a child without dealing with that child's context—the family. Professionals dealing with children are dealing not just with individuals but with whole families. For this and many other reasons, children require a different service.

This fact seems to have been overlooked by Governments, planners and managers. We became aware that many of the professionals struggling to provide a good service feel undervalued. It is almost as though, because children are small, those caring for them, and their talents and expertise, are also thought of as small. That is a wrong point of view.

I was surprised to learn during our visit to Great Ormond street hospital that paediatrics is quite an unpopular specialty. Paediatricians often earn less than other doctors—they do not go in for private practice—and they work longer hours. In general, they are regarded somewhat as the Cinderellas of the profession.

As we continued our inquiry we discovered that there is a lamentable lack of properly qualified and trained children's nurses. Only 3 per cent. of nurses hold a children's nursing qualification. That results in a ratio of one nurse to 1,400 children, which is clearly ridiculous. Depending on where we mark the boundary between childhood and adulthood, children make up between one fifth and one quarter of the population. We do not say that between one fifth and one quarter of all nurses should be children's nurses, since children are generally reasonably healthy—but 3 per cent. is ludicrously low.

We also discovered that the guidance to the effect that there should always be two registered sick children's nurses in a children's ward during the whole 24-hour period is not observed; and whereas adults expect district nurses to treat them at home, there is no such adequate service for children. There have been district nurses for adults for about 100 years, and our report draws attention to the fact that children should be entitled to the same service. But 50 per cent. of the population have no access to properly organised, co-ordinated children's community nursing services, and only 10 per cent. have access to a 24-hour children's community nursing service. That is deplorable.

We found in the course of our inquiry that children's community nurses have additional duties; the recommendation made to us by the Royal College of Nursing about how many children's nurses are needed to provide a good community service was based on the notion that an important part of their work is training parents to do for their children what adults are not expected to do for other adults for whom they are caring. I refer, for instance, to passing nasal gastric tubes. Those of us on the Committee who are parents or grandparents found ourselves thinking about how we would have managed even if we had been lucky enough to have a trained children's nurse to show us the procedure. We were not especially enamoured of the prospect.

Our estimates of the necessary increase in the number of these nurses are based on the most conservative calculations.

According to my reading of the report, the Committee found that areas with a children's community nursing service provided care that was not only better but more cost-effective. In three instances, the cost was between 11 and 43 per cent. of the cost of treating the children involved in hospital.

My hon. Friend is right, and the Government acknowledged that. I was therefore rather disappointed that, in their response to the report, they said—referring to improvements that might be made—

"This might include hospital at home schemes, community paediatric nursing and improved primary care services."

There should be no "might" about community paediatric nursing.

The eight-volume report covered many issues. One was the patients charter as it applied to children. The charter states that parents may "expect" certain things, but we discovered, on examination, that that "expectation" could be deemed to be no more than a target—something very different from a right.

We investigated the response to respite care needs, and found it to be totally inadequate. We also investigated the need for proper equipment to be provided, and heard from witness after witness that it was also very inadequate. We heard repeatedly about the fragmentation of services, and about problems relating to the boundary between social services and education, and health services. I know that my hon. Friend the Minister is interested in that aspect. We certainly feel that it requires special attention, not only in relation to the elderly but in relation to children.

We found that parents were being told to take home and wash equipment labelled "For single use only". One mother who had to use a suction device to clear a child's airway was given a packet of six for a week, although she had to clear the child's airway 56 times in that week and the packet was labelled "Use once only". I hope that the Minister will take our recommendations in that regard seriously.

We considered the need for accident and emergency departments to be properly designed for children. We pointed out that, although children use accident and emergency services far more than in-patient services, some hospitals seem to ignore the fact.

We looked carefully at the whole range of children's problems and needs. My overriding impression was that, if I had to name the most important thread, it would be the nursing thread—the need for a seamless nursing service, with properly qualified nurses. Children's nurses receive excellent training, but unfortunately not all places are being taken up, because of the exigencies of training budgets.

I hope that my hon. Friend the Minister will consider all those points carefully. I promise her that I shall come back to her for regular updates on the Government's interim response.

I must declare an interest, especially for the benefit of the hon. Member for Preston (Audrey Wise). I was destined to become a paediatrician, but moved sideways to become a holistic family doctor in general practice.

The report is valuable, as today's speeches have been. I know that time is short, but I want to highlight two parts of the report that illustrate the lack of a national strategy, which has caused confusion in regard to the local delivery of services for children. One part deals with medical advice and treatment for children in schools, and is relevant to yesterday's prolonged debate.

In many areas, school nursing services have been cut to such an extent that they have become almost irrelevant, given the vast task that needs to be performed. That task involves surveillance, immunisation, the advising of parents, teachers and pupils, the identification of social care needs, all the work connected with child abuse, the identification of special educational needs, health promotion, the support of children when they first experience anxieties about sex and, indeed, the protection of children from the consequences of sexual activity.

I am disturbed by the fact that those services have been allowed to decline without consideration of children's needs. We seem to be considering which agency is responsible for a particular service rather than what a pupil requires. As has been explained, children with a vast range of medical needs now attend normal schools. It is unreasonable to expect a single nurse to meet those needs, especially one with a potential case load of between 2,500 and 5,000 patients spread over 15 schools.

There should be a much more flexible framework, allowing specialist community nurses who may be attached to hospital departments—and practice nurses, who are very experienced in the treatment of such conditions as epilepsy and asthma—to go into schools and advise not just teachers but children themselves.

In Cambridge and Huntingdon, in my constituency, there is a greater integration of the services provided by health visitors and school nurses, but that integration is in the context of what is euphemistically termed disinvestment. What that has actually meant is redundancies among health visitors and a reduction in services, which are focused only on children who are understood to be at risk. Because of that, we have lost the universal screening services that promote good health in children and help them to become healthy adults.

The hon. Gentleman makes a valuable point, which illustrates what I am about to say.

We need to use the specialist skills that are available to the community to help people in their homes and those visiting GPs, but also to help people in schools. Children are people, and they are entitled to all those specialist services. Not all services need to be delivered by specialist paediatric nurses. This is another example of the achievement that is possible for the NHS, provided that it encourages team work.

The second issue that I must mention is the provision of mental health services for children and adolescents. There seems to be almost universal confusion about the roles of education, social services and health departments. A cultural apartheid seems to apply to the various people who deliver mental health services to, in particular, children and adolescents. It is rare for educational psychologists to talk to clinical psychologists or psychiatrists, and social workers do not get much of a look in. That must be changed. It is not just the child who suffers in such circumstances.

A few years ago, the only place where I could send a psychiatrically disturbed 12-year-old lad was the local police station. The adult mental health facility would not take him, and he was too disturbed to be put in a paediatric ward in the local hospital. That is not satisfactory. It is a direct result of planning failure, which is itself due to the lack of a national strategy.

I welcome the spirit of the Government's response to the reports, but I am disappointed at the lack of detail. This debate is particularly valuable, in that it enables us to extract further details from the Minister about the direction in which she believes that these important services should go. It is not only the children who matter, but their parents, their carers, their teachers and the broader community.

I shall be as brief as possible, as not only do hon. Members want to hear from the Minister, but she will want to respond to the points that have been made.

The series of reports represents a formidable piece of work. When I first read my Whip, I thought that the debate would last for three hours, which I did not think would be long enough—one could not even read the reports in that time. When I realised that it would last for only an hour and a half, I knew that our work would be cut out.

The introduction to the second report sets the scene very well. It says:

"Childhood is a period of rapid and uneven development … Illness, disability and problems of mental health which develop during childhood may remain with an individual throughout life … Twenty years have passed since the publication of the last comprehensive Government review of children's health services, the Court Report … The Court Report contained over 200 recommendations".

It also points out that the Department of Health said that it could not provide a check list showing whether those recommendations had been met, as there had been so many reorganisations in the national health service.

The Select Committee concludes that its consideration of reports dating back to 1959

"reinforces our view, which has gained in strength as our inquiry has progressed, that the special needs of children are given insufficient priority by policy-makers, health service professionals and others who in one way or another have a responsibility for children's well-being. Changes in attitude, not merely in policy, are clearly needed."

Although that is stated in the introduction to the inquiry, I think that it probably says it all.

Anyone listening to this debate—I take the point made by the hon. Member for Preston (Audrey Wise) that listening to it or reading it will be less expensive than buying the reports to read—will have realised that this is the House of Commons at its best. A report that was prepared under the previous Conservative Government has been introduced on the Floor of the House by the current Chairman of the Health Select Committee. Most of our work in the House is a seamless robe, which sometimes the public do not realise. I commend the hon. Member for Wakefield (Mr. Hinchliffe) for staying up—as I hope to do for the next few minutes—and I thank him for his kind words about the way in which the Select Committee carried out its work, including under the chairmanship of my hon. Friend the Member for Broxbourne (Mrs. Roe).

I mentioned that the reports represent the first major inquiry since the Court report. When they were issued, they were welcomed by one and all. Baroness Jay said of the Select Committee:

"We welcome their reports, which will make a substantial contribution to the debate on children's health."

I make no criticism in saying that, although they are a substantial contribution, they must ultimately represent more than a contribution.

I have not totalled the number of specific recommendations in the reports, but even on a cursory count I reckon that there are at least 70—I could not begin to go through them all in the time I have. Indeed, it is always invidious on such occasions to highlight particular recommendations, but I shall point out the issues that struck me as relevant, in the knowledge that other hon. Members with greater experience of the Select Committee have highlighted the same recommendations.

The Select Committee said:

"health services for children and young people are not always designed to meet their needs, but may be based on traditional custom or on the convenience of the provider. They are not always delivered by appropriate staff."

It also said that it

"endorses the 'cardinal principles' set out in Department of Health guidance on hospital care for children, but doubts the extent to which they are actual achievements, rather than aspirations. In particular, the principle that children should not be in hospital unless absolutely necessary cannot be met given the current inadequacy of community nursing"

care. It went on to say:

"many hospitals fail to meet the Department of Health standard of having at least two registered sick children's nurses on duty 24 hours a day … the Patient's Charter standard that children should be cared for in a children's ward under the care of a paediatric specialist is not being met; it is recommended that such information should be collected as part of hospital performance league tables to reinforce its importance."

That point has rightly been made by a number of hon. Members.

Does the hon. Gentleman agree that children are subjected to a vast array of environmental hazards—such as ionising radiation—which may explain the increase in childhood leukaemias both in this country and in the United States? Would not reducing such hazards lead to a decrease in the number of illnesses to which young people, with their sensitive bodies, are subjected?

With a medically qualified doctor, the hon. Member for Isle of Wight (Dr. Brand), sitting to my left, and another, the hon. Member for Norwich, North (Dr. Gibson), sitting opposite, I shall have to be careful in passing judgment, but I think that that must be right. The hon. Member for Preston rightly said that childhood is dangerous; like the last days of one's life, it is a difficult time. I welcome the fact that we are moving away from the idea that children are mini-adults and can be treated as such. It is difficult to know where the dividing line falls, but children's experiences are clearly different.

The Government's detailed and thorough response to the reports was commendable. As has been said, the reports represent an agenda for action—we all share the duty to ensure that there is action. Again, time does not permit me to go through the details, but I shall mention some of the responses, both to commend the Government and to point out that further action will be necessary.

On page 13, the Government say:

"We do not believe that it is acceptable for children to be treated by inexperienced and inappropriately trained staff. We shall ensure that measures are taken to address this problem. This will include continued action to increase the numbers of relevantly trained staff."

During the debate, hon. Members have stressed the importance of staff who are trained in the care and treatment of children. I believe that the Government's aspiration is laudable, and I hope that the Minister will find time to say something further about it.

In its extremely helpful briefing, the Royal College of Nursing highlights what the Government say on page 16 of their response. The Government state:

"We acknowledge the past shortages of qualified children's nurses have limited the opportunities for the health service to benefit from their skills. As the number of children's nurses increases, their skills can be utilised in many more areas of healthcare for children and young people."

The Government's reaction is fine and right, but we need the Minister to explain how the number of children's nurses will increase.

On page 38, the Government say:

"As the Committee noted, there continues to be a need for more child trained nurses. The NHS Executive has asked education commissioners to ensure that sufficient children's nurse training commissions are placed to meet the recommendations of the Clothier enquiry (to have at least two Registered Sick Children's Nurses or equivalent, on duty 24 hours a day in all hospital children's departments and wards) and, in addition, that adequate provision has been made for the staffing requirements of paediatric intensive care units."

Again, I commend the Government for their response, which was exactly right, but we need to have some idea of how they believe that they can take that process forward.

In preparing my thoughts for the debate, it seemed to me that three common themes ran through the reports. First, there is reference to the fragmentation, and lack of child-centredness, in the delivery of many child services. Secondly, there is a failure to follow existing good practice guidance. Thirdly, there is training, training and training, a point that has been made throughout the debate.

What is interesting about the reports—I say this as a compliment, not as a criticism—is not so much that they break new ground as that they remind us of how much there is that has yet to be implemented. It is significant that the Court report was issued in 1976 and that other official Committee reports go back to 1959 because it illustrates how Governments and Select Committee reports have so often failed to pick up and run with the excellent work done. I referred to the Department of Health's response that it could not comment on whether the Court report had been dealt with, because rules had changed and the matter was difficult.

New Governments have an opportunity. This Government are not quite bright and spanking new—if I may pinch a theme of an earlier debate in which the hon. Member for Wakefield and I were involved—but they are pretty new. We are also fortunate that the Minister for Public Health's commitment to the health and welfare of children is thoroughly accepted and appreciated on both sides of the House. There is an opportunity for a new Government to ensure that the sins of the past are not repeated. I would like to think that constructive suggestions by Opposition Members on how recommendations may be taken forward and the brooding and extremely experienced presence of the hon. Member for Preston, combined with what the Minister will bring to the matter, will ensure that the reports' recommendations will not suffer the same fate as the Court report, and that, in 20 years' time, they will be seen as an agenda that was taken forward.

I join others in paying tribute to the hon. Member for Broxbourne (Mrs. Roe) for her stewardship of the Select Committee on Health and her contribution to the debate. I also pay tribute to my hon. Friend the Member for Wakefield (Mr. Hinchliffe), and particularly to my hon. Friend the Member for Preston (Audrey Wise).

All speeches in this very important debate have made it clear that the Select Committee's conclusions and the Government's response to them are in the light of the development and implementation of children's services under the previous Government. Although my hon. Friend the Member for Preston referred to the Government's response as interim, I hope that members of the Committee will not be holding their breath over the publication of the next stage of the Government's response.

I should make it absolutely clear first that I would expect nothing less from my hon. Friend the Member for Preston than her persistence and vigilant scrutiny of Government action in the light of the reports' many recommendations, and secondly, that the Government are as one with the Select Committee in its determination to meet the many shortcomings in the service that the reports identified. I hope that there can be a spirit of partnership and common purpose as we take action in areas where the need for it has been so clearly identified.

It is important to reflect on the difference between the approach adopted by this Government and that adopted by the previous one. Several hon. Members have made clear the devastating impact of inequalities in health on children's opportunities. Inequalities are evident in almost every aspect of young children's lives. Health services for very young children are so important because they can act as an instrument to combat inequality and to promote greater fairness and opportunity for all children. That is so when judged by any measure.

Let us consider accident rates. The child who is born into a family of social class 4 or 5 is five times more likely to die in an accident before the age of 15 than a child from social class 1 or 2. Stark regional variations can be linked to poverty, unemployment, pollution and lack of educational achievement. Enormous regional variations occur in the incidence of tooth decay, which is very important to the developmental health of children. As our public health Green Paper makes clear in considering the likelihood of survival of children in the first year of their life, the most telling indicator is the country of birth of their mother.

Tackling inequality sits at the centre of the Government's approach to dealing with the problems that the Select Committee raised, as does our commitment to insisting on consistency of quality. The Select Committee was rightly critical of the preoccupation with numbers rather than the consideration of quality of interventions.

We are absolutely at one with the Select Committee and several speeches in the debate about the extent to which the impact of good work and services can be sabotaged by fragmentation. It is an enormous challenge for health, social and education services to move to treat the child as a whole person in context, as part of their wider family. That is the challenge for the Government, local government and local health services.

In the context of Sir Donald Acheson's report on health and equality, to which several hon. Members referred, it is important to understand that not all children who appear to suffer the same social and economic hardship necessarily suffer the same degree of ill health as a result. We need to understand much more about the protective factors that can act. That has been a major preoccupation of the review of services for children under the age of eight, which I have chaired as part of the Government's comprehensive spending review.

We intend to build on the very important contribution of prevention in our investment in the health of children, reiterating and underlining the importance of immunisation. I draw to hon. Members' attention yesterday's very important statement from the Medical Research Council and the Chief Medical Officer about the desirability of the measles, mumps and rubella vaccination to protect children against what were previously killer diseases.

Yes, we are absolutely committed to strengthening the role of health visitors and the important contribution of school nurses, but it is important that their role develops as part of the strengthening process, at a pace that reflects the change in the nature of services, the importance of overcoming fragmentation and the importance of applying evidence of what works.

Yes, we are determined to overcome the unacceptable degree of local variation and inequality in access to services. That is why the national health service White Paper stressed the importance of national frameworks. Yes, we see the development of healthy schools, harnessing the resources of health and education, as a very important contribution to overcoming fragmentation and the treatment of the child as a whole person.

I shall pass quickly through the specific points raised in the debate. On proposals for a Minister for children as a way of overcoming fragmentation, I draw hon. Members' attention to my remarks about the efforts to scrutinise across government the effectiveness of spending on children, reflecting the importance of how we put in place structures that address the whole child.

We are dissatisfied with the data on the level of community nursing available to children and on establishing the extent to which children are being treated as if they were adults requiring adult services. That is unacceptable. We recognise that that is particularly a cause for concern in relation to adolescents, which is why £2 million of the mental health specific grant will be dedicated to the development of child and adolescent mental health services. We are certainly open to the case for a lead purchaser for children. Target setting in relation to mental health is very much a preoccupation of the current consultation on the public health Green Paper.

My hon. Friend the Member for Preston made an important point about ensuring that equipment in hospitals is used only once, but clinical advice suggests that specific guidance may be provided on equipment used at home.

We are concerned about the shortage of children's nurses, as we recognise the important point that children are not merely small adults: their needs are very specific.

I hope that I have made absolutely clear the Government's commitment to acting on the recommendations of this important report. We see this is as the beginning, not the end, of the process, and we recognise that we must invest now for the future health of our children.

One of the strengths of the House of Commons is its Select Committee procedures and the ability to take detailed evidence on matters relating to individual Whitehall Departments; to consider carefully their impact on legislation and on the future developments of particular industries; and to take account in every way of the varying views of those who are involved, in this instance, in transport.

I was thrilled to introduce the first report of the Transport Sub-Committee of the Select Committee on the Environment, Transport and Regional Affairs, on the strategic rail authority. The Committee is lucky in having representation not only from the Conservative party but from our colleagues from across the water in the Ulster parties, and I believe that it is capable of producing a high-quality piece of work.

I warmly welcome the opportunity to debate on the Floor of the House the result of Select Committees' deliberations. It is very sad when a Select Committee produces an enormously detailed and useful piece of work that is introduced at a press conference and gets some superficial publicity only if members of the specialist press happen to be present. I am grateful that the Liaison Committee has found time to recommend that we talk about the strategic rail authority this morning. I am also grateful to my colleagues on the Select Committee and to those who helped us to prepare the report.

When the railway system was fragmented, it became obvious that there would continue to be different political views on how the future of transport should be handled. The Select Committee decided not to look backwards, as we had produced a large report on privatisation before the general election, but it was clear from all the evidence we took that there were still real difficulties in railway transport.

The difficulties were not only in the structure of the existing privatised railways. It was hard to determine the best way forward, and there was an overall lack of a strategic view. We were heartened by the Secretary of State, who gave us a clear commitment, on behalf of the Government, to create a strategic rail authority. We saw our role as that of taking evidence that could help to construct that authority and ensure that it covered all the aspects of its responsibilities to the House of Commons that would make it a really effective and useful body. That is what the report delivers.

The consensus across the railway industry on the need for a strategic rail authority was heartening. Of course, some will feel that some of our recommendations went too far and will find them too political. The aims of an authority were not only accepted but asked for. Regardless of whether we spoke about the manufacturing industry, about those who deal with passengers or about those who deal with freight, it was clear that the lack of guidance, overall responsibility and forward planning was felt throughout the industry.

We took evidence on the roles of the various parts of the Government machine that deal with the railway industry: for example, the role of the regulator. We considered what the aims of a strategic authority should be, and how it should plan its use of Government finance. We deliberated how it should consider the various parts of the industry, in relation not only to one another but to the job that they are required to do for the passenger.

The strategic rail authority must, first and foremost, have responsibility to the customer, who is being badly served by the privatised railways, and to the taxpayer. It is an extraordinary fact that the taxpayer is paying double the subsidy that went to the old British Rail system, and receiving just about half the level of service. Performance is patchy across the railway industry as a whole, but it should be a matter of concern to every one of us.

We envisaged that, as the Department said, the authority should manage the existing franchise; develop a strategic vision for investment in the national network; act as a one-stop shop for progressing investment proposals; take responsibility for some of the functions currently exercised by the Secretary of State; promote integration between rail and other modes of transport; consider the need for voluntary action by the operating companies to win more passengers; and promote the needs of disabled passengers and the personal security of all rail passengers.

We also felt that there was a need for clear accountability. The taxpayer pays for the system and initiates the money-go-round whereby large sums move in a large circle that stops at a certain point. The House is responsible to the taxpayer.

We must have clear links between elected bodies and the rail authority. The Welsh assembly and the Scottish Parliament, as well as this Parliament and the regional decision-making bodies, will want to have a direct input into both the type and the quality of services. If we are to have a radical improvement in the integration of rail, a great deal of work must be done to maximise the benefits of the existing system and develop passenger and freight services.

Many of our witnesses gave a clear picture of the existing regulator's role and said that changes needed to be made and that the regulator would always have a role as an arbitrator between certain areas of the industry. We felt that, although the regulator's role needed to be revised, he should maintain an independent status, umpiring contracts and considering fair competition issues. A lot of the work of restoring the original requirement in section 4 of the Railways Act 1993 would mean, however, that he had to take guidance from the Secretary of State. The regulator accepts that he should not be operating independently.

We believe that, in discussing the future of the railway system, we should carefully consider the role of Railtrack, which is today with great fanfare launching its report on its future role, with many comments on its intended investment in the future of the railways. Many of us will regard those figures with some disenchantment—I shall not say disbelief; that would be ungracious and unacceptable—but it is important to remember that vast sums of public money go into privatised railway subsidies. Although subsidies are nominally paid to the train operating companies, most of that public money comes back to Railtrack in the form of track access charges.

The answer to my written parliamentary question of 3 November 1997 revealed that the subsidies paid to the train operating companies in 1996–97 amounted to £2.099 billion. The same answer revealed by some uncanny coincidence that the income to Railtrack from track access charges was almost identical. If that is not a back-door subsidy to Railtrack, I should like to know what is.

I do not wish to breach the all-party consensus of the report, but will the hon. Lady acknowledge that the £17 billion that Railtrack intends to invest over the next 10 years is much more than the public subsidy that she described, and certainly more than the Government would have spent had British Rail remained in their hands?

There are no plans for the extension of the main-line electrification network. Cities such as Sheffield, Aberdeen, Hull and Bristol will continue to be served by diesel trains for the foreseeable future. The west coast main line continues to deteriorate every day, and Thameslink 2000, which is to paid for by a massive debt write-off by the previous Government, looks as far as away as ever. I should be happy if Railtrack's figures materialised in practical investment terms.

The hon. Member for North Wiltshire (Mr. Gray) is a valued member of my Committee and knows that there is considerable disquiet about the way in which Railtrack does its accounting. It has not been transparent in the past, and maintenance is not regarded by most qualified accountants as a suitable heading in connection with investment. It is clear that Railtrack has not lived up to the previous record. It has needed to be prompted, to put it in the most polite way, by the authorities already because of the shortfall in investment. It is obvious that it has considerably underspent on track and structure renewals. There is a £385 million backlog on property maintenance. Those figures are a great worry, which we must consider carefully.

Our report sets out the belief that Railtrack should no longer control safety. Our railways have always had good safety, from the time when a man walked in front with a red flag. We are a little faster than that, although not on all privatised lines. The Committee believes that there is a problem in safety remaining part of the existing organisation. The time has come to set up an independent transport safety authority that would not only continue to safeguard the levels of care that have been endemic in the railway industry, but prove to the customer how independent it is and what a good job is being done at every level. We want Railtrack to lose that aspect of its work. We should like safety regulation and the safety standards directorate to be transferred to an independent safety authority.

We also make considerable recommendations on the need to transfer freight from road to rail. There is no point in Governments talking about that need unless there is a practical way of achieving it. I hope that our suggestions will be acted on.

Freight is a significant factor in the report. The relationship between road and rail transport—the intermodal system—must encourage more freight on to rail. A significant void exists there. Does my hon. Friend agree that we must impress on Ministers that the intermodal exchange between road and rail is important and should be developed?

The Committee not only emphasised that but offered various solutions, given the need for clear strategic planning if we are to achieve that useful aim.

We also suggested that customers have little idea who is responsible for what in a fragmented railway. It is all very well for those of us who understand what Railtrack is supposed to be and what train operating companies and ROSCOs—rolling stock companies—do. Customers waiting for trains, late or otherwise, have little understanding. We were disturbed because we did not believe that existing customer organisations were easily accessible or understood or that they were performing the task necessary to reassure customers.

If we are to have standards, customers must know what they are and how to complain efficiently and simply, and they must be sure that something will be done about their complaints. We suggested that the consumer organisations should be reorganised and given a much higher profile. They must have ways of advertising what they are doing and be given a bit of muscle, so that they can shout out for the passenger. That need is felt strongly by anyone who uses the existing system.

The SRA will provide a comprehensive, clear, single body reporting to the Secretary of State. It will analyse the needs and demands of the new railway system to find which aspects are failing. It will insist on high customer standards and ensure that investment goes where it is needed, when it is needed. It will seek high—quality standards so that the ways in which passengers receive services are clearly marked and capable of delivery. It should also promote a radical improvement of the integration of rail with other transport modes.

In achieving its aims, it will need to demonstrate to the public that we are no longer prepared to accept considerable amounts of taxpayer's cash going in without clear accountability and transparency of accounting procedures, and without direct responses to the needs of customers: high—quality rolling stock; high-quality services; clean, tidy and safe stations; and proper facilities for those who use the system.

To that end, we suggested that the Minister should seriously consider whether the British Railways Board should be used as a benchmarking facility. The franchises will have to be examined as they come up. Many of us believe that some of them will collapse before the end of the franchise period. The board could be used to judge the efficiency of the system and whether it is delivering what it should. There may even be a case, although there is political disagreement about this in the Committee, for the Government taking equity in Railtrack to ensure that there is a clear line of accountability to the passengers who use the service.

I hope that the House will not just debate the report, but act on it. It is a good report—although that may be rather immodest from the Chairman of the Committee. Again, I should like to pay tribute not only to the individual members, but to those who helped us prepare and take evidence.

The report looks forward, but—for obvious reasons—it will be differently interpreted in different parts of the House. However, it is constructive, useful and detailed, and it needs to be acted upon. I expect my Government to lead the way in giving that chance to the transport system of the new century.

It is a great pleasure to follow the hon. Member for Crewe and Nantwich (Mrs. Dunwoody), and I should like to express my appreciation of the way in which she chaired the Select Committee. Those of us who know her know that she is a lady of considerable views, and it was a marvellous feat for her to chair a Committee in which there was a great deal of consensus. Speaking as someone who admires her for her views, I was pleased to see today that she occasionally returned to type.

This is the first major report produced by the Committee, and I wish to refer to the way in which Opposition Members have approached it. It is clear that the Government intend to have a strategic rail authority. We had a choice of either blindly opposing everything and trying to wreck the Committee, or of laying down benchmarks for when we examine the matter in a Bill. The latter was the right approach. The railways have gone through a period of considerable change and upheaval, and they need a period of stability in which long-term investment can be committed.

Railtrack and the train operating companies have an impressive programme of work planned, but investment takes time. I must take issue with the hon. Member for Crewe and Nantwich—£17 billion is a serious sum. Some £5.5 billion on maintenance is a serious sum. Some £8 billion on renewals is a serious sum, and enhancements of more than £3 billion involve a serious sum of money. As my hon. Friend the Member for North Wiltshire (Mr. Gray) said, there would have been nothing like those levels of investment within the public sector.

It is early days, but rail privatisation is following the same predictable path as previous privatizations—unpopular in its early stages, with all the cumulative ills of the past half-century being blamed on privatisation. If we were to substitute BT or British Airways for Railtrack in the current headlines, we could run the same stories as ran previously. Those who predicted gloom and despondency then had to eat their words, and they will have to do so again.

Does the hon. Gentleman share my concerns and those of my constituents at two derailments in my constituency earlier this year? One involved a passenger train in which eight carriages out of 10 derailed. That had never been heard of before rail privatisation. Does he accept that there are occasions when Railtrack may be forcing contractors to do work on the cheap, something that affects not only the track maintenance but the employees of the contractors—all of which has happened since privatisation?

I ask the hon. Gentleman to read the evidence from the Deputy Prime Minister. I specifically asked him about such claims, and he said that there was no evidence that Railtrack had in any way compromised itself in terms of safety. On this occasion, the Deputy Prime Minister's word is good enough for me.

In a perverse way, the change of Government has made the commitment of capital slightly easier, because there is a realisation that there is no possibility—as the hon. Member for Crewe and Nantwich said—of renationalisation. The old British Railways Board is dead, and soon, we hope, will be forgotten. The future of the railways remains firmly in the hands of the private sector. The Committee was not attempting to renationalise the railways or to make them vulnerable to short-term political interference. Those points might have been better made before privatisation, as the taxpayer would have received considerably more money had the uncertainty been removed.

We have seen a steady growth in passenger numbers, reversing the decline that occurred over a number of years. The evidence suggests that passenger growth could be as high as 25 per cent. by 2005. It is important that we look at the subsidy, which is set to decline over the next 10 years, and we must remember that a lot of BR debt was taken on by the companies.

The hon. Member for Normanton (Mr. O'Brien) and the hon. Member for Crewe and Nantwich referred to freight, which BR largely neglected. A 20—year decline in this country was reversed once English, Welsh and Scottish Railways took over. Less than 6 per cent. of freight in this country is transported by rail. On the continent of Europe, the figure is a more impressive 15 per cent. The evidence from EWS was that it was likely to triple its business within 10 years, and it is not unreasonable to suggest that, by 2010, 20 per cent. of freight will go by rail. That is 20 per cent. of a growing market.

There are a number of practical restraints on the further expansion of freight, and those need some attention. First, there is the problem of the restrictive loading gauge. If we are to see any significant increase in freight, we must ensure that high gauges are available. That will allow new international containers to be used, and it will also allow for the possibility of increasing the capacity of wagons by about a third. More importantly, it will allow piggy—backing of heavy goods vehicles. The last point was referred to by the Deputy Prime Minister as vital for haulage in the long term.

There is a considerable conflict between the needs of passengers and the needs of freight. Improvements for passengers—faster trains and more frequent services—often work to the detriment of freight. We must understand that there are environmental considerations, including noise problems. Much of freight is moved at night. I live about half a mile from a busy railway line, and I have noticed an increase in the amount of traffic in the past few months. Constituents who live closer to the track have started to complain—not unnaturally—about disturbed sleep.

We must remember that most of our freight is not time-critical: a load is sent off, but it does not matter whether it arrives the following day or a couple of days later. However, if we are to increase the amount of freight that travels by rail, we have to be able to carry time-critical freight, which means that people will be able to guarantee that a load leaving Aberdeen can be in Brentwood the following morning.

The Committee also gave consideration to the problems of international rail travel. The channel tunnel has not yet proved to be the catalyst in persuading road hauliers to

switch to rail; in fact, the tonnage carried is roughly 40 per cent. of the predicted level. The cost of travelling through the tunnel and on continental railways is such that it starts to become economic only when there is the prospect of travelling through the Alps. Continental European railways are still heavily nationally focused, and it remains, peculiarly, easier to get a truck across a European border than it is to get a train across; trucks have to fill in fewer forms, and the process is quicker.

Might not our concentration on the channel tunnel prove to be to the detriment of the 96 per cent. of British imports and exports that go through ports? In addition to the other measures that the hon. Gentleman suggests, it might be a good idea to follow a policy of ensuring that Railtrack improvements relate to movements in and out of ports, especially bottlenecks in freight movements immediately around ports.

I do not take issue with that at all, but I believe that the channel tunnel plays an important part in the expansion of rail. I find it difficult to explain to constituents who are hauliers why it is considerably more expensive—three times more expensive, according to the Road Haulage Association—to take a heavy goods vehicle through the tunnel than to send it in the shuttle, which uses the same track and the same tunnel.

The report covers two controversial matters: the equity share in Railtrack and the British Rail Board competing for franchises. We received little evidence on that, except from Save Our Railways and the Labour Finance and Industry Group, both of which seemed to take a similar position on most issues of substance. To my way of thinking, the credibility of Save Our Railways was somewhat dented when it had to withdraw some exaggerated claims in front of the Committee, as hon. Members can read in the second volume at paragraph 197.

Is my hon. Friend aware that Save Our Railways' offices are in precisely the same place as the rail unions' offices and that it is, to a significant and majority degree, financed by the rail unions?

I am grateful to my hon. Friend for making that point, of which I had not been aware, even though, at times when listening to Save Our Railways' evidence, it was like living on the last page of George Orwell's "Animal Farm", when it was no longer possible to tell the pigs from the people.

Although the strategic rail authority may care to consider whether the Government should take an equity share in Railtrack, it would be madness to do so. It would achieve nothing: not a single mile of track would be laid, nor an additional carriage purchased, nor a single station made cleaner; there would be nothing but the resonance of old clause IV.

As the report states, for the British Rail Board to compete on

"a fair and transparent basis",

it would have to be in the private sector. If it were in the public sector, it would intimidate and prevent fair competition. Any analogy between BRB competing for a franchise and a local authority contracting out to a direct labour organisation is frankly ridiculous. There was no evidence to support that view, other than from Save Our Railways and the Labour Finance and Industry Group.

If the strategic rail authority becomes a hands-on authority, second-guessing commercial decisions, it will fail. If it takes away powers from the Department of the Environment, Transport and the Regions and remains truly strategic in nature, it may succeed. It needs to tackle that delicate and crucial balance between the needs of passengers and those of freight. Above all, in the words of the report, the SRA needs

"to foster a climate that encourages private investment in the railways".

I wish to raise with the hon. Member for Brentwood and Ongar (Mr. Pickles) one point that I consider to be a significant factor in this debate. When the previous Government privatised the railway industry, the franchises given to many of the companies were so short that the companies now feel that it is not possible to invest in new rolling stock or the new materials that are required to ensure that they can meet the demand for passenger and freight services. The Conservative Government did not give sufficient thought to the way in which the privatisation should have taken place, and I hope that the Select Committee's report will address some of the deficiencies of the privatisation programme.

May I ask the hon. Gentleman a simple question? Is he advocating that the franchises should now be extended and, if so, by how long?

I can advise the hon. Gentleman that my right hon. Friend the Secretary of State for the Environment, Transport and the Regions is now considering representations from some of the franchisees, particularly Great North Eastern Railway, which is suffering from overcrowded trains and having difficulty meeting demand. My right hon. Friend is rightly giving consideration to the circumstances of a very competitive line in an area that will improve considerably as time goes on. There is one proviso, which is that the companies keep fares at a level that people can afford; otherwise, there is a danger that we might have a railway system that is out of the reach of many of those who would like to use it. My right hon. Friend has to look at many factors when considering the extension of franchises, and I support his views on that issue.

I felt that I had to draw the attention of the hon. Member for Brentwood and Ongar to the deficiency in the hurried rail privatisation programme of the previous Administration, although I do not want to move away from the Select Committee report. There are pages of evidence from the various witnesses, who contributed well to the work of the Committee. In each case, there was general support for the introduction of the strategic rail authority and, with the support in the House and within the industry, there is a fair wind for the Committee's proposals. 1 make that point to my right hon. Friend the Minister because I consider that the Government must act on at least some of the recommendations in the report. Failure to do so would impede the programme for an integrated transport system, which the report could help to bring about.

That was the point that I made when I intervened on my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody). We need to have the integration of road transport with rail transport to ensure that freight provision, which has been neglected for so long, can be improved. Although in the past rail freight has been moved during the night, there is evidence that some freight trains are being moved by day. That will help freight movements to take place within a reasonable time and, as a result, people will increasingly accept the possibility of moving freight by rail.

Hon. Members will have received briefing material from the Scottish, Welsh and English railways, setting out some of the anxieties that they expressed to the Select Committee—directly and in briefing material—about the introduction of the strategic rail authority. We are advised that they are introducing new locomotives and new wagons, which shows that greater capacity is needed to move freight by rail.

I emphasise that we must try to remove lorries from the motorways and, in many instances, from towns and cities, by transferring freight to rail, so that it may enter city centres without creating road traffic. I make a plea to the Minister to examine the evidence that has been submitted on overcrowding of some trains—especially on the east coast main line—and the evidence submitted by Lord Berkeley and his colleagues on the movement of freight.

I conclude my remarks because I know that my colleagues, who took evidence for many long hours, want to make a contribution. I believe that the Government should act on a significant amount of that evidence, and I hope that the Minister will take note of the contributions that have been made.

Although I welcome the opportunity to debate the report, I regret the fact that none of my party served on the Transport Sub-Committee, which considered this matter in so much detail. However, I have read the report, and there is much in it that the Liberal Democrats can support.

We welcome the fact that the report draws attention to failings in the regulatory system introduced by the previous Government in their headlong ideological rush to privatise the network. The report says that, under the Conservatives, the Rail Regulator was left with

"no enforceable obligation on Railtrack to spend the cash from public subsidies on maintenance and renewal of the network".

That appears to be a major omission, as does the fact that the Rail Regulator was left without scrutiny powers over the rolling stock companies.

The Rail Regulator had to dismiss Railtrack's 1997 network management statement as unsatisfactory because of a significant backlog in investment. Earlier today, Railtrack had an opportunity to show that it took last year's red light seriously. I hope that it will be evident from this year's network management statement that Railtrack acknowledges that it has a role in the development of the country's infrastructure.

The results of biannual customer satisfaction surveys produced by the train companies, which must have been of great interest to passengers, remained unpublished for many years. I am sure that the volunteers who run the Bluebell railway could have run the railways better than the previous Administration did.

Looking to the future, many of the report's recommendations would have been implemented even if a strategic rail authority had not been established. We support more demanding train service quality targets. We strongly support the moratorium on the sale of land by the British Railways Board, which is a source of major concern. If one is trying to extend a network, it restricts one's scope if all the prime sites that can be used are being sold.

If the hon. Gentleman considers the report carefully, he will see that there is no question of a moratorium on the sale of land by the British Railways Board, but that there is a question of Railtrack being given the same opportunity as other bidders when land is sold. That is a different matter. There is no presumption in the report that the right of the British Railways Board to sell land will be interfered with.

I thank the hon. Gentleman for that intervention, but the report specifically mentions a moratorium.

We strongly support the retention of the fines and penalties levied on the train operators for immediate reinvestment in passenger benefits rather than the Chancellor's slush fund. We support the shift of responsibilities for safety matters from Railtrack to an independent body, although it is worth confirming that, as was said earlier, the safety record appears to have remained very good, even after privatisation. We support the relaunch of the rail user committees. Those organisations are supposed to represent passengers, but I am afraid that their profile appears to be no larger than the stickers that are stuck in train carriages.

Our support for the report is qualified. We question how strategic the strategic rail authority will be if all the report's recommendations are adopted. There is a great risk that, by taking on so many of the operational tasks performed by the Office of Passenger Rail Franchising and the Rail Regulator, the strategic rail authority will lose its focus and neglect key objectives, such as that of developing a vision for investment in the national rail network. The strategic rail authority should be about strategy and broad objectives; it should not be about the timetabling of the 7.23 am Connex South Central service from Carshalton Beeches to Victoria. Moreover, the creation of the strategic rail authority should not involve such an upheaval in the rail industry, or such a diversion of funds, that no progress is made in clearing the backlog of between 15 and 20 bottlenecks in the system.

We seek clarification of the funding arrangements for the strategic rail authority, especially as a sharp drop in subsidy is planned for the train operating companies—from £1.8 billion this year to £0.8 billion in 2002–03. It would have been preferable had greater consideration been given to the establishment of a strategic transport authority. That would, by necessity, have had a very restricted remit, to avoid the prospect of the operational overload that already worries us in relation to the smaller responsibilities of a strategic railway authority.

The Government have repeatedly stated their intention to produce an integrated transport policy. What better way is there of promoting such a policy than through the auspices of a strategic transport authority? For example, that strategic transport authority might take responsibility for devising the Government's programme of CO₂ reduction in relation to transport. That is an area where, if action is not taken almost immediately, the Government will not have a snowball in hell's chance of meeting the Prime Minister's commitment to a 20 per cent. reduction by 2010, or even the Deputy Prime Minister's more modest commitment to ensure that, in 2002, traffic does not exceed 1997 levels.

The Liberal Democrats approve of many of the measures in the report. We shall monitor the development of the strategic rail authority, but we shall pull the emergency cord if the authority grows into an inflexible, unwieldy beast, with an appetite for detail but no vision.

The importance of the report is that it is forward-looking.

The hon. Member for Brentwood and Ongar (Mr. Pickles), spoke about a period of stability. If that means maintaining the status quo, with our railways not delivering what we want them to deliver, I would disagree with him. I suspect that many of the interests running our railways see stability in that way. The report is not about the stability of the status quo, because the status quo is not acceptable.

The hon. Member for Brentwood and Ongar also spoke about Railtrack's plans for investment—good: we live in hope, and we hope that those plans become reality. Heaven knows the amount of public money that was squandered by the previous Government on privatising the railways. It was billions. The amount of public subsidy has doubled since privatization—a fact which I am sure the hon. Gentleman would acknowledge. One would expect some hard evidence of the improvements that we are promised. In the public interest we can demand that those improvements take place. We shall wait and see.

Evidence is in place already. Is the hon. Gentleman aware that Railtrack's investment in the first six months of last year was 38 per cent. higher than in the first six months of the previous year?

I am also aware of the damaging criticism of Railtrack's record by the regulator and the Health and Safety Executive. That is not a political point that we need waste the time of the House debating, as the hon. Gentleman seems determined to do. Well-respected outside organisations are extremely critical of Railtrack's investment record. The report rightly concerns itself with that criticism.

The hon. Member for Carshalton and Wallington (Mr. Brake) referred to the intention that the public subsidy should be reduced over the next few years. I know that that is the intention, but if it is reduced to £0.8 billion, it might bring us back to the level of public subsidy that existed under the dead hand of British Railways. If many more such dead hands are removed, the Treasury will have apoplexy, because every time a dead hand is removed, the public subsidy doubles. I am sure that that is not what the Government want.

The significance of the report is that it tells Government that we need to take a strategic view of our railway infrastructure and provision. That never occurred to the previous Government. They were concerned only with privatising and fragmenting the railway system, which is what happened. The report points out to Government that, if the railways are to play the economic, social and environmental role that the country wants them to play, a strategic overview is essential.

The Committee was of the unanimous view that we cannot achieve that strategic approach with the present fragmented system. It would be impossible, and the Government should not waste their time trying to do it. We therefore strongly support the concept of a strategic rail authority, which would have an over-arching responsibility to bring a strategic view to a critical provision in our transport sector. As the hon. Member for Brentwood and Ongar rightly observed, that provision brings not only enormous challenges but enormous potential. We want the strategic rail authority to play a central role in ensuring that that potential is achieved.

That is the first point that needs to be made to my hon. Friend the Minister, who is listening intently to the debate. That message is the factor of overriding importance that the Committee considered when we took evidence and deliberated on the contents of the report.

The second aspect that I would underline is the difficult but crucial concept of public confidence. It is true that there is no hard evidence to suggest that safety is being compromised by Railtrack and the train operating companies, but there is undoubtedly a public perception that the profit motive will ultimately override those considerations. We examined the matter carefully.

Public confidence is essential if the Government are to succeed in the enormously important task of reinvigorating our railways. In that regard, the report makes several recommendations, one of which is crucial—that we should no longer tolerate the responsibility for safety being left with Railtrack. There must be a separate, free-standing body to examine the issue dispassionately, far removed from the profit motive and commercial interests. The public interest must be its overriding responsibility. If, at the end of the debate, my hon. Friend will say that the Government will pursue that aim vigorously, they will have done the railway industry, the country and the public at large a great service.

My final point involves a different aspect of the public interest. How do we bring to bear the enormous influence—not interference, but legitimate influence—of Government, for which the report calls and which most of us want? How can we, for example, tolerate a situation where the rolling stock companies were given a licence to print money?

indicated dissent.

It is no good the hon. Gentleman shaking his head. When the Angel leasing company was sold off, Nomura bank of Japan made a windfall profit of £750 million without lifting a finger. The report challenges the House and the Government to decide whether there is a legitimate public interest when public resources are milked away like that, producing no beneficial effect on the economic, social and environmental objectives in which our railways can play such a big part.

I am delighted that the report concludes that we can no longer tolerate the rolling stock companies being completely unregulated. Public interest demands that such activity be brought within the confines of positive and effective regulation so that we may see exactly what is happening. That is one example of how the public interest—which was our overriding consideration when we addressed these factors—would be well served by the Government.

I listened with interest to the points made by the hon. Member for Carshalton and Wallington, who said that the strategic rail authority should not become a great amorphous body that is involved with the 6.30 train travelling from point A to point B. People will travel not on the strategic rail authority but on the 6.30 train from point A to point B. However, the strategic rail authority should have legitimate concerns about what is happening.

We cannot continue to tolerate the present situation: an individual turns up at a railway station and finds that the train to Euston is not running; he is told that the next train is scheduled to leave in an hour but, when he tries to book on that train, he is informed that there is no guarantee that it will run either; the individual then asks, "Well, what do you advise?", and a representative of the privatised rail company at the railway station tells him, "Our advice, sir, is not to travel by train."

Must we continue to tolerate a situation whereby an individual turns up at a railway station and sees a notice saying, "We are issuing tickets only for travel today"? What happens if that person wishes to travel tomorrow? When we ask about such matters, we receive no explanation. Is that serving the public interest? I guarantee that the information I have offered to the House is correct, because I was that individual.

The report is positive and forward-looking. It does not go over the entrails of the chaos created by the previous Government. We know all about that. I look forward to the day—in the not too distant future—when this Government, of whom I am so proud, enact the majority, if not all, of this report's recommendations.

I begin by congratulating the Environment, Transport and Regional Affairs Committee on choosing this subject for its first report. The Deputy Prime Minister and his colleagues have made it clear that they intend to give transport a high profile in this Parliament. Therefore, it is right to address the issue at an early stage.

The Select Committee has made it clear that it intends to follow the debate closely. Under the wise stewardship of the hon. Member for Crewe and Nantwich (Mrs. Dunwoody), it will clearly be a robust debate. The hon. Lady has clear views about the type of transport system that she wants to see. With great respect to her, I think that the language she employed today is a lot stronger than that used in the report. The tone of the speech by the hon. Member for Stoke-on-Trent, South (Mr. Stevenson) was also much stronger than that of the report.

I sense that the hon. Member for Crewe and Nantwich may have wished for a more robust report. Her approach differs from my own, but at least we share the same objective. We want to achieve a satisfactory solution, although we differ about the means of securing that solution. From a reading of the Government's evidence, it is apparent that the hon. Lady's approach may be stronger than that of the Government. That will create difficulties for the hon. Lady and the Government, as I believe that they are on the same side.

So they tell me.

The report's central premise is that it welcomes the Government's proposals for a strategic rail authority. The Government have produced no firm proposals in that regard, but the nature of the report is immediately clear when it states that the SRA should be responsible for

"strategic planning, co-ordinating and supervising the activities of the rail industry".

The hon. Member for Crewe and Nantwich put her own interpretation on that statement—indeed, I believe that the statement is open to interpretation, and I suspect that the Government may interpret it slightly differently when they draw up their plans.

The report rightly does not recommend a strategic transport authority at this stage. I will go further and say that I hope that it does not recommend a strategic transport authority at any stage. I believe that the Government are the strategic transport authority: they have the powers, the funds—and, I hope, the vision—to embrace all community issues.

It is interesting to note that the report does not criticise the principle of rail privatisation. That is not surprising when one considers the effective role of Conservative Members on the Committee, including my hon. Friends the Members for Brentwood and Ongar (Mr. Pickles), for Wiltshire, North (Mr. Gray) and for Runnymede and Weybridge (Mr. Hammond). The report is full of constructive criticism, but it accepts the overall privatisation principle. I am delighted that, in its recommendations, the report states:

"The purpose of the Strategic Rail Authority should be to … foster a climate that encourages private investment in the railway".

That point was made by my hon. Friend the Member for Brentwood and Ongar but not mentioned by the hon. Member for Crewe and Nantwich. The conclusion is welcomed by Committee members, some of whom, I confess, I thought felt differently.

Does my hon. Friend agree that it is rather curious that the tones of old Labour have reverberated around the Chamber this morning more strongly than they resound in the report? The same applies to press coverage of the report last week. For example, a headline in The Times said, "Greater state control of rail urged by MPs". Does my hon. Friend agree that the report proposes a modest administrative change and in no sense attacks the principle of privatisation?

I am very grateful to my hon. Friend.

If that is your story, stick to it.

The hon. Gentleman implies that he does not agree with my hon. Friend. I believe that the report is fairly balanced and that the Government will probably be rather pleased by its tone, which differs from the personal inclinations of some Committee members.

Does the hon. Gentleman accept that the goal of a Select Committee is to reach a consensus? I know that it will come as a shock to the hon. Gentleman to learn that I hold different views from the hon. Member for Brentwood and Ongar (Mr. Pickles). He is a most remarkable Member of Parliament, but not one with whom I agree on every point regarding the political development of this country. That means that the report will not reflect all my beliefs; nor will it reflect everything that the hon. Gentleman believes. Its tone is consensual and its strength comes from that very quality.

I am obliged to the hon. Lady. She confirms my suspicions that the report is welcomed neither by her side nor by my side of the Committee—although it will probably be welcomed by the Government.

That is not true.

The hon. Lady has just said that she does not believe in much of the report. I am sure that the whole House—and, indeed the whole country—has heard her words.

In reaching its conclusions, I have no doubt that the Committee was influenced by the evidence given by the passenger transport executive organisations, which were no particular friends of the previous Government but which are inclined not to condemn the policy. It is very early days in the privatisation of the railways and, although there is much justified criticism at present, I believe that it is wrong to take a snapshot of the railways as they stand in March 1998 and say that privatisation has failed. I do not think that privatisation will fail.

Can the hon. Gentleman tell us when he will confirm that there is a problem?

I shall turn to that issue in a moment. Frankly, I think that the real effect of privatisation will not be felt for three, four or five years. When some of the investment comes on stream, I believe that the hon. Gentleman will defend railway privatisation like a good Tory. There will be a marked change of attitude in a couple of years.

I have a great deal of faith in franchisees' ability to improve services, and such improvements will result largely from the economic freedom achieved by privatisation. Privatisations over the past 50 years have all struggled initially. One of the first privatisations, that of British Telecom, was unpopular and passionately opposed by the Labour party. Newspapers and Labour Members gleefully reported on the number of telephone kiosks that were not working. The criticism was similar in style to that which is being heaped on the railways. People were right to criticise BT then, and they are right to criticise the railways now. However, no one in their right mind would say that privatisation of BT was a mistake. The company is a world beater of which Great Britain can rightly be proud. In four or five years, that will be the case with the railways.

rose—

rose—

I give way to the hon. Member for Cunninghame, South.

Why did a previous Chairman of the Select Committee call railway privatisation a poll tax on wheels?

Does the hon. Gentleman agree with those—

Order. The hon. Member for Croydon, South (Mr. Ottaway) should answer the first intervention before he deals with a second. He cannot take two at a time.

I beg your pardon, Mr. Deputy Speaker. I was dealing with them as a job lot.

I do not agree with the point made by the hon. Member for Cunninghame, South about railway privatisation being a poll tax on wheels. It will come right in the long term. He has fallen into the trap of thinking that the position today will continue in perpetuity, and that railway privatisation has therefore failed.

Does the hon. Gentleman agree with franchisees who argue that franchise periods are too short to make the necessary investment and that the Conservative Government got it wrong?

I shall come to that point in a moment.

Is not rail privatisation structurally different from other privatisations because the market relationship between carriage and track charges clearly acts against social policies, such as carrying more freight by rail? Labour Members have suggested that the structural institutionalisation of the possible failure of the system is a problem.

I think that I understand the hon. Gentleman's point, but freight is a success story of privatisation.

BT is a world-beating company that we can be proud of, and in the long term we shall be proud of Railtrack, which is involved in discussions about the channel tunnel rail link, is a possible bidder for London Underground and announced today a £17 billion package which the hon. Member for Crewe and Nantwich churlishly did not to welcome. The strength of the company in the private sector justifies the privatisation. The old, nationalised British Railways Board would not have been able to match Railtrack's investment and its involvement in the channel tunnel rail link and London Underground.

We all know that the west coast main line is hugely unreliable, but Virgin proposes a £1 billion order for 130 tilting trains that will knock 90 minutes off the journey time from London to Glasgow and reduce the trip to Birmingham to 75 minutes. Labour Members should be patient: just as BT became effective, we will have effective railways in three or four years' time when the investment has been made.

I am the first to admit that, 18 months after the completion of privatisation, there are problems, some of which are becoming clearer. There is an important distinction between current railway operations and long-term investment plans. In the short term, the passenger service is everything. My constituency contains 11 commuter stations in the Connex South Central area. I watch developments closely; after an excellent start and increased services, the service has become unreliable and unacceptable. Trains do not have enough carriages, and conditions are squalid at peak times; but trains are becoming victims of their own success. Passenger numbers are increasing, and the forecast is that they will continue to rise.

The Deputy Prime Minister believes that that is largely explained by the well-established link between rail use and economic growth. However, it cannot wholly be explained by that link, and, not surprisingly, the Office of Passenger Rail Franchising took a different view and expected passenger growth of 24 per cent. over the next five or six years. I share that view, because improvements brought about by rail privatisation—better stations, improved services and falling fares in real terms—will make a heck of a difference to public attitudes, and will go a long way to achieving the strategic objectives of both the previous and the current Government.

There is a problem with continuity of investment as the end of the franchise periods approaches, as the hon. Member for South Antrim (Mr. Forsythe) said. A weakness of the franchise system is that the Government of the day were so nervous that they took a number of precautions to deal with any failures, but the system is short on mechanisms to cope with success and a large growth in demand.

Although under no obligation to do so under the terms of the franchise, Great North Eastern Railways wants to improve its rolling stock, which is not old, but unexpected passenger growth is causing serious problems. As the hon. Member for Normanton (Mr. O'Brien) said, short franchise periods make it difficult to fund further investment.

I am pleased that the Select Committee has strongly recommended that the strategic rail authority should have the power to offer guarantees to existing franchisees who propose to invest in new rolling stock, and that subsequent franchisees should be required to take over the lease for such stock. The tone of the recommendation is a little heavy, but the SRA should address the issue and I am pleased that it is a priority.

An interesting passage of the report deals with freight, which is an unambiguous success story of privatisation. The report does not quarrel with that. The nation's main freight mover is English, Welsh and Scottish Railways, which has about 90 per cent. of the market. EWS reports a 30 per cent. increase in freight train miles in the past 18 months.

The Select Committee suggests that the SRA should consider how to increase freight carrying, but companies seem to be doing well without the SRA intervening. The Minister appears restless. How much time does he need to make his winding-up speech?

I need 15 minutes.

I shall conclude my remarks.

Although Conservative Members have reservations about the report, we have no difficulties with the thrust of it. Such a complex privatisation needs constant fine tuning. The previous Government would have concluded that a strategic rail authority was necessary during this Parliament. However, I urge the Government to adopt the lighter touch proposed in their evidence to the Select Committee, given that a strategic rail authority, not an executive rail authority, has been proposed.

I congratulate my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) and her fellow Select Committee members on their thorough and wide-ranging report on the Government's proposals for a new rail authority and railway regulation.

The Government welcome the report, and we shall consider its recommendations carefully when finalising our plans for the railways, which will be published in a few months.

The Committee's report is timely: it is almost exactly a year since rail privatisation was completed. In that year, the industry and its customers had to try to come to terms with the massive upheaval that was imposed on them by the fragmentation of the network. During that time, the shortcomings of privatisation have become all too obvious. Many passengers are not getting the service improvements that were promised by the previous Government. In that year, a few people have made fortunes from the railways, but many passengers have been short-changed.

Does my hon. Friend agree that the proposed acquisition of Great Western by First Group is an example of the rail privatisation leading to the creation of millionaires at the expense of the travelling public? The privatised railways are in danger of creating more millionaires than the lottery. Does he further agree that the franchising director should not let that acquisition go ahead until there has been proper consultation and proper equity among the franchisers? He should not use his position improperly to pass on some of the benefits to a franchise that is not involved in the takeover.

I agree with my hon. Friend that huge and unjustified private profits have been made from the resale of assets. The case that my hon. Friend cites looks like another example of that. He asks about the franchising director. Because of the shortage of time I shall not reply to that now, but shall write to my hon. Friend.

The Committee's report highlights well the shortcomings that we inherited from the previous Administration. We saw those problems coming, and that was why in opposition we consistently opposed rail privatisation. When we came to power in May we found a railway system that had been broken into a hundred pieces, and no strategic vision for the development of the network. Even the industry regulators acknowledge that the regulatory structure can be confusing. The railways were crying out for some leadership and direction.

Everybody acknowledges that the challenges facing the rail industry cannot be solved overnight. However, the Government have made clear their intentions. We aim to put the railways at the heart of a truly integrated transport policy; to win more passengers and freight to rail and, above all, to make sure that the railways are run in the public interest. That is why we are taking a long, hard look at the present regulatory structure, and why we have taken action within it where we can.

The House will recall that on 6 November I announced the first fruits of our review of railway regulation. We issued the franchising director with new objectives that deal with the issues that matter most to passengers—investment in decent rolling stock and stations, high standards of punctuality and reliability and the protection of passenger rights. We approved the franchising director's new planning criteria to provide an effective framework for developing and implementing worthwhile rail investment that will improve the range and quality of the services for rail users. We also agreed a voluntary concordat between Ministers and the Rail Regulator to give the regulator a clear sign of what the Government want for the railways.

We have also taken action on rail freight. We have revitalised the freight grants scheme and have increased its budget to encourage more rail freight. We have also secured commitments from the French Government and Eurotunnel that are designed to get a better deal for rail freight through the channel tunnel and beyond, not only by English, Welsh and Scottish Railways but by potential new entrants to the market.

Our measures on passenger and freight operations have been widely welcomed. Some train operators have played their part by taking steps to improve their services to passengers, but the overall picture is still unsatisfactory and there is much more to do. As the Committee's report states, the recent bulletin from the Office of Passenger Rail Franchising on the performance of the train operating companies in 1997–98 shows that punctuality and reliability on about half of the route groups surveyed were worse than in the preceding 12 months. The comments by the hon. Member for Croydon, South (Mr. Ottaway) reflect that deterioration.

I shall now turn to the centrepiece of our proposals—the new rail authority. Our manifesto contained a commitment to create a new rail authority to provide a clear, coherent and strategic programme for the railways, so that passengers' expectations could be met. I am pleased to note the Committee's endorsement of that proposal and of our aim for more effective and accountable railway regulation. The Committee made some detailed recommendations about the authority's functions. Of course, we shall carefully consider those recommendations in drawing up the new authority's detailed functions.

It may be helpful to hon. Members if I outline the general areas in which we expect the new authority to operate. We said in our manifesto that the new authority would combine the functions of the franchising director and some functions of the Department of the Environment, Transport and the Regions. We do not necessarily regard those functions as the limitation of the new rail authority's remit. The likely areas of responsibility for the new authority, many of which are referred to in the Committee's report, will include managing and enforcing existing franchise contracts; developing a strategic vision for investment in the network; promoting integration between rail and other modes of transport; promoting voluntary action by train operators to win passengers; protecting the needs of disabled passengers; and balancing the needs of passengers and freight users.

In addition to those likely functions, my right hon. Friend the Deputy Prime Minister stated in his oral evidence to the Committee that we shall also consider how consumers might be represented on the new authority. We envisage that the new authority will play an important role in encouraging more freight on to the railways.

rose—

I shall give way to my hon. Friend, but should like to make progress.

The Minister will look carefully at the role of customer services, will he not, because at the moment passengers are not being well served? That is an important matter.

I am grateful to my hon. Friend for her intervention, but in the few minutes that are left I should like to comment on safety, which some hon. Members, including my hon. Friend the Member for Stoke-on-Trent, South (Mr. Stevenson) emphasised.

The Committee's recommendation that transport safety regulation, should be focused on a single, entirely independent authority goes wider than railways. It would be a significant change in present arrangements for transport safety regulation, and would raise some complex issues. The United Kingdom's transport safety record is relatively good, and we would need to ensure that any new body would be more effective than current arrangements.

In terms of the railways, the Committee drew attention to mark 1 rolling stock and the installation of a train protection system. It recommended that Railtrack should be relieved of its role in safety regulation and that its safety and standards directorate should be transferred to an independent safety authority. The railway inspectorate's last annual report revealed that some operators have tried to reduce safety levels to the minimum that is allowed, saying that maintaining or improving on the status quo is too costly.

The Government are determined that no privatised railway company will be able to put private profit before public safety. I have already made it clear to the House that we look to the independent Health and Safety Commission as the safety regulator to ensure that standards are maintained and, where necessary, improved.

In the context of train protection and mark 1 rolling stock, I have written to the chairman of the Health and Safety Commission to make it clear that he should produce any formal proposals that he considers necessary, and I understand that Health and Safety Executive officials are working on such proposals.

The current arrangements for the present division of safety responsibilities were proposed by the Health and Safety Commission. Accordingly, we shall need to consult it before responding to the Committee's recommendations. When the commission proposed those arrangements, it said that in due course a full review should be carried out of the arrangements for setting and promulgating railway standards. I have asked the chairman of the commission to bring forward that review and to consider as part of it the extent to which Railtrack's current role in enforcing standards as well as in setting and promulgating them might be transferred. I am pleased to announce that the chairman of the commission has agreed and has said that the review will begin immediately.

The debate has been constructive. My hon. Friend the Member for Crewe and Nantwich was characteristically forthright in introducing the debate, and lucidly set out the issues. In the time available to me, it has not been possible to cover all the Committee's detailed recommendations. However, it is already plain from the Committee's report and from representations that we have received that our proposal for a new rail authority has widespread support. It was striking that even the Opposition spokesman, the hon. Member for Croydon, South, said rather lamely that, if the Conservatives had been elected to government, they would have proposed such a rail authority.

Passengers want the railways regulated in a way that is firm, fair and accountable. They should have a public service ethos, should not be driven solely by the profit motive and should be fit for the 21st century. Our proposals are a major step in the right direction and will help to create a climate in which the railways can flourish as part of an integrated transport system.

Last September, I visited a constituent of mine, Mrs. Spence, who lives in Kendal at the heart of my constituency, at her request. When I saw her, I found a lady in constant pain and completely bed-ridden, apart from access occasionally to a wheelchair, whose life had been ruined by the pain she suffers 24 hours a day. That was not always the case. In her younger years, she was a tennis player and ballroom dancer, and even marched on trade union marches when she lived in London. Today, her entire life has been ruined by the condition that is known as adhesive arachnoiditis.

In describing the condition to me, Mrs. Spence said, "It is like having a hot poker placed in your spine and spreading all over your body. It is like having a group of worms in your legs and feeling that they are wriggling around inside." She constantly feels that she has to punch her legs to try to stop the pain.

Mrs. Spence's husband, Brian, who has been a support to her throughout her life, sits up night after night looking after her, trying to control her pain and to help her. She is on constant medication. That includes a course of morphine tablets, but she has also been given liquid morphine; she often has to take it in liquid form when the pain breaks through the barrier of the tablets. She cannot put her feet on the floor without experiencing extreme discomfort. In 1980, she was told that, unless she used a wheelchair, she would be unlikely ever to leave her home again.

All that appears to stem from two occasions—one in 1971 and the other in 1973—when Mrs. Spence was injected in her spine with a chemical called Myodil. It is worth pausing to reflect on the purpose of the chemical. It is a radiopaque dye that is used when people have X-rays of their spines to enable all the substances within the spinal column to be shown more clearly on the X-ray. When she was given the chemical, she was placed on a table, injected and upended so that it sloshed up and down her spinal column. It appears that the chemical is a very sticky substance, and it bound together many of the nerve endings in the back of her spine. The consequence is constant discomfort and agony.

Mrs. Spence is not alone. I am grateful to my hon. Friend the Member for Tunbridge Wells (Mr. Norman) for drawing to my attention the case of his constituent, Mr. Peter Crawford, who is also confined to a wheelchair and suffers continuous pain requiring 24-hour care. My hon. Friend the Member for Faversham and Mid-Kent (Mr. Rowe) has told me of similar instances in his constituency. I believe that right hon. and hon. Members on both sides of the House have constituents who suffer from the condition.

In September, the Minister of State, Department of Health, Baroness Jay, wrote a letter to my hon. Friend the Member for Hertsmere (Mr. Clappison) in which she described adhesive arachnoiditis as "a rather uncommon … condition". To some extent, I wish that that was true, but none of us knows.

I tabled a parliamentary question, which received an answer from the Under-Secretary of State for Health. I asked

"how many cases of adhesive arachnoiditis have been diagnosed in the last 20 years".

The reply was:

"The information requested is not available"—[Official Report, 12 January 1998; Vol. 304, c. 152.]

That was largely because adhesive arachnoiditis is not a notifiable disease. It is not infectious, and statistics are not kept, so, sadly, none of us knows how extensive the condition is. However, there are some world experts in the sector.

One in particular is Dr. Charles Burton, the senior medical director of the department of neuroaugmentive surgery in Minnesota, a department which he founded. He is a distinguished person. Among other things, he served as a panel chairman of the United States Food and Drug Administration and was a founder of the North American Spine Society. He is probably the world's leading expert on this condition.

Recently, Dr. Burton wrote a paper, in which he says:

"Despite the availability of a wealth of published scientific information on the subject, it has not been well appreciated by the medical profession that the advanced forms of arachnoiditis may be associated with incapacitating pain, disability, or even death. In addition, the global incidence of severe arachnoiditis has only recently become more evident owing to the formation of patient self-help groups in the United States, England, and Australia. These organizations have shown that arachnoiditis represents a worldwide public health problem of considerable magnitude."

He has said that the condition is as

"bad as terminal cancer without the prospect of death to end the suffering."

The difficulty is that there is a history to that use of the chemical and its side effects. I have an article that appeared in January 1954 in The Journal of Bone and Joint Surgery, which was the official publication of the American Orthopaedic Association and the British Orthopaedic Association, and was printed both in Boston and London. The article is entitled "Arachnoiditis following the use of iodized oil." It starts:

"It is the purpose of this paper to present clinical and experimental data which suggested to us that pantopaque"—

the material that I am talking about—

"and other iodized materials may contribute to severe and disabling arachnoiditis."

An article in The Lancet as long ago as 1956 indicated similar problems relating to the chemical.

It is worth noting also that Dr. Burton points out in his paper:

"In Sweden and a number of other countries throughout the world (including the former Soviet Union) … on the basis of animal studies or clinical observation",

these substances were

"removed from clinical practice … as early as 1948",

yet in this country Myodil was used as standard practice for many decades: from the 1940s to the 1980s. Indeed, Myodil was never refused a product licence of right under the Medicines Act 1968. It was always granted those licences every five years until the late 1980s, when its manufacturer, Glaxo Wellcome, decided for its own reasons to withdraw the product from use.

The difficulty is that Myodil is an extremely unpleasant substance. Glaxo Wellcome issued guidance on its use about 20 years ago, which said that it should not be injected with anything other than a glass syringe because it would melt the rubber or plastic of any other type of syringe. There is evidence of the chemical being spilled on to a laboratory floor and melting the tiles, yet, in this country, the chemical was regularly injected into the spinal column of people as a normal and accepted part of medical practice. That was against a pattern of well-known scientific research throughout the world showing that there were problems with it.

I am delighted to note that, last month, Baroness Jay, who I believe is responsible for these matters in another place, wrote to Mrs. Ursula Coxhead of the Myodil Action Group:

"The Department of Health does recognise the association between the use of Myodil in myelography and the development of arachnoiditis in some patients."

That is a very important statement, because it has taken a long time for the Government—whether Conservative or Labour—to accept any link between the two. She adds:

"Warnings about the possibility of post-myelography arachnoiditis were included in the product information for Myodil many years ago."

That may be true, but those warnings consisted largely of exhortations to medical practitioners to remove the chemical immediately after it had been injected. In many cases—certainly in that of Mrs. Spence—that was not done, but, even where the chemical was removed in some cases, the evidence is that it was not possible to remove it all and that it did sustained and long-term damage.

That is why I and many sufferers of the condition have called for an inquiry. It is clear that there is prima facie evidence of, at best, something dramatically wrong and, at worst, serious and consistent malpractice. It is also clear that there is a division in medical opinion, which the Minister may mention in her reply. I accept that there is not yet a medical consensus on the causes of the condition or its linkage with Myodil, although it is strongly felt by some leading global experts, and the evidence appears to be accumulating.

I was disappointed when the Minister replied to my written question of 5 November last year:

"We have no plans to institute an inquiry into this issue."—[Official Report, 12 November 1997; Vol. 300, c. 596]

I hope that she will reconsider. I pay tribute to a Newcastle newspaper that does not cover much of my constituency, but is significant in the north—The Journal—which has been running a sustained campaign on the issue. Let me quote briefly from an editorial last month which sets out the case very clearly. It states:

"This is not a small claim for a minor injury. Myodil has ruined lives. It is a case which must come to court, not only to fix compensation for sufferers, but also to throw some light on what happened when Myodil was being used.

This will have to emerge in the courtroom because of the Government's steadfast refusal to hold an inquiry into the circumstances surrounding the drug's use.

This obstructive attitude is unforgivable. Those people enduring the daily agony from the Myodil treatment at least deserve to feel that lessons might be learned from what went wrong. Such an inquiry might also result in information about the extent of the problem. Health ministers admit they have no idea how many people are suffering from the problem they refuse to investigate."

Let me stress that it is not a partisan issue and that the current Government are taking exactly the same stance as their predecessors. In that respect, they are no worse—or better—than the previous Government. However, some of those concerned about the issue find it sad that, in opposition, the Government took a rather different view. In a press release issued in February 1993, under the heading "Blunkett calls for emergency action on arachnoiditis" the shadow Health Secretary, now the Secretary of State for Education and Employment, referred to

"needless tragedy" and

"the damage caused to innocent people's health"

and the need for

"a clear statement of precisely what action has been taken".

He called for specific steps, including:

"No-fault compensation should be paid … A full enquiry should be established … All invasive procedures carried out in the course of spinal treatment should be immediately replaced with safer practices such as Magnetic Resonance Imaging."

That is what the then shadow Health Secretary, now a member of the Cabinet, called for in opposition. That is what those suffering from the condition seek from the Government today.

We are considering a chilling chain of incidents. There is scientific evidence, published as long ago as the 1950s, that the chemical has devastating side effects. There is also evidence of concealment within the medical profession. My constituent tells me that in 1994 she obtained medical notes dating as far back as 1973 which demonstrated that two separate doctors and a neurosurgeon diagnosed her as suffering from adhesive arachnoiditis, but she was not told until she obtained those notes that she was suffering from anything other than a variation of arthritis of the spine.

There is evidence that Myodil was a nasty chemical and that a very large and wealthy company has taken a hostile attitude. It takes the view that, as anybody needing a myelography had a back problem, all subsequent problems must have stemmed from that. There is also evidence that, sadly, successive Governments followed the advice of their officials that it would be too difficult to have an inquiry and get to the root of the problem.

I am sure that the Minister will have looked into the matter and that she has in front of her an elegant speech drafted by her hard-working officials—no doubt the same officials who advised previous Governments. After she has read her speech, I ask her not to dismiss the issue from her mind, but to search her heart and consider whether the impulse for justice that brought her and hon. Members representing all parties to the House, and which is the purpose and function of this place, would be best served by having an open, full and public inquiry to establish the medical facts, who knew what when and where blame lies and to address the issue of compensation for people whose lives have been blighted beyond belief. They will never recover, but they may be able to have a little more comfort in their dying years if they receive some compensation.

I begin by congratulating the hon. Member for Westmorland and Lonsdale (Mr. Collins) on introducing the debate, on the elegance and eloquence of his speech, and on the care with which he is representing his constituent's interest in the matter.

Let me also make it clear to the House that my brother holds a senior position on the board of Glaxo Wellcome. In the context of my ministerial duties, I do not participate in discussions concerning the pharmaceutical industry. I raised the question of my having any conflict of interest in replying to today's debate with the permanent secretary, who feels there is no conflict of interest, and I have written to the hon. Gentleman accordingly.

The hon. Gentleman is absolutely right to say that arachnoiditis is not a party issue. Members on both sides of the House have constituents who are raising precisely the same concerns as he has raised today on behalf of Mrs. Spence. Many such people afflicted with awful and chronic illness turn their own adversity to the advantage of others by highlighting through their circumstances the broader lessons to be learned. We pay tribute to their efforts.

I assure the hon. Gentleman that I have listened very carefully to the points that he has raised. Let me begin by putting the issue of the treatment of people who suffer from arachnoiditis into its broader context by setting out the Government's proposals for developing, strengthening and rebuilding our national health service that were clearly set out in the White Paper "The new national health service—modern and dependable" which made clear our concern to develop proper support and services for people who suffer long-term, life-limiting conditions and disabilities such as arachnoiditis.

Many people suffer from conditions that will never be completely cured. Therefore, it is important for the health service to ensure that they are properly supported. We shall focus on recuperation and rehabilitation, recognising that the management of chronic pain and other palliative care is an important part of enabling people with such conditions to live as independently and actively as possible. The Government will expect co-operation, not competition, in the planning and delivery of health and social care at local level.

As the hon. Gentleman made clear, co-operation will be crucial in providing the right support for people suffering from conditions such as arachnoiditis. I hope that he accepts that all the action that the Government are taking following the publication of the White Paper and the public health Green Paper make clear our determination to rebuild public confidence in the national health service as a public service accountable to patients, open to the public and shaped by their views and experiences.

It may help if I briefly summarise the issues that the disease raises for the Government. The hon. Gentleman has made very clear the extent to which arachnoiditis is an uncommon and distressing condition, characterised by chronic inflammation and thickening of the arachnoid membrane. That membrane apparently looks like a spider's web—hence its name. It covers and protects the brain and the spinal cord.

It is particularly distressing that arachnoiditis may be a subsequent complication of an earlier injury. It is a progressive condition, for which there is no known cure. It traps nerves as they leave the spinal cord, and at the lower end of the spinal canal; it may cause a great deal of low back, neck and leg pain—and in some cases, this becomes a neurological disability.

The sad fact is that a mercifully small number of people are seriously affected by arachnoiditis. We know, as the hon. Gentleman stressed in the case of Mrs. Spence—other hon. Members will testify to the experience of other constituents—that the pain from this condition can cause misery for the individual concerned and for his or her family.

The White Paper sets out our approach to service development in the context of evidence-based service frameworks which will focus much more strongly on the quality of care. That was often neglected by the previous Administration under the internal market. The election of a Labour Government, with our commitment to rebuilding a national health service, marks an important move away from focusing solely on quantity of treatment and towards a much greater preoccupation at every stage with the quality of treatment. Pain management is developing across the country and is supported by an increasing commitment by the professions to evidence-based pain services. Quality is absolutely integral to the effectiveness of those services. I hope that that will be good news for patients.

The National Institute for Clinical Excellence will actively contribute to the development of services across the NHS by co-ordinating programmes to improve clinical standards, by issuing guidance on the clinical and cost-effectiveness of clinical practice, and by supporting clinical audit development work, making sure that quality is measured at every stage of the process.

Effective pain relief, a key component of high-quality care for people with arachnoiditis, will be one of the topics that may in due course form part of the national institute's work. Attention has recently focused on the Audit Commission's report "Anaesthesia Under Examination", which highlighted the need for commissioners and trusts to obtain better data about clinical activity and service standards, so that resources can be matched more closely to need. The Audit Commission has made a number of extremely sensible recommendations for improving the efficiency of pain clinics—recommendations which I am sure managers and professionals throughout the NHS will take on board, because they are evidently of benefit to patients.

As I said, arachnoiditis is caused by injury to the arachnoid membrane. That may result from many causes, such as infection, haemorrhage, trauma, surgery, and the diagnostic procedure known as myelography. Patients with arachnoiditis may have more than one predisposing cause.

Myelography, the cause with which the hon. Gentleman is particularly concerned, is an X-ray of the spinal cord cavity involving a lumbar puncture to inject the contrast agent or dye used into the subarachnoid space. The contrast agent or dye may then be visualised by X-ray. Myelography is used to diagnose serious conditions such as spinal cancer or a prolapsed disc. It is not a procedure used on patients who are otherwise fit and healthy. As with many difficult clinical decisions, the risks of not being able to diagnose what may be a life-threatening illness have to be set against the risks involved in the procedure itself. It is never a clinical decision to be undertaken lightly; it is undertaken only after careful consideration of all the factors involved.

As the hon. Gentleman will be well aware, no clinical intervention is completely free of risk. That is why we look to doctors to use their knowledge, skill and experience to weigh carefully the likely benefits of any procedure, such as an X-ray investigation, against the anticipated risks for the patient. It is also why we support doctors' efforts to maintain those skills. There should also be discussion with patients so that they are aware of any risks that may accompany the treatment.

Of course the Minister is right to say that we must place our trust in the medical profession; equally, that profession is subject to public accountability. Will she deal with the case for a public inquiry, which her party supported when in opposition? Now that it is in government, does her party still support the idea?

I shall be coming to the case that the hon. Gentleman made for a public inquiry.

In the past, Myodil was linked to the development of post-myelography arachnoiditis in some patients, especially when there were technical difficulties in carrying out the X-ray procedure. Myodil was withdrawn by Glaxo from the market in late 1987 for commercial reasons. Arachnoiditis was a known, if rare, side-effect of Myodil, and the appropriate warnings were given in the product information, with the advice to remove as much of it as possible after the X-ray procedure. The number of patients who suffered from that complication is unfortunately not known.

Myodil is an old product which was available before licensing procedures were in place in the UK. Following the thalidomide tragedy, the Medicines Act 1968 was introduced, and implemented in 1971. Products already available on the market were given a product licence of right and were systematically reviewed by the Committee on Safety of Medicines for safety, quality and efficacy. Myodil was reviewed under those procedures, and a reviewed licence was given early in 1987. It was therefore handled under the normal procedures for the licensing of medicines.

Things have moved on; patients today are much more involved in discussions and subsequent decisions about their care. Like any medicinal products, the contrast dyes used in myelograms come with product information supplied by the manufacturer. All medicinal products are subject to stringent assessment of safety, quality and efficacy before being licensed, and are closely monitored after licensing to detect any previously unrecognised adverse effects or any change in the balance of risks and benefits. This post-marketing assessment of drug safety is known as pharmacovigilance.

Things have also moved on in the area of diagnoses. Today, many patients who require diagnostic procedures of this nature have to undergo a non-invasive magnetic resonance imaging scan instead of myelography. But not all patients are suitable for MRI scanning, so myelography is still an important procedure. For such patients, newer, water-soluble dyes are available and are less likely to be associated with arachnoiditis.

On the hon. Gentleman's call for an inquiry, I reiterate the parliamentary answer that I supplied some months ago: we have no plans to hold an inquiry, and I hope that he understands that it would not be proper for me to comment on matters that may yet become the subject of legal proceedings. I have, however, asked officials to set up a meeting with the Myodil Action Group. Baroness Jay, who has ministerial responsibility for this matter, has agreed to chair the meeting.

I hope that, having raised this issue in the context of concern for his constituents, the hon. Gentleman accepts the responses that I have given to his questions.

I am grateful for the opportunity to raise the issue of the Rookery footpath in Barrow-on-Soar in my constituency. Once in a generation, a Member of Parliament makes a great speech. Unfortunately, this morning is not the time for that great speech in my parliamentary career. Many issues that arise in our constituencies daily are just as important to local residents as the big issues that we discuss here, and I am humbled to follow the debate initiated by the hon. Member for Westmorland and Lonsdale (Mr. Collins), which dealt with a very important issue.

Hon. Members are driven into politics to discuss the big issues, to sort out major problems and to represent our constituents nationally, but every now and then a small event occurs which dominates one's postbag. This year, instead of receiving Christmas cards from the vast majority of my constituents, my postbag was inundated with 150 letters from the residents of Barrow-on-Soar about the temporary closure of the Rookery footpath in Leicestershire.

The footpath was supposed to be closed for six months, but it became clear from my discussions with local residents, the parish council, the county council and Railtrack that this was a saga: the temporary closure has lasted 12 years. On finding that a footpath is unsafe, the traffic authority—in this case, Leicestershire county council—can take out a temporary closure order under section 14(1) of the Road Traffic Regulation Act 1984, as amended. Whenever such issues arise, hon. Members find themselves looking up pieces of legislation of which we were previously unaware. That Act was never high on my reading list, but since Christmas I have become increasingly aware of its effects.

I wish to explain what has happened in the case of the Rookery footpath. The action that I have taken so far has generated much local interest, and I am sure that it will lead to the footpath being reopened by the end of the year. I hope that this case will serve as a lesson throughout the country. Temporary closure orders that last 12 years or more are unacceptable, and I hope that we can ensure that they are not automatically renewed, as happens currently. When the county council asks for an extension of the temporary closure order later this year, I hope that a condition will be put on the order that the path be reopened.

This issue has generated a great deal of local interest. I congratulate the local press and the work of my constituents, particularly Dr. Earl, a parish councillor who has taken on this issue single-handedly and been a constant pain and threat to the county council.

I wish to declare an interest. Before 1 May last year, I was employed in Leicestershire county council's department of planning and transportation. I dealt with issues that were far removed from this one, as I was in the economic development unit and had no dealings with footpaths, so I cannot be blamed for the fact that the footpath has been closed for the past 11 years. I declare an interest because I know of the hard work and sincerity of all the officers at Leicestershire county council in dealing with this matter since I took it up.

It is always easy for Members of Parliament to criticise public servants for lack of action. When I go through the catalogue of disasters, delays and prevarications, hon. Members will see why some members of the public are right to wonder what has been happening over the past 12 years.

The Rookery footpath is important for a number of reasons. It is a cut-through from Humphrey Perkins school in Barrow-on-Soar to the village where I live, Quorn. It was used by a number of elderly residents, who remember it well, and unfortunately it is still being used by many pupils from the school.

The first order for closure was taken out in June 1986 because a wall adjoining the footpath was deemed unsafe—part of the granite was in danger of falling off, presenting a danger to individuals using the footpath. The footpath cuts through from Cotes road alongside a number of houses and crosses a busy and dangerous midland main line railway track. I use the line regularly, so I have been underneath the bridge and know that trains travel along that track at well over 90 miles an hour. It is important to reopen the footpath as soon as possible for the sake of the pupils and others who are still trying to use it. We all know the consequences of young children trying to cross railway tracks in front of fast-moving trains.

When the footpath was closed on 27 June 1986, it was unclear who owned the wall. Twelve years later, it is still unclear, which is why the footpath has remained closed. The first order was an emergency measure, which was supposed to last for just 14 days. Later that year, an order for a further three months was secured. I have a catalogue of the dates, from 1986 to January 1994, when further orders and the consent of the Secretary of State were secured. The Government office for the east midlands, as it is now known, became so used to extending the order that it did so without being asked. In 1995, the Secretary of State granted an extension to the order without the county council asking for it, so it seems to have become a piece of correspondence that went out regularly and automatically.

Unfortunately, on a couple of occasions the order lapsed by mistake, and the county council has admitted responsibility for that—a new order should have been made early in 1997. We now appear to be back up to date with the temporary closure orders and to be covered until July 1998. I hope that the Secretary of State will then find a way to ensure that work is carried out so that the path can be reopened within a reasonable time.

From what has been said so far, it is not clear to me whether the delays have been caused mainly by uncertainty about ownership, by a lack of funds for the repair of the boundary wall or by a lack of political will.

I was coming to that. Ultimately, the reason for the delay is the fact that the wall's ownership is in question; but the estimated cost of repairing the relevant part of the footpath is between £30,000 and £60,000. The county council—rightly, I suppose—does not want to be responsible for the repair of the wall and the reopening of the footpath at a possible cost of £60,000 if that proves to be the responsibility of some other body. Given the proximity of the footpath to the railway, it is felt that Railtrack and its former incarnation, British Rail's property arm, must bear some responsibility. The present reason for the continued delay is the fact that the county council is taking advice in order to ascertain the ownership of the wall and hence to establish when the footpath can be reopened.

As I have pointed out to constituents who have written to me, even if the county council is shown to own the wall, local councillors will have to decide how to find the £60,000 that is needed for its repair—and rightly so. If I may put it crudely, £60,000 equates to two teachers, or two or three social workers. It must be recognised that the county council has responsibilities. It has a financial responsibility, but it has another responsibility as well.

I am aware of the interest of my hon. Friend the Member for North-West Leicestershire (Mr. Taylor) in the right to roam and other issues relating to footpaths. I feel strongly that an issue here is the need to ensure that, where footpaths are provided, we make them available to the public. That applies particularly when public safety is involved, as it is in this instance. We rightly criticise farmers and others who cover and close footpaths, but in this case a democratically elected body—a county council—is doing that, entirely legally. I want to draw attention to the prevarication that seems to have taken place—although I am pleased to say that our actions are moving things forward.

My hon. Friend is right to say that I have a direct interest in the matter. There is a similar problem in my, neighbouring, constituency. Has it ever been established, as a result of investigation, whether the repairs could be carried out as part of a community project? That happened in the village of Thringston when I was a district councillor. Admittedly it was a larger project, but it seemed to resolve what had become an impasse.

We have not conferred about that, but the answer is yes. Dr. Earl, one of the parish councillors, has suggested that option. The county solicitor has said that the estimated cost of the work—£60,000—is so high because it will be done by hand. I am not sure by what other method the council envisages the wall's repair, but in my constituency—and no doubt that of my hon. Friend the Member for North-West Leicestershire—such repairs have been done before. Similar walls have been repaired in Birstall, where I was a councillor, under Government schemes.

I am sure that today's debate and the action taken by the county council in the last week and a half have produced light at the end of the tunnel. I am convinced that, because of Dr. Earl's work and that of the parish council—and, as I have said, my brief airing of the issue today—more has happened in the past three months than has happened in the past 12 years. I am grateful for that. I know that the county council and Railtrack are now negotiating, and I think that the footpath may be reopened as a result.

I hope, however, that the Minister will be able to say something about the legal aspects of temporary closure orders. An extension requires the consent of the Secretary of State, but there is no limit to the number of extensions for which he can provide. If an order is extended, the local authority need only advertise that. Given the position relating to the footpath—which I am sure is repeated throughout the country—we must ensure that, in future, temporary closure orders are not extended without question.

I hope that, by the time the Minister is able to respond—by producing legislation, or in other ways—the footpath will have been reopened; but I also hope, for the sake of future generations of footpath users, we have gone some way towards dispensing with a ridiculous anomaly.

I congratulate my hon. Friend the Member for Loughborough (Mr. Reed) on securing the debate.

Leicestershire county council's temporary closure of the Rookery footpath is clearly an important local issue, and I share my hon. Friend's disappointment about the length of time for which it has been closed. However—as my hon. Friend may have realised from my reply to his recent parliamentary question—responsibility for the closure rests squarely on the shoulders of the county council, and the Government's ability to exert influence is limited.

The Secretary of State's role is restricted to considering requests by the county council to extend the life of temporary traffic regulation orders closing the footpath. Such an extension was last granted on 19 February 1996, with an expiry date of 31 July 1996. The county council did not apply for a further extension, and the order lapsed. I understand that the council made a fresh order in February 1997, which was subsequently discovered to be invalid and was replaced with yet another order in January this year. That order will expire in July if it is not extended by the Secretary of State.

In considering a request for extension of the expiry date, the Secretary of State will look for evidence that the views of local users have been taken into account by the authority, but in a case such as this, in which there is a danger to public safety, those views will inevitably be given less weight. Having said that, I must emphasise that the 52 letters received recently by the Government office for the east midlands postdated the Secretary of State's consideration of the council's latest request for an extension.

The retaining wall alongside the footpath has not collapsed during the many years for which the closure has been intermittently in force, but that does not mean that its condition is without risk to the public. If the county council and its engineers have concerns about the safety of the retaining wall, it is right for the Secretary of State to take serious account of them.

There have been complaints about a lack of consultation by the county council. The legislation does not require such consultation to take place—although, given such a prolonged and sensitive closure, the council might well have benefited from explaining its proposals better rather than relying on statutory public notices.

I assure my hon. Friend that extensions to temporary closure orders are never made by Government offices unless requests are made for them to do so. I also assure him that, should the council apply for an extension of the expiry date of the current order, the Secretary of State will take full account of the points that have been made today and in letters from residents. If the Secretary of State decided that an extension should not be granted, the council would be at liberty to introduce a fresh order, but would be obliged to wait for three months before doing so.

I note the calls for the Secretary of State to intervene or to require the holding of a public inquiry, but there is no provision for that in the Road Traffic Regulation Act 1984, as amended by the Road Traffic (Temporary Restrictions) Act 1991. I suspect that my hon. Friend already knows that.

I am alarmed to learn of the risk to children who continue to use the footpath by climbing on the outside of the footbridge over the railway, but I understand that the county council has recently installed more and improved fencing and barriers to prevent such use.

I am pleased to hear that the county council has reopened a section of the footpath north of the railway to enable better access to properties on Cotes road. However, I note that, as the footbridge remains closed, that will not provide schoolchildren with the short cut they want to the south side of the railway.

I share the concern of my hon. Friend and his constituents about the use of temporary orders to close a footpath intermittently for 12 years, but I am encouraged by the fact that the Government office for the east midlands is taking a robust line with the county council. When, in February 1996, the most recent extension of six months was granted, the Government office asked the county council to consider promoting a permanent order, as that would enable objections to be heard and a public inquiry to be held.

I am disappointed that the county council seems to have disregarded that advice, and I express my dissatisfaction at the time that it is taking to resolve the problem and reopen the footpath. It is difficult to see how the delay can be consistent with the general duty on rights-of-way authorities under the Highways Act 1980 to maintain a public right of passage.

I am particularly disappointed at the prolonged closure of the footpath, as it flies in the face of what we want to achieve through an integrated transport policy. The Government recognise the flexibility that the car can bring and the fact that, for many people, the car has become a necessity, but the forecast growth in traffic is clearly unacceptable because of its environmental and economic effects. Forecasts suggest that, unless we change our travel habits, traffic levels will be between 36 per cent. and 57 per cent. higher in 20 years' time than they are now.

It is conceivable that some parents in Barrow-on-Soar are taking their children to school in Quorn by car following the closure of the Rookery footpath. The reduction in our dependence on the car through providing genuine alternatives and promoting walking, for example, is central to our achieving a more sustainable transport system. Consequently, failures to minimise the time during which footpaths are out of service do nothing to help, and much to harm, our collective efforts to bring about the changes that are necessary if we are to modify people's travel habits—we must work hard at that.

We shall set out the national policy framework for integrated transport in the forthcoming White Paper on transport, but delivery will rest with local partnerships. We very much hope that, across the country, schemes will be dealt with rather more effectively than has been the case in the unfortunate example that my hon. Friend has described.

I understand that the county council has now received advice from leading counsel about liability for the repair works to the retaining wall alongside the footpath.

The council's solicitor is now acting on that advice to ascertain who is liable for the repairs to the wall. I understand that the council hopes to complete those legal inquiries within the next month, after which it will meet Railtrack and the British Rail Property Board to take matters forward. In the meantime, the council's engineers are considering what measures could be implemented to reopen the footpath.

I can only hope that the county council's optimism is rewarded and that a solution is found quickly to the impasse that has resulted in the closure of the Rookery footpath for such an unacceptably long time.

I am delighted to have won the opportunity to debate the water industry in the House today. I thank the Minister for her presence, especially as she has just responded to the previous debate.

This is not the first time that the House has debated the industry. Indeed, I have over the years secured several Adjournment debates on the matter. However, this is the first time that I have been able to do so under a Labour Government, and I believe that the huge concern that the issue throws up justifies the use of the Minister's time.

This is a critical moment for water policy. Water pricing is undergoing its periodic review, and the Government are consulting on water abstraction licences and charging for water. Moreover, the BBC is in the middle of a specially themed water week, on which I congratulate it—I have been interested in the wide range of programmes that have been shown.

The water industry has changed beyond recognition since privatisation. This is not the moment to debate whether the industry should have been privatised—suffice it to say that the Liberal Democrats would not have taken it out of public hands. However, we must now look to the future, not the past.

There is no doubt that issues relating to the water industry are extremely emotive. Problems are all too apparent, and scarcely a day passes without a water story featuring prominently in the national press: fat cat pay-outs; water shortages; huge profits for the water companies; huge increases in bills; and environmental destruction as the search for new water increasingly drains rivers, lakes, wetlands and underground reserves. It is no wonder that people are worried and angry.

Profits across the industry have increased by some 130 per cent. since privatisation—they have more than doubled. Share prices and dividends to shareholders have, unsurprisingly, shot up as a result, despite supposedly tough regulation. To pay for that, water prices for domestic customers in England and Wales have increased on average by 39 per cent. in real terms—in other words, prices have risen by almost half.

In my constituency, and in the rest of the region served by South West Water, the price increase has been much greater—since privatisation, average water bills there have more than doubled. That is because people in the area have been forced to pay an unfair share of the costs of maintaining what is a natural resource. In the south-west, 3 per cent. of the national population are being asked to pay to clean up a third of the national coastline. Local pensioners who rely on the state pension are on average paying more than 10 per cent. of that meagre state pension on bills for which no help is available. Again, it is no wonder that people are angry.

Investment has increased since privatisation. There is no dispute about the fact that there has been necessary investment in water supplies and in environmental protection. However, whereas customers have borne much of the cost of investment, company shareholders have received most of the financial benefits. The Consumers Association concluded that more than 80 per cent. of the water companies' investment has been funded by increases in domestic consumer bills. That is despite the fact that we were told that privatisation was intended to allow greater access to private funds through borrowing and investment. Indeed, it was argued that privatisation would prevent big increases in customer bills, but that has clearly not happened.

As customers rather than shareholders have taken on most of the costs, it is little wonder that share prices and dividends have rocketed. Only a monopoly could get away with dipping into customers' pockets in such a way; in any other industry, customers would have left in droves. Water customers do not have that choice.

Water companies do not have an entirely positive record on investment either, and I hope that my earlier comments do not suggest otherwise. Perhaps most infamously, Yorkshire Water cut investment in preventing leakages, and left customers without water. Despite increased profits, water companies have largely failed to secure sustainable future water resources, and have not invested adequately in water conservation and distribution. Many of Britain's rivers, lakes, reservoirs and underground reserves have run dry through over-abstraction, which has caused major environmental problems and put at risk some of our best wildlife sites.

All too often, water companies present us with what they claim to be a stark choice—they say that they can stop increasing water bills, but only by scaling back investment in environmental protection. That is far too simplistic, and the water companies have got away with using that argument for far too long.

The regulator has struggled to get a hold on these slippery creatures; they have squealed against tough price regimes, but any so-called tough pricing formulas that have been agreed have led to further share and profit rises. Generally, as soon as the settlements have been announced, the share price has shot up, as the market has recognised that they are not tough at all.

The current review of water company prices will provide a key test. There is a danger that the review will turn into a debate about price cuts versus the environment. However, the review cannot be only about putting money into customers' pockets. It must be about setting water prices—and, perhaps more crucially, water company profits and share prices—at a level that will allow us to make good the environmental damage caused by the water companies in the first place at a cost that customers can afford. The regulator must in future consider a much broader range of issues.

Polling released by the Environment Agency shows that water consumers want environmental improvement to be funded from efficiency gains, and not necessarily price reductions. In fact, 95 per cent. of customers polled would prefer to receive the same water bill if that delivered improved environmental protection.

The water companies and the regulator should take note of that poll, as I am sure that water companies can afford to do much more for the environment. The Government must either make it clear that the regulator has a duty to consider environmental standards as well as prices—which could be effected in the current review of utilities regulation—or tighten environmental standards and make them part of the context in which the regulator has to work. He argues consistently that it is not for him to set standards, but he must recognise the standards that have been set. Let us ensure that the House and Ministers set the standards correctly.

English Nature has identified 80 sites of special scientific interest that need urgent action to protect them from the devastating effects of abstraction and sewage effluent. Almost half have been proposed as internationally important sites. Without action now, damage will be permanent.

The Royal Society for the Protection of Birds has released a list of what it believes are some of the most important of those sites, which I think it has made generally available. The sites range from the Yare broads and marshes in Norfolk to the River Avon in Hampshire and Wiltshire, where there is a decline in salmon stock, a general decline in the quality of the habitat and low flows, which are especially a problem on its tributaries. The list also includes Hewell park lake in Hereford and Worcester, highlighting serious concern about problems arising mainly from over-abstraction.

Other sites identified are the River Eden in Cumbria, Swanbourne lake in Arundel park in west Sussex, the River Kennet in Berkshire and Wiltshire, the River Wye in Gloucestershire, and the River Axe in Devon. The list is far too long to cite fully in the time available.

The status of an SSSI should in theory be enough to protect a site. The designation means that the Government have said that the site's preservation is vital to the UK's biodiversity. Indeed, the definition is that there should be no erosion of the sites—it is not that no erosion would be ideal, but that something less would be all right. In reality, though, an SSSI classification is simply not enough, as we know from the erosion that is taking place.

Worse still, in the most recent guidance to the water industry, the Environment Agency split the sites into two groups: core sites, which are of international importance and protected by European Union legislation—the so-called special areas of conservation—and non-core sites, which are protected by UK legislation. That division implies that the Office of Water Services and the water companies can give lower priority to protecting non-core sites. That split has never appeared in previous guidance, and is a backward step for environmental protection.

There is specific concern about the designation of SACs not being conterminous with SSSIs. I know from discussions with English Nature staff that, at one stage, it was suggested that all SSSIs should simply be nominated as SACs, but the previous Government were reluctant to allow that. In terms of protecting British biodiversity, there is no differentiation between the importance of sites.

The Minister must intervene to insist that money is spent to protect threatened sites. Thousands of millions of pounds are to be invested by the water companies in return for huge profits. The RSPB calculates that just £230 million more would be enough to protect all vital but threatened environments. That investment was always described as necessary—until the new guidelines came out. I hope that the Minister will find a way of getting the Environment Agency to withdraw the guidelines for water companies that differentiate between core and non-core sites. That would be a practical way of fulfilling the often-quoted Labour aim of putting the environment at the heart of Government.

The periodic price review will always be a necessary method of ensuring adequate funding for treating detrimental environmental impact, but that is really treating the symptoms, not the causes, of degradation.

Many environmental problems caused by the water industry involve abstraction in one form or another. A proper system of abstraction licensing would mean that many such problems would not occur in the first place. I know that the Government are undertaking a review of the issue.

The abstraction licensing system is inflexible and economically inefficient, and has resulted in huge environmental damage. It is clearly in need of reform. We must start managing water resources in such a way as to encourage more efficient use of water. That is the only way in which to reduce pressure on our rivers and wetlands. There is no point in spending a fortune putting right what is wrong, if we can avoid it being wrong in the first place.

One reason why the system is so bad is that it is based on what was considered important 30 years ago, when the environment was not under the same pressure, and overall demand for water was very much lower. Consequently, the Environment Agency inherited a backlog of abstraction permissions that have no proper place today.

The system operates on a "first come, first served" basis, and, in addition, many licences have been granted in perpetuity. Many were granted to allow more water to be taken than was required. In some cases, they allow more water to be taken than exists. The agency has to compensate abstractors if it revokes or varies a licence, which can be costly and time-consuming. The net effect is that many licences are effectively cast in stone, and as many as 200 wildlife sites are threatened with legal abstractions.

It is worth pointing out that the abstraction licences system is, furthermore, extremely inefficient economically. Charges are set at a level that recover only the administrative costs of regulating the system. Little attempt is therefore made to reflect the true costs of abstraction, which include enormous environmental damage.

In such circumstances, water is invariably undervalued. Without clear economic signals, those seeking to abstract have little or no incentive to use water effectively, and water is not efficiently allocated between users. Any new system must combine meeting essential water needs while ensuring sufficient water in the natural environment to protect and maintain biodiversity. I should like to suggest a few key elements that should be included in the Government's conclusions.

First, licences of right should be phased out, and existing licences should be required to meet current environmental obligations. That would bring the abstraction licences scheme into line with the system of granting consents to discharge effluent into the water environment, which already builds in a periodic review of consent without compensation, precisely to avoid the problems to which I have referred.

Secondly, the regulatory regime should be expanded to take into consideration abstraction from any form of irrigation, historic abstraction, de-watering operations and abstraction for navigational purposes. Thirdly, applications for new abstractions should include consultation with all interested parties and an assessment of the environmental impact of the proposal and the need for water. All licences should be clearly time-limited.

Fourthly, I should like incentive charging in order to encourage efficiency in the use and allocation of water. Revenue from incentive charging should be directed into projects of environmental benefit.

All those measures would be fairly easy to introduce—if the political will is there. I believe that Ministers want to take action. That will is far more likely to be apparent if the Government also have the will to reform the way in which everything is paid for. Water bills are likely to fall under the price review; the regulator has already made that clear. However, huge regional differentials in domestic bills are likely to remain, because each region will face different challenges in coming years. Unreasonable costs should not be imposed on regions with high infrastructure costs and major environmental challenges. If that were so, people would simply increasingly rebel against necessary environmental measures.

I have already mentioned the problems faced by the people in the South West Water region—but problems do not occur there alone. Customers of North West Water, and those served by Wessex Water and Yorkshire Water, will face particularly high costs of meeting the urban waste water directive. Lead will be a major concern in the north-west, and nitrates will have an impact on areas such as that covered by Anglian water. As time goes by, differential environmental impacts will hit customers very unfairly in some parts of the country, under a bills system that does not allow them any help.

The cost of cleaning up such regional problems will fall almost exclusively on local consumers, so the first change I advocate is the establishment of a new independent water services trust, funded by a 2 per cent. levy on excessive continuing water company profits, which would help to reduce unfair differences in water charges. It should be used to subsidise water projects of national environmental importance, and to encourage more efficient use of water.

Secondly, all customer bills could be cut if the industry relied more on long-term financing and less on customer price rises. There must be a requirement to fund more investment from borrowing and equity raising, rather than by dipping into customers' pockets through endless price increases. I agree with the regulator that excessive profits must be returned more quickly to customers. None of that will help share prices, but we should not be worried about that: shareholders have made a fortune.

The water rates system is unfair and out of date. Valuations date back to the 1970s, and there is no help for those on low incomes and no discount for those living alone. As a first step, moving to the council tax banding system would be far fairer.

For too long, environmental concerns have been seen as expendable—something that we can put aside while we concentrate on bringing down water bills. That does not have to be so. The recent Environment Committee report on sewage treatment, which I hope the Minister has seen, reached exactly the conclusion that ever-rising share prices of water companies prove that more could be done without increasing bills. My proposals would ensure both fairer prices and a cleaner environment.

The Conservative privatisation of water has failed to deliver. People look to Labour to do better. I hope that the Minister can brighten the proceedings at the end of our Adjournment debates this morning with some good news.

I congratulate the hon. Member for Truro and St. Austell (Mr. Taylor) on securing this wide-ranging debate, even if we have only a short time for it; clearly, we cannot begin to do justice in the time available to the many complex issues that he has raised, but I welcome the opportunity to respond.

At the water summit last year, my right hon. Friend the Deputy Prime Minister made it clear that we want a world-class, water-efficient and environmentally sustainable water industry. We should recognise that water is a necessity of life, and that that marks it out from any other commodity. We must take into account the need to give special attention to vulnerable households and the less well-off in our policy making.

I note and agree with many of the hon. Gentleman's points about privatisation, but I hope that he recognises that, as a new Government, we must work with what we have inherited from the previous Administration.

In the 1990s, there has been a sustained improvement in river quality, with a net upgrading of more than 25 per cent. of the total monitored length of rivers and canals in England and Wales; but we want improvements in quality to continue. A regulatory approach to prevent pollution or to enforce controls will often be needed, but there is a mix of measures that may also be relevant. We must get the best mix to realise our aims, be they regulatory, voluntary or economic.

We said last year that we want to explore water pollution charging. We issued a consultation paper in November on economic instruments for water pollution that sought views on a range of possible instruments, and set out in some detail a series of issues relevant to whether instruments could in practice be designed and could operate successfully. As my right hon. Friend the Chancellor said in his Budget statement, we are continuing that exploratory work.

The potential advantages of economic instruments are considerable, in that they can encourage more cost-effective improvements in water quality objectives as well as giving greater effect to the "polluter pays" principle; but to judge whether those advantages can be realised in practice, and what the wider consequences of a change would be, requires consideration of a set of complex issues.

Indeed, an acceptance that this is a difficult area is one matter on which responses to our discussion paper were consistent across the board. To provide answers to those questions requires considerable detailed work, and that work is continuing.

The periodic review of water company price limits for the period 2000–05 is already well under way. Indeed, the hon. Gentleman referred to it several times. As I said, water is not only a commodity but an essential for life, and it raises issues of public health. Water charges should be fair and affordable, particularly for the most vulnerable.

I am aware that the variation in charges to customers by water companies is a long-established concern, especially in the south-west.

The Minister will appreciate that there are five Liberal Democrat Members from the south-west present, and that, although my hon. Friend the Member for Truro and St. Austell (Mr. Taylor) referred to the national situation, there is a marked discrepancy between areas in the impact on households of water charges.

Under the previous regime, we were constantly told that the privatisation of the water companies had restricted their possibilities of obtaining European Union funding for major infrastructure projects, including the clean-up of beaches in the south-west. Is there likely to be a renewed attempt under the Labour Government to obtain outside grant support to cushion the impact of major infrastructure improvements?

That is a technical question, requiring a detailed knowledge of European Union funding regimes. As I had no notice of it, I shall write to the hon. Gentleman, so that I can give him an accurate answer.

The current water charges are largely shaped by the present system of economic regulatory control. We are reviewing the underlying system of utility regulation. The review has been considering the structure of utility regulation across all the main privatised utilities, with a view to establishing a system of regulation that is seen as fair by all, but particularly by the consumer. Consumers have long seen the regulatory system as favouring the companies, and we want to redress that balance.

In examining water prices, Ministers will consider the level not only nationally but in terms of differences between companies. The Director General of Water Services will seek guidance from the Secretary of State on broad priorities, in the form of an open letter to the Deputy Prime Minister at the end of April. We hope that the accompanying material will give an idea of how specific issues bear on individual companies, as well as the broad national picture.

In the south-west, for example, we might expect the protection of coastal waters to continue to be an important, perhaps the paramount, issue, even allowing for the major investments that are being made in the current price period.

In considering what guidance to give the director general about broad priorities at national level, we shall certainly consider the implications for individual companies, not least in terms of the effect on water bills. Some of the ideas of the hon. Member for Truro and St. Austell would have implications for bills, but I shall come to that later. Higher-quality water has to be paid for by somebody, and we must get the right balance of who should take the hit.

The process will be followed up in the autumn by more detailed work to assess the financial implications for individual companies. The Deputy Prime Minister's guidance will be drawn up after he has invited public consultation on the director general's letter. We hope that as many people as possible will make their views known, because water prices and the way in which the money is spent are clearly issues for lively debate. We want to know what people think.

The companies are consulting their customers, my Department has commissioned independent research into customer preferences for environmental improvements, and the Environment Agency is conducting its own research through its regional advisory committees. We hope that those processes will provide a valuable input to the debate, and let us judge where people's priorities lie.

In the current periodic review of water prices, we shall consider the prices not only at national level but as they differ between companies. I hope that that provides some reassurances to hon. Members.

As we get further into the review, I am conscious that the environmental agenda is uppermost in many people's minds. Last autumn, my Department was involved in the process of identifying possible future obligations on water companies for investment to improve environmental quality. Companies were asked to cost those obligations on the basis of detailed guidelines issued by the Environment Agency.

The hon. Gentleman asked whether I could get the Environment Agency to withdraw the core and non-core guidelines that he was worried about. I can reassure him that those are a device to help with data gathering, and have no implications for lesser or greater protection of special sites, be they identified under European legislation or under our own. There is no need to withdraw them, because they are not as meaningful as he seems to think.

That comment is extremely helpful. I know that most of those concerned will read the debate and accept what the Minister says, but it would be helpful if she could write to me to clarify that position and put it formally on the record.

I am happy to do that, but I hope that my assurance is worth the same whether it is given in the House or in a letter.

There are very real concerns about the need to protect all sites of special scientific interest. The Environment Agency guidelines asked water companies to cost the protection of any site of special scientific interest that was on the priority lists drawn up by English Nature and the Countryside Council for Wales and was affected by discharges from sewage treatment works or by water abstraction in the vicinity. It was especially important to distinguish the sites that are also special areas of conservation or special protection areas.

There is an important role for the conservation agencies in advising the regulators and the companies themselves on what needs to be done to protect the sites. It is vital that conservation objectives are properly established. Those objectives need to identify the habitats, plants and animals whose favourable conservation status is significantly influenced by water quality.

The conservation agencies will also need to identify the nature of the link between the water quality of the site and the conservation objectives. That is important because, if we are to ask water companies to make substantial investments to provide extra treatment, or to pay for it, we need to be as sure as we can that the treatment provided will be effective in providing the protection that such sites need.

There has been some debate about the nature of the legal responsibility placed on water companies, the Director General of Water Services and Ministers in relation to the protection of sites of special scientific interest. My officials are considering that. We are considering particularly the points made by English Nature and the Royal Society for the Protection of Birds. In a sense, however, that is not the real issue. Protection of SSSIs is a key matter to which we must give serious consideration as part of the environmental agenda in the periodic review. However, it is only fair to point out that the Government are likely to have to make some difficult decisions to balance legitimate aspirations for environmental improvements against acceptable water bills for customers. Coming from the south-west, the Liberal Members who are here know that only too well. We must take a sensible view of how much can be done now, and how much we can plan for the future. To do that, we need clear objectives and a demonstrable expectation that the action we contemplate will prove beneficial in protecting these precious environments.

Protecting SSSIs and the environment in general is a continuing task. The pressures and responses do not come and go with each periodic review. Moreover, they change in nature over time. In future, a major pressure is likely to come from climate change and its impacts on water resources and water environment. Just as pressures on the water environment have changed and are likely to change further, it is necessary that the legal and administrative arrangements governing abstraction from it are sufficiently flexible to allow an appropriate response.

That is why we launched, as part of our water summit 10-point plan, a review of the water abstraction licensing system. The hon. Member for Truro and St. Austell had much to say about abstraction. The system was put in place in the early 1960s. Although it placed a framework of controls on abstraction, it was fettered from the start by what was perceived as the need to give all the abstractions that then existed what was called a licence of right, regardless of the effect that they were having on the environment. Much as we might wish that that had not been done, the fact is that it was.

Not only those licences but most licences for new abstractions granted since, right up to the present, were granted until revoked. Granting an abstraction licence without a time limit allows no account to be taken of our improved understanding of how the water environment works or of climate change effects on the availability of water for abstraction. It hampers redistribution of that resource among other abstractors who may be able use it more wisely, and encourages the notion that the water belongs to the abstractor, even though that has never been the legal position.

We are having to consider that aspect of the licensing system very carefully. The solutions of the hon. Member for Truro and St. Austell sounded simple and logical. If they were legally possible, I would be much happier. We are trying to be as creative as we can, but we are having to take careful legal advice about the implications of changing the abstraction system. We will produce the result of the review when in a position to do so. His seemingly logical solutions are not always deliverable without considerable costs in compensation, which are likely to be legally unavoidable.

We recognise that abstractions under a small proportion of existing licences are damaging sites specifically protected under the European Union habitats and birds directive or by designation as an SSSI. We have found that voluntary variation or revocation by the licence holder cannot be negotiated. If there is no negotiation, the Environment Agency should use its existing powers, on a clearly prioritised basis and on grounds that will stand the scrutiny of public inquiry, to vary or revoke the offending licences. Unfortunately, in those circumstances, the agency must be prepared to pay compensation where necessary. That is the legal position.

We are addressing compensation arrangements in the short and longer term as part of the review. We expect abstractors to behave responsibly towards the environment, and to seek voluntary solutions wherever possible. We expect such proposals to come forward in the water companies' periodic review submissions.

Since taking office, we have encouraged a new spirit of co-operation between the Government and the water companies, based on firm regulation and the changing nature of regulation. My right hon. Friend the Deputy Prime Minister's water summit marked the beginning of that. We recognise the positive way in which the companies have responded to the challenges set them.

They have not just opposed us all down the line: they have co-operated, for which we are grateful. We recognise, as do they, that there is further to go. I hope that the hon. Member for Truro and St. Austell also recognises it, given the number of reviews and the system that we inherited.

With the Government's firm encouragement, we are confident that the water companies will achieve the level of care for all their customers and for the environment that is our vision, taking into account the elements of social justice and fairness that are so important in considering what, after all, is a necessity of life, not simply a commodity.

It being before Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.

Sitting suspended, pursuant to Standing Order No. 10 (Wednesday sittings), till half-past Two o'clock.