If he will visit south Shropshire to assess the effect upon the local community of proposals to reduce the range of facilities available at Kidderminster hospital. [46601]

The ministerial team conducts a wide-ranging programme of regional visits. I take particular interest in the west midlands, as the hon. Gentleman will know. I have no immediate plans to visit south Shropshire.

My constituents will be disappointed by that reply. I and they are conscious of the fact that Kidderminster hospital is not the only hospital in this country to be facing either closure or cuts. There are many testimonials to the Labour party's broken election promises. May I remind the Minister of what his colleague the hon. Member for Wyre Forest (Mr. Lock) said during the election campaign? He said:

"We will only prevent further cuts at Kidderminster if the Government provides enough money to the Health Authority to fund the hospital"?

The hon. Gentleman well knows that the agenda at Kidderminster is not a cuts agenda. He is well aware—because he has been a party to them—of the discussions that have taken place between his health authority and all parties interested in the Kidderminster hospital. Submissions will come to Ministers in due course, and decisions will be taken in the best interests of all the people of Kidderminster.

Is not a high standard of care provided by the staff and management at Kidderminster, which led to that hospital getting a charter mark last year? Does not the hospital deserve praise for its fall in emergency admissions? In comparison, every other hospital in the west midlands has seen rises. Will my hon. Friend accept the thanks of my constituents for the extra £13.5 million of Government money provided since the election to Worcestershire health authority, which will give the possibility of options for Kidderminster? Must not all those important factors be taken into account by his right hon. and hon. Friends when deciding the best configuration for acute services in the county?

My hon. Friend is a stout defender of the interests of the NHS in his constituency, and I join him in thanking all those who have contributed to the success of the hospital and its earning of a charter mark. The Government are committed to making sure that there is investment year on year in the NHS to enable its staff to deliver the high-quality health care that is the due of each and every person in this country. That is why the Government have found an additional £2 billion for the NHS since the last general election—money that the Conservative party would never have found.

What steps he is taking to meet the dental health needs of the people of Shropshire. [46602]

Seven investing-in-dentistry funding requests from Shropshire health authority have been approved to make national health service dental services available to thousands in the area. Access to NHS dentistry should also benefit from the approval of a first-wave personal dental service pilot in Shropshire, due to commence on 1 October 1998.

Many people will benefit from the £19 million that the Government are putting into NHS dentistry. Some 20,000 people in Shropshire—my constituents, as well as those of the hon. Member for Ludlow (Mr. Gill)—will benefit from the schemes. However, can my hon. Friend give any hope to the remaining 36,000 people in Shropshire of the 56,000 who lost access to NHS dentistry when the previous Government reneged on fee agreements with NHS dentists? Will those people have their access to NHS dentistry restored in future years?

I am grateful for my hon. Friend's support. I assure him that we shall continue to do everything that we can to improve access to NHS dentistry in Shropshire and the rest of the country. I can report that, so far, we have approved 140 investing-in-dentistry projects, giving extra access to NHS dental care to 250,000 patients who would not otherwise have had it. We are doing that by offering the NHS dentist a grant in exchange for continuing to treat NHS patients. In other words, this Government are bringing back into the health service dentists whom the previous Government drove out.

What action he is taking to improve patients' access to information about local hospitals' clinical performance. [46603]

What action he is taking to improve patients' access to information about local hospitals' clinical performance. [46615]

We want to develop a system that will provide general practitioners and their patients with access to fair and accurate indications of clinical performance in their local hospitals. As a first step, we shall publish later this year a number of hospital-based clinical indicators on deaths and complications covering a range of operations.

Is not the public availability of meaningful information on clinical outcomes an absolute prerequisite for achieving the universally high standards of clinical performance that the Government want? Moreover, had we had such data in the public purview before now, we might have detected sooner such unfortunate occurrences as the poor surgical performance on babies in Bristol or the appalling record of hip replacements. Does my right hon. Friend agree that the data can be of vital help in transforming the health service?

It is certainly our wish that the various arrangements that we are making to set quality standards and make sure that they are met will avoid awful occurrences such as the deaths of babies who had heart operations in Bristol, the cervical cancer screening failures in Kent and Canterbury and the breast cancer screening failures in Devon and Exeter. To do that, it will be necessary for the people who are conducting the operations and the hospital management to have data available to them, and we believe that it should be made available also to local general practitioners and patients.

I congratulate my right hon. Friend on using the opportunity of the 50th anniversary of the NHS to end the cloak of professional secrecy that has kept patients in the dark about the results of treatments. However, I urge him to think carefully about how he presents the information. There are areas of clinical practice where information is publicly available—for example, for in vitro fertilisation and other fertility treatments. Those tables can be misleading because clinics that use the most adventurous treatments or treat older women seem to have less successful results than those that use basic treatments, treat conservatively or treat young women. I urge my right hon. Friend, in publishing this information—which I welcome enormously—to think about the quality of information to patients, so that they can understand it as well as possible.

It is certainly the case that we are trying to make sure that any information that is published commands the support of the professionals involved. As I said in my first answer, that means making sure that the information is both fair and accurate.

Is not one of the most useful techniques to determine clinical excellence Health Services Accreditation? Can the Secretary of State assure me that its disposal will be carried out to the highest possible standards, that no undue influence will be exerted on such disposals, and that those involved in the process who may have a conflict of interest will be invited to withdraw and fall silent?

The process of accreditation of a group of doctors or an institution necessarily involves judgments by other doctors. There is no way people without the necessary professional expertise can judge other people's professional expertise. From time to time, there may appear to be conflicts of interest because of connections within the medical and other professions. We shall try to avoid that—but we cannot get away from the fact that the only people capable of judging professional competence are other members of the same profession. We do need outside influence, but in the end there is no point in getting someone who is not a liver transplant expert to judge the skill of another liver transplant expert.

Does the Secretary of State accept that the inquiry into the Bristol scandal may find that the problem was not to do with the publication of data but rather to do with the failure to act on data known to the professionals? Given the way that the media may report such data, is there not a danger of repeating the second-generation pill scare? Information wrongly portrayed in that case led to greater inefficiency, poorer health, and a greater number of unwanted pregnancies and abortions.

I am not quite sure from that whether the Liberal party is for or against the publication of this information. I thought that I had made it clear that we want the statistics published to show the nature and complexity of the operations and the general state of health of the patients. As far as I know, that commands the support of the representatives of the medical, nursing and midwifery professions; providing that we act in this way, none of the problems to which the hon. Gentleman refers should arise. Meanwhile, someone in the Liberal party needs to make it clear whether it believes in keeping the information secret or making it public.

What initiatives he is bringing forward to reduce the incidence of teenage smoking. [46604]

The Government's strategy on smoking, including plans to reduce smoking among young people, will be set out in detail in the tobacco control White Paper to be published later this year.

Does my hon. Friend agree that, if we are to protect our children and young people from the dangers of smoking, we must try a variety of methods, including controlling access to cigarettes and a ban on tobacco advertising? I hope that she will join me in congratulating Sandwell health authority and trading standards officers, who have carried out a number of visits to traders to advise them of their obligations. They have also attempted some test purchases which, in some cases, have resulted in prosecutions and fines.

Yes, it is shameful; and yes, I am delighted to join my hon. Friend in commending the efforts of authorities such as Sandwell that are seeking to protect young people from the effects of tobacco. The figures speak for themselves: there are 160,000 more regular smokers among children between the ages of 11 and 15 than there were 10 years ago. Children smoke the most regularly advertised brands of cigarettes. At current rates, smoking will kill about 1 million of today's children in their middle years. That is why it was so important that the UK Government acted, where the previous Government had failed to act, to secure a European Union-wide ban on the advertising and promotion of tobacco last week.

Does the Minister believe that the incidence of teenage smoking will be reduced by the publication by her Department—at public expense—of a glossy magazine about health targets, which contains no fewer than 32 photographs of herself? What is the justification for that extraordinary publication? Does she hope that it will distract youngsters from poster sites, or does she see herself as a ministerial nicotine patch?

Yes, I agree that health education is important, and yes, I agree that parental dissuasion from smoking is also important, but it is absolutely clear that the rate at which young people smoke will not decrease unless we ban tobacco advertising. The Conservative party, when in government, steadfastly stood in the way of protecting children's health, by blocking the European ban on tobacco advertising.

Does the Minister agree that, if we are to tackle the scourge of the increase in teenage smoking, we must give young people good role models, not only to educate them on the harmful effects of cigarette smoking, but to present to them the fact that it is uncool to smoke? Unfortunately, many young people see cigarettes as a fashion accessory. Unless we tackle that aspect in our health education literature and promotions, we shall find it very difficult to reduce the incidence of teenage smoking.

I entirely agree with my hon. Friend. He has drawn attention to another reason why the Government must lead on a range of strategies in order to reduce smoking among children—but it is our intention to reduce smoking among children, and we shall deliver on it.

How many patients were treated by the NHS in each of the last five years; and what was the average waiting time for hospital treatment. [46605]

Approximately 8 million, 8.6 million, 9 million, 9.3 million followed by a record 9.5 million finished consultant episodes in 1997–98. The average waiting time for admission was 45 days in 1995–96, the latest year for which figures are currently available.

I am grateful to the hon. Gentleman for those figures, which demonstrate the success, over 50 years of the NHS, of constantly treating more patients. I am sure that he would wish to congratulate the NHS on that—and to congratulate the Conservative party on having been in charge of the NHS for 35 of those years. However, I wonder whether he would agree that, as we try to increase the number of people going through the NHS and to shorten waiting lists, one of the most important objectives should be to reduce waiting times. Can he pledge to the House that when—if—he ever shortens waiting lists, he will also have started to reduce waiting times?

I can tell the hon. Gentleman that we have already started to reduce waiting times. For the first time since records began, there are no people waiting 18 months or more for treatment. We shall continue to make progress on that. The hon. Gentleman and his party should grasp the point that, as we reduce waiting lists, we shall reduce waiting times. With regard to his party's custody of the national health service, I remind the hon. Gentleman that his party opposed the creation of the NHS.

Is it not important to have a national health service? Arising from what my hon. Friend has just said, and in view of the 50th anniversary of the NHS this Sunday, would it not be appropriate for the Tory Opposition, especially Front-Bench Members, to apologise to the country for the fact that their party did all that it could, in Parliament and outside, to stop the national health service coming into being? Would it not be a sign of humility if the new health spokesperson for the Conservative Opposition made that apology today?

That is a matter for the right hon. Lady.

Now that it appears from press briefings that Ministers have accepted that, if more patients are to be treated more quickly and better, significantly more money is needed for the health service—there is apparently to be an announcement about that—and that a proper inspectorate is needed to ensure decent quality—there is apparently to be an announcement about that, too—will there also be an announcement that we are to have a more democratic health service at the end of the Government's period in office? Will we have representatives accountable to the public taking regional strategic decisions, and patients and ordinary people taking local health decisions? Are we to have a professionals-run health service, or a people's health service?

We shall not have direct elections to NHS boards, if that is what the hon. Gentleman is asking, but I give him this assurance. We have had the national health service for 50 years, and its achievements have been immense. I am sure that everyone in the House would want to pay tribute to all the work that all the staff have done for all that time. However, the NHS has never done a very simple thing: we have never asked patients what they want from the national health service, and what they think about the local services that the NHS delivers. We shall do that for the first time this year. There will be the first annual national survey of patients. It will happen later this year, next year and every year thereafter. It will enable us to give patients a hand in decision-making in the NHS.

Is it not the case that the national health service is owed a colossal sum of money, some of it by those indulging in private practice? If that money had been collected in 1996 alone, is it not true that we should not have been left with the mess of long waiting lists?

As my hon. Friend knows, last year this Government directed the NHS to do what it should always have done: to make first use of NHS capacity, before considering referring to the private sector.

I join in the praise of the national health service but, with reference to waiting time, will the Minister give us an assurance that the time taken by the general practitioner to get in touch with the consultant will be taken into account? There is a tendency to ignore that, and some patients are waiting far too long to see a consultant.

I agree with the hon. Gentleman. Patients are sick of waiting for GP appointments and out-patients appointments. They are sick of waiting to get into hospital, and some even have to wait to get out of hospital. That is why the Government are pledged to get waiting lists down. As we get waiting lists down, we shall get waiting times down as well.

Is my hon. Friend aware of the enormous success of the James Paget hospital, which serves my constituency, which has reduced waiting lists by 375 patients in the months from January to May this year? Following the increase in resources that the hospital has received from the Government, it expects to have reduced waiting lists by March 1999 to 225 below the figure for March 1997. Is that not proof that, in my constituency, the pledge is being honoured?

I thank my hon. Friend, and I should be grateful if he would pass on Ministers' thanks for the enormous efforts that are being made in his local hospital. We want to see that achievement replicated everywhere. We are confident that that will occur and that, by March next year, waiting lists will be lower than the record level that we inherited in May last year.

Does the Minister accept that, when the NHS was established 50 years ago, it drew heavily on the egalitarian principles that were the background to the service in Wales? Those principles enshrined the idea that people should have access to health care in line with their needs and not their ability to pay. Given that those are the principles of the national health service, will the Minister assure the House today that it is Government policy that every person who needs a life-saving, life-enhancing or pain-reducing treatment will get it as quickly on the NHS as by going privately? If that cannot happen now, when will it be achieved?

That is precisely what we want to see for the national health service. The Government were elected on a manifesto pledge that the national health service will be there for patients when they need it. Need and not people's ability to pay or who their general practitioner is should be the factor that determines how health care will be made available to individual patients.

When Opposition Members talk about their custody of the national health service, does my hon. Friend agree that it is worth reminding them that, when they left office, waiting lists were at a record high and rising? Will my hon. Friend expand on his previous comments about the need for a comprehensive health service? An insidious element of the previous Government was that treatment depended on who one's general practitioner was rather than clinical need. Does my hon. Friend agree that clinical need should be the sole criterion for NHS treatment?

My hon. Friend is absolutely right: the Conservatives' record on waiting lists and waiting times is far from happy. During their 18-year tenure of office, 400,000 people were added to the waiting list. The previous Government never managed to achieve what we shall achieve in office: getting waiting lists down not just this year but next year and in subsequent years. We shall achieve that goal and, when we do, I hope that Opposition Members will praise us.

I am sure that we shall. Do not the elderly—not just in Worthing but throughout the country—wait the longest for treatment? Emergency services are usually utilised by young people while the elderly need cataract, hip and heart treatments and the like. Does the Minister agree that resources matter in large part? When does he expect that his Government will see a real increase in resources each year that matches the average for the 18 years in which the Conservatives cared for the health service?

Shortly.

To what extent health authorities will be able to disregard the guidelines issued by the proposed national institute for clinical excellence. [46606]

We shall be consulting shortly on our proposals for the national institute for clinical excellence. We intend that its guidance will apply to all health authorities. We do not expect that any health authorities or individual clinicians will disregard advice from the national institute, but they will need to take account of local circumstances and the needs of individual patients when implementing guidance.

I am grateful to the Minister for that response. I tabled the question because some of my constituents who would benefit from using beta interferon to treat multiple sclerosis cannot receive that treatment because they live in Avon. However, if they lived in Somerset, they could receive that treatment. Some of my constituents have paid privately for the treatment and are benefiting from its use. Will the Minister give a cast-iron assurance that the national institute for clinical excellence will introduce a guideline, stating that this drug works and is effective, that will be followed uniformly across the country?

I am aware of those concerns and of the particular problems experienced in Avon. Department of Health officials have examined carefully Avon health authority's policy on beta interferon. It is fair to say that we have the worst of all worlds at present: too many unproven treatments are introduced into the national health service too quickly while too many proven treatments, on both cost and clinical grounds, are introduced too slowly. The consequence is a lottery of care. The national institute and national service frameworks are about guaranteeing fair access to treatment throughout the country. I hope that, when we publish our proposals shortly, the hon. Gentleman will welcome them.

Does my hon. Friend agree that clinical excellence is at the heart of a good-quality NHS, and should not we be wary this week of being carried away? We have a good NHS, but it could be a darn sight better. For 35 years, it let many people down because the Tories were running it. Many people have been let down by the NHS, and it is our duty to look forward to the next 10, 20 and 50 years. We must ensure first, that the Tories never get their hands on it again and secondly, that we make it as good for every British citizen as it possibly can be.

My hon. Friend is absolutely right. The best in the NHS is still the envy of the world. We may not have the best football team in the world—time will tell about that—and we certainly do not have the best cricket team in the world, but we do have the best health care system in the world. We should not talk down the prospects of the NHS. We want it to continue to expand and thrive, and to guarantee excellence and high standards everywhere.

The Conservative party welcomes the pursuit of clinical excellence, but the Secretary of State has said that the function of the national institute for clinical excellence will be to give a strong lead on clinical and cost effectiveness. Is it not inevitable that NICE will become part of the rationing mechanism, ruling out the use of certain drugs, treatments and procedures within the NHS? What assurance can the Minister give that, combined with cash limits on general practitioners' prescription budgets, NICE will not place intolerable restrictions on clinical freedom?

I welcome the hon. Gentleman to his first formal appearance at health questions. I assure him that NICE is not a national council for rationing, and I remind him that it was the previous Conservative Government who introduced cash-limited budgets for GPs.

When the House looks back at the NHS in 50 years' time, does my hon. Friend think that one of the causes of celebration will be that the Government challenged the two main causes of waste and inefficiency in the NHS now—the faith in the omnipotence of the individual clinician and the fact that so many decisions are taken for reasons of commercial profit? Will the Government redouble their efforts to ensure that we break away from so much of the mythology-based medicine from which we suffer now and go on to science-based and evidence-based medicine?

I think that the NHS wants evidence-based medicine. I do not think that there has been a time in the past 50 years when the clinical professionals, who, after all, deliver the quality of care that we all want to see for our constituents, have been so geared to improving standards. The Government want a partnership to be forged between the Department of Health and the clinical professionals—in particular, their leaders—to ensure that standards are as high as possible everywhere inside the NHS, and that effectiveness is the driving force for treating patients.

What assessment his Department has made of the impact of the ending of tax relief on private medical insurance premiums for the over-60s on the current size of hospital waiting lists. [46607]

No formal assessment has been made, but we expect that any additional demand will be small in comparison with the substantial additional resources that we are making available to the NHS.

It is too early for reliable statistics, but the anecdotal evidence, certainly from my constituents, is that the Government's short-sighted action will have a significant and detrimental impact on waiting lists. Can the Minister rise above dogma for a moment and acknowledge that co-operation with the private sector might just be part of the solution to long waiting lists?

Fifty years on and Conservative Members still have not learnt; they put the interests of private medicine before a national health service free for all at the point of use. When we come to look at the use to which the £140 million that we saved from abolishing that tax relief is put, we shall see that cutting VAT for elderly people's heating bills did more for the health of the elderly than private medicine ever did.

Is it not a fact that those who queue jump by going private lengthen the queue for everyone else? In the 50th year of the NHS, would not the most appropriate tribute to Nye Bevan be to deal with his unfinished business and get rid of private medicine for the NHS, once and for all?

Each and every person must make a decision in relation to private medical insurance. We are concerned to improve the NHS for all the people, putting the interests of the many before the few—that is the Labour way.

Is it not worth recording that Nye Bevan, whom I greatly liked and admired, not only did not try to get rid of private medicine, but, when he became seriously ill, had all his treatment in private hospitals?

Conservative Members fought against Aneurin Bevan and everything that he stood for. On every occasion, Conservative Members voted against the creation of the NHS. They cannot be trusted with it—we can.

What targets he has set for reduction in NHS management costs by 2002. [46608]

Our White Paper, "The new NHS", sets out a programme of action to release £1 billion from bureaucracy over five years. By the end of this year, £240 million that, under the Tories, would have been spent on bureaucracy, will have been released for patient care, which is what the people of this country want.

Is my right hon. Friend aware that, in the first year of the Labour Government, my health authority, Birmingham, received an extra £201,000 to improve breast cancer treatment, and £219,000 to improve intensive care for children? Can he confirm that that money was available not least because of his decision to halt the eighth wave of GP fundholding? Can I have some reassurance that the Labour Government's commitment to primary health groups will not introduce a new bureaucracy, but will be part of a continued commitment to fund money into patient care, not into bureaucracy?

It is certainly the case that primary care groups will reduce the amount of money spent on the paperwork of transactions between primary care and hospitals, and that the previous Government had earmarked £20 million to be spent simply on the paperwork of the eighth wave of fundholding. We stopped that, and £10 million went to better breast cancer services and £5 million to improving children's intensive care. I am sure that, apart from a few witless loons on the Conservative Benches, everyone in the country thinks that that is right.

While the Secretary of State remains concerned about targets, he will be aware that hospitals up and down the country face closure. In my constituency, we have three community hospitals: Burford faces the certainty of closure, Witney faces the closure of 25 per cent. of its beds, and Chipping Norton will lose beds too, yet all have an occupancy rate of more than 90 per cent. The hon. Gentleman knows that Oxfordshire community health council has decided to refer to him the absurd proposals for closures and bed cutting that have been put forward by the community health trust because of his failure to supply enough money. Will he guarantee the people of west Oxfordshire that he will save Burford hospital from closure, and save the beds that are due to close at Witney hospital?

I cannot offer any such guarantees at the Dispatch Box. As Conservative Members who still have fading memories of being in government may recall, it is proper for me to comment in detail on proposals that come before me only after I have considered all the detailed information. Otherwise, any decision that I made could be challenged in the courts. The Government have put £2 billion extra into the NHS, over and above what the Tories had put into the budget for last year and this year—£2 billion more than they had intended to spend, and £1 billion more than the Liberal Democrats promised to spend.

What scrutiny is my right hon. Friend giving to the pioneering effort across Morecambe Bay acute health trusts and Morecambe Bay community health trust in order to develop services across a wide area, and to cut the ludicrous bureaucratic costs inflicted on us by the previous Government? While I am on my foot, will he commend the sterling work of the accident and emergency department at the Royal Lancaster infirmary and look into giving the nurses more pay?

I pay tribute to all the work that is being done in the Morecambe bay area. By amalgamating four trusts, we are saving a huge amount in bureaucratic costs. That money will now be better spent on patient care, which is what people in the Morecambe bay area want.

What plans he has to ensure that capping drugs budgets in primary care groups does not give rise to rationing by GPs. [46609]

No individual element of the unified budget will be artificially capped. Health authorities and their primary care groups will continue to develop a range of measures to encourage general practitioners to use cost-effective and rational prescribing. As now, no one will be denied the drugs that they need. That is a guarantee.

I am a little disturbed that, on two occasions in the Chamber this afternoon—the first was the response to my hon. Friend the Member for Northavon (Mr. Webb)—the Minister has suggested that institutes of clinical excellence should set priorities. He is now asking GPs in health authorities to set priorities within their identified budgets. All that I can say is that we heard it in the House first, rather than from the newspapers. This health team is now actively considering setting priorities, or introducing rationing, into the health service.

GPs have already been doing that in recent years, and they will continue to do it. The local medical committees conference voted overwhelmingly for it. We have now given GPs and nurses more power and leverage than they have ever had before in the national health service. I am surprised that the hon. Lady does not welcome that.

The Minister will know that he replied to me in a written answer about the licensing and prescription of the drug Viagra. May I convey to him today the concerns of GPs in my constituency, who have asked me to draw to his attention the fact that if the new drug, for which no provision is currently made in the drugs budgets, is made available under NHS prescription, it should be available on clinical need only through hospitals, not through GP practices? GPs are very concerned about their drugs' budgets.

Yes.

When he expects there to be a downturn in hospital waiting lists; and if he will make a statement. [46610]

The evidence is that today, as we are speaking, hospital waiting lists are coming down. Early indications from the NHS executive show that waiting lists stopped rising in May and have been coming down in June: the supertanker has turned. I am confident that that will be confirmed when the validated figures are published in August. The Government intend to ensure that the waiting lists keep coming down.

That is wonderful news, especially as it was not even a planted question—I showed great perception when I tabled the question a fortnight ago. Does my right hon. Friend agree that, as a testament to the health service that we have been discussing in the past 45 minutes, we should ensure that, having built it, we now rebuild it for the next century after the destruction caused during the past 18 Tory years? That will need a lot more money, and my right hon. Friend has asked for more money in the past from the Chancellor of the Exchequer and from the Prime Minister. We shall need at least £12 billion between now and the next general election to ensure that the promises that we made last time will be carried out, and that the Tories will be sent packing.

I am sure that no one would have dared suggest that my hon. Friend had tabled a planted question. If I may say so without embarrassing him, I cannot think of anyone for whom I would rather have provided that reply. I shall bear his point in mind. When we compare ourselves with the people who founded the national health service 50 years ago, we should remember that they founded it on an act of faith. They hoped it would work; we know it works.

We congratulate the national health service, which is why the Opposition Front-Bench team are proud to wear their badges. That view does not seem to be shared by the Secretary of State or the Minister of State. May I invite the Secretary of State to ask his hon. Friend the Member for Bolsover (Mr. Skinner) to congratulate the previous Conservative Government, who built the Bolsover community hospital, which I assume his constituents use, and the nearby Chesterfield and North Derbyshire Royal hospital, which is a large, successful hospital that his constituents also use? We built those hospitals.

The right hon. Lady may expect my hon. Friend the Member for Bolsover (Mr. Skinner) to congratulate the Tory Government, but probably the only thing he would congratulate them on is being so useless that they lost the last election by the biggest landslide in the 20th century. The right hon. Lady would like the waiting lists to continue to rise, because that would be to the political advantage of the Tory party, but they are coming down.

The right hon. Gentleman has not entirely answered my question. Is this not just the first predicted, not even guaranteed, step towards getting waiting lists down to the level at which we left them? Will he also please tell us how the waiting lists for the waiting lists are doing? Why is he refusing to publish information about waiting times for out-patient appointments as requested by my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond)? Will he tell us about rationing, which has meant that four minor operations are no longer available anywhere in the country on the national health service? Is that also a means of getting waiting lists down?

I do not know how the right hon. Lady understands the concept of movement. If waiting lists were rising and are now coming down, I think it fairly obvious that that constitutes a first step—like, perhaps, the first step taken by the people who used to escape from prison when the right hon. Lady was Minister with responsibility for prisons.

May I have the answers to my questions about the waiting lists for waiting lists, the waiting times for out-patient appointments, rationing whereby minor operations are no longer available and the fact that other parts of the NHS are suffering as a result of concentration? May I have those answers, please?

We publish exactly the same information as was published by the last Government throughout the 18 years during which they were in office. They did not publish information about the length of time for which people were waiting for out-patient appointments, and we have not started to do so, although it is possible we shall.

What assessment has been made by his Department of the extent of the link between money invested in drug misuse treatment and money saved from the cost of crime. [46611]

The benefits of treatment, and the reduction of crime as a result, have been clearly established by the national treatment outcome research study. It concluded that for every £1 spent on drug treatment, £3 of the costs of crime was saved. Prevention is a key part of the Government's strategy to tackle drug abuse and protect communities from its awful consequences.

I thank my hon. Friend for her reply. Is she aware of the very different views on the link between crime and drug misuse held by the hon. Member for Rutland and Melton (Mr. Duncan), who, in his book "Saturn's Children", called for the legalisation of the distribution and consumption of hard drugs? What would be her Department's response should the shadow Health Minister call for the legalisation of crack, smack and Ecstasy?

My hon. Friend raises an important question. We know that the views of the hon. Member for Rutland and Melton (Mr. Duncan) were set out very fully in the first edition of his book, but the House is entitled to know also whether, since he has changed the chapter concerned and given an undertaking to the leader of his party, he has also changed his mind about these matters.

If the Minister has any questions about the Opposition's policy on the drugs strategy, she ought to ask me. My hon. Friend the Member for Rutland and Melton (Mr. Duncan) follows my policy.

The hon. Lady has come to the rescue of the hon. Member for Rutland and Melton, who stayed in his seat rather than answer questions from the Front Bench.

What steps he is taking to improve access to breast cancer treatment. [46612]

We have made £10 million available for breast cancer services, which is being used to support more than 300 initiatives throughout the country. Particular emphasis has been given to supporting projects that give rapid access to diagnostic services.

I thank the Minister for that and the £140,000 that has been put into Cumbria since October. The Minister may be aware that we have a local difficulty in Carlisle—people who are picked up on the screening system cannot be treated at the Cumberland infirmary. If he is not aware of that, later this week, I will be giving him a 14,000-name petition on the matter, collected by the women of Carlisle.

I can give that assurance. We have a number of pilot projects that are looking specifically at the issue of automatic call-back for screening for women over 65, and we will consider the results of those pilot projects in due course. The national programme co-ordinator is, I understand, giving advice to interested parties in his constituency about the screening service for women in Cumbria and I welcome my hon. Friend's interest in and concern about that matter.