If he will make a statement on the EU troika visits to the great lakes and to East Timor. [44513]

I apologise for the absence of my right hon. Friend the Foreign Secretary, who is attending the Cardiff European Council.

The Minister of State, my hon. Friend the Member for Manchester, Central (Mr. Lloyd), led a three-day EU troika visit to Uganda, Rwanda, Burundi and the Democratic Republic of the Congo on 2 to 4 June. The troika had productive meetings with the Presidents of each of the four countries. It reiterated the EU's commitment to promoting stability; security; democracy; respect for the rule of law and human rights; and economic development for the benefit of the great lakes region.

The EU heads of mission troika visit to East Timor, scheduled for early June, has been postponed because of Indonesian security concerns. We hope to reinstate the visit as soon as possible.

On East Timor, does my hon. Friend agree that there is now a real opportunity to solve the long-standing problem of that very unfortunate country? Does he agree that President Habibie's suggestion of special status for East Timor within Indonesia falls far short of the right of the people of East Timor to a referendum, to allow them to determine their future and choose self-determination if they wish, as is their right under international law and United Nations resolutions?

I very much agree with my hon. Friend's first comments. We now have a window of opportunity to make progress in resolving the long-standing issue of the status of East Timor. During my recent visit to Indonesia, I took the opportunity to make that point to Foreign Minister Alatas. I was pleased to note signs of movement in Indonesia—specifically, the release of political prisoners.

My hon. Friend will also be pleased to know that I had the opportunity to meet Xanana Gusmao, who talked to me about his views on the development of East Timor. He was in good health, and I asked the Indonesian Government for his early release, with that of other political prisoners.

What assessment he has made of the effect of his policy of dialogue with China on its human rights record. [44514]

We believe that our policy of dialogue, which we have pursued both bilaterally and within the European Union, supported by practical assistance, is beginning to produce results. China has taken several positive steps which we hope will bring about increasingly close co-operation with United Nations human rights mechanisms and will lead to practical improvements in areas such as the administration of justice.

Is it not the case that promises by the present Chinese Government are not worth the paper on which they are written? Will the Minister accept that the present Chinese Government are characterised by a total disregard for human rights, as demonstrated by the imprisonment of political prisoners in so-called re-education camps, by the torture of monks and nuns in Tibet and by the eradication of most things Tibetan? Is it not the case that, by failing to pursue a UN resolution, the Government have virtually given the green light to the continuation of human rights abuses and told the Chinese that economic interests are more important than human rights? Although the Government may mean well, is that not in fact an ethical foreign policy in reverse?

The hon. Gentleman draws totally incorrect conclusions in the last part of his question. The Government continue to press the human rights agenda with China. At every available opportunity, we talk about the need to improve human rights. As I said in response to the hon. Gentleman's main question, there are practical signs of improvements that we have achieved. However, it would be foolish of us to say that all is well. There is a great deal more to be done on human rights, and we shall continue to argue strongly for it.

I thank my hon. Friend for his response. The visit by the Chinese delegation arranged by the Inter-Parliamentary Union did a great deal of good in strengthening relations between China and the United Kingdom. My hon. Friend made a substantial contribution to that visit. Does he agree that such visits are the way to resolve the human rights problems and other issues in China? Long may the relationship between the UK and China continue.

It is important that we maintain and broaden the dialogue at all levels and take every opportunity to stress our concerns about human rights in China. I know that my hon. Friend, as part of the all-party China group, has taken every opportunity to speak about those concerns and to press the human rights agenda.

Is not China's human rights record still abysmal—in particular, as it relates to the one child per family policy, which enforces abortion up to full term and continues to discriminate against baby girls? When will the Government take much more positive action in their dialogue with the Chinese Government, who understand only force and pressure? Sadly, so far, we have seen no improvement in the human rights record.

I reiterate that we take every opportunity to raise those issues. I shall list for the hon. Lady what we have achieved over the past few months. We have persuaded China to sign up to the international covenant on economic, social and cultural rights. We have persuaded China that human rights in Hong Kong will be reported on separately. We have persuaded China to accept a visit from the United Nations High Commissioner, Mary Robinson. All those are successful steps forward. I am the first to admit, together with the hon. Lady, that there is a long way to go, but we believe that dialogue is the best way to make progress.

If he will make a statement on the situation in Kosovo. [44515]

We remain deeply concerned about the extreme violence and indiscriminate attacks on civilians in Kosovo. I visited Belgrade and Pristina last week and urged both the Serbian Government and the Kosovar Albanians to find a peaceful way forward. The contact group of Foreign Ministers met in London on Friday and agreed that, if Belgrade did not take steps without delay, there would be moves to further measures to halt the violence, including those that may require the authorisation of the United Nations Security Council. We welcome the meeting in Moscow today between Presidents Yeltsin and Milosevic. President Milosevic must realise that there will be no let-up in international pressure until he takes steps to end the violence and resolve the problems of Kosovo peacefully at the negotiating table.

I warmly welcome my hon. Friend's statement and the initiative taken by the Prime Minister and the Foreign Secretary to bring world leaders together on this great humanitarian issue. Some people believe, however, that NATO shadow boxing will not bring that tyrant to his knees. Some of us think that a man who, for a decade and a half, has practised the detestable system of ethnic cleansing will not be easily frightened by such manoeuvres. Is it not time that we stopped pussy-footing around and issued an ultimatum to that gangster saying that unless he stops the repression in Kosovo, we will commence military action?

The contact group has already gone a long way beyond simple condemnation of the actions of the Government in Yugoslavia. The contact group and the European Union have already begun the imposition of an investment ban and an assets freeze. A ban on air flights from Yugoslavia is under consideration. NATO is considering what steps it can take. Yesterday, for example, Operation Determined Falcon took place in airspace not over Yugoslavia but over the neighbouring countries. That was a real measure of NATO's determination. I assure the House that contingency planning by NATO continues. President Milosevic cannot claim—and nor should the world believe—that he has not been properly warned.

Whatever the great provocation, will Ministers think very long and carefully before committing the British Government to supporting direct military attacks on Serbia unless that policy has the support of the Russian Government and the United Nations Security Council? We should bear it in mind that the Kaiser is a poor role model in such matters and that many countries in other parts of the world might be attracted to the idea of taking what they regarded as just military action if United Nations support was not always considered essential.

There is no doubt that the resolution of this situation is now in the hands of President Milosevic: he should end the violence now. He should withdraw the security forces from Kosovo and allow in the international monitors and humanitarian agencies. If President Milosevic takes that agenda on board, we will begin to make progress. That is the right way forward. However, I think the House understands that options have not been ruled out at this stage.

What exactly would be achieved by air strikes?

My hon. Friend enters the realm of speculation. Actions have not been ruled out: at this moment, NATO is examining all credible options. However, the resolution of the present crisis clearly lies in the hands of President Milosevic. If he does the things that I have outlined—if he makes it clear that he intends to enter into meaningful and time-limited dialogue with the Kosovar Albanians—we will be able to resolve the crisis instantly. Beyond that, I shall not stand before the House and say that we are prepared to rule out credible options at this stage.

Does the Minister agree that the diplomatic steps taken today will work only if President Milosevic discontinues his brutality towards civilians in Kosovo and accepts that the status quo is no longer an option and that the autonomy of the province is inevitable? If those diplomatic steps are effective, will it not be another illustration of the principle enunciated earlier this year by the Secretary-General of the United Nations, Mr. Kofi Annan, that diplomacy is at its most effective when it is supported by a credible military threat?

We have received some reports of today's meeting between Presidents Yeltsin and Milosevic. For example, it is reported that President Milosevic has agreed to negotiate with the Kosovar Albanians, but at present it is impossible to say whether that amounts to anything new. In that context, we await confirmation from President Milosevic. The hon. and learned Gentleman is absolutely right: if we were to say at this stage that we will not contemplate certain credible options, we would be playing into the hands of President Milosevic, and—I must also say—the extreme voices among the Kosovar Albanians.

Will the Minister assure the House that any action taken will be consistent with the United Nations charter and will be designed not to inflame existing tensions in that very difficult region? Will he assure the House that further assistance will be given to the Government of Macedonia and that steps will be taken to assist the refugees who are at present in Albania—as well as other measures that may be necessary in order to try to resolve the conflict?

My hon. Friend has asked several important questions. Britain has certainly been active in seeking to bring a resolution before the United Nations Security Council. However, the actions taken by the international community will depend very much on the circumstances on the ground at the time. They will determine what actions are acceptable and permissible. The position of Macedonia, with its large number of permanently resident Albanians, requires considerable attention. We need to ensure that Macedonia has the monitoring that it needs, which will include a continuation of the military presence in that monitoring operation.

My hon. Friend asks about the position of displaced persons already within Kosovo and elsewhere in Yugoslavia. The best answer to that would be if the humanitarian agencies such as the Red Cross were allowed in and enabled to do the work that they do better than anybody else.

Can the Minister tell us anything about the progress of the European Union monitoring mission? The hon. Gentleman will know that I asked the Government to take a lead in pressing for monitors to be allowed into Kosovo as long ago as 10 March. Has any progress been made?

Will the Minister now answer the question that he has twice failed to answer: do the Government accept the view that no military action can take place without the authority of a resolution of the United Nations Security Council?

I pressed exactly that point with the Yugoslavian Government last week. At present, they have not given the freedom for monitors to travel that we expect of them. At a European level, we are prepared to deploy 18 more monitors immediately, with more to follow in due course. The spirit of the right hon. and learned Gentleman's question is absolutely right. We need monitors on the ground so that we can be assured that violence against the civilian population has at last come to a halt. That is a necessary precondition for all else to follow.

In terms of action at the United Nations, Britain is extremely active in seeking a suitable resolution. However, the exact course of action that will be taken by the international community in the end will depend on the circumstances that confront it at the time when that action takes place.

So that there be no misunderstanding, is it the position of the British Government that we believe that Serbia should retain sovereignty over Kosovo?

So that there be no misunderstanding, let me say that the position of the international community has been consistent. We have called for meaningful negotiations between the Government in Belgrade and the Kosovar Albanians, under the leadership of Dr. Rugova, on the basis that there must be autonomy for the Kosovar Albanians within the context of the Federal Republic of Yugoslavia.

What help is being provided through his Department to central and eastern European countries to fund political education. [44516]

We are committed to supporting the democratic development of the countries of central and eastern Europe. The Foreign and Commonwealth Office provides grant in aid to organisations such as the Westminster Foundation for Democracy, the British Association for Central and Eastern Europe and the Britain-Russia centre.

The Government also fund democracy-building and civic education programmes directly through a wide range of departmental programmes, including the former know-how fund political projects fund, the Europe command project budget, the human rights project fund and the east-west contacts fund.

I thank the Minister for that information. Are funds available to help groups that wish to improve political campaigning in central and eastern European countries? Will groups such as the European Union of Women, which next week is bringing over a group of Russian women politicians, be able to receive Foreign Office funds to help them in their efforts to improve campaigning, canvassing and fundraising among the political parties in central and eastern European countries?

Where there are meaningful projects that could be taken up, funding could be available to all political parties that wish to link up. Through the Westminster Foundation for Democracy, £411,000 was spent on central and eastern European development last year. A sum at least equivalent to that is available again this year.

In welcoming any assistance that we can give to countries overseas in developing their democracies, does my hon. Friend agree with me that we should be a little cautious in this country—certainly the Tories should be very modest in any advice that they give to countries overseas about democracy—so long as we have a system where the second Chamber has more than 700 Members who have inherited the right to legislate?

I am grateful to my hon. Friend for that question. I think, as he does, that one must be extremely cautious in offering advice to colleagues in other countries. The worst thing that any of us could do would be to adopt a post-imperialist approach whereby we tell other people what is good for them. We must lay out examples of what we think we do well; it is up to others to decide whether they think they can learn from them.

I am rather saddened that the Minister has indulged in petty politics, which is far removed from the objectives of the Westminster Foundation for Democracy, of which I am a past governor, and the educational organisation to which he referred. This country has a lot to be proud of in its democratic processes. I challenge Labour Back Benchers, if they are about to reform the House of Lords, to say which of this Chamber's powers they would be prepared to transfer to an elected upper Chamber.

These are serious questions, but the principal point is that we have to transfer the deep roots of our democracy into those countries to create stability in Europe. Does the Minister understand the imperative to enlarge the European Union to embrace those countries with new democratic principles, and is he aware of the cost that achieving that will put on the wealthier members of the EU?

The hon. Gentleman has raised a wide agenda. I have always believed that it is important to build contacts with colleagues in those countries, not only so that they can learn the technical aspects of building a democracy and of guaranteeing human rights, but so that there can be political dialogue, understanding and the building of attitudes, which are important in issues such as enlargement of the EU. The Government strongly support that, and want proper funding to be in place to achieve it.

Will my hon. Friend consider the fact that the £3 million given to the Westminster Foundation for Democracy is insufficient? I understand that the foundation intends to reduce its operation in central Europe because of demands elsewhere, which I fully appreciate, but there is an on-going need to train politicians and local activists in central Europe: Hungary has a new Government; there are extensive regional and local government elections; and new structures are being created in Poland, which is a key player. Will my hon. Friend reflect on the fact that it would be foolhardy in the extreme for us to reduce our commitment to, and support for, democratic institutions and parties in central Europe?

The grants that are made available to organisations such as the Westminster foundation are constantly under review. What is examined is how effective those organisations have been in disbursing moneys in a meaningful way, and we shall continue to monitor that. If a case can be made for an extension, we will, of course, consider it.

Will the Minister pay tribute to the establishment of the know-how fund by the previous Administration and acknowledge what an extraordinary success it has been? Will he accept bids for places for people from central and eastern Europe to attend political courses at English universities, where they would have the chance not only to receive admirable teaching, but to savour the atmosphere of a true and extremely sophisticated democracy?

I very much support the hon. Gentleman's aim of an exchange of students between central and eastern European countries and Britain. There are not many things for which I would pay tribute to the previous Conservative Government—but setting up the know-how fund is one of them.

What recent discussions he has had with his counterparts about reform of the European Union. [44517]

We have regular discussions with our European counterparts about a wide range of issues dealing with reform of the European Union.

I am sure that the leadership that the Government have shown to the EU during their presidency will have been noted throughout Europe and beyond, and many people in many countries will have welcomed the fact that the Labour party, rather than the Conservative party, was in a position to give such leadership. What stage has been reached on enlargement in the discussions that my hon. Friend has had, and will he comment on the preparations that the countries of central and eastern Europe—especially Poland, which we all want as a partner—are making for joining the EU?

My hon. Friend is right to highlight the importance that the Government have attached to the enlargement procedures in the European Union, which have been pushed hard for the past six months. That will be reflected in the conclusions of the Cardiff summit, which were made available only after 2.30 pm, so I was not furnished with them before I came to the House. I think that the Prime Minister will make a statement to the House later in the week, when he will clarify those conclusions.

I have been impressed by the preparations that have been made by all the countries that are negotiating to join the European Union. I recently visited Poland and I was excited by the fact that people saw EU membership as a great opportunity. They were prepared to make changes to their life style and to their democracy, to make changes to guarantee human rights, and to make the big changes required in their economy, including in their steel industry. I am confident that, through dialogue with the European Union in the coming years, Poland will accede successfully.

In his discussions on the reform of the European Union, has the Prime Minister taken into account the massive opposition to economic and monetary union shown by British public opinion? In particular, is the Minister aware of the result of the Gallup poll published today, which shows that only 33 per cent. of the British people support the abolition of the pound and our entry into economic and monetary union, whereas 65 per cent. oppose it and only 2 per cent. are now undecided?

The establishment of the single currency has been one of the main issues that the European Union has considered over the past six months.

And longer.

Yes, and longer. There is an understanding among the leaders of Europe—I am confident that it will be reflected in the conclusions of the Cardiff summit—that a strong structure to the single currency has been established and that it will serve well the 11 countries that will join it on 1 January and those countries that may exercise an option to join it at a later stage. The Chancellor of the Exchequer has made the British Government's position clear. When we have been able to assess whether convergence has taken place—after the next general election—a judgment will be made on whether it is in Britain's economic interest to join the single currency. It is against that background that the Cardiff talks have taken place in the past two days. All the leaders have been keen to assess the views of the business community and ordinary people. Contrary to the result of the poll to which the hon. Gentleman referred, I sense a growing understanding of what the euro would mean for life styles.

Do Her Majesty's Government accept any money from the European Commission for the propagation of the view that the euro is an advantage rather than a disadvantage? If so, what opportunities will be taken to ensure that the British people understand the implications of the actions of any Government who hand over their taxation and finance powers without being clear about the political cost to their country?

The European Commission disburses the funds that it controls for that purpose among the partner nations of the European Union. One factor that it takes into account is the view of the Government of each country. Over the next three years, we shall discuss macro-economic policy, the establishment of the euro and whether it is in Britain's interest to join. The Government want to guarantee that all those who will eventually have a say—the public will have a say through a referendum—are fully informed about what it will mean for their life styles and their workplaces.

I welcome the reform of the European Union. Do such discussions include the protection of the rights of citizenship throughout the world of citizens of the European Union? Has any approach been made to the Government of Morocco on the false allegations and extraordinary penalties imposed on European citizens, including a British citizen, Dr. Graham Hutt?

I am not quite sure of the point that the hon. Gentleman is making. In all its dealings, the European Union seeks to ensure that international standards are upheld. That applies to the matters to which the hon. Gentleman referred.

Is the Minister aware that the reform of Community structural funds and initiatives is taking place at a time when parts of Wales, and other areas of the United Kingdom, will for the first time qualify for objective l status? Will he and his departmental colleagues ensure, as the reform proceeds, that none of those areas' applications will be disadvantaged?

The hon. Gentleman is right to raise that issue and its importance to the people of Wales. Its importance was made clear to me not only in last week's debate in the House, but during my visit to Cardiff over the past two days.

There are, in fact, two issues. First, we must ask whether in the redrawing of boundaries throughout the United Kingdom, which is essentially an administrative act, a fair system is being proposed. We must also ask, when the commission reaches a conclusion, whether a fair system has been agreed—whether the system compares Wales favourably in administrative terms and how boundaries have been drawn in other European Union countries. That is the first test. The Government will want to ensure through Eurostat, the organisation that will deal with the arrangements, that a fair system has applied. As the hon. Gentleman will know, the Government have supported submissions from Wales for a redrawing of boundaries to allow the possibility of objective 1 status for part of the country.

The second issue is the reform of the structural funds system. It will take place and I expect that, following the conclusions at Cardiff, a timetable will be drawn up allowing it to be agreed before the European Parliament is dissolved for the elections in March or April. Within that timetable, the Government aim to ensure that a fair system of structural funds is agreed so that once funds have been allocated to help the countries of central and eastern Europe—which will need additional funding during the accession process—the rest of the cake can be disbursed fairly, which includes taking into account the requirements of Wales.

I am sorry to learn that the Foreign Secretary is sharing Council resolutions with the world before sharing them with his own Ministers. Does that mean that there will definitely not be a full-time report on the flop of this presidency. as there was a ludicrous half-time report, that shows what a wasted exercise it has been?

Can the Minister confirm the report in The Times yesterday that no Foreign Office Ministers participated a fortnight ago in discussions of a major review of European policy and the way forward at No. 10 Downing street? Is that not the final indignity for the Foreign Secretary and his team?

It would be a bit difficult for me to be in Cardiff with my right hon. Friend the Foreign Secretary for the last hour or so of the summit's conclusions and in the House of Commons to answer questions. If the hon. Gentleman has any suggestions about how I could have achieved that, I am willing to entertain them.

I reassure the hon. Gentleman that the future of the European Union is a major issue that affects all the states in Europe. The British Government treat it as a top priority and there have been extensive discussions among a number of Departments about some of the issues that will arise in the next six months and beyond.

What recent discussions he has had with representatives of the Pakistan and Indian Governments in connection with their nuclear tests. [44518]

If he will make a statement on the discussions he has had with the Indian and Pakistan Governments in relation to nuclear tests. [44522]

We have had a number of discussions with the Pakistan and Indian high commissions in London and with other representatives of their Governments. This morning, I had a meeting here in London with the Prime Minister of Pakistan.

When the Foreign Secretary was with his colleagues in the G8 last week, were they able to agree on joint steps to persuade Pakistan and India that there should be no more tests, that moves should take place towards non-proliferation and that they should address the roots of the problems between the two nations, including the problem of Kashmir?

The G8 Ministers meeting last week succeeded in reaching those agenda conclusions. In particular, we urged the Governments of India and Pakistan to sign the non-proliferation and test ban treaties. We also made a point that I made to the Pakistan Prime Minister this morning—that it is crucial for us to enter a dialogue with India and Pakistan so that they can deal with the fundamental issues that have divided them over the past 50 years. Resolving the Kashmir issue is an important part of that agenda.

As the testing has serious implications for the environment, for peace and indeed for trade, will the Minister clarify press statements that India is prepared to sign up to some parts of the test ban treaty? If no progress can be made, will he assure the House that he will take every. possible step to ask the United Nations Security Council to take whatever measures may be necessary?

The hon. Gentleman mentions the position that has been taken by the Indian Government—that they would be willing to consider signing up to parts of the non-proliferation treaty. That is unacceptable to the permanent five and the G8. We have made that view clear to India. We cannot have an a la carte approach to the non-proliferation treaty. The same message has been delivered to Pakistan.

The hon. Gentleman mentions UN involvement. The P5 has already been involved in those issues and, through senior officials we established at last week's G8 meeting, there will be continued monitoring of progress and developments. We will consider what further action has to be taken.

I support what my hon. Friend has said about condemning the tests conducted by both India and Pakistan, but does he not think that the position of the big five nuclear powers in that condemnation would be stronger if they were seen to be actively disarming and disabling their nuclear weapons? If we want to live, as we all do, in a nuclear-free world, perhaps we should make a start in that direction.

It is crucial that we continue the nuclear disarmament talks. The Government have taken a responsible and active role in that approach and will continue to do so. I am sure that my hon. Friend agrees that the security of ordinary people in south Asia has in no way been helped by the nuclear explosions detonated by the Governments of India and Pakistan. In many ways, those people are more insecure and more impoverished as a result of the actions that have been taken by their Governments.

Will the Minister confirm that these tests mean that the Indian state of Kashmir is surrounded by nuclear powers: India, Pakistan and the People's Republic of China? Will he acknowledge that the problem—that is what it is—of Kashmir arose under an earlier Labour Administration? Will he confirm that the Government will make every effort to ensure that Kashmir is on the UN Security Council's agenda so that the people of Kashmir can be granted the plebiscite on their future that they have been denied for the past 50 years?

I know that the hon. Gentleman has a genuine interest in the issue of Kashmir and in the welfare of its people. We recognise that Kashmir is at the heart of the continuing difficulties between India and Pakistan. If we are to improve the relationship between the two countries, we have to address the problems that are created by the status of Kashmir.

What steps his Department is taking to help bring stability to the great lakes region of Africa. [44519]

I refer my hon. Friend to the answer that the Minister of State, my hon. Friend the Member for Leeds, Central (Mr. Fatchett), gave a few minutes ago concerning the EU troika visit to the great lakes region. The troika urged regional leaders to pursue negotiated solutions to their problems and to avoid any recourse to the use of violence. Bilaterally, we are currently providing financial assistance to the Burundi peace talks, which are due to convene in Arusha from 15 June. We are also funding a number of initiatives in the justice sector in Rwanda and are the largest bilateral donor to United Nations human rights field operations in the region. In the Democratic Republic of the Congo, the EU and the UK are supporting, both financially and politically, the democratic transition process.

Will my hon. Friend expand on what steps the Government are taking to support the international tribunal for Rwanda? Does he agree that before reconciliation can take place in that country the people who perpetrated the genocide in that part of Africa need to be brought to justice? That must happen before there can be reconciliation between the Tutsis and Hutus.

My hon. Friend is right that the process of reconciliation depends absolutely on justice being not only seen to be done, but put into proper operation. That is why this Government, along with many others, are making significant contributions to the international criminal tribunal for Rwanda, which is sitting in Arusha.

We have not only provided £400,000 as our assessed contribution to the tribunal, but seconded two British police officers to help with the investigation. We are also specifically sponsoring a programme of visits by magistrates, social workers and non-governmental organisations from Rwanda to the tribunal so that they can see that the justice process is taking place.

We also welcomed the recent guilty plea by the former Rwandan Prime Minister, which has moved the process on. I can tell my hon. Friend that we shall continue to support the tribunal —which itself provides a good prelude to an international criminal court, the basis of which is now being discussed in Rome. Such a court will be another important step on the road to international justice.

The Minister will know that the United Kingdom has unique experience of Africa and that we probably have greater knowledge and experience of it than any other country in the world. Bearing in mind that experience and our continuing involvement with the Governments of many countries that have recently gained independence, does the Minister think that the countries with which we have been involved will be able to have any influence in the countries of the great lakes region in establishing law and a meaningful form of democratic government that will be acceptable to the people of Africa as a whole?

The answer, of course, is yes. Some of the states in the great lakes region are playing a very constructive role in the region. Specifically, the regional powers have brought to bear enormous pressure on the Government of Burundi to persuade them to enter a meaningful internal dialogue with the national assembly. That pressure has now resulted in a negotiated process in Arusha. I should pay tribute to former President Nyerere of Tanzania, whose individual contribution to the process has perhaps been more significant than that of anyone else. He is helping the talks reach a successful conclusion. The region, and the world, will owe him a debt.

The stability of the great lakes region is inextricably linked to political developments throughout the area, and current events continue to highlight the region's fragility and vulnerability. In the light of natural concerns about the consequences of future political change, will the Minister tell us the Government's attitude towards the multi-democracy movement in Uganda?

I should like first to welcome the hon. Lady to her new responsibilities. I am sure that this is not the last time that we shall exchange views across the Dispatch Box. [HON. MEMBERS: "Oh!") Well, I trust that she will be on the Opposition Front Bench again. She raised a very important point. There are many views on evolution of the democratic process on the African continent. Some time ago, when I was in Uganda, I made it clear that we favour an electoral process being established whereby the Ugandan people are sovereign, those who wish to stand for election are able to do so and the people of Uganda are able to vote for the candidate of their choice. I am sure that all hon. Members will endorse those principles.

When he expects to receive Sir Thomas Legg's report on arms sales to Sierra Leone; and if he will make a statement. [44521]

Sir Thomas Legg has said that he will complete his investigation and report as soon as possible. He is currently interviewing witnesses and examining evidence.

Does the Minister agree that, in many ways, the matter is really a story about the British intelligence services—which believe that they are answerable to no one when they are meddling abroad—and high-flying civil servants straight off the cast of "Yes, Minister", at least one of whom says that he cannot read his own memory? Is it not also about a shadow Foreign Secretary who believes that he has discovered some great defining issue in the lifetime of a Labour Government whereas, in reality, he is like a dog in the gutter that keeps returning to its vomit?

I was tempted to agree with my hon. Friend, at least on the shadow Foreign Secretary, but he invited me to go a little too far. Nevertheless, my hon. Friend has touched on the remarkable contrast between the shadow Foreign Secretary's view that he has chanced upon his Scott report and reality—

Nothing like.

Nothing like, as the hon. Gentleman says. Scott, of course, was a deliberate cover-up by Ministers. That Government deliberately chose to supply arms to Iraq, a regime that went to war with Britain in due course. It was a deliberate attempt to mislead Parliament. The contrast is remarkable. The right hon. and learned Gentleman has not been able to demonstrate, because he cannot, that Ministers colluded, that Ministers sought to provide arms or that Ministers sought to break the United Nations embargo—or that Ministers even sought to mislead either the House of Commons or the House of Lords. That is the difference. I shall be interested to see whether the right hon. and learned Gentleman welcomes the fact that, when he comes shortly to read the conclusions of the Legg report, he will not be locked in a room for a few minutes to review that investigation, but will have the chance to read it properly and to come before the House to say that he is sorry.

Will the Minister give us an assurance that Sir Thomas Legg will examine the relationship between all officials in the Foreign Office and Customs and Excise while he is conducting his inquiry?

Yes, of course. Sir Thomas Legg's remit is already public. Sir Thomas has already begun his investigations. He has access to all officials, to all the papers that he chooses to review and, very important, to all Ministers. I and my colleagues are looking forward to the opportunity to give evidence to Sir Thomas.

Did my hon. Friend notice the warm and enthusiastic welcome that the British high commissioner to Sierra Leone received on his return because the people there identify him with the return of democracy and hold us in the highest regard? Is not it nonsense to say that when the arms embargo was agreed by the United Nations it was on the basis that there would be no difference between the dictatorship that had taken over and the democratic forces? Surely there is all the difference in the world, as there was when there was an arms embargo against apartheid in South Africa—which hardly involved those who were fighting the regime.

Let me make it absolutely clear that the return of the high commissioner to Sierra Leone was recognised by the people of Sierra Leone as significant because his role and, indeed, that of the British Government was critical in the return of the democratically elected President to that country. That is something that the people of Sierra Leone do not want to forget, although Opposition parties try on occasion to deflect the issue.

It is important to place one point on the record. Much has been made of what I previously told the House. I said on 12 March:

"The suggestion that Britain was conspiring with hired killers is wrong".—[Official Report, 12 March 1998; Vol. 308, c. 844.]

It was absolutely right to say that then. It was wrong to suggest that we had conspired with hired killers, and it is wrong. We do not conspire and we do not work with mercenaries.

The Minister and the hon. Member for Bolsover (Mr. Skinner) appear to have forgotten that we are discussing matters that the Foreign Secretary described as "grave" and "serious". Baroness Symons told the other place yesterday that before she answered questions on 10 March she was briefed about allegations of illegal arms shipments being referred to the appropriate authorities. Does the Minister still maintain that he had no such briefing although he actually visited Sierra Leone at the end of that month? If he did not, has he established why?

I am really astonished by the right hon. and learned Gentleman's line of questioning. I recently told the House:

"At that time, I was not briefed, told, advised or in any way informed either orally or in writing of alleged arms shipments or of the Customs and Excise inquiry."—[Official Report, 14 May 1998; Vol. 312, c. 537.]

If that form of words is not comprehensive, I invite the right hon. and learned Gentleman for goodness' sake to come and tell me what more he wants. It is absolutely clear. It is before the House of Commons and before Sir Thomas Legg. When I appear before Sir Thomas Legg, I will repeat that form of words and he will be able to establish the truth. That will come back to the House.

At that point, I trust that the right hon. and learned Gentleman will have the good grace to withdraw his outrageous remarks.

Has the Minister established the reason for that astonishing failure to brief him?

rose—

He has already had two questions.

Order. The Opposition Front Bench is perfectly entitled to another question, otherwise I would not have called the right hon. and learned Member for Folkestone and Hythe (Mr. Howard). I determine the allocations allowed for those on the Front Bench.

I do not want to fail to answer the right hon. and learned Gentleman's question. Unfortunately, I did not hear it because of the noise.

Has the Minister established the reason for the astonishing failure to brief him on something that was clearly relevant to his visit to Sierra Leone?

I realise that the right hon. and learned Gentleman is in full flight in pursuit of what he feels is his political moment. Unfortunately, he is chasing the wrong target. His question will be comprehensively answered when Sir Thomas Legg publishes his report. The right hon. and learned Gentleman will then realise that his Scott report is simply a chimera, as is his political future.

What recent contacts he has had with the Myanmar Government concerning the restoration of democracy and the rule of law. [44523]

We regularly raise our concerns with the Burmese Government. Our ambassador in Rangoon had discussions with the Burmese Foreign Minister most recently on 4 May. He also remains in regular contact with opposition leaders, including Aung San Suu Kyi. We have used our European Union presidency to renew EU measures against the regime and drafted this year's United Nations Commission on Human Rights resolution on Burma.

I am pleased to hear that reply and am anxious that the name of Aung San Suu Kyi should not fall out of the news again. Have we been able to use our influence with the Association of South-East Asian Nations, which could apply pressure to ensure change in the regime?

In all our contacts with ASEAN countries we impress on them our view that there is a need for democratic change in Burma—the need to recognise the role of the opposition parties and the important contribution to the future of Burma that could be made by Aung San Suu Kyi. We want the ASEAN nations to resolve the matter internally. The United Kingdom Government and the European Union have taken their position. We consider Burma's violation of human rights wholly unacceptable and we shall continue to put that message across to all those in ASEAN and elsewhere who will listen.

Will the Minister pay tribute to the vernacular language transmissions of the BBC World Service to Burma? Has he been able to assess their effectiveness in at least influencing some people in Burma to look for a restoration of democracy?

I am always glad to pay tribute to the work of the BBC World Service, which makes an important contribution not just in communicating British values and democratic values, but in ensuring that many people in many parts of the world hear an objective news service that would otherwise be denied them. That is true in Burma, as in many other countries. I hope that it has had some impression on those who have power in Burma. I am afraid that I cannot be over-optimistic about that, but we shall continue to work towards the same objective.

What progress has been made in the middle east peace process. [44524]

What progress has been made in the middle east peace process. [44530]

Concern has been expressed at the Cardiff European Council about the continuing deadlock in the middle east peace process and the threat that that poses to the stability of the region. We have reiterated our strong support for the efforts of the United States to gain the agreement of the parties to a package of proposals which, if accepted, would open the way to the relaunch of final status talks. We have welcomed Palestinian acceptance of those proposals and continue to call on the Government of Israel to give a clear and positive response. The European Council also welcomed the increasingly substantive role of the EU under the UK presidency.

Does my hon. Friend agree that economic stability is fundamental to Israel and the Palestinians—a fact recognised by both sides? Does he also agree that we should make as much progress as quickly as possible towards the final EU-Israel association agreement, which would make a major contribution to promoting and maintaining the economic stability that is so necessary to the peace process?

My hon. Friend will know that the EU-Israel association agreement has been ratified in the House and undergone all the United Kingdom parliamentary procedures. That is true for the overwhelming majority of European Union countries. It is not true, however, for Belgium and France. The process is therefore held up in those two countries.

Land for peace is a crucial element of the middle east peace process. Does my hon. Friend share my concern that the Israeli Government appear to be trying to pre-empt the final settlement by extending illegal settlements across the whole of the west bank, with the associated road building, and by continuing planning policies in east Jerusalem that are changing the demographic balance between the Arab and Jewish populations to the detriment of the Arab population? Is he particularly concerned about the danger posed by the Israeli Government's plans for the E1 site, a huge site adjacent to Har Homa, which, if developed, would cut the Palestinian area in two?

We have always accepted the principle that land for peace is the basis for progress between the Israelis and the Palestinians. That is why we have continued to urge further redeployments by the Israeli Government. We hope—we have said so on many occasions—that they will take the United States' suggested offer, which is on the table. That is the way to make progress. We have also made it abundantly clear that we see the settlement development as inimical to the peace process and illegal in international law. We again urge the Israelis to stop the settlement development. Otherwise, it is impossible to achieve further redeployments and meet the Oslo principles, which we consider so important.

I have selected the amendment in the name of the Prime Minister.

I beg to move,

That this House notes with regret the increase in National Health Service hospital waiting lists since May 1997; deplores the failure of Her Majesty's Government to achieve implementation of its promise of an early reduction of such lists; notes that current Government policies in respect of hospital closures and bed reductions are likely to increase the lists further; notes that the proposals to abolish fundholding and reduce flexibility for general practitioners in purchasing health care for their patients will also add to the lists; and urges the Government to reconsider these changes.

We have chosen to debate waiting lists because the Government's broken pledges are of massive concern throughout the country. I was almost encouraged when I switched on my radio this morning and heard that the Secretary of State had announced another 2,000 beds. I thought, "This is wonderful. Every time we have an Opposition day, we can get 2,000 beds out of the Government." We shall consider it a great triumph if, at any time over the next month, the Secretary of State responds to our concerns and announces more money to put into the national health service. We shall be watching for that, and we hope that he will take seriously our request that he should do so.

However, my enthusiasm for the 2,000 beds quickly dwindled when I realised that they were nothing more than the same 2,000 beds that had been announced on 2 June. For one wonderful moment I had thought that we were going to get 4,000 beds, and I am sure that, from the tone of the statements by the Secretary of State, the general public were meant to think that those were extra beds. However, they are not; they are the old beds.

What is more, there is not even any evidence that those 2,000 beds represent a net gain. Are they, for example, to be set against the programme of closures and bed reductions now going on in hospitals throughout the country? This morning, I was at Kent and Canterbury hospital, where a reduction of 400 beds is threatened. Do we assume that those 400 beds will be added back in addition to the 2,000, or are we now talking about a maximum of only 1,600 beds? I would be grateful if the Secretary of State would explain both the minuses and the pluses, and tell us either the net gain or—as I suspect—the net loss.

Before the general election, Labour promised to "save the NHS", and to cut waiting lists by 100,000. They called that their "early pledge". Labour has now been in government for 14 months and we are entitled to examine that early pledge. The Government now say that they will meet the pledge before the next election, so that early pledge has become a "better late than never" pledge. Let us recall what Labour told us when it was in opposition. Its posters told us that

"NHS waiting lists will be shorter";

its mugs—that is, the china sort—told us, "Treat more NHS patients"; and its election manifesto promised to cut health service waiting lists by 100,000. Then, the Secretary of State told us:

"This Government only makes promises we intend to keep."

However, the truth is rather different: waiting lists are now 11.5 per cent. higher than when Labour took office and that early pledge has been comprehensively broken. There can be no doubt that those pre-election promises were deliberately designed to make the voters think that waiting lists would be reduced quickly; not only have waiting lists risen, but the Labour Government are deliberately adopting policies that will cause them to rise still further.

The Secretary of State has made various excuses. First, he deliberately put waiting list surgery on hold to cope with a winter crisis that did not, in fact, materialise. The Opposition have been told of cases where temporary nurses were hired at great expense, only for them to have nothing to do, because there was no winter crisis; and of waiting list surgery cancelled, only for the hospitals to have nothing with which to replace it, because there was no winter crisis—a catalogue of waste and inefficiency. I am not suggesting that the Secretary of State could have predicted exactly how mild the winter would be—after all, if he does not know how many hospitals he is responsible for closing, it is most unlikely that he would be in touch with the long-range weather forecasters. However, I am saying that he did not sufficiently think through, or keep sufficiently flexible, his priorities last winter.

Having said that, I give the Secretary of State a little bit of credit, because he accepted that it was his decision and, therefore, his fault. He bungled in his judgment, but at least he had the grace to admit that the record waiting lists were his own creation. He did so in the House, when he said:

"As top priority was given to emergencies, waiting lists have grown".

He himself made the direct connection; he then said:

"I set that priority, and the health service met that priority".—[Official Report, 18 March 1998; Vol. 308, c. 1290.]

That is more than the Prime Minister is able to do.

During Prime Minister's Question Time on 29 April, the Prime Minister flatly refused to take any responsibility whatsoever for increased waiting lists. I might add that it was not clear from his answer whether or not he held the Secretary of State directly responsible—I suppose that we shall have to wait for the forthcoming Cabinet reshuffle to discover the answer to that question. However, there now appears to be a rather interesting dichotomy, between a bungling Secretary of State for Health who admits that it is all his fault and a Prime Minister who cannot take responsibility for anything.

Despite the Secretary of State's flush of culpability over the winter pressures fiasco, it seems that he is not yet ready to make the ultimate sacrifice. Usually, if someone admits an error of judgment that causes untold misery to 133,000 people, one would not expect that person to say, as the Secretary of State said in his message to trust chairmen and chief executives, "Okay, I bungled, but you're the ones who may be fired." What makes the Secretary of State's response even more astonishing is that the people he has threatened with the boot are the Labour party's friends, whom he had appointed to trust boards barely four months before.

Let me remind the House of the figures: 79 per cent. of those appointees declaring political activity did so for the Labour party; and 84 per cent. of those appointees who are councillors are Labour councillors. That is what the Secretary of State calls

"making trust boards more representative of the people they serve",

but most people would simply call it gerrymandering.

The reason for that preponderance of Labour activists is the result of a rather convenient oversight: the Department of Health wrote only to council leaders, not chief executives, when seeking nominations from local authorities. It appears that some Labour council leaders—inadvertently, it is said—failed to pass on the letter to their colleagues in other parties, so that only Labour activists were nominated in any significant number by that method.

Of course, it must be a little embarrassing for the Secretary of State. Having gone to all that trouble to ensure that trust boards were packed full of Labour supporters, he is now in the rather awkward position of being forced to sack them all as scapegoats for his Government's broken early pledge on waiting lists.

However, trust chairmen will not have to look pensively through their morning post just yet because it seems that the people's pledges are, in fact, portable pledges, to be moved around whenever it is most convenient to the Government. In March, the Secretary of State promised, to the House and in a press release, that waiting lists would be below 1.16 million within a year—by April 1999. Three months later, on 2 June, he said during Health questions that

"by this time next year waiting lists will be down to the level that we inherited."—[Official Report, 2 June 1998; Vol. 313, c. 159.]

Was that just another bungle by the Secretary of State or has he delayed the pledge by three months? Will he now set the record straight? Will the deadline for the first new clause of his revised waiting list pledge expire by 31 March 1999 or 30 June 1999, or will he extend it again? Which is the correct pledge? I look forward to hearing his answer.

I know that the right hon. Lady has not been doing her job for very long, but I should have thought that she would have understood by now that under the useless statistical system that we inherited from the previous Government, it takes the national health service about two and a half months to come up with the figures. That is the explanation for the discrepancy.

It is always somebody else's fault. This time, it is the fault not of the trust chairmen, but of the statisticians—the right hon. Gentleman's own civil servants. He still has not answered the question, but I take it that 30 June 1999 is the date to which we are all now working. If it is, that can go on the record and we can hold him to account. That is no way to run the health service. The convenient confusion over the Secretary of State's waiting list pledge and the treatment of health service staff is just part of the picture that we are beginning to see of a health service in turmoil. In one breath to tell people that they have done us proud, as the Secretary of State puts it, and in the next to threaten them with the sack when it is the same Secretary of State's decisions that have caused the record waiting lists merely demonstrates that Labour has never been fit to manage anything. That rather sad display of macho management will serve only to demoralise health service workers even further.

Will the right hon. Lady give way?

In a moment.

The Secretary of State appears intent on alienating the most important workers in the health service. First, he alienated the nurses by giving them a staged pay rise. He said that he was embarrassed. So he should be—in July 1996, when the then Government proposed to stage the pay rises of Members of the House, the right hon. Gentleman voted against it. He voted to take his pay rise in one go. He was not embarrassed then, so no wonder he is embarrassed now, as should be the Under-Secretary of State for Health and the Minister for Public Health who also voted against staging then. Let the Secretary of State explain that to the nurses.

The Secretary of State should be embarrassed also that when he is closing hospitals across the country, there is to be a £1 billion hospital in his own back yard.

I appreciate that the right hon. Lady is speaking on behalf of the Opposition, but is she aware that the Government have made over £5 million available to West Kent health authority in the area that she represents which will be used to create 132 new beds, which were cut under the previous Government? Will she take the opportunity at least to thank my right hon. Friend the Secretary of State for the extra resources that he has made available for her constituency?

I shall discuss the position in Kent presently, and the hon. Gentleman will not then be smiling so confidently as he is now. The situation in Kent is grievous, and it is entirely the result of decisions taken since May 1997. We shall hear about that in a moment.

Will the right hon. Lady discuss what is going on in my health authority? It is getting an extra £1.8 million for these matters. Why is the right hon. Lady complaining, when every Member of the House of Commons represents a seat where millions of pounds has been allocated to shorten waiting lists? What is wrong with that? Labour is delivering.

First, that money must be allocated because the Government's policies are not working and waiting lists are lengthening. Secondly, when we discuss those millions, I shall show the hon. Gentleman that the money is not worth as much as he supposes.

I return to the demoralisation in the health service. The sources of increased pressure on waiting lists are not only the Secretary of State's bungled attempt at "tough management", as he calls it, but the pathetic financial settlement that the Government have seen fit to offer the health service. "Pathetic" is not my word; it is the word used by Dr. Sandy Macara, chairman of the British Medical Association—a group that has rarely criticised the Labour party in the past 19 years, and now says that its financial settlement is pathetic.

The BMA says that because, despite all the talk of extra money for the health service, we had an increase of 3.1 per cent. in real terms per annum, whereas the average increase under the present Government has been only 2 per cent. Of course they have made some extra sums available, but let us see what we have to remove from those extra sums. Perhaps the hon. Member for Workington (Mr. Campbell-Savours) will get out his calculator.

I have it here.

We can remove higher-than-expected inflation. That is another broken pledge; Labour said that it would keep inflation low. We can remove health service inflation. We can remove the abolition of private medical insurance tax relief, deficit reduction, the phased pay award and other black holes in Labour's spending campaign, which render the additional money that they keep talking about only a fraction of its current worth. For example, if one removes the factors that I have suggested, the £417 million announced in the Budget becomes a paltry £32 million.

The effect that underfunding has had on the health service is now visible; what will be the cost to waiting lists of another year of short change? If underfunding and winter pressures were the only factors, the waiting lists situation might not look so desperate, but that is only half the story. The entire structure of Labour's health service reforms and its hospital closures programme will have an equally devastating effect on the future of the health service.

Labour's White Paper is a blueprint for increasing the people's waiting lists. The bureaucracy proposed in the White Paper will add substantially to health service running costs. The Government claim that they can save £1 billion from bureaucracy but, without saving anything, they have already added another £150 million a year from the cost of administering the primary care groups alone. Bureaucracy to co-ordinate health authorities and local authorities will be necessary within the structure of their reforms, but they have not accounted for any cost whatever. NICE, the national institute for clinical effectiveness, and CHIMP, the commission for health improvement—to name just two of their inventions —will also cost extra money, with no resultant administrative savings. The whole White Paper appears to be a return to the command-and-control structure for the health service, with all the associated running costs. There will be a raft of new quangos, none of which will keep the waiting list pledge afloat.

The Government have not, as they frequently claim, abolished the internal market. The purchaser-provider split remains. They have only clogged up its workings with unnecessary controls and bureaucratic mechanisms, requiring constant consultation before any decision is taken. That will reduce efficiency and lead to money being diverted from reducing waiting lists to unnecessary administration. There is reduced freedom for general practitioners because primary care groups, rather than fundholders, will choose between trusts, and that will reduce the flexibility of individual GPs to choose shorter waiting lists for their patients. The reduced efficiency caused—

rose—

Go on, read from your briefing.

No, it is entirely of my own making; I have no briefing from anyone else.

I speak as a former member of a family health services authority, and that authority had some Tory nominees on it, none of whom subscribed to the concept of GP fundholders. Does the right hon. Lady think it was right that so much money accumulated in GP fundholder budgets while health authorities were running deficits? That money could have been used to treat patients and reduce waiting lists. Does she accept that while I was a member of a family health services authority, our auditors brought to our attention a number of cases where they thought that fundholders were not using the money efficiently, such as for the purchase of lavish oak furniture? Does she not think that those cases should have been dealt with, and that the money should have been spent on reducing waiting lists?

Fundholding increased flexibility and allowed doctors to choose what was best for their patients. Fundholding resulted in a vastly improved service, to such an extent that, although the early demand was cautious, there was later a huge demand for fundholding. I would have expanded fundholding, not got rid of it.

Even more disturbing than what I have described so far is the programme of hospital cuts and closures by stealth. Beds, wards and even whole hospitals are being shut down as Labour's lack of investment in our health service bites.

My constituency was marked by years of hospital closure on the promise of a new hospital corning, which was intended to be built under the private finance initiative. However, dither and delay prevented it from coming, and confidence in the health service lapsed. My right hon. Friend has redeemed the promise and we are to have a new Queen Elizabeth hospital in the area.

I am delighted to hear about the Secretary of State's U-turn in accepting the PFI, but in the month that the election was declared—in March last year—Labour said, "We have no plans to close hospitals." Labour deceived the electorate. [HON. MEMBERS: "Where?"] I shall give some examples.

In Oxfordshire, the outlook is especially bleak. Three community hospitals face the axe. One of those, Burford community hospital, contains a specialist Alzheimer's rehabilitation project. The unit is not replicable in the medium term, so if it goes, no substitute service will be provided. It will close when Burford shuts, despite being a centre of academic excellence for research into Alzheimer's. Patients using Burford will face a 40-mile round trip to out-patient facilities in Oxford.

The closure of the hospital will mean that elderly patients using Burford as a halfway stop when returning home from hospital stays will be forced to block beds for other patients waiting for treatment. I have heard that story from many community hospitals. One of their most important functions is to relieve acute beds by taking people who are no longer in need of acute beds, but who are not yet ready to return home, and rehabilitating and caring for them in the interim. If those hospitals close, that function will go with them. That can only result in longer waiting lists, as beds are blocked.

Is my right hon. Friend aware that the exact situation that she describes applies in Dorset? We have a massive bed-blocking problem, which has got much worse over the past year. [Laughter.]

Indeed. Dorset, Oxfordshire, Warminster and Wallingford are merely examples. We shall hear far more during the debate, but we should note that the response to my hon. Friend's intervention was laughter on the Labour Benches. I do not think that that laughter will be shared by the patients who fear that their hospital will be closed, or in my hon. Friend's constituency or throughout the country when people realise how deceived they were by the Government. The Labour Government said that there would be shorter waiting lists, but lists have risen to record levels. The Government said that there would be no closures, but they are now closing right, left and centre.

Will the right hon. Lady tell the House how much more money she wants spent on the health service?

We did not plan to close those hospitals, so we would have spent the money to keep them open. We spent 3.1 per cent. more every year, but the Government have spent 2 per cent. more. That is the answer to the hon. Gentleman's question.

The point is that hospital reorganisation can be very expensive. The proposed rundown of Kent and Canterbury hospital in my constituency, which my right hon. Friend visited this morning, is a good example. The community health council has pointed out that Kent health authority's figures for the likely costs of the closure are wholly unaudited, unsupported and grossly understated.

My hon. Friend is absolutely right. I intended to make those very points when I turned to Kent, as there seems to be a misapprehension that all of Kent is swimming in new Government money.

As my hon. Friend said, I visited Kent and Canterbury hospital this morning. It is an acute —not a community—hospital with an award-winning cancer unit. Local people cannot believe that there is any question of that hospital being axed, with all the in-patient facilities scrapped. People will face a 100-mile round trip for radiotherapy if the oncology unit is scrapped, for example. I must admit that I am interested in that myself as the nearest oncology centre is Maidstone. If the oncology unit at Kent and Canterbury hospital is closed—I accept that it is only a proposal at present—I want to know what extra resources will be made available to Maidstone to enable it to cope with the people who will be forced to make that long round trip.

People feel let down and disillusioned. The 465 beds at the Kent and Canterbury are threatened with a reduction to 65. How does that square with anything that Labour said before the last election? People never believed that Labour would close their hospitals; they never believed that Labour would preside over record waiting lists. They were led to believe that there would be increased funding, reduced waiting lists and hospitals kept open. The Government have failed in each and every one of those areas—and they have failed dismally.

Let the Secretary of State now make several things clear and we shall listen very carefully —I shall not be ambitious and ask him to apologise. The Secretary of State needs to tell us if and when he will meet his pre-election pledge on waiting lists. He needs to tell us how much more than his original estimate of £100 million it will cost to meet that pledge, however late it may be. He needs to tell us—he has been asked this many times during Health questions, but has dodged the issue every time—whether he will guarantee that no other areas of our health service will suffer as a result of the Government's panic reaction to tackling the waiting list problem that they have created.

If the Government eventually reduce waiting lists at the expense of other investment in our health care system, they will not have delivered on their pledge. To cut back or to marginalise other core areas of health service activity would be to cheat all hospital users. The Government have fudged and bungled their early pledge: it has been broken and twisted beyond repair. There will come a point when the Secretary of State must realise that he cannot turn around his supertanker fast enough and that he is heading on to the rocks of Labour' s pre-election early pledge. When he reaches that point, I suggest that he considers whether he should follow the example of all decent captains and go down with his ship.

I must apologise, as my voice is going—I should obviously consult our wonderful national health service. Does my right hon. Friend realise that both the Department of Health and the Department of the Environment, Transport and the Regions have had to accept that money has been cut from social services budgets in places such as Dorset? The process of unblocking beds by putting people into community care is falling down completely in Dorset —it is not just a matter of its maintaining previous levels. The Secretary of State must tell us what he is doing to ensure that the other Departments' budgets are not being cut in that way.

Indeed. My hon. Friend gives a great deal of flavour to my point, which is that we are already receiving intelligence from various parts of the health service, from chairmen and chief executives, who are telling us—

Labour chairmen.

If they are Labour chairmen, Labour Members should listen carefully to what they are telling us because it is not very helpful. They are telling us that there is such a frantic demand for statistics coming from the Government, and so much fear and panic over trying to make it look as if the Government can keep their waiting list pledge, that staff are being prevented from getting on with the job in hand. That information is coming not from politicians, but from those who are responsible for running the health service, and who are faced with the sack by the Secretary of State if they do not deliver.

The right hon. Lady knows that I am sympathetic to her attack on the Government for postponing their early pledge on waiting lists—if not looking as if they are in great difficulty in delivering it. However, the implication of the right hon. Lady's attack is that her party would put in the money to ensure that waiting lists were reduced. If that is now her party's policy, will she explain why, last Thursday, the shadow Chancellor of the Exchequer accused the Chancellor, when he announced more money for the public services, of going soft on public spending?

The Labour party made twin promises, as the hon. Gentleman will know.

Answer the question.

I am answering it. The first promise was, "We will stick to the previous Government's spending plans." The second promise was, "We will reduce waiting lists." The Labour party made twin promises at the same time. That being so, the Government cannot now blame keeping one promise for breaking the other.

How does the Secretary of State respond to the motion? He responds with exactly the same manipulation of fact—I put in no higher than that.

Will the right hon. Lady give way?

No. I shall make some progress and I have given way to the hon. Gentleman once. It was not a particularly intelligent intervention last time, and I do not suppose that he has learnt anything in the short time between because he has not been listening. That being so, I am going on.

How did the Secretary of State react to the motion? He did so by making the statement that appears in the amendment, which is that the House

"notes that by March 1998 no-one in England was waiting over 18 months for treatment, meaning that this Government has already achieved what the Conservative Government never achieved".

I say that again. The amendment states that

"no-one in England was waiting over 18 months for treatment".

Naturally we wondered what surveys had been done to establish this, and we asked. We were told that it was established through management intelligence. That is, I think, a ring-round. There is at least one case of a schoolboy who has been waiting not 18 months, but 19 months for a simple throat operation. His mother wrote:

"He can't sleep at night because his throat hurts and he can't eat properly. I know that he has got to wait his turn"—

so this is a reasonable parent—

"but it has been 19 months and that is too long for a little boy. Two months ago I wrote to St. Thomas's because I hadn't heard anything since I took him to the doctor's in 1996. They came back saying that they had looked into my complaint and they gave him an appointment to have his tonsils out on 10 June. On 28 May I got a letter saying that he could not go in because there was an emergency case coming in, but how did they know that 12 days in advance?"

That is the situation, so the statement to which I have referred is untrue and I expect the Secretary of State to withdraw it.

Is my right hon. Friend further aware that when waiting lists in Salford and Trafford, in my health authority area, have risen by about 5 per cent. in only four months, there is the further scandal of operations being moved? People are not being moved through the system and then having operations, but being removed from waiting lists and going on to deferred lists, which do not count in the official figures. That is happening, but we are still seeing waiting lists increasing dramatically.

My hon. Friend is right, but I also want to ask the Secretary of State another simple question. The first was, will he acknowledge that the statement in his amendment is wrong, which means that he cannot press the amendment because it would mislead the House?

No, I will not.

The Secretary of State is saying that that child has not waited 19 months. I shall read that into the record, and I am sure that the mother of that child will want to take it up. He is saying that she is not telling the truth, but he should be saying that the amendment is wrong and should be withdrawn, because to press it would be to mislead the House, which I am sure he would not want to do.

Let me ask the Secretary of State another simple question. He talks about 18-month waiting lists. That, of course, is for treatment. There is an easy way to make sure that no one waits more than 18 months for treatment, which is to make sure that they wait rather a long time for a consultation. Will he please publish lists of how long people have been waiting for consultations, and make them comparative, so that we can see the true state of affairs?

I of course accept that the right hon. Lady has managed to identify one person who has been waiting more than 18 months, but does she accept that, under the Conservative Government, a time was reached when 220,000 people had been waiting more than 18 months, and 92,000 people had been waiting more than two years? Would she apologise to those people, whom she let down year after year?

The Conservative Government cut the number waiting for more than a year from 200,000 to 15,000. Perhaps the hon. Gentleman would applaud that.

In considering this rather silly amendment, which contains an inaccuracy and which the Secretary of State, in all decency, should not press on the House, we should make a final survey of what we inherited, what they inherited and where we are now. In the last full year of the previous Labour Government, there was a 2.7 per cent. cut in the NHS. Under us, there were consistent rises, year on year. During our previous period in government, our spending rose 74 per cent. The Labour Government's capital investment fell; ours rose, by 66 per cent. Under us, pay for doctors and dentists went up 34.5 per cent.; under them, it went down 31 per cent. Under us, nurses' pay went up 67 per cent.; under them, it went down 3 per cent. Our lists of people waiting more than a year went down by 92 per cent.; theirs went up by 26 per cent. [Interruption.] I am wrong. I am sorry, but I thought that one of my hon. Friends wanted to intervene. I always value contributions from my hon. Friends, so I was prepared to give one of them a chance to speak.

Where are we, at the end of just over a year of the Labour Government being in power? They plan to reduce flexibility for doctors, they have closed hospitals and reduced spending year on year, and they put such an emphasis on statistics that we are being told that basic care is suffering. That can all be summed up easily: they spend less, they close more, they make people wait longer.

On a point of order, Madam Speaker. I crave your advice on something that is going on in the House—behind you, I am afraid, because of the people who are involved. The normal situation is that people in the Box send notes to Ministers. Those notes are being caught up by the parliamentary private secretaries and sent round to other people.

My only concern is that either a Minister or a PPS approaches the Box.

I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:

"notes with pleasure the £2 billion increase in National Health Service spending since 1st May 1997; welcomes the allocation of £500 million to cut waiting lists by the end of this Parliament to 100,000 below the record levels inherited from the last Conservative Government; notes that as a result of record increases in waiting list surgery the National Health Service will be opening around 2,000 extra beds and keeping open around a further 1,000 in marked contrast to the cuts under the last Government; notes that by March 1998 no-one in England was waiting over 18 months for treatment, meaning that this Government has already achieved what the Conservative Government never achieved; and further welcomes the ending of two-tier care by the introduction of primary care groups which puts doctors and nurses in the driving seat of modernisation.".

The Tory attack on our handling of the national health service seems to me to be an unholy combination of barefaced cheek and amnesia.

Will the Secretary of State give way?

No, I am not giving way for the time being. Many Back-Bench Members wish to speak. The shadow Secretary of State went on for a long time, and so that other people can contribute to the debate, I do not propose to take a large number of interventions. The motion tabled by the Leader of the Opposition begins by regretting the increase in waiting lists since May 1997. We welcome the Tories' new interest in waiting lists. I wonder why they regret only the increase since May 1997. They have expressed no views on the massive increases in waiting lists that took place before 1997. I have checked the records. Such has been the massive concern of the parliamentary Tory party about waiting lists that, during the previous Parliament, when more than 230,000 questions were tabled and answered, Conservative Members asked just 32 questions about waiting lists, which is six a year.

The reason for the concentration of interest on waiting lists as opposed to waiting times or capital spending is that Labour made the promise, and the Government are being held to account. The interest in waiting lists stems from Labour's rash promise.

The Opposition spokeswoman has taken up more time in my speech than I have, and she has already had 40 minutes of her own.

Under the Tories, there was a relentless increase in hospital waiting lists. During the 1990s, after the reforms of the national health service of which the Tories were so proud, the figure exceeded 1 million. They seem to have forgotten that, when we took over in May last year we inherited from them record national health service waiting lists, which were rising faster than at any time in the history of the service. They have either forgotten that, or they are proud of their useless record when they were responsible for the health service.

Not only do we regret the rise in the waiting lists both before and after May last year, but we intend to do something about it. That is what we promised at the general election. It is worth remembering that, at that election, the Tories proposed to do nothing more about waiting lists: they were apparently satisfied with things as they were.

Will the Secretary of State give way?

No, I shall not give way.

The people of this country want waiting lists to come down. For them, the worst aspect of the health service is the waiting: waiting for an ambulance, waiting in accident and emergency, waiting for an out-patient appointment, waiting to go into hospital, and, for God's sake, once they are in hospital, sometimes having to wait to get out again. We recognised that concern, and we promised to get waiting lists down. The Tory party was apparently quite satisfied with the situation that then prevailed.

It will not be easy to get the waiting lists down: no one ever suggested that it would be. As I said this time last year, they are like a supertanker: it will take time to slow them down, longer to stop them rising, and even longer to turn them around.

What was "early" about the Secretary of State's pledge?

It was certainly an early pledge, and we are doing something about it. If we are to improve the health service, we must take account of the state it was in when we inherited it. It was in a very bad state. It was stretched almost to breaking point. Staff were run off their feet, and there was a lack of resources. The Tory Government used to pride themselves on the way in which they looked after public money. Sixty of the 100 health authorities–60 per cent.—were in debt.

A massive increase in the number of emergency cases had been taking place for some time. When we took office, we asked the officials what research had been done into the reasons for that increase, and what had been done to tackle it. Answer came there none. The idle, useless lot who had preceded us had not examined the problem at all; we have had to start doing so.

Last summer, I made it clear that, in the coming winter—last winter—the national health service should give priority to dealing with emergencies. We realised that, given the resources then available to the NHS, we could not ask it both to bring waiting lists down and to deal with emergencies. I took responsibility for that from the day on which I said it, and I continue to accept personal responsibility. I am not ashamed to do so. I said that emergencies should come first. I took substantial steps to promote joint working throughout the NHS and with social services all over the country, and my right hon. Friend the Chancellor of the Exchequer provided an additional £300 million to cope with emergencies during the winter.

Will the Secretary of State give way?

I will in a moment.

That made 700 extra beds available during the winter to help the hard-pressed people in the health service to cope with emergencies. They achieved a brilliant success. I know that the weather was mild last winter, and that there was no flu epidemic; but last winter the NHS dealt with more emergencies than ever before, and there were none of the scandalous lists of people waiting on trolleys and mattresses in corridors that had characterised nearly every winter in the 1990s. That is immensely to the credit of those working in the NHS and local social services. It contributed to the rise in waiting lists, as I had said it would at the start, but I believe that the right priority was given.

Until recently, I had not heard one person object to that decision. Then the last shadow Secretary of State for Health said that it had been made to save my face. I possess my face, and I would not want to sacrifice anyone for the sake of my face. Nothing was done for the sake of my face.

Now the new shadow Secretary of State says that our action was a failed public relations exercise. Was what was done in the West Kent health authority area, part of which the right hon. Lady represents, a public relations exercise? Was it a public relations exercise to put £117,000 into flu vaccinations to protect the most exposed groups? Was it a public relations exercise to put an extra £1 million into 132 additional nursing and residential home placements and home care?

Will the Secretary of State give way?

No.

Was it a public relations exercise to spend £50,000 on extending district nurse cover in the right hon. Lady's area, to spend £200,000 on additional beds at Mid-Kent hospital, or to spend £150,000 on a minimum care ward and discharge lounge at Kent and Sussex Weald? Apparently so.

Will the Secretary of State give way?

I will in a moment.

Recently, at the invitation of the senior representative of the consultants in the British Medical Association, I visited Halton general hospital. That representative was proud to introduce me to a team of respiratory care nurses who had spent the winter using some of the money to visit old people and other people with chest complaints, and deal with them at home. Being in hospital would have put them in danger, owing to the nature of hospitals. That was not a public relations exercise; it was a brilliant effort on the part of people in the NHS, which was appreciated by everyone—except, apparently, the new shadow Secretary of State for Health, who would rather make cheap political points.

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I will give way to the hon. Member for Truro and St. Austell (Mr. Taylor).

The Secretary of State has rightly referred to the brilliant effort by staff in the NHS. He is aware, of course, of the situation in Cornwall, where four hospitals and a maternity unit face closure. He has to accept that it is now his responsibility to say yes or no to the health authority proposal. He will understand that there is much concern among the staff themselves in those hospitals and the maternity unit about their future, and there has been substantial delay in making a decision. Can he give any indication as to whether there is any chance of an early decision, one way or the other, which will at least relieve the burden that they are under? I hope that the decision will be to keep the hospitals and maternity unit open.

I am not supposed to adjudicate on individual decisions on the Floor of the House, because I could be challenged, whether my decision went one way or the other, and I have a quasi-judicial role in this matter. All I can say about the Cornwall situation is this: it is nothing to do with money. The chief executive of the Cornwall and Isles of Scilly health authority has said that, even if he had the money, he would close those hospitals.

I am dubious about that idea, as the hon. Gentleman and other Cornwall Members know, and I am looking at the objections to those closures extremely seriously. It is all right people saying, "Make up your mind quickly." If I had made up my mind a lot sooner, they might have got the wrong answer. If they hang on a bit, they might even get the right one.

In East and North Hertfordshire health authority, the number of people on the waiting list has gone up by a third in the past year, so will the Secretary of State apologise to the 4,000 extra people on the waiting list, and answer the question that my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) asked: what about Lee Bosley, who has been waiting for 19 months? How can the Secretary of State possibly say that people are not waiting for 18 months when here is someone who has been waiting for 19?

I do not know the details of the case that has been raised across the Dispatch Box, but the statements that I have made are based on information that has been supplied through the normal statistical arrangements in the Department of Health. Indeed, I have so insisted on it getting things right that one of the reasons for the increase in waiting lists is that it has had to look around, and has found some people who, strangely, disappeared from the waiting list last year. They are now back on because I want the figures to be accurate. If they are not, I will follow that up and ensure that something is done about it.

So will the Secretary of State withdraw the amendment?

No, I certainly will not withdraw the amendment because, frankly, I would not take the word of the people sitting on the Conservative Front Bench if they were the last people on earth. The child's mother may be right, and I am prepared to find out what has been going on, but I am not prepared to accept any accusations that are hurled at me by people on the Conservative Front Bench. If they had really been interested in the interests of the child, they could have got in touch with my Department—and I would have sorted the matter out in advance—rather than trying to make cheap points at the Dispatch Box.

We are entering just our second year of government and, with the extra money, I am convinced that we can and will tackle waiting lists. In his first Budget, the Chancellor found for this year for the NHS £1.2 billion over and above what the Tory Government had intended. In his second Budget, which was announced fairly recently, he found an extra £500 million, specifically to tackle waiting lists. That takes to £2 billion the total extra funds that we have put into the NHS since we came to power.

Of the £500 million of waiting list money, £417 million extra will go to England—rightly, Scotland, Wales and Northern Ireland will get their share—to start getting waiting lists down. That is how it will be used. Today, I have published —anyone who reads it will be able to challenge the figures—a preliminary survey of what is happening with that money, which shows that more beds are being provided, that more wards are being opened, that more staff are being taken on, that there is more operating theatre time, and that there are more weekend and evening surgeries.

Let us look at what is happening with beds. The Opposition motion accuses us of reducing the number of beds, but, as a result of the availability of that £417 million—or, indeed, only part of it—this year 2,000 extra beds will be made available to the NHS, which would not otherwise be available. Moreover, 1,100 beds which were planned to be closed will not be closed. Therefore, this year, 3,000 extra beds—the equivalent of six new district general hospitals—will be in use to help bring down waiting lists. That action is being taken at a time when we are getting on with building another six district general hospitals, including the one in the constituency of my hon. Friend the Member for Carlisle (Mr. Martlew).

Members rose—

Will the right hon. Gentleman give way?

I shall not give way for the moment.

Although the new Opposition health team have not been in the job very long, they should know that, between 1979 and 1997, the Tory Government—of whom they seem to be so proud —closed 43,000 acute beds in the national health service. This is our second year in government, and 3,000 extra beds will be available. Compare that with the 43,000 fewer beds that were available under the Tories. What a contrast!

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Will the right hon. Gentleman give way?

I shall not. I shall mention the hon. Gentleman, after which he can intervene.

This morning, the hon. Member for Rutland and Melton (Mr. Duncan)—who keeps leaping to the Dispatch Box—said on radio that he wanted to see the lists of those beds. We have published the lists. However, to save him looking them up, I tell him that, because of the Government's action, there will be 30 extra acute beds in Leicestershire, which will serve his constituency. In west Kent—which includes the constituency represented by the shadow Secretary of State for Health–125 extra beds will be available. I know that the right hon. Lady is in favour of old-fashioned courtesies—so I am just leaning forward to hear the words, "Thank you." She should be grateful that she is getting that extra money.

I shall give some other examples.

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Let me finish the list.

There will be 450 extra beds in London; 60 in Birmingham; 75 in Leeds; 73 in Berkshire; 67 in Liverpool; 36 in east Norfolk; 89 in Suffolk; 60 in Bradford; 115 in Derbyshire—because we are as interested in rural areas as in big cities—and 48 in Durham. Extra staff will be taken on. Moreover, £65 million will go into primary mental health care and community services—all of which can make a contribution by looking after people at home, so that they do not place a demand on hospital beds.

The Government's action has been welcomed across the country—except by the Tories. The right hon. Member for Maidstone and The Weald said that people are moaning about the Government's action. However, I should tell her that, in May, Ruth Carnall, chief executive of the West Kent health authority, told the Gravesend Reporter:

"We welcome this money, particularly since we understand"—

she is quite right—

"that it is not just a one-off but part of an intention nationally to enable health authorities to maintain lower lists."

The Government have had such welcomes from the people who actually have to do the work across the country.

The Tory motion, out of date as it is—as the Tories usually are—mentions bed reductions. However, as I said, there will be 3,000 extra beds.

The right hon. Gentleman has quite consistently talked about extra beds. I therefore ask him again the question that I asked him earlier: will those extra beds be over and above complete restoration of all the beds that are now being cut and all the hospitals that are now being closed? Will the extra beds in Kent, for example, mean that we will not lose 400 beds at Kent and Canterbury? If we lose 400 beds at Kent and Canterbury, 63 extra beds somewhere else in Kent will be of minimal use.

The 63 extra beds in Kent will be provided this year. Consultation is under way in Kent about proposals made by the East Kent health authority that involve changes and—if the authority has its way—bed reductions at the Kent and Canterbury hospital. That, if it is approved, may take place in future years. I am talking about this year. There is not going to be any reduction in beds in Canterbury this year.

In addition, the proposition for the changes in Kent to which the right hon. Member for Maidstone and The Weald objects comes from the members of the East Kent health authority, every single one of whom was appointed by a Tory Secretary of State, not by me. As I do not like to mislead the House, I must point out that I reappointed the woman who chairs that health authority because it seemed wrong to change horses in mid-stream. I believe that I have the support of the Tory Member for Thanet—the hon. Member for North Thanet (Mr. Gale— in so doing.

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I give way to the former Secretary of State for Health.

The Secretary of State can clear up very simply the question whether there is to be a net increase in bed space. Will he give the House a clear undertaking that the published figures for this year will show that 3,000 more acute beds were available in the national health service than were available in the health service last year? Are the acute beds in the health service going to increase by 3,000? Is that the commitment that he is giving the House?

As the right hon. Gentleman knows, under the present statistical arrangements in the Department of Health, over which he presided, we shall not get those figures until 1999. We are talking about practicalities, not crackpot statistics as provided by the Tories. The practicalities are that the hard-working staff in the NHS will this year have access to 3,000 more beds in which to treat patients. That is clearly a step forward.

The Tory motion also criticises our proposals for improving primary care and giving greater power and influence to general practitioners, community nurses and midwives. We are doing that because everyone recognises that the Tory reorganisation of the NHS was wrong. The Tories introduced a competitive internal market which produced a two-tier system. It set doctor against doctor and hospital against hospital, and it cost a fortune in bureaucracy. If anyone doubts the huge amount of waste in the bureaucracy, I shall give one simple example.

When we took office, we were faced with having to agree, or otherwise, what was called the eighth wave of fundholding. We decided not to go ahead with it. The previous Government had earmarked £20 million for last year just to pay for the bureaucracy involved in the eighth wave of fundholding. I stopped it. That released £20 million, £10 million of which was spent on improved breast cancer services across the country, including £194,000 in the health authority which serves the shadow Secretary of State and £183,000 in that which serves the shadow Minister of State.

We know from what she has said in the past that the shadow Secretary of State believes that the Tory reforms are now really delivering results, but the main result they delivered was untold harm. Talking to people in the NHS, I find it very difficult to find anyone who will admit to supporting the old system. Admittedly, the majority of people in the health service never did support it, but even some of its former advocates have publicly recanted. Even more disturbing is the fact that the odd one, well known for advocating the internal market years ago, has sidled up to me to whisper that he was a secret member of the resistance all along. Such people are not very convincing, but I give them the benefit of the doubt.

Our proposals will put doctors, nurses and midwives back in the driving seat, not only in primary care but right across the national health service. That is bad news for management consultants, but good news for the rest of us. Management consultants have done untold damage to the NHS.

GPs are rightly concerned about the future of general practice. It is natural that they should be, as it is their careers, their premises, their staff and their patients who are involved. They have raised practical concerns, and there have been talks between the British Medical Association and officials in my Department, and, more recently, between representatives of the BMA and the Minister of State, my hon. Friend the Member for Darlington (Mr. Milburn), whom I should like to thank for the amazing amount of hard work that he has put into those talks. I hope and expect that the talks will achieve a successful outcome.

We share the desire of the professions—not just the medical profession but the nursing profession—that they should have a bigger say, and the desire to raise standards. We want to carry the professions with us.

Does my right hon. Friend agree that, although GPs raised with him issues such as recruitment to the service on his extremely successful visit to Over Wyre medical centre in my constituency yesterday, there was a real sense of optimism and a determination to provide services close to the patient, or customer, in rural areas? GPs want to provide services at the local, GP practice level, rather than having to rely on acute hospital trusts and becoming involved in waiting lists.

I confirm that that was the reception I received. We want the health service to provide treatment much closer to home. Many of the procedures, treatments and operations which once had to be carried out in district general hospitals will, with new technology, be able to be delivered on GP premises, much closer to people's homes. That is one of the things that we are trying to develop.

I greatly welcome the strong support of the medical, nursing and midwifery professions for what we are trying to do to improve quality. I do not think that there has ever been a time in the history of medicine in this country when the medical profession has been so committed to trying to improve quality and standards.

Until now, there has been no national health service machinery setting clinical standards, spreading good medical practice or checking on standards of performance. We are putting that machinery in place, with the overt support of the professions. Like them, we are determined that there will be no more Bristols, no more Kent and Canterbury cervical screening scandals, and no more Devon and Exeter breast screening scandals. We are going to put in place machinery to set standards, and then ensure that they are met. [Interruption.] If we are to hear booing from the Opposition about standards, I have to say that machinery should have been in place to pick up what was going wrong in Kent and Canterbury and in Devon and Exeter, but there was not.

When I asked the Tory-appointed chair of the South Thames health region to conduct an inquiry into the scandal in Kent and Canterbury, which had not been cleared up by the previous Government, who had allowed the people who had got it wrong to produce a report and then keep it private, he said—the previous Government were responsible for some of this— that the reasons for failure were poor and confused management; there had been repeated warnings of understaffing, poor training and low morale which had gone unheeded for many years. He said that there was a lack of a clear line of accountability on both management and quality assurance for the national programme. He went on:

"I have been forcibly struck by the different ways in which the introduction of the internal market … exacerbated an already inherently weak situation … Many of the decisions which had an adverse effect on the cytology department were made … because of the perceived need to be free standing and competitive in the newly created market."

That is why we are opposed to the internal market in the NHS.

Will the Secretary of State give way?

Not at the moment.

Unlike our Tory predecessors, we are doing something about quality, and about our waiting list commitment. We admit that it will be hard to achieve. In the last year that the Tories were in power, the increase in treatment of people on the waiting list was just 1.2 per cent. To achieve what we want this year will require an increase of 10 per cent. It is a huge increase, but, on the basis of the statistics supplied to me, there are no 18-month waiters—I shall look into that. There are fewer 12-month waiters than in the past two years, and there has been the biggest fall in cancelled operations since figures were first collected.

All that depends on the people working in the health service, and on more money. We have found an extra £2 billion for the health service since we came to power—that is £2 billion more than the Tories intended to spend, and £1 billion more than the Liberal Democrats promised to spend. Last week, my right hon. Friend the Chancellor set out the Government's disciplined framework for public spending and investment. I am confident that, when the outcome of the comprehensive spending review is revealed, there will be more money available to the national health service.

The interesting question about the comprehensive spending review is not for us, but for the Tories. What will they say? They have been calling for more money for the national health service today, but last week the shadow Chancellor was attacking my right hon. Friend the Chancellor for squandering public money. We think that more money should go to the health service. Do the Tories agree? If so, do they have the agreement of the shadow Chancellor to say so?

We have no doubt that the national health service was under-resourced under the Tories, and needs more resources. Under this Labour Government, it will get more resources, not just to get waiting lists down, but to raise standards and give the hard-working staff the quality of buildings, plant, equipment and pharmaceutical products that match their excellence and commitment, putting them in a position to respond to the changing needs of the people of our country. With Labour—the party that founded it—the national health service will be renewed. It will be fit for the 21st century, and it will not be in the hands of the Tory party.

On a point of order, Mr. Deputy Speaker. I know that Madam Speaker values the rights of Back Benchers. I have heard her speak about the speed with which Ministers should reply to letters, and she has said that, whenever possible, Ministers should offer the courtesy of hosting delegations from Back-Bench Members of whatever party who want to discuss issues. This morning, I visited Warminster hospital in my constituency, where the mental health ward is due to be closed by the local health authority because of the Government's policies—

Order. I have heard enough to realise that that is not a point of order for the Chair.

Further to that point of order, Mr. Deputy Speaker.

Order. I have ruled that there is no point of order, so the hon. Gentleman cannot raise anything further to it.

I am grateful to you for calling me early in the debate, Mr. Deputy Speaker. I am required to chair a Select Committee in 15 minutes.

I apologise to you and to the House that my parliamentary duties will prevent me from remaining in the Chamber for the following speaker and for the winding-up speeches.

It is a great sadness that the 50th anniversary celebrations of the NHS are being marred by Labour's broken promises. At the general election, the public were misled into believing that NHS services would improve, not deteriorate. The reality is that acute hospitals and community hospitals are being closed, waiting lists are growing and waiting times are becoming ever longer. If the Labour party had matched the Conservative record on health service funding, the NHS would have £750 million more for next year than the Chancellor of the Exchequer has so far given it. I hope that the pressure from the Conservatives will persuade him to find additional funding.

In a recent Gallup poll on the two most urgent problems facing the country, 48 per cent. of respondents cited health, hospitals and medical services. No wonder the Prime Minister has been forced to postpone the publication of his first annual report on the Government's performance because of the growing criticism of Labour's failure to meet its key election pledges. The decision to postpone the launch of the report earlier this month has come as Ministers face embarrassment over a spate of official figures showing that the Government are encountering difficulty in achieving many of their five early pledges. The Secretary of State for Health has admitted to being embarrassed about waiting lists reaching 1.3 million—an increase of 133,300 since Labour came to power 14 months ago. He seems to be in a state of permanent blush.

Last February, I asked the Prime Minister whether he was aware that patients attending the Queen Elizabeth II hospital in Welwyn Garden City were waiting a maximum of 12 months for elective surgery in May 1997, but that nine months later they had to wait 18 months. The waiting lists have grown dramatically in every specialty. Needless to say, I did not receive a satisfactory reply from the Prime Minister.

The Labour party cannot claim naivety over the promises that it made at the general election. It must have been a calculated confidence trick on the British people. Those in the Labour leadership assessed how they could persuade electors to vote for them, produced the appropriate propaganda, inflicted it on the unsuspecting electors and are now pretending to us all that they really believed it.

Will the hon. Lady give way?

I cannot give way, because I have to chair a meeting in 10 minutes. I apologise, but I am afraid that 1 am under pressure of time.

Anybody who knows anything about health realises that Labour's health policies were never going to reduce waiting lists by 100,000 in the early years of its term of office. The Secretary of State for Health is using crisis money in a desperate attempt to achieve a short-term solution instead of identifying the fundamental problems of demand and need. His strategy will reward poor performance by throwing money at trusts with longer waiting lists. It will distort practice, undermine the development of a co-ordinated strategy and bail out the inefficient practitioner who does not make best use of his facilities.

The Government have fallen into a trap. They are trying to reduce waiting lists by treating more patients through a short-term burst of activity. History shows that to be a fundamentally flawed strategy. Waiting lists have risen inexorably since 1948. Despite an increase of more than 800,000 in the number of patients treated annually, waiting lists lengthened by 100,000 between 1991 and 1995 because more than 1 million extra people were referred to the waiting lists.

Since the election of the Labour Government, on their spurious health pledges, the rate of increase has accelerated because they have failed to recognise the underlying pressures: increased chronic illness in all age groups; greater understanding of the options available; greater expectation of medicine; increasing demands on the service; new technology; and new therapy. Evidence shows that there is an equilibrium between waiting lists and activity. Increases in activity will be met by increases in referrals, which puts further pressure on the waiting lists. The Secretary of State's shallow attempts to bail out media pledges cannot succeed. Like King Canute, he will discover that the tide of demand will inundate him.

Of course, money for waiting lists will result in extra people being treated. They will benefit and their quality of life will improve, but that political measure will do nothing for genuine clinical need. Managers under pressure to deliver the Government's requirements will target the simple and quick procedures. Cataracts, varicose veins and bunions will be treated. People will be pleased and the statistics will improve for a while, but what about the chronically ill—those with multi-system pathologies, waiting for complex, time-consuming and expensive procedures? They will continue to wait and to suffer. The Government's facile financial approach makes fiddlers out of managers and victims out of patients.

The Secretary of State should have invested the money in meeting genuine clinical need, targeting those most in need of treatment. He should also remember social need. Consider the elderly lady with a sore hip. She may not have the highest clinical need, but what if she lives four storeys up in a block of flats with a lift that hardly ever works? Such desperate social need is not recognised. She is a number on a list that is ever delayed because the resources that she requires are expensive.

If the Secretary of State were genuinely keen to achieve change rather than short-term political kudos, he would understand the folly of his approach to those requiring hospitalisation. If he put lists in the hands of primary care GPs, he could build on the unique clinical intimacy between British GPs and their patients. Operations would be done not because they were quick, cheap and easy but because they delivered the best results.

It is no coincidence that waiting lists have improved dramatically since GPs became personally involved, with doctors controlling when and where to provide an intervention and having a cheque-book to back up fulfilling the need. It is incontrovertible that one GP practice providing clinical care and managing resources will achieve more than 10 that do not—or more than 50-plus reluctant participants in one of the new Government-imposed primary care groups. Such PCGs will undoubtedly mean that the initiative taken by GPs in the past on behalf of their patients will be lost, thus damaging the opportunity to provide more services at a doctor's surgery rather than in hospital, as well as damaging general improvements in hospital services.

If the Government want the best for patients, they must recognise the skills of GPs at practice level in identifying need. Such GPs support not just a list or a number but the individual who is damaged by disease or disability—the person who needs the help of the medical profession, irrespective of whether they are first or 101st on some list. That is what a visionary Government, unhampered by bigotry, should support. Of course, such practice already exists. The Conservative Government were operating such forward-thinking, innovative policy after the introduction of their reforms.

My constituents are not concerned directly that 10, 100 or 100,000 other people are waiting for an admission or an operation. If they are distressed, in pain or incapacitated, they want treatment as soon as possible. The only way in which the Labour Government will truly benefit patients is to admit the magnitude of their folly and recognise that waiting lists are an irrelevance. They should focus on the true indicator of success: waiting times that meet the needs of the individual and not the statistician.

I rise to support the amendment and to debate the motion.

Two words came to mind when I read the motion. One was "stones" and the other was "glass houses". The Tories seem to have some block—my right hon. Friend the Secretary of State brought this up—in wanting to refer only to waiting lists since May 1997. We know fine well where the seed of the recent surge in NHS waiting lists lies—back in the first quarter of 1991, when the right hon. and learned Member for Rushcliffe (Mr. Clarke) introduced his national health service reforms.

Before those reforms, there had never been NHS waiting lists of 1 million people. Over the two years following the reforms, we saw waiting lists rise in every quarter but two. The number went through the million mark and has remained in excess of that ever since. By the time Labour took office, waiting lists were at a record high and were rising faster than at any time in NHS history. I do not think that anybody is surprised at the fact that it will take time to stem the increase and bring the figures down.

I admire my right hon. Friend the Secretary of State and the Government for taking the challenge and stating publicly that we shall do something about NHS waiting lists. I should tell Opposition Front Benchers and the House that a timetable for the pledge on waiting lists was never set before the election. I know, because I was party to the writing of that pledge into the manifesto and on to our pledge cards.

Will the hon. Gentleman give way?

The hon. Gentleman can get his fix a little later in the debate. A time was never set. In the past few months, my right hon. Friend the Secretary of State has set a time by which we shall reduce waiting lists to last year's level. Then we shall start reducing them further.

The hon. Gentleman is often very convincing, and is very nearly making a convincing point. He is failing to excuse one other thing. There cannot be a early pledge to do something as a first step in a Parliament—a manifesto applies only for one Parliament —if it is then announced that the pledge will be honoured only by the end of it.

I do not agree with that. The hon. Gentleman has covered health matters in the House long enough to recognise the reality of what has been happening in the NHS.

Why pledge that waiting lists will be reduced?

Because we shall reduce them; that is why.

The motion

"notes that current Government policies in respect of hospital closures and bed reductions are likely to increase the lists further".

About four weeks ago, Opposition Front Benchers did not know the Government's policy on hospital closures. Indeed, for a short time in the media, trust mergers became hospital closures. I was as confused as those in the Opposition Front-Bench team even before the first 24 hours of their trying to make that point were up.

If my right hon. Friend the Secretary of State is right in saying that there will be 3,000 more beds in the acute sector by the end of this financial year, it will be the first time that that has happened in the history of the NHS. We ought to be congratulating the Government on being prepared to take such action, given that, year on year, no matter who has been in office, there have been fewer beds at the end of each financial year than there were at the beginning ever since the NHS was brought into being.

In the Budget, the Chancellor provided an extra £500 million for health care, £ 417 million of which is to be spent on the Government's waiting lists initiative to provide those extra beds. About 850 schemes are being introduced by health authorities all over the country. Such schemes include the provision of more beds, the opening of more wards, more staff being taken on, more theatre time and the extension of treatment, and the introduction of weekend and evening surgeries. Those are not soundbites; they are clear and sensible ways of tackling the problems of NHS waiting lists.

I am sorry that the hon. Member for Broxbourne (Mrs. Roe) has had to leave the Chamber. Over the years, I have had a bit of time for her in her independent role as Chairman of the Health Committee. I wish that she had been a little more independent in her speech today. It is not true that the idea behind the waiting lists initiative is to introduce simple, quick and easy procedures. That is far from so. The hon. Lady said that we should target the most needy and not consider what is happening in the NHS. We can all consider individual need, but we must recognise the immediate impact that it has on waiting lists—whether for day surgery, in-patient surgery, or whatever. We must consider procedures inside the NHS, to ensure that we get things right. We must ensure that money goes to specifics and gets things done.

In the Rotherham borough, health service partnerships have already agreed a plan of action. The waiting lists initiative in Rotherham health authority will mean an additional 24 gynaecology sessions, covering 100 additional cases, including weekend cases, at a cost of more than £100,000. There will be additional theatre lists for orthopaedics, dealing with an extra 115 cases at a cost of £105,000. There will be two additional ear, nose and throat lists a week, covering 175 cases. Later this year, depending on how things pan out, it is likely that there will be a third ENT consultant, whom we have wanted for many years in my local health service. That additional ENT provision will cost £112,000. We shall get an ophthalmic consultant and extra work at a cost of £131,000; an additional colonoscopy session for 20 cases, costing more than £21,000; and an extra consultant to treat 500 orthopaedic patients annually. We have been after orthopaedic consultants in Rotherham for many years. Unfortunately, it is not the best place in the world to work. We have great problems getting people to come to our area to work in the health service. That will cost £250,000.

For general surgery, we shall get an extra arteriogram session each week to deal with 120 cases, and additional endoscopy will treat 50 cases at a cost of more than £67,000. We shall get an alternate Friday prosthetic list to deal with 25 orthopaedic cases, costing more than £79,000. An additional oral surgery theatre list for 150 cases will cost more than £99,000.

Nearly £1 million is going into Rotherham to help people. Those targets, when met, will benefit hundreds of people who have been waiting for far too long on our national health service lists. Such initiatives should result, not only locally but nationally, in the biggest increase in operations in the history of the NHS and the biggest ever cut in waiting lists. The money will be targeted to deliver what patients want most: shorter waiting lists.

In addition to the extra money, about £500,000 is available in Rotherham for innovative ways of clearing waiting lists. That money will also be invested in reducing waiting lists by maintaining the flow of operations, building on our success last winter. The right hon. Member for Maidstone and The Weald (Miss Widdecombe) said that the £300 million for the winter crisis was wasted, but it did exactly what it was planned to do. It avoided the winter crises that we had year on year under the previous Government. We could not acclaim something that was not there and get it into the media. It is nonsense. Rotherham got £769,000 extra last winter to avoid what we had suffered in years gone by.

Does the hon. Gentleman acknowledge that it was a mild winter and that pressure on the health service was less than it would have been in a normal winter?

I do not think that the facts prove that it was such a mild winter. The pressure was reduced by the initiatives mentioned by my right hon. Friend the Secretary of State, such as getting out into the community in Kent to stop flu epidemics. That was how the money was put to good use, to avoid the crises that we have had before. Better primary, community and mental health services are coming under this Government. I have a health action zone in one of the poorest areas of Britain. It will start to examine people's problems and the problems that the health service has in delivering. The Government are doing things that have been sadly neglected for many years.

We shall also start to modernise the waiting list system. Some of the extra money will go on pioneering new streamlined appointment systems, so that day patients can book the dates of their operations. It is extraordinary that people go to their general practitioner and then have to wait weeks and weeks before seeing a consultant at the hospital, and then wait weeks for treatment. I can go to one of three travel agents in my town, book holidays, hotels, car hire and everything else anywhere in the world, but people cannot book into a consultant's clinic in a hospital. The information technology that the Government have been getting on with will help us to do that. It is much to their credit that they done it when previous Governments have neglected it.

This is targeted investment, not just giving money to the NHS. The Opposition can say, "We've been giving more than you; aren't we better than you?" but this is about targeting investment, so that we know that it will get waiting lists down and improve the NHS. Good management and innovative change are important. The Government will do better than previous Governments. All Governments do better than their predecessors, because medical science moves on. We shall do better in areas where the previous Government failed, by organising and managing the health service properly.

The 18 years of Conservative government saw waiting lists rise by more than 400,000. In the next four months under Labour, they will begin to fall, and they will continue to fall. The Opposition did not ask the electorate to vote for them again in 1992 by promising to ensure that hospital waiting lists increased. This Government have the courage to do things that many thousands of people want. We have the courage to set targets. The electorate will hold us to account. When we get through this first Labour Government in many years, the Opposition will be sorry that they tabled such a motion, because they will have to eat their words.

The hon. Member for Rother Valley (Mr. Barron) gave his usual robust speech, but he did not answer the point that I put to him.

As always, we welcome the opportunity to debate health. We even welcome the opportunity to debate waiting lists, although, as I will explain, we think that the Government chose the wrong target, so this is the wrong focus for a debate.

When the Labour party was in opposition, it tried to think up a compact promise for what it would do for the national health service. Labour thought of a nice, tight soundbite, "We will save the NHS." I am happy about that, because the NHS was in some difficulty under that party's predecessors. The Labour party then tried to think what that would mean in substance. Despite all the sound advice that it will have received from professionals and from within its own ranks that people care far more about how long they wait for treatment than about how many people are in the queue with them, in the end, the Labour party chose the wrong target. Labour made only one early pledge on health and, unfortunately, it was the wrong one. The Government are hoist by their own petard. They must deliver, but they are now in difficulties.

Rumour has it that some Ministers, including senior Ministers, know that they are spending money on the wrong things. This is their bed and they must lie on it. The Secretary of State took few interventions and, in particular, refused one from my medical friend, the hon. Member for Oxford, West and Abingdon (Dr. Harris), who may know something about the matter.

My right hon. Friend knew what he was going to say.

The difficulty may be that the Minister may not like what my hon. Friend was going to say. The Secretary of State listed things to do with waiting that mattered to patients. Every one was to do not with waiting lists but with waiting times—more clear evidence from him that the Government have got their target wrong.

That evidence is backed up by what the right hon. Member for Sedgefield (Mr. Blair) said when in opposition. In 1996, when he launched the document—to which the hon. Member for Rother Valley may have been referring—"New Labour, New Life for Britain", and gave the early pledge, his explanation was:

"waiting means misery for patients. They are often in pain or discomfort."

I could not agree more. We all understand that the longer people wait, the longer, by definition, they are likely to be in pain or discomfort.

Having adopted waiting lists, not waiting times, the Government are in considerable difficulty. There was no hint that it would take five years, the whole Parliament, to get 100,000 people off the list. There was no such qualification. I challenge any Labour Member to produce one bit of evidence from any Labour candidate who said that it would take the whole Parliament. It was not even said immediately after the general election, but said some little time later. Someone must have told the Secretary of State that he had better qualify it. That is not surprising: if one makes the wrong pledge, one ends up in difficulty.

It is not only me, my party or the right hon. Member for Maidstone and The Weald (Miss Widdecombe), but the British Medical Association, the Health Service Journal, the British Medical Journal and the Government's advisers who say, "It's the wrong target, Government. We are sorry that you made that so clear."

The only problem is that, although the Secretary of State has said that he is embarrassed about the fact that the numbers waiting are rising, nobody has yet owned up to the fact that the Labour party is embarrassed because it chose the wrong target. I hope that the Minister of State will say, "I'm sorry, we were wrong;"—it makes a welcome change to hear Governments of any colour admit that they were wrong—"but we chose the wrong target. We will deliver, although it will take us longer than we said and longer than we planned —but actually it is waiting times, not waiting lists, that we should be talking about." If the great socialist Labour party nirvana can be reached by—