May I ask the Leader of the House to give us the business for next week?

The business for next week will be as follows:

MONDAY 6 DECEMBER—Second Reading of the Government Resources and Accounts Bill.

TUESDAY 7 DECEMBER—Second Reading of the Freedom of Information Bill.

WEDNESDAY 8 DECEMBER—Until about 7 o'clock, there will be a debate entitled "Cuts in Tube Investment, Ways of Paying for more Tube Investment and the General Transport Budget", followed by a debate entitled "Coalition Discussions between the Government and the Liberal Democrat Party". Both debates will arise on Opposition motions.

Motion relating to the Postal Privilege (Suspension) Order.

THURSDAY 9 DECEMBER—Debate on the World Trade Organisation Millennium Round on a motion for the Adjournment of the House.

FRIDAY 10 DECEMBER—The House will not be sitting.

The provisional business for the following week will be as follows: MONDAY 13 DECEMBER—Until 7pm, debate on the Common Fisheries Policy on a Government motion, followed by a motion on the Christmas recess Adjournment debate.

TUESDAY 14 DECEMBER—Second Reading of the Prevention of Terrorism Bill.

WEDNESDAY 15 DECEMBER—Consideration in Committee of the Representation of the People Bill [1st Day].

THURSDAY 16 DECEMBER—Estimates Day [1st Allotted Day].

There will be a debate on aviation safety, followed by a debate on inward and outward investment in Scotland. Details will be given in the Official Report. At 7pm, the House will be asked to agree all outstanding estimates. That will be followed by proceedings on the Consolidated Fund Bill.

FRIDAY 17 DECEMBER—The House will not be sitting.

The House may also be asked to consider any Lords messages that may be received.

The House is grateful for the next week's business and an indication of the business for the following week.

I welcome the announcement that the Representation of the People Bill is to be taken on the Floor of the House, in response to the matter being raised by my hon. Friend the Member for South Staffordshire (Sir P. Cormack) last week, but remain concerned at the continued absence of a debate in Government time on economic matters. I raised that omission a fortnight ago and my hon. Friend raised it last week. He was told that the Government were

"looking anxiously for an outcome to those discussions."—[Official Report, 25 November 1999; Vol. 339, c. 757.]

Nothing has been said today to allay those anxieties, and we still have not had the normal two-day autumn defence debate. Does not the failure of the Government so far to find time for those debates on the economy and defence show that the role of the House in holding them to account is already being undermined by the large number of Bills that they have decided to introduce?

Yesterday, the Chancellor announced new joint action committees to link England with Scotland and Wales. The House has yet to have a proper debate on the concordats published in October. Can the right hon. Lady find time for a debate on those two important aspects of devolution?

Can the Leader of the House confirm that the next millennium bug statement will be oral? Does she plan to make a statement in the new year telling us how things went, assuming that we all make it back here?

Can the Leader of the House confirm that the Deputy Prime Minister will reply to the first debate on Wednesday, to deal with the mounting criticism of his performance? As for the second debate, on coalition, which is of interest to all three major parties, is it not clear that only one Minister knows what is going on? Can the right hon. Lady assure us that the Prime Minister will respond to that debate?

I thank the right hon. Gentleman for welcoming the news that the Committee stage of the Representation of the People Bill will be taken on the Floor of the House. As he said, the hon. Member for South Staffordshire (Sir P. Cormack) raised the matter last week, and the Government have agreed to the request.

The right hon. Gentleman asked me for a debate on economic matters in Government time. I am conscious that such a debate is outstanding, but the right hon. Gentleman will have observed that I have not announced all the business before we rise for the Christmas recess.

Let me tell the right hon. Gentleman, especially in view of his final remarks—although I recognise that he asked perfectly reasonably for a debate in Government time—that, if the Opposition are so anxious to discuss the economy, their wish to waste half a day discussing some mythical coalition suggests rather a strange order of priorities.

The right hon. Gentleman asked about the defence debate. He knows, because I have said it before, that the Government have every intention of providing a proper two-day debate. He also knows not only that we have made it plain for some time that the defence White Paper has unfortunately been delayed, but that the White Paper must then go to the Select Committee on Defence, because that is part of the House's scrutinising role.

The right hon. Gentleman shakes his head. The White Paper does not have to go to the Select Committee but, if he talks of the undermining of the House's role while simultaneously suggesting that we should forget the Select Committee, I can only say that it is not we who are undermining the role of the House in engaging in proper scrutiny. We will have those debates when we can present the White Paper, and when the Committee has had a chance to look at it.

I note the right hon. Gentleman's request for a debate on the concordats, although there have been a number of debates on devolution issues. I can confirm that I expect the next millennium bug statement to be oral, because it will be the last before the date change.

I am perfectly prepared to consider making a statement in the new year. I note what the right hon. Gentleman said about the possibility that not everyone would "make it back"; I could give him a small list of the people whom we could do without, but it might get longer as scrutiny of it continued.

The right hon. Gentleman asked me who would respond to the Opposition day debates. He will appreciate that we have only just received notice of the debates that the Opposition intend to schedule. I can only say that the appropriate Ministers, representing the relevant Departments, will take part. I fear that I cannot undertake to provide the Prime Minister for the second half of the Opposition day, as he has much better things to do with his time than to respond to a rather frivolous debate based on frivolous newspaper reports.

Does my right hon. Friend agree that some of the most distressing complaints brought to our constituency surgeries concern medical cases in which people feel that their health has been more damaged than helped by interventions on their behalf? Some such complaints were the subject of a Channel 4 news programme broadcast in July 1998, and our right hon. Friend the Secretary of State for Health was quick to commission an independent review of the allegations that were made. I am pleased to say that the report resulting from that review is published today, and I hope that Derriford hospital in Plymouth will act equally swiftly on its recommendations.

A report by the Select Committee on Health also deals with such matters of concern. Would my right hon. Friend arrange an early debate, so that we can examine the way in which complaints are handled in the health service, and can ensure that they are dealt with as swiftly and seriously as we would all wish them to be?

My hon. Friend is right to say that people's concerns about the impact and effect of medical intervention can be some of the most distressing cases that Members have to deal with. Obviously, people hope for a successful outcome in all their dealings with the health service and will be particularly disappointed and distressed if they feel that that is not the case. I am grateful to her for drawing to our attention the recent publication of the two reports. I fear that I cannot undertake to find time for such a debate in the near future, but if, say, the Liaison Committee were to select the Health Committee report for debate, either in the Chamber, or in Westminster Hall, that would give an opportunity for those issues to be raised.

I warmly endorse the request from the hon. Member for Plymouth, Sutton (Mrs. Gilroy) not only from a constituency point of view—my constituents also use the hospital to which she referred—but because much wider national issues are involved, as I am sure that the Leader of the House recognises.

Can we have a debate, if not before the Christmas recess, soon after, on the resources available to the House of Commons Library? Did she notice in Prime Minister's questions last week that, in answer both to the leader of the Conservative party at column 610 and to my hon. Friend the Member for Newbury (Mr. Rendel) at column 612, when faced with facts that were made available by the House of Commons Library, the Prime Minister said that those facts were "simply wrong"?

In my experience and, I am sure, in that of the Leader of the House, the House of Commons Library provides an excellent service to all hon. Members. It is the first time, at least in recent history, that any Prime Minister has cast aspersions on the validity of such facts—at least since Baroness Thatcher, who used to take the view that she did not want to be confused with the facts. Will the Leader of the House arrange for an early debate on the way in which we are served by the House of Commons Library?

I thank the hon. Gentleman for recognising the worth of the observations of my hon. Friend the Member for Plymouth, Sutton (Mrs. Gilroy) and the degree to which there is common ground on the matter across the House.

Of course I noticed what the Prime Minister said. Naturally, I hang on his every word at Prime Minister's Question Time.

We all do.

As we all do. I entirely share, as I know the Prime Minister does, the view of the hon. Member for North Cornwall (Mr. Tyler) that the Library provides an excellent service. Equally, however, the hon. Gentleman will know that the Library would dissociate itself from having any responsibility for what statistics are sought and how they are used.

I cannot promise an early debate on resources for the Library, but the hon. Gentleman might ask the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) a question on the matter when House of Commons Commission questions come up next.

My right hon. Friend will know that, despite strenuous opposition from some Members in the past century, ways were found for Catholics, Jews and non-believers to take their seats without in any way undermining their religious, or non-religious, principles. Will she consider the possibility of a change of wording that would allow Sinn Fein MPs to take their seats? After all, they were elected in the same way as we were. If the peace process is to continue and, as we hope, to be consolidated, will that not be an encouraging sign of our own flexibility as a parliamentary democracy? Of course, we would need to work on the basis that there is a genuine wish on the part of the people to whom I have referred to take their seats.

My hon. Friend raises an interesting and important point. He is right to say that the House has, historically, found ways to enable people to be at ease with their conscience and to operate properly as Members of Parliament. I am not entirely sure who the issue that he has raised would be a matter for, but I will draw it to the attention of my relevant right hon. and hon. Friends. However, I share his view that, before the matter could even be considered, there would have to be a genuine wish to operate properly as Members of Parliament and in the context of the development of peace.

Has the Leader of the House been struck by the irony of the fact that, on Tuesday, we shall debate the Second Reading of the Freedom of Information Bill and, at 7 o'clock the following evening, we shall be talking about a matter so arcane that only two members of the Government could be informed about it?

It is important that we are to have a debate on the Freedom of Information Bill, which will, for the first time, give a statutory right of freedom to receive information. I take no responsibility for the other debate to which the right hon. Gentleman refers. It is the choice of his right hon. and hon. Friends.

I am grateful that the Leader of the House has found time for us to debate aviation safety, which is essential, particularly in the run-up to the millennium. Will she also find time to debate the role of Railtrack—a company at the centre of the railway system? A report issued today shows that changes in the management and the culture of the company are long overdue. It might be a good idea to look carefully at the role of a private company at the centre of one of our most essential services.

I am grateful to my hon. Friend for her welcome for the debate on aviation safety. I understand her interest in, and concern about, the role of Railtrack. The Transport Sub-Committee, which she chairs, has done a great deal of worthwhile work on those issues. I cannot undertake to find time in the near future for a special debate just on Railtrack, but she will know that the Transport Bill has been published and will offer opportunities for such concerns to be raised. I shall bear her further remarks in mind.

The right hon. Lady has had on her desk since she took office the fourth report of the Select Committee on Procedure about delegated legislation, which was published three years ago. As the present Procedure Committee is also considering the issue, would it not be helpful if the Government were to respond to the report, or at least arrange a debate on it, so that the current Committee can have the views of the House as it proceeds? We are debating modernisation. With more than 1,700 pieces of legislation going forward every year, often unconsidered by the House, it is an essential matter for debate.

As the right hon. Gentleman knows, we have found time to debate a number of Procedure Committee reports of late. He says that at least we should have a debate on the report that he referred to, but as he was, if I recall correctly, one of the principal movers behind the establishment of the sittings in Westminster Hall, he is as aware as anybody of how tight time is for debates. I shall bear his remarks in mind, but, given that discussions are in train, I am not sure whether I fully accept his view that now, rather than when the discussions are further advanced, is the time for us to have a debate.

Given the welcome developments in Northern Ireland, what does my right hon. Friend see as the scope of Northern Ireland business in the House in future? We have the Northern Ireland Grand Committee, the Select Committee on Northern Ireland Affairs and Northern Ireland questions. Has she had any indication that the Ulster Unionists might be willing to take their seats on the British-Irish parliamentary body?

My hon. Friend raises an interesting point. There may be issues in the aftermath of developments in the peace process that the House will need to discuss, although I cannot anticipate what they will be. I have not had any indication of what changes are intended for the membership of the various bodies, perhaps because people have been more engaged in dealing with the aftermath of the re-establishment at Stormont. I shall draw my hon. Friend's remarks to the attention of my right hon. Friend the Secretary of State for Northern Ireland, but I fear that I cannot give him the information that he seeks today.

The Leader of the House knows that there have been some unfounded concerns about aviation with the millennium coming on. Would it be possible to have a debate when we come back—if we cannot have it before then—on the open skies policy? The Government might be impeding some of our people from reducing transatlantic fares and allowing people to travel with more speed and freedom.

The hon. Gentleman is entirely right, and I am grateful to him for saying that some of the stories that have appeared have been unfounded. I recognise his ingenuity in linking that to the open skies policy. However, I fear that, at this stage of the Session and with legislation to get under way, I see little prospect of finding time for a specific debate on the open skies policy, although I recognise its importance.

Will my right hon. Friend make time available for an early debate on housing? The House will be aware of the developing housing and homelessness crisis in Greater London, where more than 38,000 people are now in temporary bed-and-breakfast accommodation and considerable numbers are sleeping rough on the streets. The problems and concerns in other parts of the country are more about declining estates and empty properties. The Conservative party has expressed collective nimbyism about the building of new homes in the south-east, where there is a great demand and need for affordable accommodation, and those issues should be aired. We are to have a Green Paper in the next few months, and Parliament should express some views before then.

I understand my hon. Friend's concerns about the continued aftermath of the difficulties and deficiencies in housing policy that we inherited from the Conservative party. He will know that the Government are seeking to turn that around. However, he will know also that the provision of sound housing takes time. Previous Governments of all political shades have sometimes regretted a great rush to throw up housing in the short term. I fear that I cannot undertake to find time for a special debate on the issue in the near future, but my hon. Friend may like to bear in mind the opportunities that arise in Westminster Hall, and seek a debate in that forum.

Could the right hon. Lady induce the Deputy Prime Minister to put right his dereliction of duty in not coming to the House to present a statement on the withdrawal of his proposal that Railtrack should assume responsibility for the modernisation of the sub-surface lines—the District, Circle and Metropolitan lines—of London Underground? Would it not be better—even at this late hour—if, in advance of Wednesday's debate on cuts in London Underground, he came to the House to provide the background for that debate, and to allay our suspicions that his decision had more to do with buying off the hon. Member for Brent, East (Mr. Livingstone) than with providing an effective strategy for the modernisation of the tube?

It is unusual for someone to want a statement even before a debate, and I fear that I cannot satisfy the hon. Gentleman in that regard. He talked about the withdrawal of a role for Railtrack. In fact, the Deputy Prime Minister has announced that Railtrack will not be charged with sole responsibility because it has been unable to confirm that it could do so on the basis of an integrated system. My right hon. Friend has made it plain that that was the basis of any possibility of Railtrack being given the sole role. That was announced in June. In consequence, I see no need for a statement to confirm what my right hon. Friend said was the framework of the negotiations then.

My right hon. Friend will be aware of the extreme frustration of many of my constituents in Norfolk about the fact that they are having to watch Yorkshire and north English television regionally. Last week, the Minister responsible for broadcasting came to Norfolk. Although supportive of the need to address the problem, she had to relay the information that the next major legislation on broadcasting is not likely to be until the next Parliament. In those circumstances, and given the good will expressed by Ministers—and the fact that I must be one of 30 or 40 hon. Members with constituents in this position—is there any chance that the Government will be willing to give a fair wind and some time to a private Member's Bill specifically addressing this issue?

I have great sympathy with the concern that my hon. Friend expresses, and I know that it is a cause of great resentment in the areas the he and other hon. Members represent that that choice is denied. However, I am not sure that I share my hon. Friend's confidence that legislation would be the best way to tackle the problem, still less that the best solution would be a private Member's Bill. However, I have no doubt that my hon. Friend will exercise his persuasive powers on those hon. Members who won a place in the ballot for private Member's Bills. I wish him well with his efforts, but I cannot undertake to provide the support that he seeks.

May we have a focused debate on the relationship between the Prime Minister, Mr. Prodi—the Prime Minister's friend and a man whom he admires—and the Prime Minister's crony, Lord Simon of Highbury, to explore the nature of the relationship between them, especially their views on Europe and its future, and the national veto in the European Union? The Prime Minister may agree with his crony and his friend, or he may not, but the issue is vital for the future of this country and its relationship with the European Union. We need an urgent debate to get to the bottom of the problem and find out whether the Prime Minister is a good European or whether he has already—although I can hardly believe it—fallen out with his friend, Mr. Prodi, and taken a different view.

I point out to the right hon. Gentleman that we had a debate on Europe yesterday, so it seems strange for him to call for an urgent debate today on the same European matters. He will be mindful of the fact that no Labour Government have ever given up any element of the British veto, because that was done by the Conservative Government under Baroness Thatcher. The right hon. Gentleman should perhaps focus on the rethinking that seems to be happening in the Conservative party.

I find it offensive that a senior, distinguished and internationally recognised British businessman should be dismissed and sneered at in the way that the right hon. Gentleman did by describing him as "a crony" of the Prime Minister. Every time that the right hon. Gentleman and people like him make such remarks, people in the City wonder more and more about the direction of the Conservative party.

Could my right hon. Friend find Government time to debate the role, function and effectiveness of local health authorities? The Leicestershire health authority, in an acute hospital review in the county of Leicestershire, has concluded that the almost new Glenfield hospital—a lung cancer centre of county importance; a breast care centre of regional importance, with a unit recently opened by the previous Secretary of State for Health; and a cardiology unit of national importance—is imperilled by its downgrading in status to a planned care and rehabilitation unit, which is a concept not yet known in the United Kingdom. We need to review that issue, which is of great concern to 1 million people in the county of Leicestershire.

I am aware of the reputation of the Glenfield hospital, which I visited as shadow Secretary of State for Health. I understand the concerns that my hon. Friend expresses, although I am sure that he accepts that there has never been a proposal to change, reform or close a hospital anywhere in the United Kingdom that has not caused great anxiety and concern locally, because people are naturally and properly attached to their local hospitals. I am afraid that I cannot find time for a special debate on the matter in the near future, but my right hon. Friend the Secretary of State for Health is in his place and will have noted my hon. Friend's remarks.

May I add my voice to the calls from the hon. Member for Plymouth, Sutton (Mrs. Gilroy) and my hon. Friend the Member for North Cornwall (Mr. Tyler) for a debate on the report published today, "Thoracic Surgery Services within the Plymouth Hospitals NHS Trust"? Several questions were not asked and several answers were not published in the report. It is imperative that there is public confidence in health services, and those questions and answers need to be heard in this House, which is the appropriate forum.

I take the hon. Gentleman's point, and it is clear that there is considerable interest across the House in the issues that the report has raised, although, as it was published only today, it is too early to respond. However, the issue is a good example of one on which hon. Members with a common interest might get together to request a debate—perhaps in Westminster Hall—to air the issues of concern across the locality.

The right hon. Lady will recall—probably with some horror—that she was kind enough to tell me last week that she could think of nothing that she would enjoy more than to take part in a debate on pensions policy. With Christmas coming along, may I urge her to indulge herself and arrange for such a debate next week, so that the House can discuss at some length issues such as the scrapping of the married couples allowance and of dividend tax credits, and the abolition of home income plans, of the widow's bereavement allowance and of medical insurance tax? We could also debate the £5 billion a year in increased taxation that has been imposed on pension funds. Would not the Leader of the House admit that her instincts were basically sound and that we should have a debate next week on all the many ways in which her Government have betrayed middle-class pensioners?

The hon. Gentleman probably understood that, although I said how much I would enjoy taking part in such a debate, my role will prevent that. Although it remains my view that I would enjoy taking part in that debate—as I would then be able to wrap the record of the previous Conservative Government around the necks of the hon. Gentleman and of other Conservative Members—I fear that that is an indulgence that I must deny myself, even at Christmas.

In Committee Room 9 this morning, we had the opportunity to debate the Government's change of policy with respect to the National Institute for Clinical Excellence. The Government now require the institute to consider the affordability as well as the clinical effectiveness of procedures. Is that not such an important change in policy that the right hon. Lady should give the whole House the opportunity to indulge in debate on that matter?

I sympathise with the hon. Gentleman, who makes the mistake of assuming that what the hon. Member for Runnymede and Weybridge (Mr. Hammond) said during Prime Minister's questions yesterday was accurate. However, I fear that his confidence is misplaced. The Government have not changed policy and the consultation document issued in July 1998 entitled "A First Class Service—Quality in the New NHS" stated that the institute would promote

"clinical and cost-effectiveness through guidance and audit, to support frontline staff."

There has therefore been no change in policy.

Is the Leader of the House aware of the disturbing incident in the Chamber on the night of 9 November, when my hon. Friend the Member for Aldershot (Mr. Howarth) was allegedly threatened with physical violence by a junior Government Whip? I do not think it fair to name the Whip in question, but the episode was seen by the hon. Member for St. Ives (Mr. George), who I understand is willing to come forward as a witness.

Will the right hon. Lady find time for the Government Chief Whip to make a statement to the House about the investigations that have been undertaken into the formal complaint submitted by my hon. Friend the Member for Aldershot? Although a long time has passed since that deplorable incident, the Chief Whip has not seen fit either to acknowledge that it took place, or to reply to my hon. Friend.

I am afraid that hon. Gentleman merely confirms that my ear for gossip is much worse that I feared, as I was not aware of any such incident. Although Chief Whips do not make statements to the House, I shall draw his remarks to my right hon. Friend's attention. It is always regrettable when relationships between hon. Members deteriorate. However, may I gently suggest to the hon. Gentleman that I am not sure that those relationships are improved by raising such matters on the Floor of the House.

In her reply to my hon. Friend the Member for New Forest, West (Mr. Swayne), the Leader of the House highlighted the confusion in the minds of both the Government and the public over whether cost-effectiveness will be taken into account in deciding whether people can have certain treatments or drugs. Is it not in the public interest that there be a statement—or better still a full debate—on the matter? Did not what the Prime Minister said yesterday to my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) about the cost-effectiveness of drugs amount to an admission that drugs will be rationed and that some people will get them if there is money available, and that others, regardless of their clinical need, will not?

It is an interesting phenomenon in politics, of which this is a classic example, that sometimes someone says something and someone else hears something completely different. I am at a loss to understand how the hon. Gentleman can read confusion in the Government into my identification of the fact that what was said in a document published in July 1998 is exactly what the Prime Minister said yesterday. If there is confusion, it is not on our side.

Is the right hon. Lady aware that the Italian chairman of the Federation of European Master Butchers has said that, because of consumer resistance to British beef, British farmers are singularly disadvantaged, as their beef has to be identified in Europe as being British? He said that he is perfectly happy to stock British beef, but knows that, as long as it is, uniquely, labelled as British, he will not because he and other members of the federation know jolly well that no one in Europe will buy it. Can we have an urgent debate on that and ensure either that all countries have to label their beef as French, German, Italian or whatever, or that the ridiculous ban on British beef being exported to Europe without being labelled as British is withdrawn?

I realise that it is a gross dereliction of duty, but I was not aware of the views of the Italian chairman of that federation. I know that that is a disgraceful confession, but I must be honest with the House. If he is speaking as an advocate of British beef, that is good. I know that Italy has been a good market for British beef and we hope that it will be again. I understand that the hon. Gentleman and his party are seeking what relics of advantage they can from the aftermath of the BSE crisis. However, in the long term, it would be to the advantage of British agriculture if the labelling of beef as British came to be seen as a mark of quality. Conservative Members should think more carefully about where our long-term interest lies before continuing to assert that such labelling will cause people not to buy British beef.

Will the Leader of the House reconsider her complacent replies to my hon. Friends the Members for New Forest, West (Mr. Swayne) and for Altrincham and Sale, West (Mr. Brady) and agree to a full day's debate in Government time next week on the role of the National Institute for Clinical Excellence and the policy on drug prescribing? Is she aware that the Department of Health previously assured Dr. John Chisholm of the British Medical Association that no one would be denied the investigations, drugs or treatments that he or she needed? Is she further aware that the Prime Minister's response to my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) at Prime Minister's Question Time yesterday was markedly different from that earlier pledge? Will she accept from me, in my characteristically non-partisan spirit, that my constituent who suffers from relapsing remitting multiple sclerosis, Caroline Cripps of Westcott in the south of my patch, requires those matters to be urgently addressed? Can we have a full debate on the Floor to thrash them out once and for all without delay?

I would normally be surprised at the hon. Gentleman returning to a subject on which his hon. Friends have comprehensively lost since I pointed out that what is being said now is what was said and published in 1998. However, I understand that he wished to refer to the case of his constituent, and I recognise his interest and concern in doing so. He knows that NICE is urgently considering MS treatment. Not only is what was said in the past few days about the institute to be found in the consultation document in July, but the White Paper published in December 1997 said:

"Efficiency and quality should go hand in hand … Patients suffer if resources are not used efficiently or to best effect."

It has long been clear that the Government, too, recognise the importance of cost-effectiveness.

Yesterday, the Government published the massive Transport Bill, with some 231 clauses and 26 schedules. Will the Leader of the House confirm that despite the pre-legislative scrutiny that one part of it recently underwent, full parliamentary scrutiny will be given to the Bill as a whole? As a mark of her earnest, will she confirm that there will be a two-day debate on Second Reading before Christmas, with perhaps one day on road and rail and the second on the vital matter of the privatisation of National Air Traffic Services?

No, I cannot confirm any such thing. As the hon. Gentleman says, the Bill has been published only recently; it will be debated in the House in the proper way, and will receive full and proper scrutiny. It is no good for the hon. Gentleman to say dismissively, "despite the pre-legislative scrutiny". Yes, the Bill did receive pre-legislative scrutiny of one of its most important parts. The Bill will be properly dealt with in accordance with the normal conventions of the House.

Would the right hon. Lady be kind enough to amplify the answer that she gave to her hon. Friend the Member for Walsall, North (Mr. Winnick) about the oath and affirmation that members have to take before assuming their seats in the House? Does she accept that the requirement to take the oath, or to affirm, cannot be altered save by legislation? Will she confirm that, although the House has very properly addressed the matter of Members and their consciences in the past, it has never sought to suspend the requirement for a Member to proclaim and acknowledge the sovereignty of the Queen as monarch?

I cannot amplify my remarks; the hon. Gentleman raises several important issues relating to conclusions that the House came to, presumably many decades ago, as to how we handle such matters. I can only repeat what I said to my hon. Friend the Member for Walsall, North (Mr. Winnick); the issue is important and I shall make inquiries into it. However, I am sorry that I cannot—on the hoof, so to speak—answer the question today.

On a point of order, Madam Speaker. The Official Report for Monday contains a list of the members of the Government. The hon. Member for Islwyn (Mr. Touhig) was omitted from that list. Is there any way that you, Madam Speaker, can confirm for the benefit of hon. Members whether the hon. Member for Islwyn is a member of the Government? Is this something that we should be told?

I think perhaps that it was a clear printers' error. However, I am sure that the hon. Member for Islwyn (Mr. Touhig) will be grateful for the oxygen of publicity that he has just received from the Conservative Benches acknowledging his appointment as a new Whip.

On a point of order, Madam Speaker. When the Leader of the House discovers that there was a Committee sitting this morning in Room 9 that amended the terms and provisions of the National Institute for Clinical Excellence so that, henceforth, it will have to take account of available resources as defined by the Treasury, will she be able to correct the record of the remarks that she has just made suggesting that the Government have been consistent throughout? Will she be able to change the Official Report—to have it amended—or will she have to come to the House to make a statement because she was wrong?

I have no comment to make on the political exchanges that take place in the House. I have no responsibility for the comments made either by Ministers or by Back Benchers. However, I note that the hon. Gentleman was in the Chamber while the Leader of the House was answering business questions. I should certainly have been willing to call him so that he could have put the question to her at that time and given her an opportunity to answer for herself. I am sure that that would have been the correct way to proceed.

First, I apologise to the House for the fact that I shall not be here for the winding-up speeches due to a prior engagement. I have informed you, Madam Speaker, and the spokesmen of both the main Opposition parties.

We live in an ageing society. For too long, old age has been seen as a problem. People talk of the burden of an ageing population; some even say that changes in the ratio of working to retired households in our country are unsustainable. That is not the view of the Government. A growing elderly population is a success, not a failure; it should be celebrated, not denigrated. Older people are valuable in our society, not a burden on it. That is why we have taken action throughout Government to improve the health, well-being and security of older people: restoring free eye tests, introducing winter fuel payments, cutting VAT on fuel, the introduction of the minimum income guarantee for poorer pensioners, free TV licences for older pensioners—all of that a recognition of the importance of older people to our society.

Underlying each of these approaches is a recognition that, far from there being a demographic time bomb that will overwhelm society as we have known it, the rate of growth in the numbers of older people in the next 50 years will be about half that of the last 50 years. It is true, however, that there will be more very old people, aged 85 years or more, during the next few decades. That, too, is something to be celebrated, but it means that the way that we care for people in old age must change.

Today's debate gives the House the opportunity to consider these issues in what I hope will be a calm and considered fashion. The future of long-term care is an issue that concerns each of our constituents in each of our communities. Long-term care is not just about caring for older people. It is about younger, disabled people too. The need for changes to the system of long-term care is therefore not just the product of demographic change. Change is needed for other reasons. For too long, standards of care have been too variable. Standards of care have been a matter of local discretion. About 150 local authorities and about 100 health authorities regulate care homes, often to very differing standards. Some services, such as home-based care, are not currently regulated. The regulation system has not been properly independent.

There are very real concerns about the funding of long-term care. Although only one in five old people need long-term care, as they approach old age many more become anxious about how well they will be looked after, who will look after them, how much it will cost and who will pay. The current system has failed to be explicit about these issues, not least because it has developed in such an ad hoc way in recent decades. Under the previous Government alone, there were six major changes to the benefits and rules governing long-term care.

The current system of care is confused and confusing. It provides too many incentives to care for old people in care homes and too few incentives to care for them in their own homes. Arguably, the current system is premised upon the idea that older people do not want what most of the rest of us want—the chance to live a fulfilling life in as independent a way as possible. All the evidence suggests that, all things being equal, older people want to remain as independent as possible for as long as possible.

It is right, therefore, that we re-examine all the issues to do with long-term care in the round. In our election manifesto, we said that we would set up a royal commission to examine the funding issues. In December 1997, we established a royal commission chaired by Sir Stewart Sutherland. The commission took oral evidence, conducted public hearings and received more than 2,000 written submissions. We published its report in March 1999, and I want to place on the record my thanks to the royal commission for all its work.

When the report was published, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) said that he hoped that it would stimulate debate to help find a way of ensuring that people could have access to high quality long-term care that was fair for individuals and the taxpayer. Indeed, the royal commission explicitly called for such a debate. Today the House has an opportunity to take part in that debate.

In the past, there have been too many short-term solutions for long-term care. What is needed instead is a properly considered solution that should be capable of standing the test of time. Today's generation of older people, and the generations to follow, deserve no less.

As the royal commission said, there is no obvious answer. That was reflected in its conclusions; it published a majority and a minority report. Since March, there has been an active debate on the commission's approach and its 23 recommendations. A wide range of ideas and views has been expressed. My Department has received more than 800 responses to the commission's recommendations.

It is very interesting that the Department has received 800 responses as a result of Sir Stewart Sutherland's excellent piece of work. Does the Minister know off-hand how many that he received were in favour of the minority recommendation of the royal commission?

I do not know the answer. I know from my discussions with Sir Stewart that he, too, has been receiving a fairly weighty postbag. I guess that many right hon. and hon. Members have as well. We need to consider extremely carefully the range of views that have been put forward by a full range of organisations and individuals. We need also to consider the royal commission's recommendations.

Can the Secretary of State tell us how many of the responses that he has received support the recommendations set out in the majority report? Perhaps he could give us a guide rather than an absolute number. Is it 50, 60 or 70 per cent. Can the right hon. Gentleman give us an idea or a clue?

It is so tempting to guess from the Dispatch Box. On balance, however, that is a temptation that I shall probably avoid. [Interruption.] I know that Liberal Democrats often guess about policy issues but it is probably wiser that the Government continue to take a considered view of these issues.

Since March, the Government have been taking action to improve long-term care. We are improving services by allocating £140 million over three years to help fund respite care as part of our new national carers strategy. We are providing local authorities with special grants totalling almost £300 million this year to encourage them to help older people return to independent living and prevent their unnecessary admission to institutional care. We are extending direct payments to people aged 65 and over as well as to the parent carers of disabled children.

Our approach recognises that any system for funding long-term care must be part of a wider policy of support for older people. Over the next year we shall extend this programme of support for older people still further. For too long older people have found the care system a bewildering maze full of differing rules and confusing criteria for access to services. There has been a lottery in long-term care just as there has been one for health care. The Government are determined to tackle both.

Has an assessment been made of the pressure upon both the independent and voluntary systems at this stage when we are emphasising community care? So many statutory homes throughout the country have been closed and people are puzzled about what the future holds for them.

I understand the concerns of the residential care sector. I shall be coming to that. However, I do not accept that there is a wholesale crisis in that industry. The hon. Gentleman should remember that over the course of this year, next year and the following year, social services budgets are being increased by more than 3 per cent. in real terms, with an extra £3 billion going to them.

Not in Worcestershire.

The hon. Lady says that she wants more for Worcestershire. She should have a word with the Conservative Treasury spokesmen. They are always telling us that our spending plans are reckless, madness and irresponsible. The Conservatives, Back Benchers and Front Benchers, cannot have their cake and eat it on these spending issues.

We will be taking four important steps to ensure greater fairness and transparency in the care system. First, today we are honouring another manifesto commitment by publishing a new charter for long-term care. [Interruption.] The hon. Member for Sutton and Cheam (Mr. Burstow) scoffs. I think that it is an important idea to honour manifesto commitments. Does the hon. Gentleman not agree? "Better Care, Higher Standards" will for the first time give people who need long-term care the information that they need to know what they can expect from their local health and housing authorities as well as social services.

The charter will require local health, housing and social care agencies to implement local charters by June 2000. In that way everybody will know what to expect, how they will be treated and where to go to get effective help and advice. Annual public satisfaction surveys of services covered by the charter will be published.

As we know from our postbags and surgeries, many people going into long-term care, and their relatives, are naturally anxious and worried about their future. I hope that the new approach to setting standards will ease some of these worries and ensure that people receive a higher quality service at this crucial time in their lives.

It is all very well talking about charters, but the Prime Minister spoke about these issues in the most inflammatory terms during the general election. He said that we, the Conservatives, were

"forcing pensioners to sell their homes"

and that pensioners deserved better than that. There is a royal commission report, and the Secretary of State passed over it in about four minutes. It was allowed to gather dust for six months. Is it true that the report will never get out of the long grass because its recommendations will be too expensive?

I would be extremely cautious if I were the hon. Gentleman. As I remember it, he served as a Minister in the previous Government. They established a royal commission on criminal justice. It was set up in June 1991 and the final Government response was made in June 1996—five years later. If the hon. Gentleman will wait a moment or two, I shall set out very clearly the timetable for our response. It will be far shorter than the previous Government managed with their royal commission.

Will the Secretary of State confirm that the announcement he has just made about a long-term care charter is about providing guidance to local authorities to draw up their own local charters? Will he confirm that that was a policy of the previous Government, when they required local authorities to produce community care charters? Is his announcement not just a relabelling and recycling of old policies?

No, that is not true. We want to ensure that there are clear national standards in all areas—in the national health service and in social services, too. The hon. Gentleman will be aware that, last week, the Minister of State, Department of Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton), published new information about the performance of individual social services authorities. I take a fairly fundamentalist view on this issue. I believe that the people who pay for and receive such services have the right to know how well they operate or, in some cases, how poorly they operate. We shall continue the drive to make such information available, not just locally but nationally.

Will my right hon. Friend give way?

Yes, but I will get on to my second point.

If we publish information about how well local authorities do, is it not important that it is accurate and up to date? Is it not true that the information recently published on Wirral social services was grossly inaccurate on the improvements that Wirral has made not only during the period of the inspection, but, much more importantly, since the inspection?

I am reliably informed by my hon. Friend the Minister of State, Department of Health that the Wirral local authority not only provided the information that was published, but that it was invited to comment on the draft publication. My right hon. Friend's point is not quite accurate.

Wirral made comments, but damn all effect they had.

We shall look into that issue, but I am now determined to move on to my important second point; it is only the second out of four.

Secondly, early in the new year, we shall consult on new guidance to give everyone fairer access to social services. We want to iron out the unacceptable variations that exist at present and to create a fair set of rules and procedures that everyone can follow and understand. The aim will be to achieve greater consistency between local authorities in the way that they apply eligibility criteria for accessing all adult social services, including long-term residential care. Importantly, the guidance will stress the need to align social services criteria with NHS continuing health care criteria. It will also stress the need to agree eligibility criteria with housing agencies to ensure a properly co-ordinated response to people's needs.

Thirdly, we also want the care provided to older people by the health service to be of a higher standard in future. Older people are entitled to be treated with dignity and respect wherever they use the NHS. They are entitled to have fair access to health care; age discrimination has no place in the modern national health service that we seek to establish. That is why next year we shall publish a new national service framework for older people. For the first time, we shall lay down clear national standards, defining the treatment and care that older people can expect in all settings—whether in hospital, general practitioners' surgeries or from social services—as they move from hospital into care or back home.

The national service framework will be ready next year for implementation by April 2001. In the meantime, we are making good progress in eliminating mixed-sex accommodation in the NHS, which many old people feel—I agree with them—threatens their dignity and self-respect.

Fourthly—[Interruption.] The hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) is having difficulty counting, but this is my fourth point. Fourthly, we want to ensure higher quality in all aspects of care. We are currently consulting on draft national minimum standards for residential and nursing homes. Final standards will be published next year. The quality of care provided in people's own homes, however, is not currently regulated at all, so in the new year we shall launch a consultation exercise on possible new standards in that area.

The setting and enforcement of standards of home care providers will be central to our drive for higher quality social care services. Other elements will include the first ever quality strategy for social care, together with improvements in the training, qualifications and regulation of the social care work force, far too many of whom remain unqualified.

rose—

rose—

I want to make a little progress. I have given way many times, and I know that many hon. Members want to speak.

Together, those four steps will help to deliver a fairer and better integrated system of care for older and disabled people. They will improve user and carer choice, as well as the consistency and quality of the long-term care system. All those initiatives were either called for by the royal commission, or go significantly beyond its recommendations. In total, we are already actioning 11 of the royal commission's 23 recommendations, so we are making good progress.

rose—

I shall give way, and then I shall turn to funding issues.

I thank the right hon. Gentleman for giving way, and I rise on a genuine point of information. Has he just said that he will establish a new police force to oversee how people are, in their own homes, looking after elderly people?

No. The hon. Gentleman should try to put aside his ideological convictions and think about the type and quality of care that people receive. We are contemplating, for the first time, means of ensuring that standards among home care providers are as high as possible. That sector has never been regulated, and as a consequence, as we are all too aware—or should be aware—from our constituency experience, standards have not always been as high as they should be, and in some cases abuse has taken place. We are determined to avoid that.

rose—

rose—

I shall give way once more and then I must crack on.

Does my right hon. Friend recognise that the many frail, elderly people who are cared for in their own homes by a single carer are more at risk and more vulnerable than elderly people being cared for in a residential setting, where they are surrounded by many more people and have regular visitors? That is one reason why it is vital to consider regulating home care.

I am grateful for my hon. Friend's support. I know that she comes from an active background in social services and that she understands the issues. Social services authorities are all too aware of some of the problems that occur precisely when the system of domiciliary care services is improperly regulated.

Many of the royal commission's suggestions for changes to the funding system for long-term care have substantial cost implications, both now and for the future. Those costs range from over £1 billion a year to over £6 billion a year. As a Government, we are committed to a prudent, disciplined approach to public spending, so we have already set out our spending plans for the three years to March 2002.

Looking to the future, the 2000 spending review will agree new spending plans for a further two years. We intend to complete the review by next summer. It will aim to find out how best our spending programmes can contribute to achieving the Government's overall objectives. In particular, we want to create a fair, inclusive society where communities are secure and healthy. Improving the care of older people will be an important element of the Department of Health's input into the spending review. The review will consider long-term care funding, alongside changes to improve the quality and delivery of care. Our proposals on financing long-term care will be completed next summer when funding decisions will be announced. We aim to publish a White Paper around that time.

We shall base any future reforms in this area on three key principles: choice, fairness and quality. Similarly, just as elsewhere in our welfare reform programme, our policy will be that people should provide for themselves where they are able to do so. In particular, people prefer and should have the opportunity to remain at home for as long as possible. There will, of course, be situations where a person needs to be admitted to a residential care or a nursing home, and that choice should be available, but any reforms to the system of long-term care must reflect and reinforce the crucial policy objective of encouraging independence through choice.

We know that we need to find a fairer way of funding long-term care for the future. There are around 375,000 older people in residential care and nursing homes in England. The taxpayer already helps to fund the care costs of about three quarters of them, fully or in part. Of those people in residential care and nursing homes, about 100,000 with assets over the present capital limit of £16,000 fund their own care. We established the royal commission because of widespread criticisms of the current arrangements.

The means test for residential care is hard on those with only modest amounts of capital, usually their family home, and lower retirement incomes. It also leads to a widespread fear that people will be forced to sell their homes in order to fund their long-term care requirements. There can be pressure for the immediate sale of the home when people enter care. Sometimes, of course, selling an empty house makes sense, but premature sale can rule out the possibility of people returning home after some support and rehabilitation. Many older people are anxious about a decision to sell, and the move into care can itself be extremely stressful.

I am grateful to the right hon. Gentleman for giving way. Does he agree that long-term care requires long-term solutions? Is he aware that the average worker, over a 40-year working life, pays more than £100,000 in national insurance? Would it not be better to move towards a system whereby a properly funded pension was built up, which could be put towards the funding of proper long-term care?

As the hon. Gentleman rightly says, we must consider these highly complex issues. They are issues not just for the Department of Health. They cut across the entire Government—the Department of Social Security, the Department of the Environment, Transport and the Regions, the Treasury and other Departments are all involved in the discussions. It is extremely unlikely that there is one simple big-bang solution, but it is important that we understand the nature of the problem in order that we can begin to posit where we could move in the future.

rose—

No, I will not give way. I have already taken too much time and I must move on.

There are insufficient incentives for authorities to rehabilitate and support people in their own homes. The charges that people pay for care at home vary too much between different parts of the country. Private financial products for long-term care, as they are currently structured, do not deliver attractive options for most people who have to pay for their own care. Finally, the system as a whole needs better ways of assuring and improving the quality of care.

The Secretary of State said that one of his principles was fairness. As he develops his proposals, will he bear in mind that what many people regard as one of the most unfair elements of the present system is having to sell the family home, particularly a modest family home, in order to qualify for state assistance, whereas others who have not struggled to build up a home of their own are in a better position?

I understand that. I understand both the unfairness and the very real fear that that causes among people who are growing old, their relatives and carers.

rose—

I shall give way to the hon. Gentleman because he is so persistent, but that will be the last time.

I am grateful to the Secretary of State for recognising my persistence. Will he ensure that when he returns to the House after the review, he can justify the present situation in which a dementia sufferer must pay for nursing care? How can that be fair? Will it be addressed in the review?

I shall come on to these important issues in a moment. They were raised explicitly by the royal commission and in the commission's consultation, and I am sure that they are reflected in the postbag that the Department of Health has received since the royal commission produced its report.

It is now time to explore practical ways of addressing these fundamental failings in the current long-term care system, and I shall set out for the House how we intend to do just that.

Many of the possible changes to the funding system raise complex practical issues. As part of the 2000 spending review process, we shall be exploring some of those issues and the commission's recommendations in detail. The royal commission raised six issues in both the minority and majority reports which we are examining in particular detail.

First, the royal commission recommended that consideration should be given to providing nursing care free, whether delivered in the NHS or in private nursing homes. Even within the royal commission, there were different approaches to the definition of nursing care. We will be working with interested parties to see if the definitional problems can be overcome. Come what may, we will need to weigh that option against other priorities for funding long-term care.

Secondly, we intend to explore with the financial services industry how it could best design long-term care insurance products and other financial products to see if they could be made attractive to a wider audience.

Thirdly, we are exploring the costs and effects of possible changes to the residential charging rules. Those include the treatment of houses where a former carer continues to live. They also include measures to ensure that local authorities use their powers to avoid an immediate sale by helping with care home fees while taking a charge over the person's home.

Fourthly, we are considering the implications of changes to two social security benefit payments. As we said in the social services White Paper, we are considering transferring to local authorities the funds for the income support residential allowance, which is currently paid only to people living in independent residential care homes. We are also considering transferring to local authorities the funding and care management responsibility for people who entered care homes before the 1993 community care changes and who have preserved rights to income support towards their care costs.

Fifthly, we are reviewing policy and guidance on continuing health care with a view to improving consistency and equity of access to services.

Sixthly, we shall consider the implications of a forthcoming report by the Audit Commission on charges for care at home, as we look at ways of reducing the scale of variations in local authority domiciliary care charging policies.

Where appropriate we intend to publish short consultation papers on those issues. The lead Government Department in each case will involve key organisations, including users and carers as well as independent sector care providers. That detailed work will help to inform the Government's final decision on the future funding of long-term care following the conclusion of the next spending review.

As well as preparing for that detailed work on funding issues, we have been considering the royal commission's other central recommendation for a national care commission. Devolution means, as the royal commission recognised, that the remit of any such organisation is likely to be confined to a single country. However, we believe that many of the functions proposed for a care commission are just as usefully done for England as for the United Kingdom as a whole.

The four main roles suggested for the care commission were monitoring, representing the consumer, providing national benchmarks and encouraging the development of better services. Those are all important. Each is already being carried out, at least in part, by existing organisations, including my Department, ombudsmen for the NHS and local government, and professional training and regulatory bodies. We also believe that there is merit in bringing together many of the individual functions suggested for the care commission through a single organisation covering England. The key test is that any such body should have a coherent role which will improve matters for everyone who needs long-term care.

Our social services White Paper published last November proposed the establishment of eight regional commissions for care standards to enforce new minimum standards for residential as well as domiciliary services. In the light of the royal commission's report I have looked again at whether eight regional bodies would give us the national overview and consistency that we seek. I have concluded that they would not. I can therefore announce today that we have decided broadly to accept the royal commission's recommendation in this area. Our Bill on care standards will establish a single national care standards commission. The measure, which sets out its broad functions, will be introduced in another place today. The commission will take up the four main roles that the royal commission proposed and will, therefore, be established in the way in which the royal commission suggested. I hope that the Bill will complete its parliamentary stages next summer.

The national care standards commission will be responsible for ensuring that all long-term social care in this country is provided at a consistently high standard. For the first time, there will be a single, independent, national watchdog, which will be responsible for ensuring high standards of care wherever it is provided and whoever provides it. The new regulatory regime will be simpler and more streamlined than previous regimes, and, crucially, there will be a level playing field for public and private sector providers.

The new commission will be uniquely well placed to advise and inform Government and consumers. It will build on its regulatory function by monitoring and reporting on trends in the provision of long-term care. We also intend that the commission will be able to put together the information with demographic and resource data, and thus advise Government, as required, on trends in the long-term care market.

The commission will have the power to investigate complaints and to report on them. It will also be able to ensure that consumers have clear and accurate information on services. Building on its regulatory role, it will be able to take a view on quality standards nationally, as well as reporting publicly on each of its inspections. The standards that it enforces will include output measures, and it will have to reflect the views of local service users on the service.

The commission will report every year on service performance against standards, and it will give providers advice on meeting the national standards. It will also be able to run helplines to guide people to registered providers.

Overall, the national care standards commission will be a powerful new body, which, I believe, will make a major contribution to driving up standards of care and to giving people the necessary information to make choices about their long-term care needs. I hope that it will be up and running by spring 2002.

The Government are committed to improving long-term care for older people and for disabled people. The changes that we are already implementing, and the further changes that I have outlined today, seek to promote choice, improve quality and provide fairness for people who need long-term care.

The royal commission has played its part, and I thank it for its work. My speech today, by outlining work in progress and broadly accepting one of the royal commission's two main recommendations, shows that we are tackling seriously and constructively the issues that it raised. My announcement today is not our last word on long-term care, but it shows our determination to take the necessary steps to put long-term care on a sounder and more sustainable footing.

The Secretary of State has created a smokescreen of minimalist announcements and reheated old announcements in his attempt to distract attention from the Government's simple failure to address the royal commission report's principal recommendation. There is much worthy exploring and investigating, but nothing of substance. I hope that the Secretary of State appreciates the disappointment that his words will cause those up and down the country who have waited with bated breath for some sign of a Government response to the royal commission report, which has been in the Government's hands for nearly nine months.

The hon. Gentleman puzzles me. I have a brief from the Conservative parliamentary resources unit—

I hope the hon. Gentleman paid for it.

I shall happily pay for it—it is a very useful document. It contains a revealing sentence:

"Over the next few months, the party will develop new areas of policy which will be ready well before the next general election."

Is the hon. Gentleman criticising the Government for that?

I am glad that the hon. Gentleman is reading Conservative research department briefs—perhaps he seeks a position in the shadow Cabinet. However, his idea of opposition may be different from mine. We shall develop our policies and put them before the electorate at the next general election. They will be based on our response to Government policies that are outlined at that time. It is no part of our responsibility to develop policies and feed them to the Government to steal from us—just as the hon. Gentleman has acquired that brief by means that we know not.

It is a delicious irony that the Secretary of State, who has come to the House today to defend the Government's inaction in response to the principal recommendations of the royal commission report, may be the Treasury Minister who ensured that those recommendations were rejected in the first place. Before the general election, Labour apparently identified long-term care as an area for urgent action. Perhaps it would be more accurate to say that it identified that as an area to be exploited in the pursuit of votes. In a press release dated 10 March 1997, the then shadow Secretary of State for Health said:

"We will establish a royal commission which will lead a national debate on a comprehensive review of the care system. Changes cannot be made piecemeal."

I hope that the Secretary of State will bear that in mind as the Government embark, as he has said, on an exercise to cherry-pick the report and dribble out a series of piecemeal changes, as he has admitted they are doing.

The hon. Gentleman has said that the Government have rejected the main recommendations of the report. There are two main recommendations, one of which they have accepted. They have promised a response on the other within months, so how does he explain his assertion?

Well tripped. When I referred to the principal recommendations of the report, I meant the one concerning funding. As the hon. Gentleman knows, that is the key issue being debated in the country and it is of key concern to the 400 organisations that submitted evidence to the royal commission. We must address ourselves to that issue first and foremost.

In a press release dated 25 April 1996, the—now—Secretary of State himself said:

"Labour would end the geographical lottery in community care by setting national eligibility criteria for NHS continuing care".

To date, the Department of Health's contribution to fulfilling that pledge has consisted of intervening with taxpayers' money in the Coughlan case to overturn the court decision and re-establish the legal basis for precisely that

"geographical lottery in community care".

Most laughably of all, in a press release dated 10 March 1997 the current Secretary of State for Culture, Media and Sport told the world that by focusing

"on quality rather than throughput in the NHS we will remove the perverse incentives for hospitals to discharge patients too early".

In office, the Government have sacrificed quality of care and practically everything else on the altar of throughput in an attempt to meet the Prime Minister's waiting list pledge. Far from ending premature discharging, the system of cash bonuses and penalties that they have introduced has encouraged health authorities and trusts to discharge patients early.

Immediately after the general election—in fact, on the first day of the new Parliament—the right hon. Member for Brent, South (Mr. Boateng), then an Under-Secretary at the Department of Health, gave some pointers to the Government's thinking:

"We recognize … the importance that people attach—particularly in their later years—to the home in which they have lived all their lives and which, if they are home owners, they hope to pass on".

He identified at that stage that avoidance of enforced home disposals was a key issue. In the same debate, he said:

"The previous Government … began a process of consultation on insurance provision as a response to the crisis in long-term care … We will not go down that road."

He was ruling out in advance any consideration by the royal commission of an insurance-based solution—a policy that contradicts the later Green Paper on welfare reform—which does not seem to have done his career any harm. However, I was interested to hear the Secretary of State apparently ruling insurance-based solutions back into the equation.

The then Under-Secretary went on:

"For us, consensus on how we provide for our senior citizens … is a critical issue that we do not intend to shirk."—[Official Report, 14 May 1997; Vol. 294, c. 156-58]

Whether he intended it or not, the Government have given a pretty good imitation of shirking. After the setting up of the royal commission in December 1997 and its reporting in slightly more than 12 months, as it was asked to do, nine months have passed during which the listening audience of 10 million pensioners could have heard a pin drop.

Will the hon. Gentleman remind the House of how long it took the then Tory Government to respond to the Audit Commission's 1984 report? Was it not an Act of Parliament of 1990, which then took three years to implement, that represented that response?

What I will remind the hon. Gentleman of is the fact that, at the last general election, the Conservative party presented a specific proposal for starting to deal with problems in long-term care. The then Opposition rubbished that proposal, and promised the public an urgent alternative solution. Here we are, two and a half years later, with 100,000 more homes forcibly sold to pay for long-term care; and what has the Secretary of State told us today? He has told us that we shall have to wait another year for the Government's solution.

The former Secretary of State, who presented the royal commission's report to Parliament, indicated that he agreed about the need for an informed debate on the recommendations. Given that he told us in the same statement that the commission had taken evidence from 400 organisations and received more than 2,000 written submissions, had made more than 100 visits and had met 1,000 individuals—all of which had informed its recommendations—I think we are entitled to ask what further debate will achieve, other than providing the Government with a fig leaf enabling them to reach conclusions that are diametrically opposed to those of the commission.

More experienced hands than me, both inside and outside Parliament, instantly recognised in the call for informed debate Whitehall-speak for "Drive it into the long grass, and hope that it gets lost." Ministerial answers to oral and written questions since then have confirmed that view. Typical was a question posed on 6 July by the hon. Member for Pendle (Mr. Prentice), who humbly inquired when the Secretary of State expected to have concluded the debate. And the answer he received?

"We expect that debate … to be an on-going one".—[Official Report, 6 July 1999; Vol. 334, c. 499W.]

In other words, "Never".

Even more enigmatic was the Prime Minister's reply to a similar question asked by me on 26 July. He told me:

"We are considering the Royal Commission's proposals and the reactions to the Commission's report. We will announce our decisions in due course."—[Official Report, 26 July 1999; Vol. 336, c. 30W.]

That prompts us to ask whose reactions were being considered—those of the hundreds of organisations that have welcomed the commission's principal recommendation with open arms, or those of the Prime Minister's next-door neighbour.

The truth is that the Government set up the royal commission expecting it to propose a low public spending solution. The Government would then have hidden behind the commission's report, and argued that it had weighed the evidence and reached a proper conclusion. Unfortunately for the Government, however, the commission did not play ball.

May I make a point on that very subject of funding? Is my hon. Friend aware of a serious report in today's Times? It states that, according to the Royal College of Nursing,

"many of the 42,000 nursing home residents who pay for all or some of their nursing home costs could be entitled to have the nursing care element of their fees paid".

Furthermore,

"Christine Hancock, general secretary of the RCN, said that the way health authorities used criteria to exclude the vast majority of nursing home residents from long-term NHS care amounted to 'wholesale rationing in the NHS'."

Is that not wholly contrary to what Ministers, including the Prime Minister, have been saying? Unless further funds can be found for the health service, there will be no real solution to the long-term care problem.

I have seen the draft report from the Royal College of Nursing, which will be published tomorrow, and I will shortly deal with the implications of the Coughlan judgment and access to long-term care.

The Government find the report's principal recommendation unacceptable, but they have not had the courage to say so openly. Only the persistence of the grey lobby has prevented the ball from being lost in the long grass—and, if I may say so, only the repeated insistence of Opposition Members has eventually given the House an opportunity to consider the matter.

Is my hon. Friend aware of the recommendations of the Select Committee on Health consequent on the report? It said:

"Failure by the Government to act urgently would be a serious dereliction of duty."

Does my hon. Friend think that there might be anything in the fact that the Select Committee happens to be abroad while we are holding this debate?

The Secretary of State feigns amazement, but my hon. Friend is right. The Health Committee clearly stated that failure to act urgently on the commission's recommendations would be a gross dereliction of duty. I was looking forward to hearing whether the hon. Member for Wakefield (Mr. Hinchliffe), the Committee's Chairman, regards the Government as guilty of that charge. Sadly, as we know, the debate has been timed to ensure that some of the most well informed and interested Members who would have wanted to contribute cannot be here. Most notably, some Labour Back Benchers who are critics of the Government on the issue are not able to take part in the debate. I look forward to a discussion with the hon. Gentleman, when he returns, to find out his view on that issue.

One suspects that the only debate on the royal commission report that really mattered happened long ago in the Treasury and that the conclusion of that debate was clear some time before the public even saw the report. As I have said, one might speculate even that the Secretary of State for Health, then Chief Secretary to the Treasury, would almost certainly have been the one wielding the veto.

Meanwhile—we must never forget the point—each year, some 40,000 home owners whose plight the then Under-Secretary of State, the right hon. Member for Brent, South, so touchingly acknowledged in May 1997, have been forced to sell their homes to pay for long-term care. Another 100,000 homes have been lost as another early pledge gathers dust.

How many people were saved the indignity and distress of selling their homes by the Conservative Government's proposals to increase the limit to £16,000 in the early 1990s?

A number of people will have been saved that indignity and distress by the increase in the limit. It is self-evident that if the thresholds are increased, fewer people will be caught by the trap. At the general election, the previous Government proposed immediate relief—not a total solution to the problem—which the Labour party rejected outright with the promise that it had a comprehensive solution. Two and a half years later, 100,000 homes have been lost and no comprehensive solution is available.

rose—

I allow the hon. Member for Broxtowe to intervene and tell me what the royal commission said about those proposals.

The royal commission said:

"The scheme as presented by the previous Government was rather complex, and it was difficult to see where the benefits lay, and to whom."

I also note that a later paragraph casts considerable doubt on the £40,000 figure.

I wonder whether the hon. Gentleman believes that everything in the royal commission report should be accepted. Is he arguing that all the report's arguments should be accepted by the Government and the House? I do not accept the royal commission's analysis of the previous proposals.

As the hon. Gentleman knows, the private insurance industry feels that it was not given an adequate opportunity to present its ideas to the royal commission. The royal commission rightly observed that private insurance could never be the complete solution. The industry itself has acknowledged that, but it feels that it was not given an adequate opportunity to put the case for a mixed model of private insurance and public provision. Now the Secretary of State has effectively told us that the Government are considering going down the route of private insurance.

The range of options is no different from what was available in May 1997. The only difference is that 100,000 people who could have benefited then from change have already lost their homes. "The debate" is code for delay and indecision, while a private battle rages between the Treasury and the Department of Health over who should take the rap.

The hon. Gentleman appears to be concerned about people losing their homes as a result of the cost of long-term care. I suggest that he refresh his memory as to which party was in power when many long-stay national health service beds were closed and care was transferred from the NHS to local authorities, which marked the beginning of the policies that he is now criticising. I remind him, in case he has forgotten, that it was, of course, the Conservative party.

The hon. Lady is right, but that is not the point that we are discussing. I shall come to the demarcation line between NHS continuing care and social care provided by local authorities in a moment.

I make no apology for concentrating the greater part of my remarks on the Government's inaction in response to the royal commission's principal recommendation, which is about funding. However, the report also deals with other vital issues that remain largely unaddressed as a result of the Government's paralysis over the principal recommendation.

The provision of care—what type of care, what type of choice and who should provide it—is as important as the means of paying for it. I was pleased to hear that the Secretary of State agrees that choice is the key. We must never forget that in discussing long-term care for the elderly we are talking not about statistics or units, but about individual people—and elderly people at that, who almost by definition have clear and precise ideas about what they want and do not want. No single model of care will provide adequately for such a disparate population. It is essential that in structuring a funding system we should seek to stimulate choice and diversity in supply so that provision is responsive to the needs and wants of the individuals who will use it.

There is a consensus across the House that the promotion of domiciliary care—care for people in their own homes—is greatly preferable where practicable. All the surveys show an overwhelming preference among elderly people for staying in their own homes for as long as possible. I was interested in the Secretary of State's announcement on standards for domiciliary care and his allusion to the possibility of a short-term disregard at the beginning of a period of care to avoid what might be termed accidental institutionalisation of people because they needed to leave their homes for a relatively short period. It was disappointing that the Secretary of State had nothing concrete to say on that, even though the press had been speculating that the Government might be able to make an immediate announcement.

The Government have rightly recognised the vital role of voluntary carers in supporting the elderly, among others. How best to support them—whether to provide support directly or through more effective respite provision—is a matter for debate. There is broad consensus that support for carers is not only a moral imperative, but economic common sense, recognising the huge burden of work that they shoulder, unpaid and often unsung. I hope that the Secretary of State will acknowledge that we confirmed to his predecessor our broad support for the initiatives on that.

There has been a significant transformation in recent years, as local authorities have increasingly retreated from the direct provision of accommodation. However, there is still a significant amount of local authority accommodation in the system. We support the Government's proposals, subject to seeing the details, to level the playing field by requiring local authority care homes to meet the same standards as those operated by the independent sector. I should like an assurance that the final standards that the Secretary of State alluded to will be available before the House has to consider the forthcoming Bill on care standards, so that if, as we suspect, the detailed standards are to be introduced by regulation, we might at least have an idea of the standards that are to be imposed later when we consider the principal provisions of the Bill.