On a point of order, Mr. Deputy Speaker. I seek your guidance on the form of our debates, which appear to be causing problems with regard to time keeping. Two weeks ago, at an Adjournment debate involving a Foreign Office subject, at which, I think, the hon. Member for Chesham and Amersham (Mrs. Gillan) was present, a Minister was late, although I emphasise that it was not the Minister of State, Foreign and Commonwealth Office, my hon. Friend the Member for Neath (Mr. Hain), who is never late for debates. As we know, he is always ahead of history and usually ahead of time. At the debate to which I am referring, the Minister of State, Foreign and Commonwealth Office, my hon. Friend the Member for Leicester, East (Mr. Vaz), was entertaining people who were accompanying the Queen of Denmark. There was, alas, a contest between his obligation to be here and his obligations to be polite to reigning European monarchs.

Such events always cause tension for parliamentarians, but they emphasise the need for flexibility in the form of our debates. I know that you will take such matters into consideration, Mr. Deputy Speaker, and I hope that you can give me a ruling on whether some flexibility can be allowed today.

I understand what the hon. Member is saying, but the rules are specific. If, at the appointed time, the hon. Member who is to open the debate is not present, the sitting is suspended until the time at which the next topic is to be discussed. Given that the hon. Member for Ilford, South (Mr. Gapes) is not in the Chamber, I am bound to suspend the sitting until 11.30 am.

An A-Z plan of Surrey would show that my constituency has at its centre, like a giant bull's eye, the intersection of the M25 and M3 motorways. To some extent, the area is dominated by its transport infrastructure. As a district, Runnymede suffers from the problems of economic success, which are, of course, different problems from those of economic failure suffered by other parts of the country, but real none the less. There are tremendous development and land use pressures as well as dominant transport problems. The transport infrastructure, principally the M25 motorway and Heathrow airport, together with the proximity of Runnymede to London, are important drivers of prosperity in the area, but they are also a threat to the quality of life. Our challenge is to achieve the right balance between economic prosperity and the quality of life.

The M25 has been under pressure since it was completed in 1986. The section between junctions 12 and 15 has already been widened to dual four-lane for most of its length and dual five-lane for the other part. The previous Government considered introducing parallel link roads alongside the motorway—three-lane roads, which would ease the pressure on the main motorway and deal with the problem of weaving by removing non-through traffic from what traffic engineers call the main line. Those proposals gave rise to considerable local opposition including that from local Members of Parliament, led by my immediate predecessor. The proposals would have involved a significant additional land take in a green belt area and would have imposed considerable environmental impacts.

In 1995, the previous Government, listening to the concerns expressed by local people, scrapped the proposals for the link roads and put forward an alternative scheme, which would have involved dualling to five lanes the stretch of motorway between junctions 12 and 14, and to six lanes the section between junctions 14 and 15 but, importantly, with no additional land takes. The whole expansion was to take place within the existing curtilage of the motorway. No doubt, the Under-Secretary of State for the Environment, Transport and the Regions will have in her brief today the comments of the then Opposition. In June 1995, the right hon. Member for Hull, East (Mr. Prescott), now the Secretary of State for the Environment, Transport and the Regions, described the proposal as lunacy. When the previous Government went out to consultation in 1996, the hon. Member for Nottingham, North (Mr. Allen), the then Opposition spokesman on transport, described it as "£100 million motorway madness".

In 1995, as a prospective parliamentary candidate new to the area, I recognised the pressures on that section of the M25 and the need for an immediate solution to the bottleneck that it had become. In 1997, I fought the general election on a platform of support for the scheme under which there would be a final widening with no additional land take, of commitment to the environmental benefits as a spin-off for the local community, and, crucially, of the need for longer-term solutions to ensure that there would be no further widening. The Labour party, reckless as ever, clearly implied that it was against the scheme and would scrap it. Indeed, Ian Peacock, the Labour party candidate who stood against me in Runnymede and Weybridge at the general election, said in a public meeting that a Labour Government would scrap the M25 widening scheme on day one. Labour says one thing and does another. That is now familiar to those of us who watch the Government's style, but the public were more gullible then and believed what was said. Perhaps even the candidate believed it; perhaps he is one of the great disillusioned.

As on many other subjects, Labour lied to the electorate in a reckless and unprincipled way in order to be elected. Many disillusioned electors in Egham who voted Labour for the first time in 1997, largely because of this issue, now feel betrayed. Labour came into office in 1997 with what my constituents thought was a clearly stated position on the M25 widening programme, but it did not announce the scheme's scrapping on day one. Instead, it put it into a review, which is new Labour-speak for a cold store for difficult decisions. After review, it was put into a further review, and on 31 July 1998—the last day of the parliamentary Session—a newly appointed Minister for Transport announced a 180 deg U-turn and confirmed that the scheme would go ahead.

It is curious that, on the same day, the Department of the Environment, Transport and the Regions published a document entitled "M25 London orbital motorway: the future strategy". Among other things, the document stated:

Building our way out of congestion on the M25 is not an option. That kind of thinking leads to 14-lane monster highways which simply fill up with traffic within a few years. The Government totally reject that approach.

So much for integrated transport policy. There is no sign of coherent thinking, even between two announcements on the same day by the same Department.

Why did the Government decide to make the U-turn? The official answer was that the congestion problems on that section of the M25 were "immediate and acute" and had "a broader economic impact". As for immediacy and acuteness, the building work will not start until 2002–03 and will take two years, so something that was "immediate and acute" in 1998 will take at least seven and possibly eight years.

Local cynics suspect that "the broader economic impact" is a reference to terminal 5, but the Government have always denied that. Terminal 5 will access the motorway via a spur road from the planned dual six-lane section. It has not gone unnoticed among my constituents that some of the greatest advocates of terminal 5 have been ardent enthusiasts for the Government's other great building project at Greenwich. There is a strong belief locally that the Government have already decided the outcome of the terminal 5 inquiry, and that the decision to widen is to facilitate terminal 5 and create a scenario in which the inspector at the inquiry cannot use traffic as grounds to recommend refusing the terminal.

An interesting exchange took place during the inquiry, when a witness from the Highways Agency said that its position was that there would be no terminal 5 if there were no M25 widening. The inspector said:

You are effectively saying that T5 depends not merely upon the spur but upon a widened M25.

The official replied:

Yes, I think that that is the department's position, sir.

When the inspector asked:

How do I report the department's position? Have I got to tell the Secretary of State that T5 should be permitted only if and when there is a guarantee for M25 widening?

the official responded:

Yes, I think that that is the position, with respect, sir, that you find yourself in as of today.

In July 1998, the Government resolved that problem for the inspector by confirming the scheme. In November 1998, the then Minister of Transport, now the Secretary of State for Scotland, told me on the Floor of the House that terminal 5 was in no way taken into account in any of the deliberations in arriving at the widening decision. That is an astonishing suggestion for a major infrastructure decision, and it has little credibility among my constituents.

We were told in the summer of 1998 that the widening had to go ahead because of an immediate, acute need, but it will not be in place until seven or eight years after that date. Coincidentally, that is around the same time that the construction of terminal 5 will be under way—if, as I am confident will happen, the Secretary of State for the Environment, Transport and the Regions approves its construction, following the inquiry's completion.

As far as my constituents and I are concerned, the contract has not been let or even informally discussed. We do not know whether it will be a contract to design, build, finance and operate, or some other form. Suspicion exists that the Government are delaying widening that section of the M25 in order to link it explicitly to consent for terminal 5, and to squeeze BAA for a substantial financial contribution to the costs of widening. Such suspicions abound in my constituency and it is time for the Government to approach the problem with some openness so that we know exactly what is going on.

I am opposed in principle neither to widening the M25 within the existing motorway boundary nor to constructing terminal 5. However, in both cases I expect local communities to be given substantial environmental benefits as a quid pro quo for playing host to major pieces of national infrastructure. In the case of terminal 5, those benefits will most importantly include ending early-morning flight arrivals, for which there will be no justification once the terminal is built. I shall later detail the benefits that my constituents expect in relation to M25 widening, as some compensation for having it imposed on them.

I am not opposed to those two projects, but I am opposed to a Government who say one thing and do another by recklessly pandering before an election to lobby groups—whether they are campaigning against the building of roads, or for animal rights or human rights abroad—only to abandon them cynically afterwards. All those groups, and many others, were exploited by the Labour party in its lunge for office in 1997, then abandoned once they had served its purpose. I can speak for campaigners in my constituency who opposed widening of the M25, and I assure the Minister—should she be in any doubt about it—that they have long and bitter memories of the treatment that they received at the hands of new Labour.

Nearly three years into the Government's term of office, there has been a complete U-turn on the widening of the M25—the building will not start for another two or three years and the jams continue. There is a denial, which no one believes locally, of any link to the terminal 5 project. There is no sign from the Government of any serious, longer-term solution to pressure on the M25 that would avoid the demand for further widening in future. However, while Labour's deceit still rings in my constituents' ears, we need to move on to fight the next battle. The Government's only real action in the so-called management of the transport problem has been a vicious, swingeing increase in taxation of the motorist, with no effective alternative transport proposal, at least in the suburban areas of the M25.

I wish to focus on that huge pot of billions of pounds of additional tax money that the Government have confiscated from motorists. I want some of the money to be used to reduce the environmental impact on communities that include major transport facilities and I seek a commitment from the Minister that the Government will spend some of it on appropriate solutions to transport problems, even if they are more costly. Motorists are paying for their necessary but sometimes anti-social activity. Let us at least ensure that their money helps minimise the impact that they make on others.

The technology of road surfaces has developed dramatically in recent years. Quieter surfaces have been in use on the continent for some time and have finally been accepted and used by the Highways Agency. However, the Government's announcement last year of a £5 million noise mitigation fund is ludicrously inadequate. The new surfaces are obviously more expensive, but they are quieter, quicker to lay which means less disruption to motorists when repairs are required—and have better skid resistance and, in some cases, better spray characteristics. Those surfaces should always be used on trunk roads. Motorists should pay, and it is certain under this Government that they will.

I should like the Minister to specify a definite time scale for the start of the work to widen the M25. When will the work start, and when will the tender be published? I should like an assurance not only that porous asphalt or a similar surface will be used, which I believe we have already received, but that the contract will include a noise specification that represents the best technology available at the time, that there will be full transparency in arriving at that specification and that there will be proper consultation to reassure the local community and the local authorities involved.

I should also like an assurance that where the motorway passes through residential areas, especially in Egham and Thorpe, the most effective sound barriers will be used, and that before the contract is let the specification will be published in draft form for consultation, either as a performance specification or as a build specification. I am not specifically asking that sound-absorbent barriers be used, because I realise that the choice involved may be more complex than simply absorbent versus reflective. However, I should like an assurance from the Minister that effectiveness, not cost, will be the determining factor, because the cost of sound barriers is a trivial component of the total cost of the scheme. I should also like an assurance from the Minister that details of the contract and the performance specification will be made publicly available so that my constituents and the local authorities in my area can discuss them openly and transparently.

I recognise that such measures will be expensive, but, as the Government have ensured, the motorist will pay. If my constituents are to be asked to host an expanded piece of motorway infrastructure, and if the motorists using it are to be asked to pay through the nose for the privilege, the least that they can jointly ask of the Government is that the financial pain felt by the latter is applied at least in part to reduce the environmental pain suffered by the former.

I should like an assurance from the Minister on those matters not only for my constituents in Runnymede, but in the interests of communities everywhere and of responsible motorists who acccept the impact that transport infrastructure makes and would like some of their taxes used to mitigate that impact on the communities through which they pass on their journeys.

As is usual, I congratulate the hon. Member for Runnymede and Weybridge (Mr. Hammond) on securing the debate. I thought that he would take the opportunity to use the maximum time possible to discuss the possible effects of a major scheme on his constituents and use the time productively to discuss how to minimise those effects. However, he wasted his Adjournment debate time by making yet another empty political gesture that bears little relation to the needs of the area, with only a quick run-through right at the end of his speech of the major issues involved, about which people who live locally are worried. I shall discuss those issues in my response.

As the hon. Gentleman is aware, the M25 London orbital road is a key part of our motorway network, as well as a London outer ring road. It is effective in keeping lorries and other long-distance traffic out of London, and is one of the busiest motorways in Europe. As he said, pressure on the M25 is all too evident, especially at peak periods. All parties are united that something must be done, especially during peak periods.

In our 1998 White Paper entitled "A New Deal for Trunk Roads in England", we announced a programme of 37 schemes for the following seven years and a series of multi-modal and roads-based studies. We also announced our refocused investment priorities for the trunk road network—to give priority to maintenance, make better use of existing roads and tackle some of the most serious problems through a carefully targeted programme of improvements. We have viewed the problems of the M25 in that context since we came to office.

The Highways Agency has been charged with developing sustainable solutions to be used wherever possible as an alternative to building new roads. Building our way out of congestion on the M25 is not an option. Such thinking would lead to a 14-lane highway, which would fill up with traffic in the next few years. The objective is therefore to develop a long-term management strategy for the motorway that embraces all modes of transport, changes in land use and interaction with local transport networks to secure safe and efficient operation in an environmentally acceptable way. That is what distinguishes our proposals from those of the previous Government.

The cornerstone of the Government's transport policy for road users seems to be to increase tax. What estimate has the Minister's Department made of the impact of the tax increases on motorists announced so far on peak-hour usage of the M25 between junctions 12 and 15?

I cannot tell the hon. Gentleman that in this debate, but I shall write to him. I am dealing now with proposals for M25 widening and the hon. Gentleman's allegations, particularly on an alleged Government U-turn.

The problems between junctions 12 and 15 are acute. Maximum capacity has been squeezed from this section by traffic management techniques. Controlled motorway operation has helped to smooth flows and reduce accidents, but there are still stop-start driving conditions for many hours on most days. More capacity is needed to provide the necessary headroom to evaluate other measures at this location and to allow a breathing space while wider, integrated transport policies take effect.

A scheme to improve this section of the motorway entered the roads programme in 1989, as the hon. Gentleman said. The scheme that we are discussing today would widen the M25 to five lanes in each direction between junctions 12 and 14 and to six lanes in each direction between junctions 14 and 15, within the existing highway boundary.

The hon. Gentleman has made much of statements made on the previous scheme by my right hon. Friend the Secretary of State for the Environment, Transport and the Regions, when he was in opposition, and of subsequent U-turns. An environmental impact assessment was published in 1996, and public exhibitions were held. Representations were then made by individuals, local authorities and statutory and representative bodies, all of which the Government considered when we came to power in 1997. We announced that we would review the roads programme that we had inherited against the criteria of accessibility, safety, economy, environment and integration. We listened to all the views that were expressed during that period. We concluded that additional capacity was needed where the amount of traffic was causing severe congestion at times and threatening jobs and prosperity over a wide area. We felt that widening should be a key part of a long-term strategy for managing traffic on the M25.

The hon. Gentleman talks about the previous Government's attitude and action—or inaction—in putting forward what would have been a disastrous scheme, but withdrawing it following representations, particularly from local people. Yet he calls it a U-turn when the Government try to implement the environmental impact assessment by producing a much improved widening scheme, having listened to the views that have been expressed—including his own—that the scheme should go ahead. He accuses us of lying and of U-turns, when what we have done is not dissimilar to what the previous Government did: we have listened to people. The difference between us and the previous Government is that we are proceeding with a necessary scheme that will mitigate the effects that local people are concerned about and provide a sustainable future for the M25 and the surrounding area.

With respect, the difference is that the Labour party's official candidate told public meetings during the 1997 general election campaign that a Labour Government would scrap the scheme on day one. That did not happen, and my constituents feel that they have been misled. In the light of her defence of the Government's views on this matter, will the Under-Secretary accept and invitation to address a public meeting in Egham, at which she can express those views and judge for herself local people's attitudes towards them?

The contorted positions that the hon. Gentleman is obliged to adopt on this matter defy belief. A Labour party prospective parliamentary candidate is not a member of the Government, so it is absolute nonsense to accuse the Government of making a U-turn in respect of something said by such a candidate, and the hon. Gentleman knows it. As I made clear, we undertook a review on taking office. We responded to the views of local people and people such as the hon. Gentleman, who support the scheme, so I find his contortions incredible. I shall mention his point about a public meeting to my colleagues, who will doubtless respond.

On terminal 5, the hon. Gentleman should be in no doubt that the Government's proposed widening scheme would go ahead in any case. That is made clear by road congestion assessments that have been in the public domain for a long time. We have sensibly decided to put on hold the start date, which is now planned for 2002–03, when the decision on terminal 5 and the potential need for a spur road will be known. Unlike the previous Government, we are planning sensibly. It would be nonsense to begin major road works now, only to discover that we must revise the building and construction schedule and add the spur road to a section that has already been widened. The hon. Gentleman prefers to deal in the currency of political chicanery, and accuses the Government of duplicity. However, as any straightforward person can see, we are approaching two major building projects in a sensible way and making sure that their time scales are co-ordinated and additional problems not created.

One of the main subjects for debate should have been the potential impact of construction work and widening on people who live in the area. However, and doubtless to the regret of many of his constituents, the hon. Gentleman chose not to focus on those important questions because he was more interested in making cheap political capital from his time in this Chamber. We have made a thorough assessment of the impact of traffic noise, air quality, motorway lighting and so on. Traffic noise is a major concern, and the hon. Gentleman knows that we plan to use porous asphalt throughout the scheme. It provides a quieter road surface, and will ensure that, notwithstanding the increase in traffic, householders will experience no more motorway noise in 2010 than they do at the moment. Porous asphalt will reduce noise levels experienced by about 850 of the 1,100 householders who live near the motorway. The scheme will provide a significant overall benefit in terms of noise, air and water quality, lighting and landscaping.

The hon. Gentleman has missed an opportunity. He has failed to raise issues that are of most concern to his constituents.

I am grateful to have an opportunity to discuss the funding of Barnsley district health authority, which is of great concern to many of my constituents and to parliamentary colleagues in this Chamber this morning. I want to concentrate on what appears to be the low level of funding allocated to Barnsley district health authority, in contrast to the area's needs. That is not a new issue; it has not arisen overnight, this year, or recently. It has been of concern for many years, so it is not an issue for which this Government alone must take responsibility. Barnsley has been for many years one of the lowest funded health authorities in the whole country. I am probably right to say that, for a considerable period, we were the lowest funded health authority in the country, despite greater health problems and inequalities than many other areas, especially those in close proximity with similar problems. Barnsley's history at the centre of the Yorkshire coalfield has left a legacy of disability. A large proportion of households in Barnsley borough about one in three—have one member of the family with a disability. Other acute needs are also made worse by the funding shortfall.

I want to consider funding in some detail. It is a complicated issue, which I do not profess fully to understand. I shall keep the figure as simple as possible. As hon. Members will probably be aware, health authority funding is expressed as an actual figure, in terms of money available, and as what is known as a percentage from target. For example, the target figure is usually expressed as 100, so the percentage figure is above or below 100 depending on whether there is underfunding or overfunding for the particular health authority. Barnsley is consistently underfunded. In 1997–98, Barnsley's percentage figure below target was 97.37 per cent., while in 1998–99 it fell to 94.76 per cent. In 1999–2000, the figure rose to 97.02 per cent. However funding for the forthcoming financial year–2000–01—is a decrease to 96.89 per cent.

It appears that Barnsley is falling further and further away from the target funding of 100 per cent. The figure of 96.89 per cent. makes Barnsley the worst-funded health authority in the Trent regional authority, which comprises 11 others. However, according to the indicators used by Trent regional authority—morbidity, coronary heart disease, cancer, stroke and other indicators—Barnsley has the worst problems in Trent. We have what I perceive as the greatest need, but we appear to be falling behind in relation to funding.

I said earlier that the problem has persisted for several years and that the present Government should not bear sole responsibility for the funding that is available. For the forthcoming financial year 2000-01, Barnsley's funding allocation is £168.14 million. That involves a cash uplift of 7.62 per cent., which compares favourably with a national average of 6.78 per cent. and which is the highest cash uplift in the Trent region. However, in relation to authority funding in the Trent region, Barnsley is still at the bottom of the pile, and we are moving further away from the target funding. We are one of the lowest-funded health authorities in the country. We are in a sorry position—we cannot find solutions to the problems that we have identified, let alone attempt to pursue health prevention initiatives that involve, for example, changes in life style and diet.

The situation was highlighted on national television recently, and that coverage was discussed in our local press. We witnessed the unfortunate headline "Barnsley on the sick list". The article stated:

Barnsley was today named as the worst health authority in South Yorkshire.

The first league table marking performance was based on death rates from cancer and heart disease… and deaths from "avoidable" diseases such as TB and asthma.

Barnsley was ranked 102 out of 120… Experts said the league table showed that some of the country's most deprived areas had the worst healthcare provision.

That is our problem—we are one of the most deprived areas but our health care provision is one of the poorest in the country. We do not seem to be able to access the funding that we need to correct the situation.

The report of the health authority finance officer, which was submitted to the health authority on 22 February, highlights some of Barnsley's problems. The report stated that following the financial settlement:

The forecast year end outturn… showed a projected underspending of £195,900 compared with the previously predicted significant overspend.

That forecast outturn has been improved because an "additional allocation of £736,000" had been made available

to the Authority in respect of generic prescribing and the identification of further sum of £421,000 of further slippage within the reserves… The forecast year end outturn took no account of the £800,000 borrowings which the Authority had been required to negotiate and which would form a first charge on its allocation for 2000–01.

That means that the authority has a year-end deficit of about £1.2 million.

We have gone from facing a considerable overspend to facing an underspend of £200,000, although there is a first charge of £800,000 on the authority's funding, and £400,000 has been taken from the reserves. The health authority's funding involves a deficit of £1.2 million for this year end. Why does Barnsley health authority have an underspend of £200,000 at the end of the current financial year when in reality it faces a considerable deficit?

I raised the issue of deprivation and health need in Barnsley when I met the chief executive of Trent regional health authority last year. The indicators and statistics that the authority uses were beginning to show Barnsley in a very poor light in terms of various categories of health provision—consistently the worst of the 11 authorities in the Trent regional health authority area. I have already referred to the television survey that ranked us 102nd nationwide.

Of the 11 authorities, Barnsley has the worst level of morbidity, in respect of every cause of death, for people under the age of 65. It has the worst record for lung cancer, cervical cancer, hypertensive and cerebrovascular disease and coronary heart disease, and for the early detection of cervical cancer and inappropriate surgery in respect of children's glue ear. Looking at that list, it is easy to see where Barnsley's problems lie, and the difficulties that it faces. I have referred only to the categories in which Barnsley has the worst record. Categories in which it is second worst include colon cancer and suicide, and the list goes on.

To make matters worse, there is only a narrow gap, in terms of health provision, between the best and worst areas of Barnsley. That suggests that problems extend throughout the borough; no area is better or worse than any other, and the situation is poor across the whole health authority area. I should point out that that is not the fault of the local hospital. A recent headline in the local newspaper, headlined "Praise for hospital", states:

Hospital bosses in Barnsley have been praised for bucking a national trend by rarely cancelling operations.

The health authority staff at the hospital have recently been singled out for substantial praise.

It is clear from the establishment of the South Yorkshire coalfields health action zone that some of Barnsley's problems have been recognised. Given the priorities that will be addressed by the action zone, I hope that the position can gradually be alleviated by encouraging people to improve their life style by changing their diet and so on. The question of low incomes and deprivation is a different kettle of fish, which can be addressed only by better economic performance in the longer term.

When I raised the matter with the director of Trent regional health authority last year, I pointed out that Barnsley is an area of extreme need in terms of health provision; it has a poor record and the least amount of money. He replied that the people of Barnsley have low aspirations and are reluctant to complain. I suggested to him that if I start to tub-thump and shout about it, his budget situation will deteriorate, because I will make people aware of the situation that they face and the fact that they should be demanding more from their health authority, but the money is not available. He was inclined to agree, which surprised me. More should be done to equalise funding across Trent regional health authority to try to alleviate Barnsley's problems.

I shall refer to a couple of other problems that Barnsley faces. We have recently lost accreditation for an ear, nose and throat surgeon because we could not provide sufficient training opportunities for junior doctors and we contravened the rules on junior doctors' hours. We are also facing accreditation problems with orthodontic surgery, orthopaedic surgery, dermatology and general surgery.

There are major problems throughout the area with the prescribing of wrong drugs and too many drugs. Problems will also arise with the reconfiguration of health authorities in Barnsley, but they do not concern funding and I do not expect the Minister to respond to them today. I hope that any attempt to reconfigure the health trusts in Barnsley will not disguise the fact that our funding is low, but I have considerable reservations about that reconfiguration.

I refer the Minister to a letter that I received recently from the Barnsley local medical committee of general practitioners. There is an air of desperation in the letter which refers to funding being badged for various purposes but schemes and areas in Barnsley being desperately in need of development with no funding to allow diabetic and cardiology services, both of which are Government priorities, to be pursued. Dr. Kenneth McDonald, secretary of the committee, concludes his letter by stating:

It feels very much as if we are being penalised for achieving financial probity in an area where there is a large amount of socio-economic deficit leading to considerable medical problems that as GPs we are very keen to address, but are hamstrung due to funding deficit.

I look forward to the Minister's response and hope that she can give me some hope for the future.

I thank my hon. Friend the Member for Barnsley, Central (Mr. Illsley) and congratulate him on raising the debate on the funding settlement for Barnsley. My ministerial colleagues and I are aware of local concerns about past and current funding for the district. His constituents will be aware of his hard work and that of his colleagues in Barnsley to ensure that the area receives better health care facilities in future.

We have backed our commitment to the national health service with significant additional resources for the NHS in England of £1.9 billion during our first two years in government and, from the comprehensive spending review, almost £18 billion during the next three years. That represents the largest ever cash injection into the NHS.

In December, my right hon. Friend the Secretary of State for Health announced total funding of £34 billion for England's health authorities for 2000–01. That represents an average cash increase of 6.8 per cent., which is a rise of 4.2 per cent. in real terms. Those resources are additional money for modernisation and to help to create the fast, fair and convenient health services that people expect. They will also tackle health inequalities, which my hon. Friend described so clearly in relation to Barnsley.

I want to make a couple of points about the way in which we allocate resources nationally before turning to my hon. Friend's specific points about Barnsley. Funding is allocated to health authorities on the basis of the relative needs of their population. A weighted capitation formula is used to determine each authority's target fair share of resources so that similar levels of health services can be commissioned for populations with similar needs. The previous Government took account of the indices of need to the extent of only 80 per cent. when using the weighted capitation formula. The present Government, on the advice of the resource allocation group, increased the weighting in the formula to 100 per cent., increasing the account taken of deprivation because we want to tackle health inequality. That has already made a significant difference in Barnsley. The result was an additional £1.3 million added to Barnsley's target in 1998–99. We also need to make progress towards that target, which is exactly what we have been doing during the past few years.

The weighted capitation formula is used to set the targets, which then inform the allocations. It depends on factors such as additional need indices, which contain health and socio-economic variables. It is based mainly on work by York university to investigate the link between social and economic circumstances and the use of national health service in-patient services. The formula itself does not determine allocations. Actual allocations reflect decisions on the speed at which health authorities are brought nearer to targets, through the distribution of extra funds. The pace of change is decided annually—by Ministers for health authorities, and by health authorities for primary care groups. The key decision in pace-of-change policy is how extra resources should be deployed between across-the-board increases to maintain continuity and stability and differential distribution to bring under-target health authorities such as Barnsley closer to their target allocation.

To satisfy those objectives, all health authorities have in recent years been given real terms growth. The additional funding has been distributed to target those health authorities that are furthest from their fair distribution of resources. All health authorities were given a minimum cash increase of 6.2 per cent. for 2000–01. To supply the extra resources needed by under-target health authorities, the average cash uplift was 6.8 per cent., although the highest cash increase allocated to under-target authorities was 8.5 per cent.

My hon. Friend was right to say that, as a result of decisions made by the previous Government, Barnsley district health authority started well below its fair share of resources. To bring Barnsley up towards its fair share, it is receiving above average increases each year. Its allocation per head is £719 per person, compared with an average per head, across the country, of £675 per person. Barnsley therefore receives more per person than the average.

As my hon. Friend and I agree, that is not the right way to make the comparison. Once health needs are taken account of, Barnsley has not been given its fair share. Under the previous Government, the formula did not fully reflect deprivation. We have made progress towards the target with an increase of 7.8 per cent. this year, compared with a 6.6 per cent. average increase. In 2000–01, there will be a 7.6 per cent. increase, compared with a national average increase of 6.8 per cent. As my hon. Friend mentioned, that is the highest increase in the Trent region. He is right to say that we need to go further, and sustain above average increases in future for the population of Barnsley.

My hon. Friend mentioned the growth in the percentage gap between the actual position and the target in 1999–2000 and 2000–01. In fact, that reflects an accounting change, rather than a change in resources for services. As he is aware, Barnsley has had above average increases, but there has been a technical change to the baseline because of a revaluation of the NHS estate. The baseline for Barnsley, as a result of that revaluation of capital and estate, is lower. That is not because of lower resources for services, or additional resources for services for other areas. It is simply about a revaluation of the baseline. That makes clear Barnsley's continued need for above average increases in future. Those increases must be sustained to tackle the health inequalities that he mentioned.

Concerns have been expressed about how well the current formula matches NHS cash to health need. A new formula is required that reflects the way in which the new NHS is managed and uses resources. The Advisory Committee on Resource Allocation is currently overseeing a wide-ranging review of the formula. The review is in its early stages. We expect a progress report, which is a major undertaking, in about a year. We have therefore frozen the current formula to maximise stability and certainty for health authorities, while the review takes place.

My hon. Friend referred to Barnsley health authority's financial position. I am aware that at the end of January 2000 it forecast a small deficit of £315,000 and that it expects to carry an underlying deficit into the next financial year, as a result of GP prescribing and mental health out-of-area placements. The additional cash uplift for 2000–01 will contribute significantly to reducing that deficit, but I understand my hon. Friend's concern. The health community is in continual discussion about its financial position and is endeavouring to bridge the gap without falling short of service targets. The outcome of its work will be discussed with the Trent regional office of the NHS executive in early March.

My hon. Friend correctly identified prescribing as one element in Barnsley's financial situation. That will be a key issue for the health authority next year as well. As for all other health authorities, the price increases in generic medicines last year caused a major problem, although it has been mitigated in the current financial year by an additional allocation to Barnsley of £736,000.

My hon. Friend is aware that Barnsley's prescribing performance has not been of the highest standard. I share his concern that, in three of the Audit Commission's four indicators for prescribing performance, Barnsley ranks the lowest in England. The reasons for the poor performance are complex and reflect Barnsley's long-standing problems with the provision of primary care.

A range of actions has been put in place to tackle poor prescribing performance. The health authority has allocated resources to employ prescribing support to pharmacists in both its primary care groups. The pharmacists will work with the PCGs and individual practices to promote more cost-effective prescribing.

Among the health authority's targets for improved prescribing performance is a 25 per cent. reduction in benzodiazepine prescribing and a 7 per cent. increase in generic prescribing in 2000–01. A reduction in benzodiazepine prescribing is strongly desirable on clinical grounds, as there is broad consensus that its use should be kept to a minimum. The Trent regional office of the NHS executive is monitoring the health authority closely to ensure progress on these issues.

However, my hon. Friend will be aware that Barnsley's difficulties require more than simply a fair funding formula. We must modernise services and tackle the root causes of ill health. In July 1997 my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) invited Sir Donald Acheson, a former chief medical officer, to undertake a review of health inequalities in Britain. That report was a landmark that placed health inequalities firmly on the national agenda. It covered their deep-rooted causes, not only the upstream causes such as poverty, unemployment, low skills and poor housing but the downstream causes such as smoking, diet and exercise. My right hon. Friend was right to point to the higher mortality rates in Barnsley. Although death rates from coronary heart disease are declining, there is an upward trend in suicides.

The Government are committed to reducing those inequalities by taking action on a broad front: the minimum wage will help those on low incomes, and the working families tax credit and increases in child benefit will help to counter poverty. We shall also deal with poor housing and the broader coalfield issues that my constituency shares with my hon. Friend's. We also want to tackle directly some of the downstream causes of health inequalities, particularly in coalfield areas and in Barnsley.

My hon. Friend is aware that Barnsley, Rotherham and Doncaster comprise the South Yorkshire coalfields health action zone. Indeed, it was one of the first wave of HAZs launched in 1998 to tackle health inequalities in an area ravaged by pit closures and industrial decline. The HAZs are testimony to our determination not simply to look at the funding formula for the services provided to people once they have become ill but to tackle the root causes of ill health in areas like Barnsley. In its first year, the coalfields health action zone received additional funding of £520,000 from the main programme; in the current year, it has received £3.3 million as well as £100,000 in development money. Barnsley's share has been £918,000, which will enable it to put in place a range of initiatives to tackle the root causes of ill health.

I understand my hon. Friend's concerns about resources in Barnsley. The Government are working to tackle such health inequalities by increasing the fair-funding formula that is distributing more resources to Barnsley, by giving additional resources for health promotion and the prevention of ill health through health action zones, and by modernising health services.

Order.

I am grateful for the opportunity to introduce a debate that will last for half an hour, which was the time taken by the BBC Radio 4 programme "Face the Facts" yesterday evening to set out the case of Ruth Wyner and John Brock. I shall not refer to the broadcast in detail, as I hope that the BBC will put a transcript of the programme on its website, but I wish to pay tribute to the hon. Member for Cambridge (Mrs. Campbell) who was quoted in the programme.

I shall not go into detail about the conviction and sentence of Ruth Wyner or John Brock, the manager and the director of the Wintercomfort project in Cambridge. They have been granted leave to appeal against their sentences. To discuss their conviction would be to tread on the borderline of what it is appropriate to refer to in this Chamber. I wish to declare two interests: first, my brother-in-law, Dr. George Reid, senior bursar at St. John's college, Cambridge is a trustee of Wintercomfort. Secondly, before becoming a junior Minister in 1984, I was the chairman of the Church of England Children's Society, which ran 100 projects that were mostly to do with vulnerable young people. The society continues that work and when I asked its director, Ian Sparks, to describe the policy before the start of this debate, he replied, "Risk minimisation."

Obviously, there are people in jail who are drug misusers. Ministerial replies have informed me that drugs were misused in prisons about 18,000 times last year. The Prime Minister said to me in an oral answer two weeks ago that the proportion of prisoners involved in the misuse of drugs had fallen from more than 20 per cent. to below 20 per cent. I pay tribute to those in the Prison Service who, since 1995, have been making progress. The problem has not been swept under the carpet; it is being recognised. I pay tribute, too, to the Select Committee on Home Affairs, which covered the misuse of drugs in prisons in a report published in November. I hope that the report has drawn a reasonable response from the Government. I suspect, however, that the Government have already responded to the Committee and that the Committee will publish its response to the Government shortly.

The Home Affairs Committee dealt with the importance of tackling drugs misuse in prisons. I shall illustrate the scale of the problem. Last year, people were detected as misusing drugs in Highpoint prison more than 100 times, while the actual supply of drugs was detected on only seven occasions. For every 20 times that people are known to be misusing drugs, those who supply them will be caught only once. Catching suppliers of drugs is not easy, even in a prison that is under total control. The point of people being in prison is that they do not break the law, yet at Highpoint, as an illustration of other prisons, there is an obvious problem. The Home Affairs Committee recommended the use of sniffer dogs, both for visitors and for those making random visits around the prisons.

I commend the fifth report of the Home Affairs Committee. Paragraph 175 on page lvi refers to the need to ensure that Prison Service treatment projects and programmes sufficiently involve outside agencies and expertise. I recommend that the Government ensure that Ruth Wyner and John Brock are released from prison and that they use them as advisers. Those two people have 30 years of experience of dealing with people who are vulnerable and on the streets. In the overall spectrum, Home Office Ministers are supposed to have total control over prisoners. Those who run hostels have some control over their residents. Those who operate day centres such as the Bus project run by Wintercomfort in Cambridge have virtually no control, except for the opportunity to ban. Similar projects can be found in Worthing, in West Sussex, and around the country.

I will not mention what the judge said about sentencing, because that can come before a higher court. However, an organisation with decent guidelines which its employees follow, and which are known to the police, is an example of the expertise that underlies the recommendation of the Home Affairs Committee. It said that the anti-drugs strategy could be derailed if steps were not taken to ensure that there was an adequate pool of drugs workers and agencies in the community, to assist in the development of prison programmes and to provide the vital aftercare for released prisoners.

By misuse of drugs, I refer not to the use of alcohol or cigarettes, which I covered to some extent during the Adjournment debate that I initiated on 13 May 1998, and which can be found at column 291 of Hansard, but to the conventional meaning. When people are on the streets and are drug misusers, they are vulnerable. I will deal not with the crimes that they commit, but with their vulnerability. Where is their contact with medical services? Where is their contact with those who can involve them in risk minimisation? For example, where do they start to learn about moving from heavy drugs to light drugs? Where do they learn to go from the multiple use of needles to using a needle just by themselves? How do they reduce from misusing drugs seven times a week to twice a week, on the way to being clean, as some young people did when I was involved in such work? Few people go in one jump from being a drug misuser to not misusing drugs at all.

It is probably recognised that more people leave prison addicted to drugs than go in addicted. I hope that that is changing. The previous Government took that seriously, as do the present Government. The Minister, whom I am glad to see here today, and his colleagues in the Home Office and in other Departments have spoken well on this issue. I hope that the Minister does not mind responding to the debate today.

I will now refer to the debates on what became section 8 of the Misuse of Drugs Act 1971 when it was going through the House and another place. The Act followed the legislation of the 1920s, the Dangerous Drugs Act 1965 and the Bill introduced by the Labour Government in early 1970, and continued with the Conservative Government after the general election in 1970. In Committee—I forget whether it was in the other place or in the House—people said that prison governors were vulnerable to prosecution, because section 8 applies to those who manage, not to the ordinary worker. There were explicit references to the risks to prison governors and, I think, to Ministers. If there were no references to Ministers, I make them now, because both they and prison governors are as vulnerable as Ruth Wyner and John Brock.

I cannot believe that Parliament intended Ministers to find themselves in front of a judge in King's Lynn, charged with the same apparent offence as Ruth Wyner and John Brock. I recommend to Ministers that they set out a policy similar to Wintercomfort's, and I am grateful for the advice given to me about the matter. Prisons do not run drop-in centres, but their employees may work in good faith and to the best of their abilities, after seeking the advice of the police and setting up an advisory committee. Wintercomfort and the Bus project certainly did that.

Despite the reliance that the Prison Service may put on its advisory committees or its links to the police, its employees or those who manage prisons on its behalf could be subject to proceedings without any warning, in the same way as those who run day centres. The law could apply to any day centre or hostel in the country, or to those who administer university lodgings.

I suspect—but I have not yet found out whether it is the case—that a confidentiality policy would apply if someone in prison said, "Look, I have a drugs problem, can I get confidential help?" The Minister may not deal with that today, but it applies to those who run hostels or day centres. There must be confidence between the people running an organisation and those who ask for its help. That applies to the staff of charities, and I suspect that it also applies in prisons.

It is also important that people comply with the law. I suspect that some people in prison, if they were consulted confidentially, would not share information unless there were a court order. Let us remember that there was no court order in relation to Wintercomfort. It is for Parliament to make the duties of prison staff, prison governors and Ministers clear, just as we should make clear the position of charity workers, so that there is no ambiguity. I cannot believe that, either in day centres or prisons, those who need help are refused it. It is not consistent with a civilised society that people who run projects in day centres or prisons to the best of their abilities, who do not connive in or profit from the supply of drugs and who do not pursue any political agenda should be imprisoned for sentences of draconian lengths—or at all—for simply doing their jobs. The response from ordinary people is epitomised by an email that Mike and Mary Evans sent to the Home Secretary after listening to the "Face the Facts" programme last night. They were disturbed by the case and say that, when people are

part of the solution to the drugs problem,

but are

treated as though they are the problem,

something is wrong. It is for Parliament to raise the issue.

I have focused the debate on prisons and other centres of drug misuse, because in the whole Prison Service in the first 11 months of 1999, prison staff were prosecuted in relation to the supply of drugs on three occasions. Hon. Members and those who work in this field, in prisons and elsewhere, should not rest until there is justice, and that applies in prisons and day centres.

Does the hon. Member for Cambridge (Mrs. Campbell) have the Minister's permission to speak?

Yes, Madam Deputy Speaker.

I congratulate the hon. Member for Worthing, West (Mr. Bottomley) on securing the debate. It is timely, and I have a great constituency interest in the matter. I agree that we must do everything possible to reduce the use of drugs in prisons and, if possible, eliminate it.

It may help my right hon. Friend the Minister if I describe my experience of visiting my constituent, Ruth Wyner, in Highpoint prison three weeks ago. I was searched and put through the full procedure before I entered the prison. Sniffer dogs were in evidence and I assume that, if I had been carrying any contraband material, they would have picked that up as I went into the prison. What perturbed me was the fact that, after I left the prison, Ruth Wyner was, I understand, strip-searched. I do not know whether that was meant as ritual humiliation or whether there was a necessary purpose behind it. If my understanding is correct and she was strip-searched, was she being treated differently from other prisoners? Did prison officers consider that they had a well-founded suspicion that I had covertly passed her contraband material in breach of prison regulations? If not, what was their purpose?

The hon. Member for Worthing, West carefully enunciated the policy of Wintercomfort and the confidentiality agreement, which was a reason why my constituent was arrested and convicted. It may be interesting to know that Ruth, while in Highpoint, has been involved in a training course to become a Samaritan for other prisoners. While undergoing that training, she was told that confidentiality was extremely important when talking to other prisoners about their problems. Ruth's response was, "Does that include drugs?" "Of course," was the reply. What is the difference between the situation in prison and Wintercomfort's policy concerning the importance of confidentiality towards vulnerable clients, which landed Ruth in prison?

I am pleased to have had the opportunity to speak and I thank the Minister and the hon. Gentleman for their courtesy.

All hon. Members will be grateful to the hon. Member for Worthing, West (Mr. Bottomley) for raising the issue, which is serious both in its broad context and, for Ruth Wyner and John Brock, in its narrow context. The hon. Gentleman will appreciate the inhibitions under which I must operate in terms of the case's appeal status. As it is sub judice, it would not be appropriate for me to refer specifically to that case, but I am happy to deal with the broad context.

On a technical detail, we know that an appeal against the sentence will be heard, but it has not yet been agreed that there should be an appeal against conviction. Are Ministers inhibited in speaking about the conviction if an appeal has not yet been allowed against it?

In the final analysis, that would be a matter for you and your colleagues, Madam Deputy Speaker. Call me a cautious, old-fashioned lawyer, but when there is a whiff of an appeal, my policy is to make no reference to the specific facts that support conviction or to those matters prayed in aid of the appeal.

In relation to the broad context that the hon. Member for Worthing, West raises, we understand the concerns that some agencies have following the convictions of Ruth Wyner and John Brock. Managers, staff and trustees of day and night shelters should ensure that all reasonable steps are taken to prevent the supply of controlled drugs on the premises in accordance with the law. The key lies in an effective drugs policy that enables managers and staff to work effectively with the police to prevent drug dealing on their premises.

The Home Office and, where relevant, colleagues and officials in other Departments—I think especially of the Department of Health—will consider the extent to which it is necessary to give further guidance in the light of the case. That is being given urgent attention as we speak, not least because the Government recognise the onerous responsibilities that fall on managers, staff and trustees of such centres. They do a difficult and challenging job in circumstances that are often equally difficult and challenging.

I shall try to deal with the broad question asked by the hon. Gentleman and the specific points raised by my hon. Friend the Member for Cambridge (Mrs. Campbell). Drugs are a real and present danger in our society. We are determined as a Government to develop and implement a concerted strategy to tackle drug misuse and stifle the availability of illegal drugs on our streets in the wider community and in prison. The key to that lies in an effective strategy to prevent the supply of controlled drugs in prison, and in the Prison Service ensuring that drug use and trafficking in prisons are perceived by all concerned as serious offences that merit firm action. A prisoner may be segregated. He may also be transferred, to disrupt the network of contacts and supplies. Both responses are appropriate, although the latter is, rightly, more frequently used.

Experience tells us that the fact that someone has been convicted of a trafficking offence does not automatically mean that he will try to deal drugs while in custody. The prison authorities must, however, be alert to that possibility and some prisons have developed innovative strategies for managing drug traffickers. Elmley prison, for example, has designed a separate unit and regime for traffickers to address their offending behaviour, while Whitemoor prison has developed a protocol for the identification and management of suspected traffickers. I sat in on a course in a women's prison that was specifically designed for women used as carriers by unscrupulous criminal elements, who are often based overseas. Those women had been shamefully used, with disastrous consequences for them and their families, and courses have been developed to assist them. We also know that there is an advantage in dealing with drug trafficking by indirect methods. Dealers cannot operate without supplies or a market and the Prison Service devotes much effort to preventing drugs from being smuggled into prisons and to breaking the habit of identified drug users.

The general emphasis in recent years has been in improving security procedures, for which the hon. Member for Worthing, West was good enough to give the Prison Service credit. That has brought real benefits in tackling drug trafficking. A range of measures has been adopted to improve perimeter security, including increased patrolling, searching the ground near the perimeter fence before inmates are allowed access, and the use of dogs and of closed circuit television. Drug detection dogs are increasingly used, actively and passively, to deter and discover drug smugglers and there will in future be at least one drug dog for each establishment. I have witnessed the benefits on the ground of that measure.

Domestic visits are the most common means of smuggling drugs into prison. My hon. Friend the Member for Cambridge related her experience of a visit to her constituent. The searching of all visitors and the use of the security procedures that she detailed are, for good reason, common occurrences. The use of dogs and specific counter-measures such as the provision of lockers for visitors' luggage and improvements to the layout of visit areas, including the provision of low-level fixed furniture and the increased use of CCTV, all have a role to play. The hon. Member for Worthing, West described how drugs use at Highpoint prison has decreased as a result of the vigilance of staff; the response to testing supports that finding. I am sure that hon. Members understand why such vigilance should be maintained.

Intelligence-led searches are part of such vigilance. If smuggling of contraband is suspected, prisoners will be strip-searched after domestic visits. After my hon. Friend the Member for Cambridge had done me the courtesy of calling my private office yesterday, the Prison Service told me that the search of her constituent was the result of random search procedures used at Highpoint. Following domestic visits, a 10 per cent. random search takes place. I am assured that such a search was involved in the case of Ruth Wyner. No discourtesy was intended to my hon. Friend, and no suggestion was made that any contraband had been passed over. I apologise if my hon. Friend felt that the search was deliberate; it was not. It was part of the random security measures used at Highpoint, which have had positive results.

No Member of Parliament would mind being searched in extremis. We should not be treated differently from other people, and the explanation given could apply to any of our constituents. I should add that I am grateful for the interest of my hon. Friend the Member for South-East Cambridgeshire (Mr. Paice), who is also present for the debate.

The interest of all hon. Members is welcome, and reflects interest in the wider community. We have set aside an additional £76 million for the Prison Service to develop its drug strategy over the next three years. That money will mainly be used to expand drug treatment programmes in prisons.

My hon. Friend the Member for Cambridge, who mentioned confidentiality, and the hon. Member for Worthing, West raised the important issue of how to involve the voluntary sector, which has an enormously important role to play as part of the CARAT service which will provide counselling, assessment, referral, advice and throughcare. We are forging good links with the national health service and the voluntary sector in ensuring that a range of suitable programmes for prisoners is available to cover all drug problems, whether low level, moderate or severe.

We want to build confidence and trust between the Prison Service and the voluntary sector, and that of prisoners and users, which will involve a respect for confidentiality. However, people involved in the voluntary sector and CARAT teams must understand that confidentiality has limits. CARAT teams are different from the Samaritans, which is a life-saving operation that does wonderful work with listeners in prisons, and which, according to tradition and accepted practice and procedure, is based on complete confidentiality. In specific, exceptional circumstances, such as the possibility of an escape or the introduction of illegal contraband into the prison, everyone working with CARAT teams must understand that they have a duty to inform the appropriate authorities. There is a distinction between the two organisations.

This is an important topic to which we have not been able to do justice. I reiterate my thanks to all hon. Members who contributed. We shall continue that vital work with care and sensitivity, ensuring that it is evidence-based and that best practice is developed and spread throughout the Prison Service to tackle a problem that affects the whole of society and to which prisons are not immune.