I hope that the Minister, who I am glad to see in his place, will agree that although the debate is unambiguously broad in scope, few subjects are more important to our constituents. The state of the economy in Wales has considerable impact on the livelihoods, prosperity, and life chances of the people whom we represent. Indeed, the strength of the economy conditions the amount of money that is available for public spending. I am pleased that the Government have invested substantial extra resources in long-term prosperity and vital public services; that would not have been possible without the Government's sound management of the economy.

I shall make some general comments on the bigger picture before dealing with specific issues. I hope that the Minister will respond to some of my points in his winding-up speech. I am particularly interested in pursuing the increasingly serious position of the rail infrastructure and the effect that the rail crisis—that is what it is—is likely to have on the economy, and on the Welsh economy in particular. I am sure that other hon. Members share those concerns. I would also like the Minister to respond to the issue of the high levels of economic inactivity that, unfortunately, still plague the Welsh economy. I shall also make a few remarks on the rural economy and the need to ensure a choice of energy supply, particularly gas, to those who live in rural communities.

There is no doubt that the Government have a good story to tell on the economy. Inflation and interest rates in the United Kingdom as a whole are at their lowest for 30 years. Unemployment is down to historically low levels and 1 million new jobs have been created in the UK. The Government should be proud of that worthy record. Exports, manufacturing and business investment are growing and the UK economy is continuing in a cycle of growth. The Chancellor can be congratulated on creating the conditions of economic stability that will enable us to provide long-term and sustainable prosperity for all the people of the UK—and of Wales. That is in stark contrast to the official Opposition's apparent platform, involving a severe programme of no less than £16 billion-worth of cuts—which they will have to explain to the people of Wales in due course.

Has my hon. Friend read the report in The Times this morning of the Opposition's manifesto pledge that, if they were ever to get anywhere near government, they would cut small business support by hundreds of millions of pounds in order to achieve that £16 billion-worth of cuts?

That is a pertinent point. It is even more pertinent that Tory candidates will have to explain to constituents throughout Wales how the cuts will be reflected in public services.

Will the hon. Gentleman give way?

In a moment; I want to develop my point.

My right hon. Friend the Chancellor is right to emphasise that we must turn our backs on the years of boom and bust. He is also right to emphasise the need to make tough choices to create economic stability in stark contrast to the years of boom and bust.

In Wales, unemployment has fallen to record lows: 40,000 more people are in work than at the time of the general election in 1997. There have been historically high increases in the Welsh block, which will shortly be running at £10 billion per annum. That will make a major difference to the amount of money available for public services. Together with many colleagues who are present, I was pleased to hear my right hon. Friend the Chancellor announce that £420 million will be available for objective 1 funding over the next three years. That will make a big difference to the Welsh economy.

The minimum wage, introduced by this Government, is helping 100,000 people in Wales. It boosts the average income of those in receipt of it by about one third.

The hon. Gentleman made a passing reference to £16 billion—an example of the fantasy figures that the Labour party has dreamed up. He will have to wait until we present our Budget, not present his own fiddled figures.

The hon. Gentleman also mentioned objective 1 status, and we are delighted that that money is being made available. However, he will accept that there is widespread concern and confusion in Wales about how objective 1 funding is distributed. We are 11 months into the budget of a five-year programme, yet a number of local authorities simply do not know how to go about applying for some of the funds. Does the hon. Gentleman share my concern that the Welsh Assembly and local authorities should be made more aware of how objective 1 funding will be made available, especially in areas of west, north and mid-Wales?

I am not sure how that point arises from what I said. I am entirely confident that the National Assembly for Wales, working in partnership with the Labour Government at Westminster, will be able to deliver and exploit the full potential of objective 1 funding. After all, the Labour Government secured that funding for Wales.

Will my hon. Friend give way?

Yes, as I know the interest—some people might say obsession—of my hon. Friend in the subject.

On the subject of grants to Wales, is my hon. Friend aware that the previous Conservative Government took away assisted area status from vast parts of his constituency and mine? That contrasts greatly with the Labour Administration, who, at the 11th hour, allowed our constituencies to be included in the objective 1 map of Wales.

It will not come as a surprise to my hon. Friend that, not for the first time, I am in complete agreement with him.

I mentioned the minimum wage. In addition, the working families tax credit is helping about 80,000 families in Wales and making a significant impact on many people's quality of life. Pensions are a big political issue throughout the United Kingdom. I am pleased that the Government have introduced increases in the basic state pension, which will mean that pensioners will be on average about £11 a week better off than in 1997.

Although the conditions of stability and economic prosperity applying to England can be seen in Wales, there is no mistaking the challenges still facing the Welsh economy. Historically, there has been a prosperity gap. Members from south Wales are present today. I am a north Wales Member, but I am well aware of the serious deprivation in places such as Blaenau Gwent and Merthyr Tydfil. Again, there is a historical challenge to be overcome. Anyone interested in finding out more about the context should refer to the excellent book recently written by my hon. Friend the Member for Merthyr Tydfil and Rhymney (Mr. Rowlands).

Unfortunately, Wales has lagged behind. It was recently announced that Welsh gross domestic product had dropped slightly as a percentage of United Kingdom GDP, which is worrying. The holy grail of trying to create a new economy in Wales with high-value jobs—a knowledge-based, information technology-literate economy—still seems some distance away. The National Assembly for Wales and, indeed, the Government in London have much to do to achieve that end.

One crucial problem in Wales is the continuing high level of economic inactivity—a legacy of our industrial past. Many people still suffer from long-term illness; many more have dropped out of the job market. The level of economic activity in Wales is currently about 55 per cent., compared with 62 per cent. in the UK. That statistic speaks for itself.

Does my hon. Friend share my pleasure at the fact that of the 1 million extra jobs created by the Labour Government, half have gone to people aged over 50—an age bracket that often has high levels of economic inactivity?

I agree entirely, which brings me to the Government's proposals for increasing the participation of over-50s in the labour market. I make no apology for dwelling on that subject because I represent a constituency with the highest number of pensioners in Wales and one of the highest in the United Kingdom. No less than 35.5 per cent. of my electorate are of pensionable age. Over the past 20 years, the proportion of people aged between 50 and state pension age who are not working has doubled. Currently, about 2.8 million men and women over the age of 50 in the UK are not working. Most do not take redundancy voluntarily. More people wish to retire early nowadays, but of that 2.8 million, the majority would prefer to continue working.

On the question of people not retiring voluntarily, would my hon. Friend care to comment on the steel manufacturers, Corus? When it took over the steel industry a while ago, it gave a commitment to the work force that the plants and their jobs were secure. It is now treating the community with contempt, throwing people on the scrap heap. The workers are not going voluntarily; they are forced to go. What does that say about the steel industry in this country and, in particular, Corus?

That is a very worrying feature and I well understand my hon. Friend's concerns.

More than half of people aged over 50 who are now economically inactive receive most of their income from state benefits. The economic cost of that is great, and has a dampening effect on Welsh GDP, which lags quite considerably behind the rest of the UK. The performance and innovation unit recently published a policy document on the issue entitled "Winning the Generation Game". It states:

The drop in work rates among the over 50s since 1979 costs the economy about £16 billion a year in lost GDP.

That is for the UK as a whole, but I imagine that the figures for Wales are significantly higher.

What are the causes of those relatively high figures? There has been restructuring, but there is also a culture of writing people off once they reach their early fifties. Reference has already been made to the shedding of labour at Corus. There is a prejudice against older people and a feeling that they cannot contribute, although many of them continue to want do so. There must be a change of culture and fairer access to lifelong learning for everyone. We must provide greater help for displaced workers to re-enter the work market. We must enable older people to make better use of their skills.

I welcome the Government's new deal programme for the over-50s. Can the Minister give us an assessment of its success to date? It is basically dependent on individualised programmes of support for unemployed people. There is an employment credit, which is a wages top-up. That is a valuable incentive to work. Can the Minister give us any statistics relative to Wales? It is early days, as the programme was introduced only in April 2000, although there were earlier pilot schemes in north-east Wales. What does he think will be the success of that measure?

Many pronouncements and directives come out of the European Union. I speak as one who is becoming increasingly sceptical about certain aspects of the European project, not least the single European currency. It is fair to say that several European institutions lack the characteristics of open and democratic ones. It is an increasing worry, and I am reflecting the concerns of my constituents.

Would my hon. Friend bear in mind the concerns of my constituents who have recently lost their jobs at Panasonic? I suggest that one reason for the loss of jobs at Corus is the low value of the euro in comparison with the pound. The owners of concerns such as Panasonic and Sony are most concerned that we join the euro in the foreseeable future, as it is the basis of most of the market for such products.

Unfortunately, that is not just an economic question, but a political issue. British manufacturing as a whole, although under considerable competitive pressure due to the high value of the pound relative to the euro, is still succeeding. We have a relatively large manufacturing sector in Wales, which, admittedly, has had problems and difficulties recently, but is making a good fist of it. There is a debate to be had about the single currency and its possible effect on not just the UK economy as a whole, but the Welsh economy in particular.

What approach will the Government take regarding the proposed European Union directive on age discrimination, which is designed to outlaw such discrimination? It has yet to reach the Commission and the Council of Ministers, but its introduction is proposed for 2005.

Is the Wales Office represented on bodies that deal with the implementation of the new deal for over 50-year-olds? Does it have an input into the issue of increasing participation in the labour market for those aged over 50?

I am drawing to the end of my comments, but I should like to refer again to the rail crisis. Some hon. Members may have read an article in The Guardian last week that described the increasing concerns of the business community about the effects of the rail crisis on business. Does my hon. Friend the Minister agree with the north-east business person, who says that the most serious impact of the rail crisis

is that it exposes the isolation of regions like this?

He was referring to the north-east, but his comments could equally be made of Wales. He continues, saying that the isolation

poses problems for overseas investment‖but it also raises questions about the expansion plans of British businesses to the regions.

Does my hon. Friend the Minister agree with a comment made to me by a senior member of the Welsh Development Agency, that the rail system, especially in north Wales, is so bad that we tend to be a road-based economy, so Railtrack's problems do not make too much difference? That is an indictment of the lack of an integrated transport system for north Wales.

I should also like to mention gas supplies to rural communities—a subject in which I am increasingly interested. Several local communities in my constituency—chiefly Betws-yn-Rhos and Gellrifor—are campaigning to ensure that their areas, which are relatively close to larger suburban or urban communities, can access mains gas. The Tory Government liberalised the gas market and introduced the split between transporters and suppliers of gas. Hon. Members may recall that, before the measures were introduced, British Gas could subsidise the capital costs of piping gas to rural communities through a cross- subsidy from its supply operation. That is no longer possible. Gas transporters such as Transco are in the invidious position of having to charge individual consumers large sums—as much as £2,000—before they will even begin to think of piping gas to the communities.

We hear much about the need to create a more inclusive society, and about combating social and economic exclusion in rural communities. Many problems that beset Welsh agriculture, and British agriculture as a whole, are global and reflect tremendous global competition. However, the Government could surely take action on the matter. I recently tabled a parliamentary question about it, and was told by a Department of Trade and Industry Minister that a working group had been set up to explore ways in which to relax the regulatory framework policed by the Office of Gas and Electricity Markets, which would facilitate greater choice in energy supplies for rural dwellers.

What are the views of my hon. Friend the Minister about how the Wales Office and other United Kingdom Depts can facilitate the admirable project to create a sustainable economy to which the National Assembly for Wales has committed itself? Does he have any observations on how to create a market in sustainable energy supplies, particularly in rural communities?

The subject of the debate is broad, and I know that other hon. Members are anxious to speak. In recent months, however, there has hardly been a plethora of Welsh-based subjects for Adjournment debates in Westminster Hall. I hope that this will be one of many future debates.

I congratulate the hon. Member for Clwyd, West (Mr. Thomas) on securing this debate. As he said, it is an important subject about which many stories can be told. However, my story about the Welsh economy is not as rosy as that told by the hon. Gentleman. Indeed, Mr. Deputy Speaker, he used so many United Kingdom figures that I began to wonder whether he was still in order, although he must have been in order as you allowed him to continue.

I start by picking up on the hon. Gentleman's slight criticism of the Government, which is that the Welsh gross domestic product has fallen by 3 per cent. during the past three years. The latest regional estimates, published on 27 June by the Office for National Statistics—not my favourite body at the moment—show a decline in GDP per head in Wales relative to that of the whole UK from 82.8 per cent. in 1996 to 79.4 per cent. in 1998. Unfortunately, the Labour Government presided over that decline, despite all the good things that they have done with the new deal.

Will the hon. Gentleman give way on that specific point?

If the hon. Gentleman insists.

I thank the hon. Gentleman for giving way. He admitted that he had difficulty with the Office of National Statistics, but the latest statistic that he cited was for 1998. How does that relate to the present Government's performance? They did not come to office until just before then.

Perhaps the hon. Gentleman should take the matter up with the ONS. That statistic is the latest available.

The European target for Wales is 84 per cent. per head by 2002, but I doubt whether we shall reach that figure by then. Perhaps the Minister thinks that we shall. The fact is that we are lagging behind the rest of the UK, and the hon. Gentleman cannot deny it.

Will the hon. Gentleman give way?

I shall not give way now; I want to develop my arguments.

The GDP figures are important. Wales has objective 1 status because our GDP lags behind the European and UK averages. In the recent three-year comprehensive spending review, Wales received a settlement of about £200 million in addition to the Barnett formula. That must be seen against the £628 million needed during the same period for the objective 1 project, which is made up of a European allocation of £421 million and matched funding of £207 million.

I acknowledge that there has been a break in the Barnett formula, but the inadequate allowance of those figures in the comprehensive spending review means that Wales ends up with an increase in the normal block grant of 7.3 per cent. compared to 8 per cent. for the UK as a whole. Perhaps that is the reason for the figures that the Institute of Welsh Affairs will publish tomorrow, which show that education spending in Wales is lower than in the rest of the United Kingdom. It begs the question of why the Government are so keen on the Barnett formula if they cannot deliver the full funding package for objective 1 status in Wales.

Earlier this year, the Government said that they might review the Barnett formula, but the Secretary of State for Wales recently told the Select Committee on Welsh Affairs that he was no longer in favour of such a review. Will the Minister give us his thoughts on whether a review of the Barnett formula would be appropriate? The figures for the Welsh GDP, as part of the overall UK figures, show that the regions are lagging behind.

Will the hon. Gentleman give way?

Not for the moment—I want to pursue this particular argument. I will give way to the hon. Gentleman later.

I shall quote from a recent statement:

Since 1990 the share of GDP within the UK has declined significantly in the North East, the North West, the West Midlands, Wales and Scotland. It has increased significantly in the Eastern Region, London and the South East. Those are the symptoms of something fundamental. We don't have to look far for some of the causes. In 1998 manufacturing businesses invested over ten times as much in research and development in the South East than in the North East…Lack of investment, poor skills and education qualifications, these are some of the underlying causes we need to tackle. In the modern economy we cannot build a strong economy, a strong nation, if we have a tail of under performing regions. We need all our regions firing on all cylinders.

Apart from the fact that I would describe Wales as a nation, not a region, I agree completely with that quote from the Secretary of State for Trade and Industry. We should be debating the need to deal with the problems that he outlines, not glossing over what has been done in the Welsh economy.

Does the hon. Gentleman agree that the Welsh Assembly's recently announced 60 per cent. increase in the new apprenticeships scheme is a way of dealing with the issues that he has raised?

I agree, but there are other ways, to which I will come later. I welcome what the Welsh Assembly—the National Assembly, rather—has done in that regard.

The hon. Gentleman is annoyed with the Office for National Statistics, which is in my constituency, for not giving the figures that Plaid Cymru wants. The ONS is devoted to giving objective truth. Farming's contribution to the Welsh gross domestic product reflects our overdependence on that industry and shows why Welsh GDP is lower. Farming's contribution was calculated as zero, but those arriving at that figure forgot to take into account things such as tir mynydd payments. In fact, we have a dependent industry from which the contribution to GDP is a minus quantity—less than zero. To take one comparison, the steel industry contributes 6 per cent. and the rest of manufacturing industry contributes 28 per cent. That is our problem in Wales.

I am pleased that the Labour party wants to campaign in Wales on such an agenda at the next general election. I look forward to great gains in rural areas. Some 13 per cent. of GDP in my constituency comes from farming, so I cannot accept the figure of 0 per cent.

Will the hon. Gentleman give way?

I am still dealing with the previous intervention. The decline in GDP that I outlined is continuing, and has nothing to do with farming. I would imagine that the recent decline of farming would have exacerbated the decline in GDP.

I shall continue for now, and will give way to the hon. Member for Vale of Clwyd (Mr. Ruane) later. I want to outline what has happened in manufacturing in Wales over the past three years. Since 1997—these are incontrovertible, up-to-date figures, if the hon. Member for Newport, West (Mr. Flynn) is concerned by them—8,000 manufacturing jobs have been lost in Wales. Some 2,000 jobs have been lost in agriculture in Wales, and approximately 2,000 jobs were lost in manufacturing during this summer alone. Other hon. Members have raised their constituency interests in some of the Japanese companies in Wales. The job losses have been put down partly to uncertainty over entry into the euro, and Japanese companies and other inward investors in Wales would feel more confident if we had a clearer line from the Government on that. They are also partly due to the lack of regional incentives and operating aids in Wales.

How many jobs have been created in manufacturing in Wales?

The Minister's own figures are that 30,000 jobs have been created in Wales during the past three years. I do not know how many jobs have been created in manufacturing, and I doubt that he will tell us when he winds up. In any case, 30,000 jobs were created in Wales during that period, not 80,000, which was the figure that the Minister supplied to the House on another occasion. In that period, the Government have increasingly relied on what I would call muck jobs—temporary and part-time jobs in the service sector with firms such as Kentucky Fried Chicken or McDonald's. Those jobs do not have the skills that we want to be developed in Wales, and the Confederation of British Industry report published on Tuesday underlined the importance of manufacturing in supporting the service economy. In that respect, long-term problems are being stored up in Wales.

I was interested in what the hon. Gentleman said about his constituency. Can he confirm that claimant-count unemployment has gone down by almost 10 per cent. in his constituency during the past year? What has caused that reduction?

The hon. Gentleman must have known what I was going to talk about next. His claims are incorrect. On the Government's International Labour Organisation figures for my constituency, unemployment in Ceredigion is 5.5 per cent, a reduction on the figure under the Conservatives that I welcome. However, the employment is not in long-term, sustainable, well-paid and high-skilled jobs that I want to be created in Wales.

There is a huge income gap between Wales and the rest of the United Kingdom. Figures for April 2000 show that average income in Wales is £19,134 a year, making the average Welsh worker nearly £50 a week worse off than those in the rest of the United Kingdom. In Wales, 21 per cent. of children live in workless households; the figure for the rest of the United Kingdom is 18 per cent. The proportion of the working age population living in households where no one works is 16 per cent. in Wales, but 13 per cent. in the rest of the United Kingdom. The proportion of working-age people in households with incomes below half the mean income is 22 per cent. in Wales, 2 percentage points higher than the United Kingdom figure of 20 per cent.

On the matter of the income differential between England and Wales, can the hon. Gentleman explain how his party's policy of independence for Wales—getting rid of the Barnett formula—would help the Welsh economy? Would Wales not lose about £1.5 billion of extra income from Barnett at a stroke if it went for independence?

I have never heard such a wonderful argument for the Barnett formula. My party's policy is not independence for Wales, so the hon. Gentleman should address his comments to another forum. He obviously feels that the Barnett formula is defensible; we, too, look forward to defending it in a general election campaign.

The proportion of the working-age population in Wales with a qualification is 79 per cent., which is also lower than that in the United Kingdom.

I shall speak about what is needed to improve the economy in Wales. One of the worst aspects of the Welsh economy at present is that we are at the bottom of the United Kingdom regional competitive index. A recent report from Cardiff university—it was published by the House of Commons Library, in case hon. Members doubt its statistics—shows that Wales lags behind the rest of the United Kingdom in competitiveness and in information technology jobs creation, a subject mentioned by the hon. Member for Clwyd, West. The mid-term prospect for Wales in that regard is poor; Wales lacks competitiveness, and UK taxation levels do not favour areas of Wales that need operating aid. The UK economy is run to benefit the south-east of England; it does not benefit Wales to the same extent.

The hon. Gentleman has given a beautiful, descriptive but well-known analysis of the problems that we face in Wales and which the Government are tackling head-on. Will the hon. Gentleman give us some idea of what his party proposes to do about the problems?

My intention was to conclude with an analysis of what needs to be done. If the hon. Gentleman will contain his enthusiasm for a little longer, he will hear some of my party's ideas.

In Wales, a greater balance is needed between the new high-tech jobs and the more traditional industries like manufacturing, which should be seen as a traditional industry and protected and enhanced within Wales. Although the knowledge economy is thriving in the south-east of England and London, it is failing in Wales. At present, Wales has 21,000 jobs in IT, and although that sounds like a lot, it is only 2 per cent. of United Kingdom IT employment, although we have 5 per cent. of the UK work force. It is the lowest percentage for any of Great Britain's regions or nations. That is disastrous for Wales's prospects of taking advantage of the revolution in information technology.

The situation is just as bad for agriculture. We have the worst crisis for 50 years. Although the price of milk has stabilised recently—owing to the fact that so many farmers have withdrawn from milk production that there is a shortage for the winter—the price of lamb and beef has dropped.

Before the hon. Gentleman leaves the subject of information technology jobs, will he explain where, if there is such a shortage, they should come from?

I have already told the Chamber that I shall conclude by mentioning that, so perhaps I may be allowed to continue.

The influx of beef from the continent, and in particular French beef, given the way things stand in France, will have a huge impact on agriculture in Wales. Not only is rail infrastructure lacking in Wales, as the hon. Member for Clwyd, West mentioned, but freight is not carried by rail in rural Wales.

I shall conclude my remarks—as promised several times now—with some ideas for the future. An idea from my constituency is being developed at Aberporth, at the Defence Evaluation and Research Agency facility, which is to be privatised, having been within the Ministry of Defence. An exciting project exists there to produce just the sort of information technology facility that hon. Members have been asking for in Wales. I understand that the Treasury is currently considering an application from the Ministry of Defence for a £6 million training application for Aberporth. That shows the way ahead. The plan does not involve objective 1 funding. It is the capital modernisation fund for the United Kingdom that is relevant. That shows what could be done in rural areas and throughout Wales to enhance information technology skills and development. I hope that that idea will receive a warm reception in Government, because it will go some way towards changing the low-wage economy of west Wales.

I referred to a report by Robert Higgins of Cardiff university, which made it clear how Wales lags behind in the competitive league. He says:

At a global level, London and the South East are performing as well as the top-ten most competitive nations.

However, he adds that at the lower end of the scale, Wales, among others, is "ranked alongside…Hungary, Chile" and similar nations. I do not think that that is what the Government want for Wales. It does not accord with their rhetoric for Wales. We need policies that will make a greater impact on the more deprived and uncompetitive regions or nations of the United Kingdom, such as Wales. That means that we need stronger regional economic policies. The stability of the British economy in general at the moment means that there is enough surplus and strength to allow the Chancellor to offer the regions, and Wales in particular, the sort of aid that will lift productivity and improve their economies.

As a start, in the Budget next year cuts could be made in corporation tax as an operating aid for companies starting business in Wales, Scotland and the north of England, particularly, perhaps, in the objective 1 area. That would be perfectly acceptable and allowable, to provide a greater incentive to foreign investors. It has been done in Ireland, so it hardly seems right that we could not do it here. Local investors would be able to expand their work force. If each of the small businesses, employing fewer than four people, that account for 60 per cent. of jobs in Wales, could be encouraged by cuts in corporation tax and an improvement in national insurance arrangements to take on new staff, a great deal could be done to create and enhance jobs in Wales.

Will the hon. Gentleman give way?

I am concluding, so I think that the hon. Gentleman will have to catch your eye, Mr. Deputy Speaker.

It is clear that Wales needs stronger regional economic policies. The failure of the Government to provide them makes clear the need for a full legislative Parliament in Wales, so that the operating aids that I have called for could be the subject of argument at the right level in Europe and the United Kingdom. The main factor that holds Wales back is the fact that its economy is not sufficiently looked after or linked to the economy of London and the south-east. That is a barrier to our further expansion and improvement in the European Union. Present Government policies can at best only alleviate, but not heal, the deep divisions, wounds and deprivation in Wales.

Members rose—

Order. The hon. Member for Ceredigion has been accommodating in allowing numerous interventions. Five Back Benchers will be seeking to catch my eye in the debate. By convention in this Chamber we allow the principal Front-Bench spokespeople to speak 30 minutes before the end of the debate, so there are only 16 minutes left in which the five Members may speak. I am simply alerting hon. Members to that fact. What happens is entirely up to hon. Members and their self-discipline.

On a point of order, Mr. Deputy Speaker. I should like to apologise on behalf of my colleagues and myself; we are attending an important meeting relating to miners' compensation for bronchitis and emphysema. It is not intended as a discourtesy to the Chair that we have to leave.

I am obliged to the hon. Gentleman for that information.

I congratulate my hon. Friend the Member for Clwyd, West (Mr. Thomas) on provoking this debate. He represents the area in which I was brought up and has been assiduous in promoting the economic interests of areas such as Colwyn Bay—a subject on which he and I attended a meeting when he was elected. He is right to say that the Government, in a short time, have begun to change the Welsh economy, but that we must ensure that we do not return to the failed policies of the past. Those of us who have seen the devastation caused by those policies—young people who wanted to work but were denied the opportunity; the undermining of public services such as health and education; the economics of boom and bust—can never want to return to them. The hon. Member for Ceredigion (Mr Thomas) grudgingly acknowledged that things have improved, but his memory seems to be a little short. A little less whinge, and more encouragement for the progress of the Welsh economy, would be appropriate.

The recent differences made to our economy are massive. There has been an end to boom and bust, which is crucial because a stable economy allows businesses and families to plan. There has been an end, too, to the draining of cash into the payment of debt—both nationally and to pay off the debt built up during the Conservative years in, for example, the health service in Wales. Most importantly, we have got young people into work.

I appeal to Conservative Members to stop undermining the new deal. I have seen young people in my constituency begin to stand tall with confidence because the new deal has given them the opportunity to work and train. I recently met some young people at a site developed by Cardiff community housing association, one of whom had been not only unemployed but on the streets. He had been trained, motivated and shown a future by that housing association, as well as accommodated. This Government have addressed the vital social and economic issue of employment for the first time in a couple of decades. However, a big job remains to be done, so it is crucial that the Government continue to build a strong economy.

Much work must be done on the economy to bring prosperity to all parts of Wales. Labour in local government created much of the success in transforming the economy of the centre of Cardiff and Cardiff docks, but we should recognise that there is still high unemployment in constituencies such as Cardiff, South and Penarth. The October figures show that it has the highest number—the percentage is lower—of unemployed men of any constituency in Wales. The neighbouring constituencies of Cardiff, West and Cardiff, Central are also in the top 10, so we must not assume that the job has been finished. A nation is judged through its capital city and the regeneration of Cardiff and the valleys of south Wales is as important as the regeneration of rural communities. Every part of Wales shares the need for progress.

The steel industry and exporters should also be helped. The stability of the economy is good for all. The weakness of the euro is causing enormous problems in the steel industry, not only to Corus but to organisations such as Allied Steel and Wire—the headquarters of which are in my constituency—as well as firms connected to the industry. I hope that those difficulties—some of them the products of success—will be recognised and addressed.

Finally, as the next stage in the new deal, we need to bring those who have been excluded into the world of work. Young people in our highly populated urban areas, those with learning difficulties, and offenders must share—as every part of Wales must share—in the developing prosperity of this country.

Thank you, Mr. Deputy Speaker, for calling me to speak. I apologise in advance for not being able to stay in the Chamber to listen to the Minister's response to the debate.

I wish to draw attention to the good news; I am sure that other hon. Members will want to mention the developments that have been announced in their constituencies. On Friday, for example, 300 jobs in auto components in Llanelli were announced; 400 jobs were announced at Unilever information technology headquarters in north Wales; 800 high-quality jobs were announced at Lloyds Trustee Savings Bank in Bridgend; and 1,400 jobs have been created by Conduit plc in the constituency of Cardiff, Central. During the past three weeks, 3,000 new jobs have been announced in Wales.

The hon. Member for Ceredigion (Mr Thomas) mentioned the losses, but it is important to bear in mind the number of high-quality jobs that have been created.

Does my hon. Friend agree that there is a danger of Plaid Cymru Members talking down Wales with their doom and gloom prophecies for the Welsh economy, and scaring off potential inward investors?

Absolutely. The good news to which I have referred follows the 1,700 jobs that have been created in British Aerospace in north Wales. I acknowledge that the good news was preceded by job losses that affected the constituencies of my hon. Friend the Member for Cardiff, Central (Mr. Jones) and I—for example at Panasonic, Sony and Hitachi, where many of our constituents lost jobs—although that was linked to the crisis in the traditional television manufacturing industry and the change from analogue to digital.

There have been a series of job losses for people who have worked in traditional industries for many years in my constituency as a result of the closure of production at Alloyed Wheels, Aeroquip and Viscosuisse. On Monday, I visited Federal Mogul, on the Llanishen trading estate in Cardiff, which is reducing its work force. However, it is maintaining a commitment to Wales by concentrating on its PTFE seal product and retaining 85 of 200 jobs. It hopes to develop a centre of excellence, working closely with the university.

Last week, I attended a meeting at the House of Commons in celebration of the achievements of companies that have been awarded millennium product status. One of those companies was VA from Cardiff, North, which had developed the award-winning, non-spill baby's cup that has swept the world markets. It was invented by Mandy Harberman, who had the good sense to realise the need for such a cup. The firm is going from strength to strength with new inventions, which is all good news. Despite the losses in manufacturing, 300 jobs in the manufacture of gear sticks and car components were announced on Friday in the constituency of my right hon. Friend the Member for Llanelli (Mr. Davies). We thought that no such jobs would be created again in Wales, so such news is very encouraging.

The new starts show that Wales is moving up the value chain. We must accept that there has been a structural shift of certain types of work to eastern Europe, where the wages are one sixth of those in Wales, and to Africa, where the wages are one tenth of those in Wales. That work includes garment making such as Baird wear and work in analogue television, which has been transferred to eastern Europe.

The key matter is what has to be done in Wales. We must have much better high-technology than elsewhere. We must encourage research and development. We must not have the branch factory mentality, but embrace information and technology, and financial issues. It is important to work with universities on new products, as Federal Mogul in Cardiff, North is doing, and to increase training in this new era.

The National Council for Education and Training for Wales will come into being next year, and it must help workers move up the skills chain. We need to change the nature of the Welsh work force and increase the number of skilled people in Wales. As I said to the hon. Member for Ceredigion, the Assembly is in the process of increasing modern apprenticeships by 60 per cent. I am concerned about modern apprenticeships, as they are still subject to much gender stereotyping, although that will take many years to change. Nevertheless, we welcome the apprenticeships, which fit well with the Government's new deal. They are important to getting women back into work. Call centres offer workers the opportunity to return to the labour market and develop their skills.

The shape of the economy in Wales is changing. It is an optimistic picture—there is great sadness at the loss of many traditional jobs, but the challenge is to develop skills to fit new demands. All the Government's efforts, here and in Wales, are helping in that task.

Every month, I look up the published figures on unemployment by constituency. I have a table of unemployment figures for the past five years. When the Labour party was elected to govern, there were 1,536 people on the claimant count in my constituency. The latest entry for my constituency is 964. That is 600 fewer on the claimant count, which is falling at the rate of about 200 a year. Therefore, in four or five years, given the election of a Labour Government and continuation of our excellent economic policies, there will be full employment. Youth unemployment has dropped by 80 per cent., and long-term unemployment by 40 per cent., despite the problems in the rural economy. Clearly, agriculture has experienced difficulties, but the buoyant economy and large number of infrastructure projects are creating jobs at an enormous rate.

The Government have negotiated objective 1 status, which will give a terrific boost to west Wales and the valleys. Clearly, we are impatient to see the results, which is the responsibility of the Assembly. This year, £60 million has been allocated to Welsh Development Agency, tourist board and agrifood partnership projects, which are under way. We want local government and private industry to become heavily involved as soon as possible.

I share the vision of my hon. Friend the Member for Cardiff, North (Ms Morgan) about the need to up-skill the work force. I hope that most of the objective 1 resources are allocated to education and training, so that we attract high-skill, high-tech jobs. The challenge for the Assembly is to achieve not just a 2.5 per cent. economic growth rate, which is expected for the rest of the United Kingdom, but 3 per cent., 4 per cent. or even 5 per cent. growth every year for the next seven or eight years, so that the differential between Wales—and west Wales and the valleys—and the rest of the terrain is rapidly closed.

The last time that I heard the hon. Member for Ceredigion (Mr. Thomas) speak I said that he was suffering from repetitive whinge syndrome. Clearly, his condition has become even more chronic. Throughout his speech this morning he accentuated the negative.

Objective 1 status is welcome in Wales, and a great success for the Labour Government and the Welsh Assembly. However, the map is a crude distortion. It is not a precise representation of deprivation in Wales. Since the achievement of objective 1 status in Wales, the Welsh Assembly has provided a list of the 100 most deprived wards. Although Ceredigion is covered by objective 1, it does not have a single ward in the top 100. My constituency is outside the objective 1 area, yet it includes four of the most deprived wards in Wales, including the most deprived ward in all of Gwent. [Interruption.] I am pointing out that, in proceeding with objective 1, we must bear in mind that many other areas in Wales need help.

The steel industry has a magnificent record as a modern, efficient world-beater, and it has made a huge contribution to the Welsh economy. For the sake of every steel worker in Wales, it now needs assistance from the Government.

I shall try to condense a 10-minute speech into two minutes.

I do not recognise the Wales that was described by the hon. Member for Ceredigion (Mr Thomas). It is a different tale in my constituency. National and international companies such as Phoenix Glass, H and H Electronics, AVVA Engineering, MITA, Pinnacle, Pilkington Space Technology and Hotpoint are creating jobs in my community—every single one of which is a manufacturing job. TRB, a Japanese company, decided—as its first ever foreign investment in Europe—to locate in St. Asaph business park in the Vale of Clwyd.

The success in my constituency is due to co-operation—not the confrontation that we saw in the Conservative years. Central Government, the National Assembly for Wales, Business Connect, the Welsh Development Agency, the employment services, CELTEC and Denbighshire county council are working together in my constituency to attract and create jobs. Having said that, I should like my hon. Friend the Minister to address a number of potential problems in the Welsh economy.

Whingeing.

No, constructive criticism—not talking Wales down, as Plaid Cymru Members do day after day, week after week, month after month, under their leader, Ieuan Whinge Jones.

We need to source more goods internally. Wherever possible, contracts must be given to Welsh companies such as Hyder and British Aerospace. Wales must be internationalised. The new National Assembly gives us a great opportunity to do that through branding Wales. We need to increase our exports and to create added value in our communities, especially in raw, agricultural and timber products. We need to expand information technology in Wales. I hope that the Welsh Affairs Committee will examine the problem of broadband availability and take-up.

We need targeted growth sectors, not a scattergun approach. For example, central parts of north Wales should focus on opto-electronics. The Welsh opto- electronics forum wants to increase the number of jobs in that sector from 2,500 to 7,500 over seven years. That private sector initiative should have the full support of the agencies and government bodies that I have mentioned.

The biggest problem facing Wales is a skills shortage. If we do not build a skilled work force, the jobs that are created will be for people who live outside Wales.

Thank you. Mr. Cook. I shall be as brief as I can.

Order. I should remind right hon. and hon. Members that when the House decided in its wisdom to conduct parallel proceedings in Westminster Hall, it determined that they should be presided over by a Deputy Speaker.

My sincere apologies, Mr. Deputy Speaker. I shall not make that mistake again.

The history of Wales is littered with stories of success and of decline. Our main problem is that we have not experienced sustained growth over long periods of time. The creation of the National Assembly has given us the opportunity to focus on long-term planning.

The history of my family is in Cyfartha Ironworks in Merthyr Tydfil, which hit the buffers in the 1920s. The ironworks was mentioned in the book by the hon. Member for Merthyr Tydfil and Rhymney (Mr. Rowlands) entitled "Something Must be Done"—the phrase with which the then Prince of Wales responded to the devastation in Dowlais. Fortunately, there was investment and regeneration in the 1940s, which the hon. Gentleman described in his book. Rural Wales thrived during and after the war, but now that prosperity has plummeted. There are serious infrastructure problems in the Welsh economy that must be addressed.

The scourge of Euro-scepticism has affected almost all British political parties, but it is essential that we enter the eurozone at the right exchange rate as soon as possible. Whereas the Welsh manufacturing industry constitutes 28 per cent. of the economy, London's, for example, constitutes only 10 per cent. We are affected badly by the disparity in the exchange rate, and for that reason, agriculture has been hit by a 40 per cent. drop in commodity prices. The Welsh economy must be directed towards job creation, which is the most important issue. The challenge is to change and develop our traditional skills, and get rid of obsolescence. The economy is still out of balance: there are too many traditional industries and not enough new, cutting edge ones.

We must improve our infrastructure; our roads and railways are appalling. Efforts are being made to improve matters, but that process needs a massive injection of capital. One problem is that we have little banking or insurance in Wales and minimal access to risk capital. There is a lack of innovation, entrepreneurship and skills, and we need to diversify. The National Assembly for Wales is addressing all those points, but, as has been said, the problem is the continuing decline in gross domestic product. We must make up the difference between Wales and the remainder of the United Kingdom, which is why Wales qualifies for objective 1 and objective 2 funding. Welsh people have many innate skills at their elbow, but we must have more small business growth, technological change, increased skills, investment and marketing.

Population exchange is a big problem. Young people are leaving Wales and older people are moving in, so there are fewer economically active people. As a result, there is a productivity gap, especially in manufacturing.

To some extent, manufacturing problems in my constituency have been centred on Laura Ashley, which has experienced difficulties. Does my hon. Friend agree that some of the big, traditional companies are resolving their problems? It is good to see Laura Ashley back on its feet.

Yes, I very much agree with that. My hon. Friend has been in the Select Committee on Agriculture all morning and must return there now, but I am pleased that he was able to join us here, albeit briefly.

We have lower growth because we do not have enough economically active people. We must close the productivity gap. That is being addressed, but we need more investment in the Welsh Development Agency—as set out in the partnership agreement between the Liberal Democrats and the Labour Government in the National Assembly for Wales—and the Wales tourist board. We must increase the availability of risk capital through Finance Wales, and improve marketing of agricultural produce through the agrifood partnership. The stability in the macro-economy is good, but we must put the micro-economy right and invest in our infrastructure. That long-term project will challenge Governments in the new century, and we need to get down to it. We must create the wage levels and jobs to sustain the Welsh economy in the future, so that we can increase the amount of money in the Welsh economy and match levels in the rest of the UK.

In the vein of the contribution from the hon. Member for Vale of Clwyd (Mr. Ruane), my speech will be full of constructive criticism. Before I say anything else, I congratulate publicly the right hon. Member for Swansea, East (Mr. Anderson) on becoming a member of the Privy Council, which recognises his contribution to the House over many years.

Many hon. Members have spoken about the problems in Wales with the loss of manufacturing jobs, particularly in the south Wales corridor in the past few months, and the crisis in farming. No one can doubt that there are problems in some sectors in Wales. 1 was in Cardiff yesterday with representatives of the Federation of Small Businesses, the Confederation of British Industry and the Cardiff chamber of commerce, and five points were made to me.

Will the hon. Gentleman give way?

I shall give way once, because I have only a little time left.

I am interested in the fact that the hon. Gentleman had a meeting with the Federation of Small Businesses in Wales because he has a part-time small business. What is his explanation for the fact that when he and his party were in power, the number of small businesses in Wales—according to VAT registrations—fell by one fifth? Is not the news about Tory proposals to cut the Department for Trade and Industry budget for small businesses part of the story of their failure to help small businesses?

The hon. Gentleman needs to appreciate that, when Margaret Thatcher came to power in 1979, she had to transform the entire economy. We all remember the winter of discontent and the changes that had to be made in Wales. Without the changes that she and my right hon. Friend the Member for Huntingdon (Mr. Major) made, Wales would be in a much poorer state.

The Federation of Small Businesses made five nonparty political points. The first concerned the supplementary business levy, which could be introduced at 1 per cent. a year on businesses over five years. That money will come from profits, but some smaller businesses do not make profits. They see the levy as an extra stealth tax on businesses and they are very worried about it. Will the Minister please examine that?

Many industries in Wales traditionally use a lot of energy. Will the Minister make representations about the climate change levy, because businesses in Wales could be hit disproportionately due to the high number of manufacturing jobs?

At-work car parking charges are a threat in Wales and are seen as another stealth tax on businesses.

The Government say a lot about deregulation and cutting red tape, but during the past three and a half years, £5 billion-worth of extra red tape has been imposed on businesses. I shall give one example from my own business, to which the hon. Member for Bridgend (Mr. Griffiths) referred. I had perfectly adequate weighing scales, but a man from Swansea council said that they must be metric. After years—more than a century—of selling products in pounds and ounces, we were told that we must replace weighing scales. My business can withstand the extra £400 cost, although I greatly resent it, but many small businesses in rural areas do not have the money to do so. Many seem to operate as social services and do not make profits, but they have had to replace perfectly good weighing scales. Will the Minister consider how the extra bureaucracy can be cut?

I was delighted with Brynlie Williams' comments on the second protest about fuel costs. If the first protest had continued for one extra day, it would have had a disproportionate impact on Welsh industry. Some industries were laying off people, so we know that it had an enormous impact. The Chancellor of the Exchequer says that he is listening, but, unfortunately, he has done very little. I do not know of any garages in Wales that sell low-sulphur fuel. The Chancellor has merely frozen the tax on fuel at the high level it was when the protest started.

The euro and Europe have been mentioned, and businesses have been told to prepare for the euro. The Labour-dominated Trade and Industry Committee has said that businesses must spend around £30 billion on getting ready for the euro. That is an enormous cost on businesses and I ask the Government to examine it.

Will the hon. Gentleman give way on that point?

I am sorry, I do not have time to give way.

The Federation of Small Businesses yesterday launched a report on barriers to growth and survival. Will the Minister consider that report carefully, because it is critical not just of his Government but of successive Governments and their lack of support for businesses over the years? Table 18 refers to dissatisfaction with Government-funded business support services and states that 51 per cent. of businesses are dissatisfied with the business advice that they are receiving. Dissatisfaction with locally provided services among businesses in Wales is even starker: 74 per cent. are dissatisfied with the level of local support, 71 per cent. are dissatisfied with council business charges, and 76 per cent. are dissatisfied with the level of business rates.

The hon. Member for Cardiff, North (Ms Morgan) mentioned education. Some 50 per cent. of businesses in Wales are dissatisfied with the availability of suitable labour, 43 per cent. are dissatisfied with literacy in the labour force, and 40 per cent. are dissatisfied with numeracy. On government in general, 81 per cent. are dissatisfied with the volume of legislation produced in this House, 83 per cent. are dissatisfied with the complexity of legislation, 79 per cent. are dissatisfied with the rate of legislative change, 79 per cent. are dissatisfied with the way in which legislation is interpreted, and 66 per cent. are dissatisfied with the way in which EU regulations are implemented.

Some 927 businesses in Wales contributed to the report. Small businesses in Wales, in particular, are crying out for this Government to help them locally and nationally, so I ask the Minister to look carefully at this report. We need to help our fledgling small businesses in Wales to flourish. At the moment, they are not getting that help.

We have had an interesting debate this morning, in which a wide range of Members participated. I, too, shall begin by congratulating my right hon. Friend the Member for Swansea, East (Mr. Anderson) on his appointment to the Privy Council. 1 also want to congratulate my hon. Friend the Member for Clwyd, West (Mr. Thomas)—whom I am sure will one day become a right hon. Friend—on securing today's debate in Westminster Hall. It has given us the opportunity to discuss the Welsh economy and the many other issues raised this morning.

It is clear that unemployment in the constituencies of the right hon. and hon. Members who have spoken today is lower than when the Labour Government took office in May 1997. Indeed, the same can be said of the constituencies of those hon. Members who have been unable to contribute to today's debate, and we need to recognise that fact. I accept that there are still pockets of deprivation and difficult areas. There will always be shifts in the balance of the manufacturing industry, and there will be some gains and losses at different points in the economic cycle. However, we should remember that, in terms of people of working age, 40,000 new jobs have been created throughout Wales since the general election, at a rate of approximately 1,000 a month. In other words, an extra 1,000 people a month have been given the opportunity to earn a decent wage, and are no longer reliant on benefits.

The hon. Gentleman says that 40,000 new jobs have been created since Labour took office. Why, therefore, did he say a fortnight ago that 80,000 new jobs had been created?

As I just said, the figure of 40,000 relates to people of working age. If one includes people beyond working age who have taken up employment, the increase is 80,000.

Does my hon. Friend agree that the current situation in Wales is unprecedented? Indeed, it is so new that we do not have a word for it. There are substantial areas of Wales in which unemployment is lower than in the 1950s and 1960s, when we used to talk about full employment. Should we not start talking about areas of nano-unemployment, rather than listen to the Jeremiahs among the Opposition who have overlooked this new phenomenon?

My hon. Friend makes a valuable point, and I can quote a number of such constituencies. For example, unemployment in Montgomeryshire is currently 1.8 per cent.; in the constituency of the hon. Member for Brecon and Radnorshire (Mr. Livsey), it is 3.1 per cent.; and in Ceredigion, it is 3.8 per cent.

Will the hon. Gentleman confirm that he is referring to claimant numbers rather than International Labour Organisation figures?

The figures that I have used relate to the number of people who currently claim unemployment benefit. Unemployment in Wales is at its lowest level for a considerable time, and that is thanks to the work that the Labour Government have done and the key economic indicators that we have generated and supported.

Will the Minister give way?

I should like to move on to the bulk of my speech, but I shall give way to the hon. Gentleman in a moment.

My hon. Friend the Member for Clwyd, West hit the nail on the head when he said that unemployment in Wales is at its lowest level for some considerable time. More people are in full-time employment, and fewer people are in temporary work, than in May 1997.

We have the security of objective 1 funding, which the Government brought forward—against anxieties expressed by Plaid Cymru Members. In addition, we have provided the basic input of improving wage levels through the minimum wage, which now benefits 100,000 people in Wales; the working families tax credit, which benefits more than 80,000 people in Wales; and, as my right hon. Friend the Member for Cardiff, South and Penarth (Mr. Michael) mentioned, the new deal, which has had a massive impact on reducing youth and long-term unemployment and, as my hon. Friend the Member for Clwyd, West said, on tackling age discrimination and long-term unemployment for older people.

I agree that the new deal has been a success, and I congratulate the Government on that. However, does the Minister agree that in large parts of rural Wales young people are having to leave and the elderly population is increasing? Job creation is still a massive priority in rural Wales, with the fallout from agriculture and other declining rural industries.

I accept that. The Government are committed to helping tackle rural poverty and rural unemployment. The figure for Montgomeryshire is 1.8 per cent., and in the hon. Gentleman's constituency, the figure is slightly more than 3 per cent. We shall tackle unemployment and create a strong economy wherever possible. Yesterday the Government produced a rural White Paper relating to England, and some aspects of it will affect the economy of Wales. A great deal is being done for rural areas, one of which I represent. I accept that we need to consider how to tackle those issues.

Will my hon. Friend note that the leader of the Liberal Democrat party in Wales has just commended the new deal despite the fact that the Liberal Democrats opposed the funding mechanism of the windfall tax on utilities, which provided the money to operate the new deal?

I welcome my hon. Friend's contribution, which shows how the Liberal Democrat party faces in different directions in different constituencies. To be fair, at least the hon. Member for Ribble Valley (Mr. Evans) and his party are honest, because they said that they will scrap the new deal and the working families tax credit and abolish many of the mechanisms that have helped create the levels of employment that we have in Wales today.

My right hon. Friend the Member for Cardiff, South and Penarth made a strong case for some of the key reasons why the Government have been successful in helping to create a strong economy. We now have stability in Wales in terms of the Government's economic policy. We have low interest rates that are helping businesses. We are attacking long-term unemployment through the new deal. We are raising income levels through the minimum wage and the working families tax credit. We have a commitment to objective 1, which is working not only in objective 1 areas but throughout Wales as a whole.

My hon. Friend the Member for Cardiff, North (Ms Morgan) mentioned several manufacturing industries that are now success stories not only in Wales or Britain but worldwide. British Aerospace, in my own area of north-east Wales, is now a world-beater, and many thousands of manufacturing jobs will be created there because of the actions of this Government and the National Assembly for Wales.

My hon. Friend the Member for Vale of Clwyd (Mr. Ruane) mentioned a number of firms in his constituency. When I met and addressed the information and communication technologies forum in north Wales, which he organised and which Ministers were invited to address, I found that there was great understanding and commitment to the Government's progress on developing information technology, supporting the development of new technologies and making sure that, with the support of the Assembly, Wales is ready for the challenges of the next generation of businesses as well as those of the previous one.

I mean this question constructively: have the Minister or the Secretary of State had an opportunity to speak to the leaders of the Japanese high-technology industries in Wales that are unfortunately shedding jobs at present? We must find out why that is happening so much in that sector.

Officials and colleagues from the Wales Office and from the National Assembly have contacted businesses in Wales that have announced job losses recently. There is concern about what is happening and we must look at the problem. I know that colleagues from the National Assembly are looking at ways in which we can tackle some of the issues, arrange meetings and discuss job losses, and how we can develop and strengthen that sector to prevent further losses. I know that my hon. Friends the Members for Cardiff, Central (Mr. Jones) and for Cardiff, North are concerned about the impact of those job losses in Cardiff. They have raised the matter with me and my right hon. Friend the Secretary of State, and they are fighting to ensure that we can secure those businesses in south-east Wales and Cardiff. It is important that we look at the problem. Action will be taken. We will meet them and discuss those matters.

Overall, jobs come and go, but the economy in Wales is strong. It is developing and it is secure. All hon. Members who have spoken in this debate have raised important issues, some of which were specific, but it is difficult to cover all areas in the short time available.

My hon. Friend the Member for Clwyd, West mentioned rail infrastructure. The Government and Railtrack must put safety first, but I recognise that the current difficulty is short term. It is causing problems for transport in north Wales in particular. In the long term, the Government are committed to improving the rail system, because it is important to the infrastructure and strong economy of north Wales. I hope that Government investment in the rail system in England and Wales will, in due course, benefit the economy of Wales as a whole.

I am grateful for my hon. Friend's comments about the rail system. Does he think that it would be cheaper to invest in a better long-distance bus network in Wales? Does he share my astonishment that, every morning, I can get a bus from Monmouth to Aberdeen, but not to Bristol, Cardiff or London?

The Government are certainly committed to investing in bus services in rural and other areas. The National Assembly has received a great deal of additional support and resources because of the comprehensive spending review settlement, which has allowed it to choose how to invest in an integrated bus service and in supporting rail services in Wales.

My hon. Friend the Member for Clwyd, West mentioned the age discrimination directive, which is an important issue in his constituency. The directive is currently going through the stages of consultation in the European Commission, and the Government will consider his representations in due course. We need to consider its implications at the finalisation stage—once it has been passed—but at present we have neither agreed the directive nor looked at its implementation.

I am conscious that time is pressing. We have had an interesting debate. A number of key issues have been raised by hon. Members. I will read their speeches and write to hon. Members whose concerns were not addressed today. The key message of the debate is that, fundamentally, the Welsh economy is strong and growing stronger because of investment by Government via objective 1 in west Wales and the valleys, because of the economic stability that the Government have been able to bring about, and because of Government support for the new deal. It is also growing stronger because of Government investment through the comprehensive spending review. In all sectors of the Welsh economy—the rural economy, tourism, manufacturing and the public sector—the Government are investing in real public services and real manufacturing jobs, promoting tourism and supporting infrastructural developments to help Welsh industry.

The hon. Member for Ribble Valley raised various concerns, which I shall investigate further. However, neither he nor the wider Welsh community should forget the 18 years of Conservative government, which destroyed the economy—

Order. We come now to the second topic for consideration today—health services in London.

I am grateful for the opportunity to start this debate. I shall concentrate on south-west London, but the concerns expressed there are representative of the whole of London. My hon. Friend the Member for Sutton and Cheam (Mr. Burstow) will focus on London-wide health issues.

What are the main health issues in south-west London? Primary care; the recent strategic direction discussion document published by the Epsom and St. Helier trust; the merger of health authorities; and the threatened closure of Orchard hill. A few weeks ago I secured a debate on Orchard hill, so I shall not raise it again today, other than to say that since that debate, I had a meeting with Peter Andrew, one of the parents fighting the closure. He remains worried, because if the site is closed, the idea of a home for life for residents in a secure and safe environment, allowing a degree of independence that could not be provided elsewhere, will be lost and parents' and relatives' wishes will be disregarded.

I should like to draw the Minister's attention to the volume of changes undergone by the local health economy. We recently had community trust and mental health trust mergers, but I shall not focus on them today. Currently, primary care groups are moving to primary care trusts; there are primary care trust and health authority reorganisations and trust reconfigurations. I shall visit my local ambulance station in the next few weeks and will doubtless learn of organisational changes there, too. There is a great risk that all those changes will divert attention from the delivery of front-line services.

Will the Minister support a moratorium on the introduction of any new organisational changes within the NHS to allow changes that have just been, or are about to be, implemented to bed down properly? Does she agree that NHS staff might be suffering from severe reorganisational overload?

I shall now deal with local primary care group and primary care trust set-ups. I had understood that primary care groups were supposed to be mapped on to existing communities. The London borough of Sutton is just such a community, yet it has two primary care organisations—the Sutton primary care group and the Nelson and West Merton primary care trust. All the GPs in the Sutton primary care group are based in the London borough of Sutton, whereas Nelson and West Merton primary care trust GPs are based at more than one borough.

Will the Minister explain how that benefits local residents? There are two sets of business plans and priorities, two different codes of practice and, possibly, two speeds and tiers operating in relation to primary care. Neither the local authority nor the Royal College of Nursing considers that the duplication brings benefits. They agree that primary care groups or trusts should be coterminous with local authorities—I thought that that was also the Government's view—as it is a more sensible and easier form of management.

A document supplied by my local health authority states that

those PCTs that are co-terminous with the local authority boundaries…have the potential to become a key integrative force.

Presumably, that means that those that are not coterminous do not have such potential for the local health economy. That would be extremely regrettable. Even the Department of Health's website, which I checked last night, mentions primary care groups, including all general practitioners in an area.

The Government say that they are trying to get rid of postcode prescribing, and I support that aim entirely. However, the presence of two primary care organisations in the London borough of Sutton appears to be introducing a new, multi-tier health system that is not even based on postcode. Two people with the same postcode— they may even live in the same house—could receive different levels of service from their respective GPs if one has a GP in the Sutton primary care group and the other a GP in the Nelson and West Merton primary care trust.

Will the Minister explain, in writing if not immediately, why the Government have let that situation arise? I am aware of difficulties resulting from the partnership arrangements entered into by GPs in the Nelson and West Merton primary care group. Does she accept that there was some failure in the legislation that allowed such a partnership to be established?

I want to refer to the strategic direction discussion document of the Epsom and St. Helier NHS trust. I welcome the fact that the trust has described it as the equivalent of a Green Paper, which should mean that serious consultation will take place. My hon. Friend the Member for Sutton and Cheam and I will conduct our own consultation on the proposals through a public meeting early in the spring, a meeting with health professionals affected by the proposals and, I hope, a meeting with Sutton seniors forum, the local forum for old-age pensioners in the borough. I am pleased that the trust has agreed to provide speakers where relevant for those meetings.

What would be the impact on the St. Helier and Epsom hospitals if the proposals were implemented? Helpfully, the answer to that is set out on the last page of the briefing pack for Members of Parliament. There will be a small transfer of those expectant mothers likely to experience the most difficult births and of child inpatients and complex accident and emergency cases from Epsom general hospital to St. Helier hospital. The transfer of elective adult in-patients and day cases in the other direction will be much larger.

It is not appropriate for me to comment in detail now on whether the proposals are in the interests of patients. My hon. Friend the Member for Sutton and Cheam and I should conduct our public meetings and consultations to find out the views of the local community and its health professionals. There are already matters on which we would need to focus, should the proposals be implemented. One is the 24-hour ambulance shuttle service that apparently will be established to run seven days a week, 365 days a year. The service will transfer to St. Helier the small number of critical patients who, having been received at the accident and emergency ward of Epsom general hospital, cannot be dealt with there. Anything that requires a 24-hour operation, 365 days a year, will obviously be labour and cost-intensive. Guarantees would be needed that the service would be maintained, not cut, when budgets are squeezed.

I want an assurance from the Minister that the changes proposed in the discussion document will not lead irrevocably to the downgrading or closure of Epsom, St. Helier and Sutton hospitals, and the creation of one hospital to replace them. The trust accepts that the changes could be a staging post towards such a proposal, but if so, people do not want to feel that if the first step is made, the trust will have burnt its boats and that other options could not be considered. The local community does not want to be bounced into having only one hospital and it will oppose such a decision if it cannot be shown that it will deliver better-quality medical care.

Patient care must be the priority. I understand that hospitals have been given special grants to improve hospital entrances, other public areas and cleanliness. It is clear from the local government statement on Monday that the Government believe that the way forward is to earmark grants for specific projects. What efforts is the Department making to ensure that providing grants for specific projects is clinically the best thing to do? My impression from a visit to my local hospital was that if it had had a choice about using those moneys, it might not have chosen to use them to improve the public areas.

I appreciate what my hon. Friend says. However, he will agree that there have been many complaints in recent years about the appearance and cleanliness of hospitals, a matter that I have raised previously. Will he ask the Minister to comment on the ever-growing lake across the main entrance to the out-patients department at St. Thomas' hospital, which seems to be getting bigger by the week?

If there is time, I am sure that the Minister will want to comment on the lake outside St. Thomas' hospital and on finding a solution to the problem, even if that means a bucket and a brush. My hon. Friend made two serious points, with which I agree. Cleanliness is important, but if hospitals are given large sums of money, they should have some flexibility in deciding that the best use of that money is to invest in patient care rather than tarting up the public entrances.

The merger of health authorities is an important issue. If the trust's proposed reorganisation was not enough, the health authority is now consulting about a possible merger with a neighbouring health authority or authorities. I sounded out the Royal College of Nursing about the changes; its view—before the full consultation is completed—is that a stage 2 health authority would be better than a full regional health authority. It takes that view partly because of the arrangement for the primary care trust, which covers Sutton and Merton, but also, presumably, because the health authority is supposed to provide best practice, from a regional and national perspective, and to have local knowledge. An area such as Wandsworth, Kingston, Merton, Sutton and Croydon might be too large for those involved to get to the bottom of what is happening there.

Will the Minister give some guarantee that should any such merger proceed, the health authority will not be subject to a further upheaval just a few years later? It worries me when I read in the "Re-organisation of Health Authorities in South West London" consultation document issued by an independent management consultant that the current configuration exercise is to establish health authorities that have a life of three to five years. In the worst-case scenario of just three years, it would not be too long before yet another upheaval. In fact, I suspect that the authority would not have completed the merger within three years, before embarking on another one. It would not be appropriate for a health authority to go through the same trauma just three years after the previous upheaval.

The health economy in south-west London has experienced, is experiencing or is about to experience major upheaval. It is time to consolidate and sort out the basics; getting enough nurses and doctors and, improving the standards of cleanliness and the quality and quantity of food available to patients, who are often malnourished when they arrive and, according to some of my constituents, are even hungrier when they leave hospital. Given that change seems inevitable, I would like a guarantee from the Minister that the configuration adopted for primary care—or, in the future, care trusts—locally will sit comfortably with existing communities instead of cutting across them.

I would also like an assurance from the Minister that she will not allow the Merton, Sutton and Wandsworth health authority to be sidetracked into devoting much time, effort and money into a merger process with neighbouring health authorities when it should be focusing on assessing the changes that the Epsom and St. Helier trust proposes to many services, such as maternity, paediatrics and ambulance provision.

Finally, I hope that the Minister will be able to guarantee that the trust proposals will be allowed to proceed only if it can be clearly demonstrated that they are in the patients' best interests.

I appreciate the opportunity to speak in the debate and thank the hon. Member for Carshalton and Wallington (Mr. Brake) for introducing it. He spoke about health services in south-west London. I shall speak primarily about health services in north-west London but I shall refer also to the ever-growing process of centralisation of hospital services in the capital, which is to the detriment of overall health care, certainly in outer London. The hon. Gentleman maintained that many of the problems that afflict the health service in south-west London could be found elsewhere in the capital. This is the case in the part of rural Middlesex which I have the privilege of representing.

In an Adjournment debate on the Floor of the House on 13 November, I spoke about modernising acute hospital services in west London, with particular reference to Harefield hospital in my constituency, which is under dire threat of closure as a consequence of ill-thought-out proposals. There is within the capital a volume of change, to use the expression of the hon. Member for Carshalton and Wallington, which is deeply unsettling for personnel in the NHS and above all for patients and the general public. They feel that the service is in a constant state of flux and they have no confidence in the NHS management to manage the rate of change successfully and smoothly. Above all, they are affronted by the lack of public involvement in that process of change. It seems to them to be a thoroughly undemocratic procedure, pursued behind closed doors in an atmosphere of extreme secrecy. Health officials then spring changes on the public that they would not have wished, that they deplore and that they have little opportunity to change through the consultation process. Indeed, Mr. Cook—

Order. Not for the first time today, I must remind hon. Members that when the House, in its wisdom, decided to hold proceedings in parallel fashion in this Chamber, it determined that the presiding officer should be a Deputy Speaker.

Indeed, Mr. Deputy Speaker. I am only too delighted to give you the right nomenclature. I wrongly thought that the proceedings were as in Committee.

The rate of change to hospital services in west London has been mirrored by the number of Adjournment debates which I have had on the Floor of the House. One was on St. Vincent's hospital in Eastcote, which was virtually forced to close as a result of the Government's decision not to allow health authorities to put NHS work in so-called private hospitals—even though St. Vincent's was a medical charity and not a private hospital. There was also a debate on Mount Vernon hospital in Northwood, many of the services of which have been stripped away. It will lose the burns and plastic units to Northwick Park in the spring of next year. There were two debates on the future of Harefield hospital, on 2 December 1998 and 13 November 2000. I spoke again on 28 July 2000 about the future of this outstanding centre of excellence.

The rate of change to hospital services is so dramatic and bitterly opposed by local people that their elected representatives must spend a disproportionate amount of time concentrating on NHS issues that should be managed efficiently and effectively by the NHS itself, which it clearly is not doing. Indeed, there has been an all-out assault by the NHS on hospital services in my constituency. The assault is not yet terminated, but I hope that it will be checked by a wise decision—which I trust that the NHS will make—not to go ahead with the closure of Harefield hospital.

Vested interests are at work, which is the most malign aspect. This is evidenced by the consultation process on the document to which I referred, which was issued by the West London Partnership forum of four health authorities in west London, led by the Kensington, Chelsea and Westminster health authority. It relates to the centralisation and rationalisation of renal services, paediatric services and cardiothoracic services in west London. The exercise has been flawed by the fact that the Kensington, Chelsea and Westminster health authority is a member of the Paddington basin regeneration partnership, which would benefit from one of the most important proposals—to create a new cardiothoracic hospital in the Paddington basin.

The first meeting in the so-called consultation took place on 13 July in the Metropole hotel, Paddington. The hotel—surprise, surprise—is also part of the Paddington basin regeneration partnership, and stands to benefit from the proposals, so it is hardly impartial and objective. St. Mary's NHS trust in Paddington would also be a beneficiary of the proposals, as paediatrics would be concentrated there, and there would be a spin-off from the new cardiothoracic hospital alongside. It, too, is part of the Paddington regeneration partnership, which vitiates its independent status and damages public confidence in the process.

As I explained, Kensington, Chelsea and Westminster health authority has led the consultation proceedings, which will be wound up tonight in Imperial college, which is another potential beneficiary of what is planned. It will provide the general public with a final opportunity to have their say. However, it must be unambiguously stated that, although the public can have their say, there is no evidence that national health service officials listen to them—let alone carry their suggestions forward into implementation of new policies. This may gravely damage public confidence and lead to a total alienation of the public from the NHS management.

On 30 June, the Kensington, Chelsea and Westminster health authority asked Westminster city council for outline planning permission for the new hospital for cardiothoracic services at Paddington basin, for which it had not even issued the consultation document. It represents an intolerable presumption, pre-empting at a stroke the entire consultation process. There were two objectives behind that pre-emption. First, the health authority wanted to ensure that its planning application was in as early as possible, assuming that the consultation would be a rubber stamp and make no material difference to its proposals. Secondly, it wanted to make certain that the new Greater London Authority, which became operational on 3 July, had no role in assessing the planning implications. It was important for the health authority to circumvent the GLA's strategic planning role for the capital by getting in its application before the GLA began its operations. This was a highly unethical and unedifying little device, providing a further instance of public confidence being gravely undermined.

The new cardiothoracic hospital at Paddington basin is to be funded in part by the sale of land on the Royal Brompton and Harefield hospital sites. Any of us could tell the NHS that a far more cost-effective option would be to develop Harefield hospital, which falls within my constituency. The NHS national plan explains that the Government are rightly laying greater emphasis on improved cardiac care and that more moneys are being devoted to this admirable cause. However, Harefield might also be funded and its facilities modernised and improved. The hospital is already about the best in the world as regards care. There must be further investment in equipment, but the site and location are ideal, the personnel are committed and local people are supportive. Paddington basin is about the worst possible location for a new cardiothoracic hospital, lying in the middle of the most congested, polluted, lawless and unpleasant environment in central London. It will be much harder to find staff to work there and much more expensive to keep them.

An additional improvement to cardiothoracic services, as outlined in the document, will take place at Hammersmith hospital and will be funded by an extra £13 million. Renal hospital care is to be concentrated at that hospital, and the build-up of those services should surely be enough for Hammersmith. The £13 million should go to the improvement of Harefield hospital, and it could be done now without drastically affecting the outline plan which has been put to the public. That would be a much more sensible policy.

Even in the most favourable circumstances, the new cardiothoracic hospital in Paddington basin will not be operational until 2006. Let us use the moneys from Hammersmith hospital and the moneys being made available under the NHS plan for cardiac medicine to improve Harefield hospital. In that way, an outstanding centre of excellence, which has done more heart transplants than any hospital in the world, can continue to operate to the benefit of all.

The final point is that NHS services in London are often planned centrally and take no account of the knock-on effect outside the metropolitan area. Harefield hospital is a case in point. It takes patients from all over the country and from abroad. Only 10 per cent. of the hospital's patients come from the borough of Hillingdon, where it is located. For it to be treated merely as part of the London NHS service is parochial and inadequate. The four health authorities concerned ought to have involved neighbouring health authorities much more widely, but they made no effort to do so. It is a national decision, and it should not be taken on a London basis.

I share the anxieties of the hon. Member for Carshalton and Wallington for south-west London, but drastic changes are needed also in north-west London. A good place to start would be to forgo the option of closing Harefield hospital. The hospital has had an outstanding past and it has a great future. People believe in it, and it should be allowed to carry on successfully.

I congratulate my hon. Friend the Member for Carshalton and Wallington (Mr. Brake) on bringing this subject to the attention of the House. The Minister has about 15 minutes to speak about the health service in London. She has my sympathy, because it would take about a week to do that properly.

I want to speak not only about the problems, but about the good features of the London ambulance service NHS trust. Way back in the last century, I was a casualty officer at University college hospital. I was there for more than a year and came to know the London ambulance service, as it was then, very well. Last weekend, I went on a trip down memory lane. I spent Saturday night with the ambulance service in Richmond, and went out the ambulance men on their calls.

I am delighted to report that nothing much has changed. Medicine and emergency treatments may have changed, but members of the ambulance staff have the same extraordinary character; a combination of intelligence, quick thinking, intense patience, hard work and the ability to laugh off the most extraordinary difficulties. I hope that the House shares my admiration for them. About 700,000 calls per year are made to the ambulance service in London, and the ambulance staff answer them in about 350 vehicles. I cannot speak too warmly of them.

I was pleased also to hear the tremendously warm words that the ambulance crews had for the newly appointed chief executive, Peter Bradley. He has come up through the ambulance service but, even in the exalted position of chief executive, he finds time every week or two to wear a reflector jacket and act as a crew member somewhere in London. He wants to know the problems and difficulties that are being encountered by the ambulance service. That is some chief executive. I commend his activities to all chief executives in the health service, many of whom are out of touch.

The ambulance staff are being asked to do the most extraordinary things, but I am glad to say that standards in London are extremely high. That is due largely to Dr. Fionna Moore, the medical director of the London ambulance service, who trains and retrains the ambulance crews and organises seminars and teaching sessions for them, so that they can perform ever more difficult procedures and provide ever more advanced medical treatments to their patients on the way to hospital.

I am enjoying the hon. Lady's description of the marvellous work done by the London ambulance service, but will she confirm for the record that it is bottom of the national league for response times?

I am coming to that. Response times are important, but it is also important to point out first what is excellent about the service. I hope that the hon. Gentleman agrees.

The quality of the service in London is good, but there are no national standards. It depends entirely on the medical director; another director may not be as good. The Minister needs to address that problem and ensure that there are national standards and protocols for ambulance services, so that the quality of the London ambulance service does not slip back if it has a change of staff. We have a helicopter service in London, albeit a scanty one. The police or ambulance service can summon a helicopter if they are in an extremely serious hole and need urgent help from the doctor on board. Helicopters are good, but there are far too few of them.

The hon. Member for Runnymede and Weybridge (Mr. Hammond) mentioned response times. An ambulance should respond to a call inside eight minutes. As we all know, however, the London ambulance service's response rate is appalling. Its target was to attend 55 per cent. of calls inside eight minutes, but it achieved only 32 per cent. To someone who goes out with an ambulance, as I did, it is obvious that a vehicle travelling along the ground—albeit with flashing blue lights and a siren—simply cannot get through the London traffic. The problems with public transport have made it even worse. A journey in my car last week between Westminster and Kew, where I live, took two and a quarter hours. An ambulance making the same journey—a distance of less than six miles—will not make it in less than half an hour, even with its blue lights flashing. The problem is extraordinary and must be addressed.

The hon. Lady is making an exceedingly important point about traffic. With the benefit of her experiences in the ambulance and in her car, does she agree that locating a premier heart hospital—which will take the most critical cardiac cases, involving people teetering on the edge of death—in the centre of London is absolute madness? Would it not be much better to keep the hospital at Harefield, which has easy access—because it is close to motorways and open country—and is a far more rational location?

At times, I have been slightly irritated by the hon. Gentleman's constant advocacy for Harefield hospital, but his points in this debate have made me think. I am listening to his arguments and I entirely agree with him. The more I think about concentrating all our high-powered emergency services in the centre of London, the dafter it seems. The hon. Gentleman has done much to change my mind.

The problem is difficult to solve and is compounded by a shortage of ambulances. In Richmond, for instance, one ambulance is on duty and another is shared with surrounding areas such as Hounslow and Chiswick. Richmond does not have a spare ambulance. If one of them breaks down, that's it folks—unless a spare stand-by ambulance from another area can be used. That is a serious problem.

Does my hon. Friend agree that there is a need for much greater communication between the ambulance service and other providers such as St. John's ambulance? Such organisations often have ambulances sitting idle that could be used.

Yes, I was going to come to that. The call-outs that I experienced and was told about while I was working with the ambulance men ranged from the most trivial to the most serious and appalling cases. The 999 calls cannot be refused, although the switchboard tries to prioritise them. There can be a bit of a queue for an ambulance. On Saturday evening, for example, our ambulance service—fully equipped with defibrillators, paramedics and goodness knows what else—was called out by a woman who had splashed vinegar in her eye. An ambulance had to go out to that call, which seems an extraordinary waste of resources. I do not know how may hundreds of pounds that must have cost.

My hon. Friend the member for Carshalton and Wallington is quite right. We could use other resources for the non-urgent cases. I would ask the Minister to address the matter of obviously minor injuries. We trust NHS Direct to make judgments about whether a patient should go to hospital or the local pharmacist and we could do the same with the ambulance service. If NHS Direct is to be allowed to call ambulances in the future if it considers a condition serious, could not the two services liaise in some way so that the ambulance service can refer a patient with vinegar in her eye back to NHS Direct for advice? We need to think this out so that we do not use valuable teams to go out to trivial injuries. The other problem on a Saturday night was the drunks.

Will the hon. Lady clarify whether she is arguing for the routing of 999 emergency calls through NHS Direct?

I am asking for it to be looked at. I am not being dogmatic. If we can allow NHS Direct nurses to call ambulances, why can we not allow what turn out to be trivial cases—although they may not seem so to the person involved—to be referred back to NHS Direct when 999 is called unnecessarily? I would like to have a discussion and to work through what would happen if we did that.

I come back to the problem of the drunks, who are often an absolute pest. They occupy hours and hours of ambulance and casualty time for the sake of a couple of stitches on a chin, as I saw at the weekend. It was nonsense that hundreds of pounds were spent on someone who had fallen down because he was drunk and had a small cut on his chin. We must rethink the service if we are to use it more effectively.

One of the biggest problems for the London ambulance service is keeping staff. The average ambulance man with full paramedical training earns about £20,000 a year. They start as trainees at around £12,000 and work up to £18,000, but with overtime they can get £20,000. These are people who do cardiopulmonary resuscitation, set up intravenous drips and make judgments as to whether to call a crack team in the helicopter service; they earn, if they are lucky, £20,000. As long as they are paramedics, they stay at that level. There is no increment for years of service, apart from inflation. That is another outrage. Ambulance men are the lynchpin of the emergency service and they should be properly rewarded.

I discovered that eight ambulance men had recently left the Chiswick station in south-west London. They are not leaving the ambulance service; they are just moving out of London. If one moved right out into the countryside, one could exist on that sort of pay and find somewhere decent to live. However, people cannot live on that pay in the London area. Three are leaving Richmond. One told me that he was going to the west country where, instead of his cramped, two-bedroomed rented flat, he will be able to afford a mortgage and buy a three-bedroomed house with a nice garden. What chance is there of retaining those valuable staff if we do not tackle the problem?

I was asked to inquire as to what had happened to the help with mortgages scheme that the Government trumpeted in the spring. Health service staff were to be allowed interest-free mortgages, but ambulance men in London do not seem to have heard anything about the scheme. The ambulance service is desperately short of staff; it is more than 400 down on its requirements. Although the Government have in their wisdom told the service that it can have more staff and that more funding is available, it is necessary to find and recruit the people. The same is true of nursing and many other professions allied to medicine in the London area. The problem is a serious one and needs to be taken seriously.

The people who work in the service are denigrated because they do not achieve their targets, but they provide care of extraordinarily high quality to the patients with whom they deal. We should always remember that. The health service should cease to worry so much about targets and should pay more attention to the quality of care.

I apologise to you, Mr. Deputy Speaker, and to the hon. Member for Carshalton and Wallington (Mr. Brake), for missing his first few remarks. I congratulate him on obtaining the debate, which allows us another opportunity to discuss our concerns.

I support my hon. Friend the Member for Ruislip-Northwood (Mr. Wilkinson) in his remarks about the removal of services from our borough, and the potential threat to Harefield hospital. Unlike the hon. Member for Richmond Park (Dr. Tonge), I have never been irritated by my hon. Friend's advocacy of his constituency interest; such advocacy is probably the highest calling that anyone in this place can have. The people of Harefield and the Harefield hospital are lucky to have such a doughty crusader to speak for them.

Local Members of Parliament stand shoulder to shoulder on this issue—and I include the hon. Member for Hayes and Harlington (Mr. McDonnell) in that. Only last week, we had a third joint meeting of what I suppose these days is called the health economy in Hillingdon. I am not a great one for modern phrases, but I suppose that that sums up the matter quite well. At each of those meetings, the constant theme is the lack of confidence in consultation.

Yesterday I was here, listening to an interesting debate instigated by my hon. Friend the Member for Eddisbury (Mr. O'Brien) about community health councils. There was a strong impression that consultation on that matter had been along the lines of announcing, "There will be consultation about the future of community health councils, but they will be abolished." The same theme has been constant in my constituency and others. Consultation affecting Harefield and Mount Vernon hospitals has been of the same kind. Limited consultation is arranged, but everyone knows what the outcome will be. That does nothing to encourage belief in what the national health service is providing locally.

Of course, local provision is not what we are considering with respect to Harefield hospital. Harefield carries out 170 operations a year, of which 62 are heart and lung transplants. In total, 2,300 successful heart transplants have been carried out, which is a world record. Harefield is a European training centre for cardiologists. Some 60 countries send doctors there to be trained, who then return to their countries with new skills learned at Harefield. Some 95 health authorities purchase health services from Harefield hospital, and that covers roughly 9,500 episodes a year.

As the hon. Member for Richmond Park said, my hon. Friend the Member for Ruislip-Northwood has, of necessity, raised the issue many times, but it is always worth repeating such things. More than half of patients come from west, east and north Hertfordshire, Hillingdon, Harrow, Bedfordshire and Buckinghamshire, so access is very important. The hon. Member for Richmond Park mentioned the problem of access to the proposed complex at Paddington basin, with regard not only to gridlocking on the roads, but the public transport system. Like many other London Members of Parliament, I often use the underground, and the system is not at its best. For patients, and especially for visitors who must make several trips to the hospital, the state of underground and road systems will lead to further stress.

Although I am a lay person in these matters, there is a point which strikes me as obvious. Harefield is a marvellous location for care following the sort of surgery that we are discussing. Anybody who has been there will realise why the site was chosen. It is a superb location for recuperation. I cannot believe that the Paddington complex, even with its wonderful new buildings, will provide that same natural environment for recuperation; that is common sense. Many patients who come for major surgery come from a long distance away. Accommodation costs will be much higher in the centre of London. Many such matters have been brought before the House before, but we have reached a crucial period.

Costs are often mentioned. I found it striking that, according to figures supplied by the West London Partnership, Harefield needs only £20 million to bring it up to a minimum viable standard, whereas the new complex will cost£132 million. I am a simple person, but I cannot help feeling that the difference between those two amounts could be better used than for providing a new hospital when we already have a superb hospital that needs only bringing up to standard.

A report commissioned by the NHS Executive in 1999 and carried out by York university found that bigger hospitals are not necessarily better in terms of efficiency or quality of care. The report concluded that, overall, there was no compelling reason to believe that further concentration of hospital services would result in improved efficiency or automatic improvements in the quality of clinical outcomes. I am a great believer in the idea that small is beautiful. My constituents want to feel that their national health services are a part of the community, and the insistence on centralisation flies in the face of what people want.

Does the hon. Gentleman agree that a lot of that change is being driven by the general public's need for clinical excellence and expertise? The royal colleges, which are in charge of these matters and in charge of training, insist that hospitals should be big so that there is available the necessary expertise for the training of junior staff.

We all want clinical excellence, but I am not entirely sure that big always means the best. I concede, however, that I am a lay person and that the hon. Lady has great experience in such matters.

I should like the Minister to respond to all the issues that I have raised, although I am beginning to become a realist in this place. I am sure that all Members of Parliament hear horror stories about the national health service. In the past few weeks, I have been contacted about what has gone on in the Hillingdon hospital and elsewhere, and such matters must be dealt with. Occasionally, however, people write about the wonderful care that they have received, so we must be careful not to concentrate on the bad side. I pay tribute to those who work in the national health service and who have to work under extreme pressure for various reasons, many of which I cannot lay at the Government's door. Some I can, but I shall leave that for another time.

I congratulate my hon. Friend the Member for Carshalton and Wallington (Mr. Brake) on securing the debate and on giving us the opportunity to discuss the health service, which is one of the most important issues that face us all. He referred to the massive change that the NHS is experiencing throughout the country, particularly in south-west London.

I must resist the temptation of becoming embroiled in my constituency interests, but the debate has rightly drawn attention to the worry that perhaps too much management time is being invested in reorganisation, rather than in the key issues of delivering better health outcomes for the population of London. Reorganisation, for its own sake, is a distraction; a worry that is echoed by some managers. I hope that there will be less reorganisation and more focus on delivering much of the health agenda for which the Government have been calling and many of us support.

Hon. Members have highlighted another part of London. My hon. Friend the Member for Carshalton and Wallington referred to south-west London, and the hon. Members for Ruislip-Northwood (Mr. Wilkinson) and for Uxbridge (Mr. Randall) rightly drew attention to the health service in north-west London. They spoke of their experience of the process surrounding decisions affecting Harefield hospital. Both hon. Gentlemen were right to highlight the lack of accountability and transparency in the NHS decision-making process and the fact that, all too often, the formal consultation stage, when it is reached, comes far too late to have a serious effect on that process.

The hon. Member for Uxbridge made the important point that when we debate the health service, it is inevitable that we focus on those matters that are not entirely right. I make no apology for the fact that I may do that in my speech. However, he was right, as was my hon. Friend the Member for Richmond Park (Dr. Tonge), to highlight and praise much of the dedicated work of NHS personnel in all positions.

The debate is timely. We must recognise that we are on the verge of the busiest time of the year for our health and social care systems. It is a time of great stress and strain for all care staff, when the health and social care systems are tested to their limits. Signs are already emerging that this year's winter pressures will be every bit as intense as last year's. All it will take is another flu outbreak or a major incident to tip our health and social care systems over the edge. I wish to explore why the system is still vulnerable. Some of that vulnerability is a result of the previous Government's failure over a decade or more to invest in NHS and social care capacity. There are fewer nurses, doctors and beds.

Three factors will be crucial to managing winter pressure: the looming bed crisis in the private nursing home sector; the shortage of NHS beds; and the poor performance of the London ambulance service. The most recent annual returns state that London has lost 2,491 nursing home beds. The trend and the analysts point to an acceleration in home closures during the past year; something that will continue. About 50 per cent. of all admissions to nursing homes take place direct from hospital. Nursing home beds are therefore a critical part of the bed-blocking equation. Fewer nursing home beds means more delayed discharges.

Why are there fewer nursing home beds? The answer is simple; the cost of running care homes is increasing much faster than the level of state funding. A care home worker can earn more stacking shelves in Safeway than he or she can earn caring for a frail, elderly person, and that is even before one takes account of the extra costs of recruiting and retaining staff in London.

This year, the fees for state-funded nursing home places increased by only 2 per cent. On top of the rise in costs, many people in that sector feel uncertain about the future. The way in which the Government handled the new care standards for homes has undoubtedly done serious long-term damage to confidence in the market, which is at an all-time low. Costs are rising. People will not want to invest in the market; it gives no return at present. However, there is a certain return, in that the land is worth more with flats or houses on it than nursing home residents.

Problems in the nursing home sector are compounded by bed and staff shortages in the NHS. About a third of all nursing vacancies are in London. It does not pay to be a nurse in London. The Office for National Statistics says that the average wage in London is now £28,812. What pay is on offer for nurses in London? The Nursing Times advertises a qualified D grade staff nurse post with a starting salary of £17,257, including London weighting. That is £11,000 less than average London earnings. Even highly qualified staff are paid less than the London average. For example, the salary of a grade G ward sister to run a specialist ward in London is advertised as £23,962. It is hardly surprising that London has such a chronic nursing shortage, given that the pay is so out of touch with market conditions.

Depending on which newspapers one reads or to whom one talks, the figures vary, but it has been stated that there will be an extra 41 intensive care beds in London this winter. Is that figure accurate? Yesterday, my office contacted the NHS regional office to find out whether London will receive those extra beds and the staff to support them. Despite repeated questioning, that office would not comment on the plans for intensive care beds. It refused to comment on the number of beds, where they will be and whether they will be fully staffed and up and running by the planned date of 1 December. How many extra beds will be available to the NHS in London this winter compared with last winter? How many staff will be needed to support those beds? How many of those staff are in post today or will be in post on Friday, 1 December? Will those extra beds be fully staffed and operational by then?

I want to clarify the term "intensive care beds". The report that drew attention to the 41 beds refers to "critical care beds". Mention has been made of high-dependency beds, intensive care beds and critical care beds. Are not the Government simply playing a game with terminology?

The hon. Gentleman makes a fair point and one that I am sure he will develop later. Different reports that use different terminology cause the confusion. I hope that the Minister will be able to shed light on such issues.

Without the extra beds and staff, London will be facing another winter of trolley waits and ambulances ferrying sick people around accident and emergency departments for want of a bed. My hon. Friend the Member for Richmond Park referred to the London ambulance service. She rightly paid tribute to the dedication of ambulance crews and touched on the difficulties that crews face in respect of alcohol abuse, which affects the efficiency of the NHS and has a physical impact on ambulance crews. The numbers of assaults due to people being intoxicated is an unacceptable factor in the work of those crews.

Despite the dedication of the crews, the performance of the London ambulance service is the worst in the country when compared to other urban ambulance services. If one dials 999 in London, three times out of five the ambulance will take more than eight minutes to arrive. The best performance is in the west midlands, where in three out of five cases the ambulance arrives within eight minutes. Things in London have got worse and not better over the past year, as the ambulance service moves away from the Government target of a 55 per cent. response rate for 999 calls. A host of factors combine to make London the bottom of the league in that respect.

I hope the Minister will comment on traffic, which is a key issue. What assessment have the Government made of the impact of the extra traffic on our roads this winter due to the crisis in the railway system and the safety work that is being done? That extra traffic makes it even more difficult to achieve response times. What contingency plans have been made to ensure that there are extra ambulances to guarantee some attempt to achieve those times?

In addition to the delays on the roads, delays are happening in hospitals. More than 1,000 hours a month are wasted as ambulance crews are forced to wait for patients to be admitted, which means that fewer ambulances are available to respond to 999 calls. That figure is based on average turnaround times collected in April and June. Does the Minister agree that turnaround times are likely to rise during the winter? What steps are being taken to prevent a further fall in attendance times as a result of the time spent waiting for a bed to become available? Another factor is that many of the dedicated professionals leave the service because they cannot afford to live and work in London.

A failure to recognise the collapsing confidence in the nursing home sector and the bed shortages that it is causing will exacerbate bed blocking in the NHS this winter. The failure to plan for increased capacity in the NHS for over a decade or more further exacerbates the pressures caused by bed blocking. The result is care gridlock in our system; life or death delays in 999 calls and more trolley waits in overstretched accident and emergency departments. Will the Minister lift the veil on the issue of how many beds will be available, whether they will be new beds and whether they will be fully staffed from 1 December?

I, too, congratulate the hon. Member for Carshalton and Wallington (Mr. Brake) on securing the debate. Our previous debate on London health services was on 14 June. Following the implementation of the Ternberg report, it is right that the House should regularly review progress in the development of those services. I am disappointed only in that not one London Labour Member of Parliament has bothered to attend the debate, despite the political stranglehold that the Labour party has on the capital. I hope that the House continues to monitor London health services, taking into consideration what matters to patients—the outcomes—and not the input made to the service by the Government, although that is what the Government would prefer to discuss.

The hon. Member for Carshalton and Wallington said that in south-west London, we see a microcosm of the problems affecting the health service in London. It is also fair to say that, despite the special problems facing the service in London, the city represents a microcosm of the problems facing the NHS throughout the country.

Since our previous debate on the NHS in this Chamber, the Government have released their NHS national plan—a 10-year plan delivered after three years in office by the party that told us that we had 24 hours to save the NHS. With the 10-year plan in front of us, we can see the gap between Government rhetoric and the reality experienced by the people of London in their daily contact with health services.

The NHS in London has a revenue budget of about £5 billion and employs about 140,000 staff, so it represents a significant part of the NHS nationally. As we move towards the annual winter pressures, the media, which is largely based in London, will focus on what happens in the NHS in London. That will put London's health services under the spotlight—and under a tremendous amount of political pressure as well.

Among the national issues that impact on London in particular—some of which have already been mentioned by hon. Members—staffing is key. Nursing numbers in many London trusts are 25 per cent. below establishment numbers, which constitutes the worst shortage in the country. On this morning's "Today" programme, the Minister valiantly defended the Government's record against comments by the Royal College of Midwives about the midwifery crisis in London. Like me, she will have heard a midwife from King's college hospital say that its maternity department had to close twice in a week. That was the first time in 13 years that it had to refuse admissions.

In respect of the reduction of junior doctors' hours, five of the 10 worst non-complying trusts are London trusts. Even at the level of qualified surgeons, there are great difficulties in recruiting and retaining staff in London. The national service framework for coronary heart disease requires that, by 31 March 2001, no patient will wait longer than 12 months for cardiac surgery. Will the Minister concede that that requirement will not be deliverable in London, and that the Government are exacerbating the problem and alienating senior cardiac registrars by threatening to bar them from private practice when they become consultants?

I should not leave this issue without mentioning the problem of ancillary staff. Even when it is possible to find nurses from the Phillipines or Spain, or doctors from Germany or Finland, hospitals often find it difficult to clean wards, move patients around and deliver food to them. The pressure to find ancillary staff is worsening all the time.

Like other hon. Members, I pay tribute to the tremendous work undertaken by London NHS staff. They work under great pressure, and often for little thanks. Many face daily abuse and violence, and morale is at rock-bottom. That is made worse, I am afraid to say, by the brick bats that Ministers—and the Prime Minister himself—regularly aim at doctors in particular.

As the hon. Member for Sutton and Cheam (Mr. Burstow) said, another problem is bed blocking, although I fear that he may have understated it. He mentioned a figure of some 2,400 beds a year, based on recent statistics. However, according to figures that I collected yesterday for Kingston upon Thames—the smallest London borough—there has been a net loss of 300 beds in the residential and nursing care sector since 1 April this year. That suggests a meltdown and, as the hon. Member for Sutton and Cheam said, it leads directly to the bed-blocking problems that will undermine the Government's careful preparations for this year's winter crisis.

The previous Government closed Queen Mary's hospital in Roehampton without making any provision for the extra beds that were consequently required. Does the hon. Gentleman agree that that has contributed to the intense problems in Kingston and, indeed, Richmond, which is part of my constituency?

The hon. Lady is addressing a slightly different point. Bed blocking is created by the inability to discharge patients who have completed their clinical care and need continuing social care. As she well knows—if she does not, her hon. Friend the Member for Sutton and Cheam does—that is a major problem that undermines the Government's attempts to deal with this winter's NHS crisis.

On 23 November, just one intensive care bed was available in London. The hon. Member for Sutton and Cheam mentioned that 41 additional beds were promised, but no one has been able to confirm whether they are intensive care beds. The number of outpatients in London who wait longer than 13 weeks is on the rise. One major London trust told me yesterday that orthopaedic outpatients are waiting more than one year to see a consultant. In London, the number of operations cancelled on the day is rising.

The suspended list, comprising of patients who no longer appear on the waiting list because they have been suspended, is a scandalous device that is widely used in London and elsewhere to reduce waiting lists and achieve targets. How many patients in London are now on the suspended list, following the scandal at King George V hospital in Ilford more than a year ago?

One in four of the longest accident and emergency waits in the country occurs in London. Waits of more than two hours are increasing—a fact that is regularly mentioned, no doubt much to the annoyance of Ministers, by London community health councils in their casualty watch reports. For example, on 21 August, Tower Hamlets community health council reported that a 66-year-old patient with abdominal pain waited on a trolley for 19 hours after the decision to admit him. Is that why the Government are so anxious to abolish community health councils? Can the Minister look hon. Members in the eye and tell them that she expects the Government's new patient advocates, who are employed by their NHS trusts, to sendunsolicited—to Members of Parliament the kind of damning information that we regularly receive from CHCs?

It is easy to focus on the big headline issues that affect London's hospitals, but we must never forget that alongside the great centres of excellence are some of the worst performing and worst delivered primary health care services. For the sake of the NHS in London, I appeal to the Minister to ensure that when the Government address the special problems that London faces—such as the inexorable rise in TB cases, falling levels of vaccination, rising teenage pregnancies and the above-average rate of adult male mental health problems—they do not forget the requirements of ordinary people who do not have high-profile needs, belong to a specially targeted group or have Government ring-fenced money directed at them. The future of the NHS in London depends on maintaining a consensus based on the understanding that the needs of ordinary people can be met by the service; that after all the high-profile and glamorous work has been done, enough money will be left to deliver proper primary and community health care services.

Will the Minister tell the people of London how she can square the Secretary of State's rhetoric two weeks ago"when he announced a doubling of the ring-fenced money to address inequalities"with the fact that Camden and Islington will be the only London boroughs to receive any of that extra money? London will receive only £1.3 million of the £130 million that was announced. Can she explain to the people of Newham why, given that the Government are supposedly addressing inequalities in health care, a place such as Newham will receive no additional money whatsoever under the initiative announced by the Secretary of State? In reality, that initiative is about distributing money away from London to places further north.

This has been a useful and interesting debate, and I look forward to the Minister's response. I hope that she will deal with some of the specific points that I and other hon. Members have made.

I add my congratulations to the hon. Member for Carshalton and Wallington (Mr. Brake) on securing the debate. We last debated the subject during the consultation process on the NHS plan, so this is a timely opportunity to discuss how the plan will take forward proposals for the NHS in London and the implications of that.

The NHS faces particular challenges in London, a diverse city with a population of more than 7 million. An additional 2 million people come to the capital each day for leisure purposes and another 1 million non-Londoners commute daily to work in the city. That inevitably places great pressure on the national health service. London's greater mix of ethnic groups and sharper extremes of wealth and poverty—with high unemployment, low pay, poor housing, crime and environmental pollution in some areas—all contribute to the problem.

The NHS employs more than 140,000 people in London alone and is the largest employer. It is larger by far than any company and in most boroughs it is among the largest employers. I join the tributes made by hon. Members today to the immense contribution made by hard-working NHS staff throughout the city and the difference that they make to patients' care and patients' lives.

I shall respond to some of the general points that have been raised, especially those in the context of the NHS plan, but I shall try first to deal with some of the specific issues.

The hon. Member for Carshalton and Wallington referred to Orchard Hill, where the health authority is in discussion with the local community following the judicial review. He also referred to proposals concerning primary care groups and trusts and changes to health authorities. He knows that I am limited in what I, as a Minister, can say because any proposals for change would have to go through extensive public consultation and the proposals have not been announced. We prefer to encourage coterminosity because it can make joint working, especially with local government, considerably easier. However, there must be flexibility to cope with local circumstances and communities.

The NHS plan covers fundamental change not in institutions and restructuring, but in ways of working in institutions and in partnership among institutions. Reconfiguration sometimes contributes to that, but sometimes it is a distraction. We expect health authorities and institutions throughout the country to make delivery of the NHS plan a priority and to ensure that any changes are in the context of delivering better care for patients. The hon. Member for Carshalton and Wallington knows that I cannot comment in detail on the Epsom and St. Helier NHS trust because the consultation is only just concluding and proposals may be referred to Ministers. However, it was helpful to hear his views.

It was also helpful to hear the views of the hon. Member for Ruislip-Northwood (Mr. Wilkinson). As he said, consultation is under way and as proposals may be referred to Ministers later, he will know that I cannot comment at this stage. However, I can tell him that we shall keep benefits for patients at the top of our criteria for assessing any proposals for change.

The hon. Member for Richmond Park (Dr. Tonge) referred to a lake at St. Thomas' hospital. I visited the hospital less than a month ago and I did not see a lake, but I shall ensure that her comments about it are passed on. She also paid tribute to the hard work of the London ambulance service and I join her in that. The target response for ambulances throughout the country is eight minutes. The London ambulance service's aim is to reach 55 per cent. of patients within eight minutes by the end of March next year.

There are additional problems in a busy capital city, but the service has made considerable progress. In the past seven years, the demands on the service have almost doubled and, in the same period, the number of responses meeting the eight-minute target has increased from 12 per cent. in 1993 to 41 per cent. today. Clearly that improvement needs to continue and the amount of medical, support and emergency services that we can provide through the ambulance service is supported by the NHS plan. I shall write to the hon. Lady about the issues that she raised concerning links between the ambulance services and NHS Direct. We have invested an extra —21 million across the country to improve ambulance response times, and to meet the national service framework in respect of coronary heart disease.

The hon. Members for Runnymede and Weybridge (Mr. Hammond) and for Sutton and Cheam (Mr. Burstow) raised various issues concerning London that I shall try to address as I cover some more general points. We are setting out a huge programme of implementation for the NHS plan, which includes setting up a modernisation board with task forces in many areas to oversee the programme. I am pleased that a London modernisation board has been set up, and I am delighted that it includes clinicians and managers from the NHS, partner organisations and patient and user representatives. Clearly, to implement the NHS plan, we need an effective partnership across the city.

Part of the story of implementing the NHS plan and addressing many of the concerns raised by hon. Members concerns extra resources for the NHS in London. This year, there has been already a significant increase in resources for the NHS in London. Next year, there will be an above average increase of 8.9 per cent., including extra help to tackle both inequalities and the cost-of-living supplement. The cost of living is a particular issue in respect of recruitment pressures within the city. For the first time, we have given health authorities a guaranteed minimum level of funding not only for one year, but for future years.

The Secretary of State announced a —70 million increase in the ring-fenced inequalities fund. Why has only —1.3 million of that money gone to London, a city with two thirds of the most deprived local authority wards in the country?

I have been searching through my papers for detailed figures about the allocations, and I shall write to the hon. Gentleman on that point. Clearly, there is an inequalities issue in London; that is why we have health action zones in Hackney, Lambeth, Southwark and Lewisham. We must tackle inequalities right across the city. That is why, for example, we are examining both the causes and prevention of health inequalities, which the Conservative Party fundamentally failed to do in 18 years in office. Inequalities are at the top of the Government's agenda.

Returning to the issue of extra money, there will be a —493 million increase for London next year, which will take its total allocation to more than —6 billion. Compared with an average real increase of 3 per cent. in previous years, an increase of more than 6 per cent. over several years constitutes a sustained increase.

The hon. Member for Runnymede and Weybridge was happy to list a series of complaints about the NHS, but I am interested to know how he expects them to be addressed. We have set out a clear programme for investment and reform, and I am unsure whether he is calling for resources in addition to that extra investment, or whether he intends to abandon his proposed subsidy for private health insurance to make up the shortfall in the investment that would be needed to match our proposals. Over the next few years, our capital investment plans include —3.5 billion to be invested in primary, community, mental health and hospital settings.

Will the Minister write to me to answer the questions about intensive care beds, so that we can have those answers on the record?

I shall certainly write to the hon. Gentleman. I was about to discuss our preparations for winter, with which I shall try to deal rapidly. We have already made available more than —34 million of additional funds for the winter in London, and we shall set out the exact proposals on critical care beds and acute beds. I understand that plans are in place for an extra 40 critical care beds and an extra 400 acute beds, compared with last winter. We shall set out further details in due course about the extra capacity in the capital this winter.

Discussions are continuing about further investment this winter, which is needed. We also need to reform the way in which things happen. Many excellent proposals have been put into operation in London already, including the innovative cancer collaboratives, which change how NHS care is provided. A huge number of other proposals will come on-stream as a result of the NHS plan, which should make a substantial difference to the care of patients in the capital city.

I welcome the opportunity to debate a matter that is of great importance to my constituents and to those living in mid-Essex, especially relatively shortly after the publication of the latest report by the chief inspector of prisons. It is a cruel irony that today is the sixth anniversary of the death of Christopher Edwards. I am pleased to see the hon. Member for Braintree (Mr. Hurst), who has worked on behalf of his constituents, Mr. and Mrs. Edwards, the parents of Christopher Edwards. I note, too, that the hon. Member for Colchester (Mr. Russell) is also present. What goes on in Chelmsford prison is important to other hon. Members in the county and beyond.

As the Minister knows, in the past three and a half years, the chief inspector of prisons has produced three reports on Chelmsford prison. After the publication of the March 1999 report, I was so worried about the situation in the prison and the chief inspector's report that I secured a debate on 31 March 1999. During that debate, the then Parliamentary Under-Secretary of State at the Home Office said:

I hope that, this time next year, the hon. Gentleman is in a position to secure a debate following the report to discuss improvements.—[Official Report, 31 March 1999; Vol. 328, c. 1070.]

Sadly, 18 months later that is not the case. The next report has just come out, and in it the chief inspector states:

If this was the report of our first inspection of Chelmsford prison for a number of years, I would be pointing out that much of what it contained was wholly unacceptable, because it showed that prisoners clearly came last in the priority list for too many members of staff. That it is not the first, or the second but the third report in three and a half years to have said exactly the same thing makes it far worse, because it discloses that, yet again, the Prison Service has failed to address some very significant identified failings to do with the treatment and conditions of prisoners allocated to the prison.

I hope that the Minister agrees that that is a fairly damning indictment of the apparent inability of the Prison Service to tackle problems and adopt the recommendations that the chief inspector keeps making in respect of the prison.

For the sake of fairness, before I talk about some of the on-going problems highlighted in the report, I shall mention those important areas in which positive action has been taken since the 1999 report. First, a new reception building has been opened, which is a great step forward; it certainly meets the vast majority of criticisms and recommendations made by the chief inspector in previous reports. Secondly, the cell call bell system, which has been a major cause of concern in the past, has been replaced with a new electronic system which, according to the report, seems to be working well. I warmly welcome that fundamental and important step forward. Thirdly, an enhanced thinking skills course has been introduced, which benefits the prison environment.

However, turning to the recommendations that have not been achieved, the picture is more sombre: 41 of the chief inspector's previous recommendations either have not been achieved or have been only partially achieved. Given that this is his third report, that record is dismal and gives great cause for concern. Time does not allow me to discuss all 41 problems, but I shall draw attention to a few of them, the first of which is the health care centre. In his preface to his latest report, Sir David Ramsbotham states:

The regime in the Health Care Centre is profoundly unsatisfactory where, quite apart from the poor physical standards, the laid down standards for the in-patient regime, particularly for young prisoners, are in no way being met.

He continues:

The regime for vulnerable prisoners, from whom all work opportunity has now been removed, is an affront to the Prison Service's Statement of Purpose.

Unfortunately, the health care provided is of a standard that would be totally unacceptable to the population outside prison life. That cannot continue to be tolerated.

The report reiterates that previous recommendations for the health care budget to become needs-based have not been achieved. Similarly, the recommendation that the delivery of primary care should be the same as within the national health service has not been fully achieved. To achieve that, the report states, rightly, that there should be increased use of skilled primary care nurses equivalent to NHS practice nurses. I hope that something will be done urgently to address the problem and meet the recommendations.

The report is also quite damning about the failure of an audit of the new system for identifying mentally disordered people within the criminal justice system and adjusting staff levels to meet increased need. Given the sad history of Chelmsford prison in that respect, I am concerned that more has not been done to implement Sir David's recommendations. Apparently, up until April, when the unannounced visit took place, the courts had sent 58 faxes to the health care centre about new prisoners at risk of self-harm. There appears to have been no audit of the scheme and a registered mental nurse was not always available at reception to screen such prisoners. As the chief inspector rightly says, that omission should be rectified, and I trust that it will be.

More needs to be done to minimise self-harm in the prison. Apparently, in the 12 months to April this year, there were 70 self-harm incidents at the prison, including 12 attempted hangings, one of which, tragically, resulted in death. Such a record is not acceptable. The unannounced visit took place more than six months ago and the report has only just come out; if nothing has been done to implement the recommendations during the intervening period, will the Minister ensure that implementation becomes a matter of urgency?

I should also like to draw attention briefly to paragraphs 3.03 and 3.04 of the report, which deal with the length of time that prisoners stay locked up in their cells. Paragraph 3.03 states:

In concluding whether Chelmsford has moved forward in terms of the treatment and outcomes for prisoners, we were disappointed to find that in the 17 months since the last inspection prisoners were still spending too much time locked up. The official routine showed reasonable time out of cell every day for association but, in practice, bore little resemblance to the reality. There had been no improvement since our last visit and the reasons for this, we were told, were mainly attributable to staff shortages.

Paragraph 3.04, on a related issue, says:

Conditions for some prisoners, notably vulnerable prisoners and young patients in the health care centre were considerably worse—

in other words, worse than during the previous visit by the chief inspector. The report states:

Routines and regimes were still being dictated by minimum staffing levels and cancellations of exercise and association were a regular weekly occurrence. Levels of assault, self harm, use of force and adjudications had not abated. Provisions for education through care and resettlement were inadequate and sometimes worse than before.

Both those paragraphs mention staff shortages as part of the problem. Are they due to staff illness, or are too few prison officers employed at the prison to carry out day-to-day operations to an acceptable standard, as defined by the chief inspector of prisons?

Those are just some of the problems highlighted in the report. The question remains what can be done to ensure that the report's recommendations are implemented in full. Given that the report followed an unannounced visit in April, some of the recommendations may already have been achieved. I hope that the Minister can enlighten me in that respect. I do not want to dwell on the past, as little can be gained from trying to attribute blame. I prefer to concentrate on the crux of the problem. Where do we go from here and what can be done to ensure that remedial action is taken to fulfil the chief inspector's recommendations and to enhance and improve the environment of Chelmsford prison, which has been the subject of so much continual and persistent criticism?

I have several questions for the Minister. First, what has been achieved at the prison since the unannounced April visit? Secondly, when the chief inspector returned in April this year, why did he find that so many of his previous recommendations had not been, or had only partially been, achieved? Thirdly, is money the problem? It is easy to blame every problem on lack of money, but I do not want to fall into that trap if it is not justified. Is there a serious problem with funding?

As a constituency Member of Parliament, I appreciate that when we debated the issue in March 1999, the Government made available extra funds to ensure that recommendations on the reception area were adequate funded. However, I want to know whether funding or other factors are responsible for the problems, delays and sloth; if the answer is other factors, what are they? Is there a culture of inertia, or does the Prison Service disagree with some of the chief inspector's recommendations? Finally, what can be done to ensure that the chief inspector's recommendations are implemented as quickly as possible? If the validity of the recommendations is accepted, we need proper pressure and timetables to ensure that they are implemented as realistically and swiftly as possible.

The provision of health care in the prison is a disgrace. Will the Minister give an assurance that it will be improved as a matter of urgency to ensure that prisoners are treated to the same standard of health care that we expect from our own NHS health care? It is shaming that, for a third time, Sir David Ramsbotham and his team have produced a damning report on Chelmsford prison. Sir David has promised to return next May. What assurances can we have that his next report will be a pleasure to read, rather than a litany of embarrassing failures?

I congratulate the hon. Member for West Chelmsford (Mr. Burns) on securing the debate and thank him for the courtesy that he did me in informing me in some detail of the points that he intended to raise. He and several other hon. Members on both sides of the House take a continuing interest in Chelmsford jail. I am glad to see other hon. Members from the county here this afternoon, some of whom have also made representations to me expressing concern about the treatment of their constituents in the prison.

We meet again to consider an adverse report on Chelmsford prison from the chief inspector of prisons on a particularly sad day for the parents of Christopher Edwards. All those in the Chamber will want to extend to them our deepest sympathy and condolences on a day that must be poignant with memory for them. We owe it to Christopher and to others who have died in the prison system, and to our fellow citizens, to ensure that prisoners are held securely in safe and decent conditions, so that the public may be better protected and the causes of offending may be better addressed.

The hon. Gentleman identified several improvements that had been made since the House last considered a chief inspector's report on conditions at Chelmsford. However, hon. Members will ask, rightly, as did the chief inspector, why the Prison Service has

failed to address some very significant identified failings to do with the treatment and conditions of prisoners allocated to the prison.

It was in response to just such concerns on the part of the chief inspector about other places that my right hon. Friend the Home Secretary asked Lord Laming to lead a working group on targeted performance improvement. He did that out of recognition of the fact that the Prison Service has failed on several occasions to deal adequately with problems that have been identified. We are determined that that should change and that the Prison Service's performance should improve at Chelmsford and elsewhere.

One of the most important recommendations of the working group's report, which was published on 27 July, endorsed the way in which the more robust operational management by area managers and the deputy director general of prisons was increasing the service's success in identifying matters of concern and dealing with poor performance. A great deal of work has been done to drive up standards in the Prison Service, including the introduction of performance standards, audits and targets tailored for each establishment. That is to be welcomed. The chief inspector has an important role in identifying prisons that are failing to achieve what they should.

The Prison Service is aware of the establishments that present problems, and Chelmsford is one of them. The area manager and deputy director general identified it as one in which an improvement in performance was not only to be expected, but demanded. There is no doubt that in April, when the inspection took place, the regime was not operating as it should have been. Conditions fell short in several respects. Some progress has been made and recognised, but it has not been sufficiently uniform to give us cause for satisfaction.

However, it is right to say that a great deal of progress had been made since the previous inspection report was published in March 1999, and that progress is continuing. Of the 99 recommendations in that report, 43 had been fully or largely achieved by April 2000. The effort in achieving that should not be underestimated. Problems as extensive as those at Chelmsford, which have arisen over a number of years, cannot all be remedied overnight—indeed, they have not been.

I am grateful to hon. Members and the board of visitors at Chelmsford prison for keeping up the pressure for improvements in standards. The members of that board are drawn from the local community and we are enormously indebted to them for giving their time voluntarily to serve on it. They are, of course, independent of the prison service, so it is worth noting what they said after the publication of Sir David's report. The board states:

The Board of Visitors share Sir David's concern that prisoners at HMP Chelmsford are still spending too much time locked up but the Board is disappointed that Sir David has not recognised in his comments the valuable work being done by staff in difficult circumstances.

Since the inspection in April, management and staff have agreed upon a complete reprofiling with a view to improving conditions for prisoners.

The board of visitors recognises the steps that have been taken. The reprofiling was necessary and has, as a minimum, protected the delivery of the existing regime. The board went on to say that it looked forward to the extension of activities, including evening activities that the reprofiling should deliver.

During the previous inspection, major concern was expressed about the reception facilities. As has been said, they have been improved. The facilities took up no fewer than 18 of the chief inspector's recommendations on that occasion; 14 have been accepted and wholly or partly achieved, and three are no longer relevant as a result of the new building. In contrast with the inadequate conditions found previously, inspectors found that the area was clean, procedures were in place to ensure that all areas were hygienic and decent. In addition, staff dealt with new arrivals sensitively. A review of reception procedures had taken place and the reception experience had been improved. That major piece of work was implemented while maintaining daily throughput of prisoners.

After the concerns expressed about the cell call bell system and the speed of staff response, it is good to see that, not only has a new system been installed and works correctly, but staff responses are good and the management monitoring of response times is identified as an exemplar of good practice.

The Minister will be aware that I secured an Adjournment debate in July on the installation of safe cells, which could reduce the number of suicides involving remand prisoners by up to two thirds. Will he tell us whether there is a programme for the installation of safe cells in Chelmsford prison?

We are working throughout the prison service on the incremental introduction of safe cells. I would expect that to apply to Chelmsford as to everywhere else.

I shall now deal with some of the specific issues raised by the hon. Member for West Chelmsford. It is important to recognise what has been achieved since the unannounced visit in April by Her Majesty's chief inspector. In terms of health care, new money has been given for a health care centre, which is an important development that involves considerable capital spend on the part of the service. In addition, senior health care managers have been seconded; a project manager for new health care provision has been put in place; Essex health authority and Chelmsford have undertaken a joint needs analysis to provide a blueprint for future action; a steering group chaired by the governor of Chelmsford is to look at current health care provision; transitional arrangements for the move to the new health care centre have been made; the existing health care centre has been redecorated, which is important in improving the atmosphere in which staff are asked to carry out their work; there is daily association for health care prisoners, including TV, pool and board games; provision has been made for education, library and some charity work; and a national taskforce has been set up to improve health care standards.

Those provisions were all undertaken in the context of improved arrangements between the NHS and the prison health service, which were a necessary reform initiated by the Government. The hon. Member for West Chelmsford, who was my predecessor at the Department of Health, will be only too aware of what it has taken to get the NHS and prison health care system working as closely together as they are. That cooperation should have happened a long time ago, but it did not; it is happening now and the hon. Gentleman's constituents should be direct beneficiaries of it.

I shall say a few words about vulnerable prisoners and young offenders. Vulnerable prisoners now have increased access to the prison library; education facilities are provided at least twice a week, subject to further developments in the new year, when we want to improve provision for vulnerable prisoners; and they now share the full range of visits facilities. For their induction, young offenders can be moved on to a young offender wing and they can stay on induction for up to one week to familiarise themselves with the new routines. They can have another trusted young offender as a cell mate under a "buddy" system, which is important in terms of both induction and bearing down on suicide; once off induction, they can elect to share a cell with a friend. We are delivering a further review in respect of young offenders, which will give Monday to Friday evening activities from April 2001.

There have been real improvements in the regime across the board, but we are not complacent. Because it remains important to ensure that we deal better with the transition back into the community, we now have a full-time employment co-ordinator, employment is now allocated on induction, and attendance at work is now closely monitored and reported to the governor on a weekly basis, all of which are important in terms of time out of the cell. There is also improved performance in respect of self-harm: again, there is no room for complacency, but the suicide prevention management group is hard at work increasing the length of visits to maintain family contacts and prisoners now move to activities on a free-flow system; that increases the amount of time prisoners spend on those activities and visits and out of their cells.

A raft of measures has been implemented, with still more to be done. I welcome the on-going attention that hon. Members from the county have paid to the subject and to today's debate. I particularly welcome the opportunity that the hon. Member for West Chelmsford has given us to address an important issue. The prison has failed in the past, but it has now turned the corner and is improving its regime and the service that it provides to the people of Essex and the public as a whole.

I welcome the opportunity to debate this rather unusual subject. Although it is an important constituency matter for me, it is also a matter of national interest. I believe that the events surrounding the demolition of the twin towers should be told in Parliament and a national disaster thereby exposed.

It is nothing short of scandalous that the demolition of the twin towers should have been proposed. They are known around the world; they are an icon and one of the best-known of English buildings. To those hon. Members who travel to London on the west coast railway, they are a landmark—I apologise to those who have different landmarks. They are an important part of our national sporting heritage and their demolition will be a major loss. I shall describe the events that led to that disastrous decision being made and make clear what a serious blow it is to my constituency. Given some of the press reports, it is important that the true facts are known.

I thought it strange when I first heard that Halton borough council wanted to put in a bid for the towers for the national rugby league museum. However, when the members of the council told me about the plans, I realised what a great innovation it would be as an anchor for a national rugby league museum and the development that would accompany it. Many people thought that the bid was not serious. Some, especially the metropolitan elite, found the idea of a small northern town—Widnes, of all places—bidding for Wembley towers amusing, but we in the north-west did not think so. It was a great pleasure to see the plans, which are here today. Eventually, people began to realise that it was not a joke, but a serious proposition.

Halton borough council's interest in the twin towers arose when the Rugby Football League proposed a national museum for rugby league. I was born and bred in Widnes, the greatest rugby league town in the country, and I have been many times to Wembley. Given the size of Widnes, its record outstrips even those of Wigan, St. Helens and Leeds—

And Warrington? Mr. Twigg: And Warrington.

The national rugby league consortium, which consists of Halton borough council and the Rugby Football League, proposed to locate a major new visitor attraction on a site to the south of Widnes town centre known as Venture fields. The national museum was designed to appeal to enthusiasts and the general population. Incorporating the Wembley towers into the building would give it a unique design and provide a major landmark on the banks of the Mersey. They would be visible for some distance, especially from the Runcorn-Widnes bridge, which is one o? the busiest thoroughfares in the country.

Discussions with Wembley commenced in February 2000. From the outset, Wembley insisted on a confidentiality agreement, and Halton borough council entered into such an agreement despite the problems that it would cause, particularly in promoting wider support for the project. The council sought a partner for the project and, after talking to a number of companies, settled on St. Mowden plc. With that partnership in place, a development and consulting team was put together. It was a serious proposition, with serious players.

Studies put the cost of removing the twin towers at —2 million and the cost of erecting them in Widnes at —1 million. St. Mowden agreed to finance the relocation, expecting to recover the costs from the final development, and the council agreed to underwrite the risk. Provided the overall scheme was successful—there was every reason to believe that it would be—there would be no call on the public purse.

A detailed method statement was prepared, showing how the towers would be removed. The contract for the work of removing the towers was won by Birse plc, a well-respected civil engineering company. Most important, the method statement was accompanied by a commitment to dovetail the removal of the towers with the Wembley demolition programme, to ensure that it had no adverse impact on the national stadium project. It is important to highlight that, given some recent press reports on the subject. Work on the site was expected to start in early November and to be completed within 16 weeks. The towers were to be relocated to a secure storage area and, subsequently, transported by road to Widnes. Even the route had been resolved and cleared with the necessary authorities—the plans had got down to that sort of fine detail.

The project team and the finance were in place, the method and plan were sorted, and the timetable was within Wembley's parameters—as they stood before the sudden change was made. All the important ingredients were therefore in place, to such an extent that when I spoke to Halton council—I was not especially closely involved in the detail—I was told that its members were confident, that I need not do much and that they expected to hear shortly. That is how signed, sealed and delivered the project appeared to be. Contracts were drawn up with fine tuning well in advance. St. Mowden acceded to Wembley's demand for —100,000 to be deposited in escrow. I am not sure whether the money has been returned yet, but it was deposited.

Even when Wembley belatedly stated that the council could not refer to the twin towers as "the twin towers" talks continued to resolve the issue. The contracts were close to completion by mid-October. Out of the blue, to use a rugby league metaphor, a late tackle—

On the blind side.

Indeed—all negotiations were broken off. A letter was received out of the blue that said that Wembley was unilaterally withdrawing from the negotiations. No reason was given.

The chief executive of Halton borough council tried to contact Wembley to speak to its chief executive to ask for an explanation. Eventually the chief executive wrote to say that he could not revive the scheme and that the council would now have to put up —10 million to secure the towers. A nominal fee of —1 has previously been agreed for the towers, subject to the cost being borne by anyone but Wembley stadium. From the letter, I understand that under a new contractor, a company called Multiplex—I am not sure whether that is an Australian company—was now calling the shots, and that and it had decided that it could not find a window to proceed. Arrogantly, the letter refers to Wembley's "unilaterally" deciding

that the risk and costs involved in salvaging the Twin Towers

were

becoming too much for … yourselves and ourselves to bear.

That told the borough council.

Does my hon. Friend agree that the twin towers are part of our national heritage and should be protected?

I am sure that my hon. Friend will not be surprised to learn that I entirely agree. That is one of the reasons that I requested today's debate.

As an aside, I should point out that the letter also states:

The National Stadium Lottery Grant was spent in full many months ago.

I do not know how it was spent—on land, perhaps—but I have seen no major development on the Wembley site.

It was clearly impossible for Halton borough council, a small unitary authority, to come up with —10 million—I understand that at least —10 million is required. We do not know how the figure was arrived at; no explanation has been provided. Has it been plucked out of the air? I shall return to that point in a moment. From that moment on, it seems that the towers were effectively condemned to become rubble, and part of our great national heritage would die.

Besides the loss of the towers—a scandal in itself—there are major consequences for others and for our country as a whole. A major blow has been dealt to the development of the national rugby league museum, which would have been one of the most innovative in the country. As I said earlier, the towers were to have been erected on the Venture field site in Widnes, a reclaimed brownfield site that has stood vacant for 15 years. The national rugby league museum would have been built to help anchor site development, using the towers as icons to attract visitors and interest in the location. Major commercial leisure investment would have been targeted to complement the museum, with associated non-food retail and other mixed uses of adjoining land. In total, almost 70 acres of brownfield derelict and contaminated land would have been opened up and developed in what would have been a regionally significant reclamation and regeneration site. Indeed, it would have been similar to the area covered by the dome.

The site without the towers would prove much less interesting. We have not been able to do anything with it for 15 years, and the opportunity to transform an area has been unilaterally closed down by Wembley's action. That is a great shame. Questions need to be asked about the decision. People want to know whether Wembley ever really wanted the towers moved to Widnes. Was there ever any intention of agreeing to the move? As I said, some people felt that ours was not a serious proposition and that it would never come to fruition, but it came close to doing so. I wonder whether the intention was ever there.

Will the towers still be standing in February 2001? The omens are not good, given the Wembley stadium project's track record on meeting deadlines and ensuring that things happen. If they are still standing in 2001, the council would have time to dismantle them and take them up to Widnes. I shall be watching very closely. Why —10 million? We do not know how that figure is arrived at or what it means. It is all to do with contract delays, but we have no real idea. At this late stage asking for an explanation will profit us little.

Given the use of lottery investment in the Wembley project, will my right hon. Friend the Minister say whether there is anything that his Department can do to help? Major lottery investment is involved: —600 million-plus is being invested in Wembley, and Brent council and English Partnerships are, rightly, trying to effect a regeneration project of the back of that. I have no problem with that. By way of comparison, —800 million is being invested in the area around the dome and Greenwich council and the Government are trying to effect a regeneration project on the back of that. Again, I have no problem with that, but it is important to make the comparison. Let us compare those figures to the —3 million of private cash underwritten by council capital. If our project had been on the banks of the Thames and not the Mersey, would it have succeeded? Would we be faced with the same situation today? I wonder whether such people as Ken Bates, chairman of Wembley National Stadium Ltd., would have pulled out all the stops if it had been in London. I am not sure that he was ever in favour of the towers coming up north, but the question remains.

Halton council and the Rugby Football League deserve great praise. The whole project fitted in perfectly with Government policy: there would have been a partnership, an innovative local council, private-sector cash, and the use of a brownfield site—not to mention the saving of some of our heritage, which is just as important. I will return to the issue of heritage before concluding my speech.

I have had the privilege of playing at Wembley on a number of occasions with my hon. the Member for Bradford, South (Mr. Sutcliffe), as part of the parliamentary football team. I cannot say that it was a total success for me—or the team for that matter—but it was a great privilege to play there. I have watched my teams play at Wembley many times over the years—

Not recently.

Yes, but I prefer not to go down that road. Widnes Rugby League club and Runcorn football club have both played at Wembley over the years—Widnes, of course, being one of the clubs most regularly in attendance. It would have been most fitting for the twin towers to have come to Merseyside and north Cheshire in the north-west, given that football and rugby teams from that region more than any other have played in so many Wembley finals over the years. Dare I say that it has been a second home for some north-west clubs? There is a sentimental and a good case for having the twin towers in the north-west, given our domination of that stadium for so many years.

The project's failure is a blow to the game of rugby league. It was a state-of-the-art innovation and would have resulted in the best sports museum in the country. I wonder whether rugby league receives the support that it deserves compared to other sports. The concept was very exciting and the museum would have been second to none.

It is outrageous that the twin towers will be lost. I understand that the stadium or the towers are listed, although I am unsure of the details. How can the demolition of listed buildings be allowed? Perhaps my right hon. Friend the Minister will be able to shed some light on that matter. Simply to bulldoze Wembley and reduce it to rubble, lost to the nation forever, is an act of vandalism on an unprecedented scale. I know that some people will argue that it would be difficult to take the towers down because they are concrete, but we have had experts look at the project and we believe that it is feasible. It is one of the lines put out by Wembley, but from what we know and what our experts say, it could have been done. To bulldoze the towers is to commit an act of vandalism.

There has been much criticism of the project to rebuild Wembley and its escalating costs. I do not want to discuss that criticism at length, because time is short. However, problems have arisen at every stage, and it is not unconnected that a problem has arisen with the future of the twin towers. We are suffering because of someone else's difficulty in managing the project properly. I find it amazing that a simple solution to the problem cannot be found in this day and age.

At a late stage, after many months of negotiation, Wembley suddenly found that the contract did not allow a window of opportunity. I do not know enough about the details of the matter, but that does not seem to add up. I refer back to the question of whether the towers will still be standing in February 2001. I wonder what it will say about the project if, because of such a late discovery, we lose the towers. Will my right hon. Friend the Minister explore the matter further and investigate what can be done? He might ask Wembley to rethink its decision because if it continues on its present course, it will score the biggest own goal in the stadium's history.

I have written to the chief executive of Wembley National Stadium Ltd. to ask him to reconsider the decision in the interests of the nation, rugby league and my constituency. Ours would be a tremendous project, which would carry the spirit of Wembley forward and provide a major visitor attraction for my constituency.

In keeping with the sporting spirit of the occasion, I ask the Minister to kick off the second half of the debate.

I congratulate and thank my hon. Friend the Member for Halton (Mr. Twigg) on obtaining the debate and raising an issue that is of great concern to him and my hon. Friends the Members for Warrington, South (Ms Southworth) and for Weaver Vale (Mr. Hall), who have given him steady support in his campaign. The matter is of intense concern to many people throughout the country because the twin towers are iconic. I welcome the opportunity to respond on such an important subject.

Wembley stadium is world famous, having witnessed many great moments in sporting history, notably the "white horse" cup final at the stadium's opening in 1923, the Olympic games in 1948 and the World Cup final in 1966, which you and I, Mr. Deputy Speaker, remember vividly. It has also witnessed great moments in the history of Widnes and Runcorn's rugby league prowess, as well as some other matches that England football fans may prefer to forget.

Why, then, is it being demolished?

That is the very point that my hon. Friend has raised, and which I shall address.

Sports men and women from around the world have aspired to perform at Wembley, but it has also hosted other memorable, world-famous events such as the Live Aid concert for Ethiopia in 1985. The twin towers have come to symbolise the stadium's importance and have a unique place in the hearts of sports fans everywhere. It is unsurprising that the redevelopment plans for the stadium have given rise to much concern about the fate of the towers.

The proposals for a new national stadium will involve the demolition of the existing stadium and its replacement by a new one, planned to seat 90,000 people, with vastly improved space standards, accessibility and visibility. The redevelopment will mean an increase in the overall width of the stadium on the north-south axis. There is little, if any, room to expand southwards because of the railway, so the proposed new stadium must extend 40 m to the north of the line of the front of the existing stadium, thus necessitating the demolition of the twin towers. In any case, the height of the new stadium would dwarf the twin towers if they were incorporated in the new development.

The stadium's architectural and historic importance was recognised by its being granted grade II listed status in 1976. My hon. Friend raised the question of how a listed building or structure can be demolished. Listing means that, in addition to having to obtain planning permission from the local planning authority—in this case the London borough of Brent—the developers are also required to obtain listed building consent. In view of the stadium's listed status, the application for listed building consent was accompanied by a full heritage study. It considered the question of whether the stadium was capable of adaptation and the feasibility of retaining the twin towers, as the new stadium will have to be extended to the north of the existing stadium, and concluded that there was no scope for including the twin towers in the new development.

English Heritage is a statutory consultee for such applications. Having considered the conclusions of the heritage study and taken into account the merits of a proposed replacement stadium and the wider community benefits, English Heritage did not raise any objections to the application for listed building consent, which was accordingly granted. However, one condition of listed building consent is the provision of a complete photographic record of the stadium. That means that if anyone wants—this may be of interest to my hon. Friend the Member for Halton—replicas of the towers could be constructed elsewhere on the basis of the photographs taken together with the original engineers' drawings of 1923. That work has been completed.

In addition to ensuring that the stadium is fully recorded, English Heritage is monitoring the removal and preservation of all artefacts of historic interest in the stadium for resiting or display in the new stadium. Some of them will be deposited temporarily in the new football museum at Preston, which opens next month. They will include plaques and other features commemorating the opening of the stadium in 1923, the 1948 Olympic games and the 1996 World Cup in 1966. Other architectural features will be preserved in the Brooking Collection Trust in Surrey.

I should make it clear that English Heritage fully acknowledges the historic and cultural importance of Wembley stadium and the symbolic role of the twin towers. However, it also recognises that the stadium has shortcomings as a major sports venue: sightlines and space standards are poor, because the stadium was originally built with open terraces for standing spectators, which were later converted for seating. The fans who attend events are acutely aware of those shortcomings.

English Heritage has not sought the reconstruction of the twin towers nearby as part of the proposed new development. Here I come to some important and practical considerations, in which I know that my hon. Friend the Member for Halton will take an interest. The twin towers are constructed of reinforced concrete, poured and cast on site, rather than in demountable materials capable of being taken down and rebuilt block by block. I am advised that the thinness of the reinforced concrete and the skeletal nature of the towers' internal structure would pose major problems in structural engineering if an attempt were made to move them to a new site. The towers have no backs, and were never intended to be seen as isolated structures. My hon. Friend clearly takes a different view as to the feasibility of moving the towers. It would seem that there is room for genuine differences of professional opinion on that point.

Following the unveiling of the design for the new Wembley stadium last summer, a number of interested parties approached Wembley National Stadium Ltd. with proposals to move the twin towers. Most were put off by the scale of the challenge and by the current state of the towers, including large cracks in some of the walls that are visible from the inside.

Will my right hon. Friend tell us whether it is the view of Wembley National Stadium Ltd. that the nature of the towers' construction means that they cannot be moved? It certainly did not seem to be a barrier in agreeing the deal with the national rugby league museum and Halton borough council, which has since fallen through. As far as I am aware, that was never an issue that would have prevented the deal from going ahead.

I understand that the advice reached my Department from English Heritage, but I am happy to try to find out its source and to make that information available, as far as I am able, to my hon. Friend. That will give him a better basis for understanding the practical realities of the project that he has presented so eloquently and which would be of great pleasure to large numbers of people if it were carried out.

With St. Modwen Properties, Halton borough council put forward the only serious proposals for the twin towers to form part of the fa"ade for a new rugby league museum in Halton. As my hon. Friend explained, discussions took place but were terminated by Wembley National Stadium Ltd. I fully understand my hon. Friend's frustration and it is indeed regrettable that the proposals made by Halton borough council and the Rugby Football League to relocate the twin towers were unacceptable to Wembley National Stadium Ltd. However, it remains a matter for the company to decide within the terms of the listed building consent that was granted. My hon. Friend invited me to intervene with the heritage lottery fund, but it is an important principle that Ministers do not try to dictate to lottery distributors. In fact, legislation rightly debars us from doing so.

Many sports stadiums around the country dating from roughly the same period as Wembley stadium have undergone huge transformations over the past decade. Some football clubs have relocated to new state-of-the-art stadiums in response to ground safety requirements and the need to bring sports facilities into the modern age. Such changes are not exclusive to the United Kingdom: in the United States, for example, many famous baseball fields have been replaced or are about to be replaced by new state-of-the-art facilities.

A new stadium at Wembley will provide Britain with a world-class stadium fit for the new century and give the country renewed hope of hosting major international sporting events. More importantly, with its spectacular 400-ft arch, the new stadium will pass on the Wembley magic to new generations of sporting stars to create the sporting memories of the future. The twin towers will never be forgotten and many people would be happy if it proved possible to recreate them at a fitting site elsewhere.

We can now move on a little early to the final debate in Westminster Hall today.

I am grateful for the opportunity to draw the Chamber's attention to the serious and unacceptable implications of the proposals of the central Sussex partnership programme in the document "Modern Hospital Services for Central Sussex—A challenge for us all". My right hon. Friend the Member for Horsham (Mr. Maude) and my hon. Friend the Member for Arundel and South Downs (Mr. Flight) are closely involved with these matters and associate themselves fully with my remarks.

In my 17 years as a Member of Parliament, I have never known an issue so to galvanise the community. Following the debacle at Crawley hospital, in which local opinion was clearly trampled on, the Minister should be aware that public opinion has been greatly inflamed by the proposals. Everyone understands that the national health service cannot and should not stand still and that real difficulties still need to be addressed, but my constituents and I believe that the proposals for the Princess Royal hospital are reckless, foolish and, above all, wholly lacking in common sense and practicality.

The Princess Royal is a modern, purpose-built acute hospital with 328 beds on the outskirts of Haywards Heath. It opened in 1991 and is most conveniently co-located with specialist mental health and neuroscience services. The hospital has a full accident and emergency service with resuscitation facilities for seriously ill patients. A refurbishment of its facilities has just been completed following a —150,000 grant from the NHS executive. The department is recognised for junior medical staff training and approximately 32,345 patients attended for treatment last year. The Minister should know that that number has been rising steadily throughout the mid-1990s. The hospital also provides a full range of general medical services, including for patients admitted as emergencies. Elderly people are cared for expertly on specialist wards and the hospital also provides comprehensive surgical and orthopaedic services, including for all emergencies.

During the past year, 9,090 patients were admitted to the Princess Royal hospital as emergency cases; 3,812 were admitted for treatment as planned patients and stayed one or more nights. Alongside its ward-based patient care, the hospital has an active out-patient department where, during the past year, consultant teams have seen 76,763 patients. It directly employs 41 consultant medical staff across all specialties and receives services from a further 21 medical staff supplied by neighbouring hospitals. It employs 421 nursing staff, 220 technical clinical support staff, 68 hard-pressed midwives, 73 junior medical staff and 339 support staff. In total, there are 1,162 staff, all of whom are dedicated to their work and those for whom they care. All of them are extremely anxious about the future.

I hope that the Minister will acknowledge that the Princess Royal hospital is an excellent hospital that is at the heart of its community. It is important that she understands how proud we all are of the service that it provides, the skills and excellence of its staff and its enlightened management, to whose efforts I pay warm tribute. I acknowledge that a great deal of hard work was put into the central Sussex review by good and honourable people who are trying to provide the best local services. There is some good stuff in the report to work on, but, as I explained to the hon. Lady when she was good enough to meet me, the central Sussex review was really a south Sussex review. It did not include Crawley and it lumped Mid-Sussex in with Brighton and Hove. That was not a good start and it unbalances the services that are required.

The report identified three frameworks to be discussed prior to more detailed consultation. They have all been given pretty short shrift. Following a meeting with Sir Williams Wells, the regional chairman of the NHS executive for the south-east, which I attended with my hon. Friend the Member for Arundel and South Downs and my right hon. Friend the Member for Horsham, it is clear to me that the review team is out to obtain a result based on framework 3. That would culminate in the accident part of the accident and emergency department being transferred to the Royal Sussex County hospital. That would mean a downgrading of the Princess Royal hospital, with all the attendant problems of skills lost, a serious morale crisis and declining services.

Following the publication of the proposals for discussion, there have been a series of public meetings in the area. On Thursday 31 August this year, I attended a large meeting in the Clare hall at Haywards Heath. Nearly 700 people were present and officials of the central Sussex partnership programme had a good opportunity, in reasonably dignified and certainly attentive surroundings, to state their case. It is safe to say that their proposals met with universal opposition, much of it extremely well informed.

I draw the Minister's attention to some of the points that were made at that meeting, which have since formed the non-medical argument. First, I refer to the growth of Mid-Sussex and surrounding areas, which is to be substantial under the Government's new housebuilding plans. That really demands a fully funded and properly equipped A and E hospital, and given that our overall infrastructure is already deemed to be pretty inadequate, it seems incredible that it is now to be further downgraded if the proposals come to pass.

Secondly, it shows an astonishing sense of political priorities that the Government can find an extra —47 million and the rest to bail out a bankrupt folly such as the dome, yet despite the substantial new money going into the NHS, it is still seriously proposed that we should not have a fully funded and properly equipped accident and emergency department in a nine-year-old hospital in a busy area.

Thirdly, the Minister will not be familiar—there is no reason why she should be—with the problems of transport and traffic in our part of Sussex. However, the assumptions that have been made with respect to bringing people through the intolerable traffic on the approach to Brighton are clearly unacceptable and inaccurate. In fact, the proposals are downright irresponsible on those grounds alone.

Fourthly, it is difficult for my constituents to understand how, with one of the biggest international airports in the world on our doorstep, emergency planners do not deem a full accident and emergency service at the Princess Royal hospital to be essential to assist in a major accident, which would have to be dealt with by the East Surrey hospital at Redhill. Finally, battle casualty receptions in the event of a war also need to be taken into consideration: at the time of the Gulf war, Gatwick was to be a major receiving station, and it would clearly be so designated again in the event of major conflict.

I was, as I said, grateful to the Under-Secretary for agreeing to see me very promptly—during her holidays, in fact—after the meeting at Haywards Heath. At that meeting, I had the opportunity to convey to her the strong feelings and profound anxiety of all those who spoke—and, I think, everyone at Haywards Heath. Mid Sussex district council, our excellent and highly valued community health council, the local town councils and many other bodies, thousands of individuals and our local newspapers have all come together to protest vigorously against the proposals. They believe, rightly, that the Princess Royal hospital must remain a major accident centre offering the full range of emergency medical and surgical services.

We are all especially anxious about whether a hospital that does not treat acute trauma and emergency surgery will be viable in future. Would such a hospital be accredited for junior doctor training, as the Princess Royal is at present; and how could the already frantically busy hospital in Brighton cope with the extra load when it is already impossibly overstretched and under extreme pressure—something that often creates difficulty for emergency and waiting list admissions?

It is difficult for me, on behalf of my constituents, to accept the premise in framework 1, to the effect that there is no choice but to move to framework 2 or 3 to secure good services in future. I agree with my hon. Friend the Member for Arundel and South Downs and my right hon. Friend the Member for Horsham that the needs of the community are not the first priority in frameworks 2 or 3. It appears to us that hospital planning is being driven by the medical royal colleges and their opinions on how and where doctors should be trained and services organised, with little regard to the impact on services for local people. My constituents rightly ask why those eminent bodies are able to exercise their considerable influence and baleful power with such profound effect when they clearly are clearly unaccountable to the taxpayer and to local people. If the NHS plan is to work and if local hospital services are to be truly sensitive to local needs and demands, the royal colleges must be challenged by the Government to work in a more open framework of public accountability.

I congratulate the Mid Sussex Times on its robust campaign to retain the important services in question and on the depth of its well informed reporting. That paper's proposal for framework 1-plus is the most acceptable for the future. That would involve retaining the full range of accident and emergency services and making further investment at the excellent and admirable Princess Royal hospital until other long-term arrangements could be made, possibly through the building of a new hospital providing the full range of emergency medical and surgical services to serve the wider area. It is difficult to understand why that was not proposed in the first place.

We should focus on the Princess Royal hospital as the main acute general hospital dealing with complex trauma. Haywards Heath is close to Gatwick and the M23 and is pretty much at the centre of central Sussex, with a good road network. As I showed the Under-Secretary when I came to see her in her office, using the map that she helpfully produced, it is madness for the area's major trauma hospital to be at Brighton. Planners have seen to it that the Royal Sussex County hospital is carefully insulated from the world that it serves by a complex network of small roads and unspeakable traffic. The Princess Royal has facilities for helicopters to land to take emergencies to the Hurstwood Park neurological centre. The Royal Sussex does not have those facilities.

The Princess Royal is an absolutely first-class hospital that is widely admired and respected. It does a superb job and has the support and—most important—the complete confidence of the community that it serves. Disappointingly, the proposals in the review document are focused too much on short-term changes to address immediate problems, and give no sense of any long-term strategic planning or thought. Such decisions cannot be taken in isolation from the situation elsewhere in the south-east, where weighty and profound issues requiring a far more strategic approach remain to be dealt with.

There is scope for the re-ordering of services, as between Brighton and Hayward's Heath. However, although we all understand the need for such operations to be achieved as effectively and efficiently as possible, the case for downgrading the A and E has not been made. Indeed, as the debate has matured. it has become clear that, given the will, there is the opportunity to expand the Princess Royal in the interests of the whole area. Will the Minister assure me that public consultation will be a genuine exercise—unlike in respect of Crawley hospital—and that the views and opinions of local people, many of whom have made it their business to become extremely well informed about the matter, will be taken into account and respected?

I beg her to examine with the greatest of care these difficult questions, which go to the heart of the future of the national health service in West Sussex and the interests and welfare of all my constituents.

Order. I see the hon. Member for Arundel and South Downs (Mr. Flight) rising. I presume that he is seeking to catch my eye in order to speak. As this is a private Member's Adjournment debate, I must ask him whether he has the sanction of the initiator of the debate and has notified the Minister of his intention to speak. He has not notified me, as he is obliged to, that he wishes to intervene.

I apologise for having advised neither you nor the Minister of that, Mr. Deputy Speaker, although I told my hon. Friend the Member for Mid-Sussex (Mr. Soames). Initially, I believed that I would not be able to take part in the debate, but, having managed to ensure that I am here, I should be grateful if I could add a few comments.

As we started a little early, I shall use my discretion and allow the hon. Gentleman to contribute to the debate. However, I ask him to allow the Minister adequate time to reply.

Thank you, Mr. Deputy Speaker. I shall be brief.

I congratulate my hon. Friend the Member for Mid-Sussex on his effective, realistic and robust presentation of the arguments, and thank the Minister for her sincere and genuine involvement in the matter. What happened in Crawley has left constituents on the east side of my constituency lacking in trust in the national health service. If the Princess Royal hospital is permitted to decline, a whole community will no longer trust the NHS.

The matter has two different aspects. First, in practical terms, given that another 20,000-odd people will come to live in the area over the next 15 years, it cannot make sense to have no full A and E unit and no full-service hospital of the size of the Princess Royal. Brighton has neither the facilities nor the access necessary.

Secondly, there is the bigger issue of the presence in the community of hospitals of the size and nature of the Princess Royal. Such hospitals are desperately needed and measures that cause them to be run down because they lack crucial facilities such as A and E make no sense. Citizens cannot travel long distances to hospitals. They may need to visit, say, specialist cancer hospitals, but it is precisely such hospitals that are the strength of our health service. As my hon. Friend the Member for Mid-Sussex pointed out, if one removes an accident and emergency unit, a downward spiral is almost inevitable. The royal colleges, which often pursue policies without considering the citizenry at large, are behind the initiative, and I implore the Minister to get to grips with them.

The entire community broadly accepts the framework 1 proposal, but it is crucial that the consultation process be genuine and not a whitewash. Otherwise, the faith of an entire community in the administration of the national health service will be lost. As was said, the Princess Royal hospital is an excellent hospital. Unlike certain others, it cannot be argued that it is poorly run or inadequate. It services a fast-growing community, and every common-sense argument that the community has advanced is in favour of maintaining the current facilities.

I congratulate the hon. Member for Mid-Sussex (Mr. Soames) on securing this afternoon's debate. It would appear that I am rapidly developing a reputation for getting out the map before I start any discussions, so I should point out that I am aware of the traffic problems in the area: the Labour party conference has been held in Brighton for a number of years, so I have been stuck on those roads myself.

I pay tribute to the hon. Gentleman's keen and active interest in this issue, which is of great importance to his constituents. He raised the matter with me in September and with the Secretary of State for Health during last week's Health questions. I acknowledge and appreciate the hard work that the hon. Gentleman has undertaken at his local hospital and I am well aware of the good work that is carried out there.

I shall do my best to allay any concerns that the hon. Gentleman may still have, but before I discuss central Sussex, I should like to comment in general on what is happening in the national health service. When the Government took office in 1997, we inherited an NHS with many recognised problems: standards were too variable, there were too few staff, and they were frequently rushed off their feet. That was owing to years of underinvestment and neglect, but we are now putting that right.

The hon. Gentleman will be aware that, in July, the Government published the NHS plan, which set out the most fundamental and far-reaching programme of reform in the history of the NHS. It is a 10-year plan that is designed to improve every aspect of the health service. It provides for the extra resources needed to support the programme of change, but it also provides for modernisation of the way in which the NHS is run. A fortnight ago, my right hon. Friend the Secretary of State for Health announced further funding to speed up the pace of implementation. The announcement confirmed that, from April next year, health authorities will receive an average cash increase of some —29 million. In 2001-02, the West Sussex health authority will receive —552 million"a real-terms increase of —40 million on the preceding year.

In addition, next month the Government will publish a detailed NHS plan implementation programme not only for health, but for social services. It will set out the investment and progress that will be necessary in the coming year. It is becoming increasingly clear that good health care involves health services and social services working closely in partnership.

On the question of what has been happening in central Sussex, in the Mid Sussex NHS trust, a new consultant surgeon has been appointed at the Princess Royal hospital to support emergency surgical care. A new admission and discharge team has also been appointed to help manage capacity at that hospital. The trust is working with the Mid Sussex primary care group and social services to develop intermediate care services. That has enabled the creation of a 6-bed step home unit at the Princess Royal hospital and a community rehabilitation service that provides additional therapy support.

Of the —63 million in additional funding that the Government provided for this winter, —382,000 is being spent on initiatives in central Sussex, including extra district nurse cover, extra GP out-of-hours cover, extra patient transport service cover and increased day hospital hours. West Sussex is one of the areas in the south-east that qualified for additional cost-of-living allowances for qualified nurses, midwives, health visitors and professions allied to medicine. West Sussex will receive —2.2 million additional funding for that initiative. There is much to build on in central Sussex, as I hope the hon. Gentleman acknowledges.

On the provision of acute hospital services in central Sussex, the central Sussex review concluded at the end of 1999 that the Brighton Health Care NHS trust and the Mid Sussex NHS trust should work more closely together to make better use of existing facilities. The review also found that they needed to ensure that they served a sufficiently large population to provide a full range of services. In early 2000, the central Sussex partnership programme was set up as the successor to the central Sussex review to implement its findings. The CSPP produced a discussion document entitled "Modern Hospital Services for Central Sussex—A challenge for us all" in which it set out how hospital services were changing and why it was necessary to plan for the future. That is sensible: the NHS cannot remain static.

The document was launched on 21 August and written comments were sought by 13 October 2000. It produced a huge local response. The press release on 30 October stated that the CSPP had received 150 letters, and a petition to save the accident and emergency department at the Princess Royal hospital attracted 147,000 signatures. I am in no doubt about local feeling on the matter.

The document set out three potential frameworks for the long-term provision of services in central Sussex. Each was based on the Princess Royal hospital and the Royal Sussex County hospital. The CSPP favoured the third framework, whereby all trauma treatment and emergency surgery would be carried out at the Royal Sussex County hospital and all other medical emergencies would be treated nearest to where patients live. The welcome purpose of the discussion document was to ensure that local people had an opportunity to help to shape developments at the start of the planning process.

I would like to take this opportunity to put on the record that no formal proposals for change have been made in central Sussex. No decision has been made or will be taken on the basis of the discussion document. I do not, therefore, intend to defend those frameworks. However, I can give an undertaking to the hon. Members for Mid-Sussex and for Arundel and South Downs (Mr. Flight) that their views will be passed to the CSPP. It has acknowledged that more detailed work is needed to examine the evidence and present people with more facts. The comments received and discussions held so far will be invaluable in shaping the next stage of the programme.

I have today received a copy of a press statement issued on 27 November, which I hope hon. Members will welcome. It is headed "Local people to be involved in planning hospital services" and states that the CSPP has asked two

independent facilitators … to help. Both have … national experience of involving local people in having a say about how public services are run.

That should be seen as recognition that more work is necessary and a commitment that that work should be done. It would be inappropriate for me to comment on the frameworks at this early stage, but I assure the hon. Gentlemen that the Government are committed to ensuring that all those who need]services have access to them, wherever they live.

The hon. Member for Mid-Sussex spoke passionately about accident and emergency departments. They have an important role and that is why we have invested —115 million in their modernisation. That investment will provide new assessment and observation wards, improved resuscitation facilities, better links between and A and E and primary care, and better diagnostic facilities. It will also enable improvements to be made to the general redesign and to looking after the needs of staff.

However, we owe it to patients to ensure that we make the best use of the services we have. Many people who attend A and E have minor injuries that could be treated by telephoning NHS Direct and receiving advice from appropriately trained primary care staff. Thankfully, the majority of patients who attend A and E do not have life-threatening injuries or illnesses requiring immediate attention, but those who need such attention must be confident that they will see suitably trained staff with access to support and back-up from appropriate clinical specialties. That is why we must consider new technology, the skills mix and the evolving role of emergency ambulance services, which will play a key role. In some areas they are already providing a fast and responsive service, and we need to roll that out everywhere.

Better information and communication systems will also improve matters. For example, access to medical histories, improved clinical skills and developments such as telemedicine will give paramedics greater choice about the most appropriate care for individuals and the most appropriate place for care or treatment. New technology and better organisation are not threats to the NHS. The information revolution will transform the way in which its services are delivered.

Both hon. Gentlemen expressed concern about the influence of the royal colleges. I want to say straight away that the training of NHS staff is important: we must ensure that all our staff are trained to the standards needed to provide the services that NHS patients deserve. However, we must balance training needs with the needs of the service, and we will not let the training needs of doctors, as defined by the royal colleges, dictate how services are to be provided. We must not forget that the reason for training NHS staff is to provide quality service to NHS patients. That is our priority, toward which all our efforts must be directed.

The medical royal colleges encompass great expertise in medical training, but, rightly, they have no role in deciding service provision. Moreover, it is not their job to approve medical training in hospitals—that role is given to the specialist training authority. However, the STA consists almost entirely of royal college representatives; there is no point at which the voice of the patient, or even the voice of the NHS, can be clearly heard. When colleges have visited hospitals on behalf of the STA to look at medical training, it has sometimes proved difficult to demonstrate that the needs of patients and of the service have to be put first. That is simply unacceptable.

The hon. Member for Mid-Sussex will be aware that the NHS plan established our intention to replace the bodies that deal with postgraduate medical training—the STA and the joint committee on postgraduate training in general practice—with a new unified body: the medical education standards board. Setting up the MESB will require considerable change, especially in legislation. Simply combining the two bodies would merely replicate existing problems. We will ensure that the MESB takes full account of the importance of ensuring high quality, locally accessible services for patients and that its methods are clearly accountable, both externally and internally.

I hope that the hon. Gentleman is reassured about our intentions regarding the direction of training. While it plays an important role, it must serve patient needs within the NHS framework. The MESB will decide whether individual doctors have reached the required level of skill and competence to work independently in the NHS. That is an important role. It will, of course, need the advice and opinions of the medical profession—but that must always be directed towards patients' needs rather than doctors' wants.

I acknowledge the strength of local feeling that arises whenever changes are proposed in the NHS and I want to know what the hon. Gentleman's constituents have to say. The central Sussex partnership programme must listen to their concerns and take them on board in a way that is not only responsive, but is seen to be responsive. I was grateful to the hon. Member for Arundel and South Downs for making the point that unless the people whom we serve are confident that their voices are being heard, we will all have failed.

Whatever the final proposals, I stress that they will not be about cutting services, but about reconfiguring them within the entire population area so that they best provide the appropriate services. We are committed to ensuring that the services in central Sussex are comprehensive, high quality, accessible and, above all, safe. I give the hon. Member for Mid-Sussex and his constituents my commitment that we will make no changes that would jeopardise their medical services and that we shall take careful note of the results of the consultation.