What plans he has to introduce legislation on the fluoridation of drinking water. [156283]

Over the last 40 years, the fluoridation of water in selected areas has made a worthwhile contribution to improving oral health, but we are taking further expert advice on the effects of fluoridation before considering whether changes should be made to the current legislation which leaves the water undertakers to decide whether to agree to health authority requests for new fluoridation schemes.

I am personally strongly opposed to the mass fluoridation—the mass medication—Of the public water supply, so I ask the Minister how the present Government and the Medicines Control Agency can reconcile their policy and practice with United Kingdom and European medicines legislation because the whole purpose of adding fluoride to drinking water is to treat, prevent or cure a disease. That is the intention of those authorising the process, and that is how the consumer perceives it. Is there going to be legislation compulsorily to medicate our total water supply?

It was our desire to establish a good scientific evidential basis for fluoridation. The York report was published last October and as a consequence of that we have asked the Medical Research Council to provide a better evidential base; but as the hon. Gentleman rightly pointed out, the purpose is to improve the dental health of this nation, so I hope that, despite the fact that we shall be asking for evidence, he welcomes the tremendous investment in South Cheshire health authority, which has approved some 27,000 extra registrations for dentists. He now has a dental access centre in his constituency, and some £60,000 was invested in the dental care development fund. We are therefore working on both fronts—to improve the dental health of the nation and to obtain better evidence.

My hon. Friend is aware that this is a hugely contentious issue. I wonder whether, in the light of the fact that the Government are committed to devolving decision making in a range of areas to local people, there may be a commitment in principle to enable local ballots to take place to ensure local determination on whether fluoride is added to water supplies.

Despite the number of applications that we have had for fluoridation, none of them has succeeded simply because we have made it absolutely clear that the majority of the population would have to be in favour of any extra fluoridation, should it be implemented.

But is not the evidence extremely mixed, including that from the York report? Although it appears that fluoride does have some good topical effect on teeth, too much fluoride discolours teeth and we do not yet know its long-term effects on the bone mass. Fluoride is, after all, a poison. Will the Minister comment on that?

Of course there are also hugely varying levels of naturally occurring fluoridation in the country—there are many areas where fluoride occurs naturally in the water. That is why there is a two-pronged attack. We are not only looking at the evidential basis of what adding fluoride would do, but at the same time improving access to and the quality of the dental services available. In particular, we are paying attention to what happens to children—setting up pilot projects that encourage young children to brush their teeth more frequently. We are working along both lines, to improve dental health and to do further research on fluoridation.

If he will make a statement about the provision of community disability equipment. [156284]

An additional £105 million is being made available to the national health service for community equipment services over the three years from April 2001, and local authorities are receiving additional provision in their personal social services settlements. New guidance aimed at improving these services was issued last month and copies of the guidance are available in the Library.

I thank my hon. Friend for that answer. In parts of the country such as my own, where assessments are carried out by social services in one local authority and the implementation of disability services in the home is carried out by the housing authority in another, there is some confusion. I am sure that the guidelines will be very helpful. Would my hon. Friend note that last Friday I opened a disability equipment loan centre organised by the British Red Cross in Buxton, and take this opportunity to welcome the co-operation of the voluntary sector in this way?

Yes, I certainly would. May I start by wishing my hon. Friend many happy returns as I believe that it is his birthday? Also, I hope that he will have another happy return in the not-too-distant future.

I certainly agree with my hon. Friend about the importance of the voluntary sector and the role that it can play and the contribution it can make in this important area. I strongly agree that there is an overwhelming case for the integration of social services and NHS equipment services at a local level. My hon. Friend will be aware that the Government are committed to seeing that take place, and we have issued guidance to local authorities and the NHS to ensure that that can take place in 2004.

Despite the Prime Minister's personal intervention, taking responsibility for community disability a year ago, it remains an area of failure, although we welcome the announcement of the money today. However, the Audit Commission's recent report—Called, rather ironically, "Fully Equipped"—States that poor quality services are stripping disabled people of their dignity. Will the Secretary of State match our proposal to establish a single fundholder to pay out incapacity benefit and with the power to purchase physical aids, physiotherapy and a range of other medical treatments?

We need to be absolutely clear about one thing: the problems did not start on 1 May 1997. In fact, the report to which the hon. Lady refers represents just as much a description of the Tory years, when they were managing the NHS, as anything else. Of course, we would take her strictures on the subject a little more seriously if she and her hon. Friends would match our spending on social services, because she will be aware that the report deals with social services issues. She will also be aware that until and unless the Conservative party matches that spending, her words and her crocodile tears will be dismissed as completely contemptible.

What major capital investments in cancer treatment facilities have been made in the last two years. [156285]

Some £95 million from the new opportunities fund and £100 million of NHS resources are being invested in cancer treatment facilities, and 56 new linear accelerators, 95 new CT scanners and 35 MRI scanners have now been allocated across the health service.

I thank my right hon. Friend for that answer. I am sure that he will be aware of the announcement last week of the additional resources for the Royal Preston hospital, which will ensure that the facilities in that hospital can meet the needs of the people of Lancashire. We welcome that, but can he assure us that that hospital will be able to meet the needs of all the people in Lancashire in the future and supplement the facilities that have been traditionally provided at the Christie hospital in Manchester?

There is a very important role for both hospitals, and it is extremely important that we invest in more equipment and staff in those cancer services and, indeed, in greater prevention of cancer in the first place. As my hon. Friend is well aware, after decades of the shameful neglect of cancer services, the investment is now being made. It is worth my hon. Friend's reminding his constituents in the weeks to come that, under the previous Government, not a single penny was earmarked for cancer services funding, but under this Government in this financial year £280 million extra will be invested in modernising cancer services.

Is the Secretary of State convinced that the NHS has yet got the balance right between surgical and chemical or radiotherapy cancer treatments? Is he aware that this country has pioneered the microsurgical treatment of cancer, which increased survival rates and reduced the complications and indignities suffered by patients when it was adopted and disseminated abroad? Why is not more effort being put into disseminating those skills throughout the NHS?

With all respect to the right hon. Gentleman, a big effort is being made to ensure that not only chemotherapy and improved radiography services and so on are available, but that more surgical options are available to cancer patients. As he is aware, during the past year or so, we have made great strides in ensuring that, although all the problems have not been solved, there is at least progress on the waiting times that cancer patients have to endure for initial outpatient appointments. We set a target for patients to be seen within a fortnight. Thankfully, about 100,000 women with suspected breast cancer have now been seen within a matter of weeks, rather than months, which was the situation previously, and they go on to a variety of treatments, including surgery.

The right hon. Gentleman is right to suggest that we must get the balance right, but to do so we must ensure that the investment is sustained. If he is as concerned as he says he is about those issues, he might have a word with his colleagues on the Conservative Front Bench to remind them that watching Labour's health funding for the NHS is an important priority for his party.

I welcome the investment in cancer treatment, but, as my right hon. Friend will be aware, mesothelioma is a particularly nasty form of cancer, caused by exposure to asbestos. This year, there have been 1,500 deaths from mesothelioma, and Professor Peto's forecast is that that will rise considerably and peak in about 2010 or 2020. He will also be aware that the Macmillan foundation is training a network of nurses to provide care for people suffering from mesothelioma, but there is a need in the initial stages for an information line. Will he consider how an information line may be set up and co-ordinated in the first stages to support that network of nurses?

If my hon. Friend cares to write to me with his suggestions. I will gladly consider them. He also made an important broader point, which is that inevitably in the NHS service we often focus on how we can improve treatment services. However, as we all know, a huge number of deaths from illnesses such as cancer and coronary heart disease are preventable by action in the workplace and by tackling such things as smoking. We are committed to such preventive action, and it will be worth my hon. Friend's reminding his constituents that while the Government are backing measures that mean that fewer people will smoke in future, most notably by a ban on tobacco advertising, the Conservative party, despite its warm words, refuses to back such a ban.

Labour's manifesto at the last general election pledged to end waiting for cancer surgery. Does the Secretary of State consider the pledge to have been met?

As the hon. Gentleman knows, we set a target for reducing—[Interruption.] If the hon. Gentleman can wait before asking another question, he will get an answer to the first. We set a target for reducing the time that it takes to get people with suspected cancer into hospital. I am pleased to say that between 95 and 97 per cent. of women with suspected breast cancer are now being seen within a fortnight. We have set additional targets for people to be seen within a fortnight for all forms of suspected cancer, including lung and prostate cancer. As a consequence, we are reducing the waiting times for all forms of cancer treatment.

If he will publish guidelines for NHS trusts about the information to be given to women facing sterilisation operations relating to the chances of failure. [156286]

The Department of Health funded the Royal College of Obstetricians and Gynaecologists to review and publish guidelines for sterilisation for all its members. The guidelines state clearly that all women should be informed, before a sterilisation operation, that the failure rate is around one in 200.

I thank my hon. Friend for that reply. My question was inspired by my constituent, Marilyn Kearney, whose daughter Phoebe was born after Marilyn had had a failed sterilisation. She was not properly informed of the one in 200 failure rate; indeed, the person who operated on her thought that it was much lower. Since her plight has been publicised, women throughout the country have been in touch with her to say that they were not informed of the failure rate. What can the Government do to make sure that women undergoing the operation know that they risk a one in 200 chance of it failing, which might influence their decision about whether to proceed?

My hon. Friend makes an important point. It is critical that women get full, accurate information before they make such important decisions. The guidelines to which I referred were disseminated to all the members of the royal college and are widely available to the trusts. However, we will pursue with the royal colleges what further measures might be possible to ensure that the guidelines are being adhered to throughout the country.

Is the Minister aware that I was fortunate in gaining a place in the ballot for private Members' Bills in this Session and that my Bill covers standardised patient consent forms for all patients in the NHS and the independent sector? Does she agree that all patients should be given a standardised form, explaining the treatment that they are about to receive and its risks and benefits? Will she support my Bill and its principles?

I certainly support the principles of informed consent for all patients. We are keen to see measures that would improve the information given to patients as well as the counselling and support that they receive. It is not simply about providing patients with written information and particular facts; they must also have the chance to ask questions and to receive proper counselling, especially when they have conditions or face operations for which choices have to be made or where there are alternatives to the treatment that is being offered.

If he will make a statement on waiting times for acute care. [156287]

Average waiting times for admission to hospital have fallen to 13 weeks, compared with 15 weeks in June 1998. By the end of 2005, no one will wait more than three months for a routine first out-patient appointment or more than six months for non-urgent admission to hospital under the targets set out in the NHS plan.

In that case, will the Minister please telephone Dr. Ian Rummens, the secretary of my local medical committee, who has said that, despite there being a very mild flu epidemic this winter, it has been impossible to get patients into acute beds in any Shropshire hospital and into hospital in Hereford and Wrexham Maelor? Will the Minister please ring Dr. Rummens and address the question of increasing the number of acute beds?

I am not clinically qualified to know whether the hon. Gentleman suffers from amnesia, but he certainly has problems with his memory. About 40,000 hospital beds were lost under the previous Government, and this past winter has been the first for many years in which the number of general and acute beds went up. There were also more critical care beds in the national health service. The statistics for Shropshire show that the number of in-patients on the waiting list has fallen from the peak of 9,635 to 7,200 in February this year.

What can be done to ensure that general practitioners give accurate information to patients about waiting times? I was contacted recently by a number of constituents who complained about how long they had been told they would have to wait for care. When I looked into the matter, I found that the information that they had been given was wildly inaccurate. When I told them that, they felt rather aggrieved and there was perhaps the suspicion that they had been put under pressure to seek private treatment to receive quicker care. What can be done to make sure that GPs provide accurate information to their patients about such matters?

I would certainly be very concerned if there was any suggestion that patients had been encouraged to go private in those circumstances. We have made it clear to hospital trusts that we wish them to provide local GPs with consultant-specific information about waiting times, so that GPs are able not only to inform their patient correctly and accurately about any likely length of wait but can decide according to the condition of their patient whether to refer to a specific consultant with specific expertise or whether a generic referral to a particular team of consultants might be more appropriate and might involve a shorter wait. We have publicised that guidance over the past year to the NHS, and I will be happy to follow the matter up in my hon. Friend's area to see whether that system is operating. That is the way the problem should be tackled.

Given the current concern about the increasing incidence of cases of tuberculosis, with a 50 per cent. rise in London over the past decade, is not the Minister concerned about the waiting times to see thoracic consultants? They have more than doubled since the Government came to office and have gone up fivefold in London. Is not that in no small part due to the fact that we have half as many specialists per head of population as the European average? Although we know that the Government have plans to recruit more doctors and nurses, that will take time. What can the Government do to accelerate the process for this particular speciality?

The hon. Gentleman is right to say that we have made clear our plans to increase the number of consultants, including thoracic consultants, in the NHS in the years to come. We take TB very seriously. As he knows, there has been a worldwide resurgence in cases of TB, so that is why it is important to expand the capacity of the NHS to deal with the health problems that arise.

The hon. Gentleman referred to London. London, as a region, has already set itself the target of increasing the number of TB-trained nurses, and that is why we are also expanding the number of doctors and nurses across the board.

Is it not true that cutting waiting times depends not only on the availability of consultants, but on having sufficient theatre space and theatre time? Will my right hon. Friend assure me that the extra £116 million invested in Bradford royal infirmary, which serves my constituents, will help to contribute to reduced waiting times in the future?

The unprecedented investment that the Government are making in the NHS is enabling us to expand its capacity. I was able to refer earlier to the increased numbers of beds in the NHS, and we have 17,000 more nurses and more than 6,000 more doctors in the NHS. The capital programme that we have under way, which includes the largest ever hospital-building programme in the history of the NHS, will clearly expand operating theatre capacity. Those measures taken together can give us confidence that we will continue to cut the time that it takes people to receive treatment.

Is the Minister aware that behind the Casualty Watch revelation that the worst wait of all in an accident and emergency unit was at the Kent and Canterbury hospital, is a burgeoning list of delays in elective surgery, as reflected in my postbag which has a flood of cases of delayed operations? Are the Government still unwilling to review their plans to spend £102 million reconfiguring buildings in a programme that will provide no extra capacity whatsoever, when half the area's consultants unanimously decided in a meeting to pass a motion saying that there was insufficient capacity to provide decent health care?

First, the Government have exceeded their manifesto commitment to cut waiting lists. The in-patient waiting list is 125,000 below the figure that we inherited. As for the Casualty Watch figures, the hon. Gentleman should be a little careful. Two out of the top three cases were kept in the accident and emergency department because of a clinical decision; it was not that no beds were available in the rest of the hospital. The doctors involved made a clinical decision that it was right to keep those patients under observation in the accident and emergency department. It would be wrong to believe that a lack of capacity lay behind their treatment.

Of course I am aware that the proposals for the hon. Gentleman's area are controversial. However, I believe that the Government's investment in them will allow us to deliver a national health service in east Kent of which he can be proud. Controversies often surround such issues. That is why decisions are taken only after careful consultation and consideration.

I suppose that if 50 per cent. are unanimous, the other half take a different view. However, does my right hon. Friend agree that the best way to bring down and keep down waiting lists is to abolish the nonsense of the internal market, to sustain investment in the health service and to modernise it? The only people who can expect to gain from the Conservatives' policies are those who can afford to buy their treatment.

My hon. Friend is correct: we need to get our priorities right. One of the Government's priorities has been to save £1 billion from the bureaucracy associated with the internal market and to plough it into patient care so that we can treat more patients. He will be aware that the Conservative party proposes to remove £340 million from the money that is invested to treat people on the waiting list, which would cut something like 310,000 operations for cataracts, hernias, knees, hips and so on. That is music to the ears of those who wish to promote private insurance, but a great concern to his constituents and to mine.

In its 1997 manifesto, Labour said that it would take

"100,000 people off waiting lists"

and cut the cost of bureaucracy. Will the Minister confirm that his Department's figures show that the cost of running the Department of Health has increased by £30 million? Contrary to the impression that he just tried to give the House, the total number of patients waiting—in-patients plus out-patients—has increased by 93,000 in England and Wales. Can he spare us the spin for once, admit that the figures are correct and tell us that Labour has failed on both its main pledges?

No, I shall not do that because the truth is that, when we were elected in 1997, about which the hon. Gentleman has reminded us, in-patient and out-patient waiting lists were going up. This Government have successfully turned the corner on both those waiting lists. In-patient lists are down by more than we promised in the manifesto and out-patient waiting times are also falling. Over the past year, for the first time since records began, both in-patient and out-patient lists have been falling.

If he will make a statement about his plans to cut the incidence of coronary heart disease. [156288]

We have made investment in treating coronary heart disease and its prevention a priority. There are more heart specialists and more heart operations, and there is more help for people to give up smoking—the biggest avoidable cause of death from heart disease.

Is my right hon. Friend aware that people who have a family member with heart disease are four times more likely to suffer the same disease themselves? In the light of that fact, will he congratulate the British Heart Foundation, which has visited more than 40 towns and cities to publicise that issue? Does he agree that raising awareness of heart disease is incredibly important in combating it?

I very much agree with my hon. Friend. The British Heart Foundation plays a very important role, not just in public education but in the support that it offers families who are hit by this dreadful disease. Heart disease is the biggest killer in the country; it kills around 150,000 people a year. I know that the BHF is looking to launch a major research programme into the genetics behind heart disease, and that is welcome. I hope that my hon. Friend will join me in welcoming the recent announcements of my colleagues in the Department of Trade and Industry. An extra £71 million is to be invested, jointly with the Higher Education Funding Council and the Wellcome Trust, in some of these areas.

I notice that the hon. Member for Woodspring (Dr. Fox) was quoted in the papers this morning as saying that the £71 million is being spent on the treatment of phobias. Nothing could be further from the truth. The money is, for example, for research at the university of Oxford into computer simulation to aid better treatment and drugs for heart disease and diabetes; for research at the university of Glasgow into genes that trigger conditions such as depression, asthma and cancer; and certainly for research, in places such as Nottingham and University college, London, into human brain disorders including schizophrenia, autism and memory decline among the elderly. I hope that my hon. Friend will welcome that, unlike the hon. Gentleman.

While I am referring to the hon. Gentleman, I might add that I would have thought he would welcome research into phobias; after all, it could be helpful for the Conservative party, given the prevalence of Europhobia, homophobia and xenophobia among some of those on the Conservative Benches.

Is the Secretary of State aware of the unequivocal support of my constituents who have suffered from the most serious form of coronary heart disease for the Wythenshawe heart transplant centre, which is under threat of closure? Is he aware that that is a centre of excellence, the work of which is most highly valued throughout the north-west? Its location is easily accessible for patients from south of Manchester, including those in the constituency of my hon. Friend the Member for Macclesfield (Mr. Winterton).

Keep it in the family, as they say.

On the serious issue that the hon. Lady raises, as she knows, the Department and Ministers have received representations not only from people in the north-west, which we take very seriously, but from colleagues in Sheffield and Birmingham too. Some difficult decisions will have to be taken, and they must be informed by the best clinical advice that we can get. She is aware of some of the clinical issues around these matters. As yet, Ministers have not received formal advice. I hope that we can make the right decision as soon as we are able, but, in the meantime, we hear the representations.

I know that the Secretary of State is aware that prevention and early intervention are key to tackling heart disease and greatly reduce the risk. Does he therefore accept that creating health awareness at a young age is the key? Will he strengthen links between the Department for Education and Employment and the Department of Health to ensure that sports education in schools is given very high priority?

That is very important. There are certain things that we need to do in the short term, and things that we must do in the longer term. There is more that we can do in the short term to increase the number of cardiologists, cardio-thoracic surgeons and heart operations, and that is happening, but the greatest gain in tackling coronary heart disease will come from improved prevention, rather than improved treatment. As my hon. Friend says, sport in schools is incredibly important, as is diet among school children. She is aware that we have introduced an initiative to provide free fruit to children in school for the first time. It is hugely welcome in the schools where it has been tried out, and I have no doubt that in the longer term it will bring great benefit in terms of health gain, not just among the children who receive a free piece of school fruit, but among their families.

The Secretary of State will be aware that figures show that failure to screen adequately means that up to 30 per cent. of coronary care beds in the United Kingdom are occupied by patients who do not have a cardiac problem. In the Government's overall strategy, what is the place of Troponin testing, and what are the Government's plans?

We need to do more not just in respect of screening, but, as the hon. Gentleman is aware, to ensure that when patients are referred by their general practitioner to hospital, they are treated as quickly as possible. That is why we have established 130 rapid-access chest pain clinics—first, to ensure that the people who need heart treatment get it as quickly as possible and, secondly, to screen out the people who do not have heart disease but who might have some other form of chest pain. That is what the rapid-access chest pain clinics are doing. They are widely available in many hospitals across the country and by 2003 they will be available in all hospitals. If the hon. Gentleman is as serious as he says he is about tackling coronary heart disease and improving cardiac care, I hope that he agrees that it was a fundamental mistake of the Government of which he was a member not to earmark a single penny piece for improvement in heart services.

If he will make a statement about co-ordination of health and social services policy to support carers. [156289]

The national service frameworks for mental health, older people and coronary heart disease will help to ensure greater attention to carers' needs across the NHS and social services. The additional flexibility introduced by the Health Act 1999, together with the new powers to establish care trusts, will also lead to closer integration of health and social care. By 2003–04, an additional 75,000 carers will benefit from extra services.

Does my right hon. Friend agree that more has been done to support carers in the first four years of this Government than at any other time in the past, and that with the national carers strategy, the Carers and Disabled Children Act 2000 and the increase in social security benefits for carers introduced this week, there is a significant improvement in provision for the 9,000 carers in Monmouthshire? Given that the Conservative party has made no commitment to match the Government's commitment to social services spending, does my right hon. Friend accept that the Carers and Disabled Children Act 2000, which is to be introduced by local authorities later this year, would be jeopardised?

My hon. Friend makes some important points. It is worth quoting Diana Whitworth, the chief executive of the Carers National Association, on the publication of the recent national service framework for the elderly. She said of the policies in that document:

"Carers have often been marginalised or excluded by healthcare professionals. The NSF"—

that is, the national service framework—

"promises to tackle that once and for all."

That is just one example of the endorsement of the extra investment in financial support and services for carers that the Government have introduced. My hon. Friend is right to say that all that is threatened by the Conservative party's refusal to promise to match our investment in social services.

Will the Minister join me in praising the service provided by the minor injuries unit and respite care beds at the Victoria hospital in Lichfield? Will he finally end the confusion that has reigned for the past three years regarding the future of the Victoria hospital? Will he say once and for all that the Victoria hospital will remain open?

Few people have done more to create a cloud of uncertainty over the future of the Lichfield hospital than the hon. Gentleman. What I can say to him and to other hon. Members is that the investment that the Government will make in support for carers, as well as that which we are making in intermediate care, provides the best guarantee of continuing good provision of community facilities for those who need care and respite care. He will understand that all that is threatened by some of the policies that he supports.

What progress is being made in preventing young people from taking up smoking. [156290]

The most recent evidence shows that smoking rates among children aged from 11 to 15 fell from 13 per cent. in 1996 to 9 per cent. in 1999, while adult smoking levels also fell. However, smoking rates among 16 to 19-year-olds rose between 1992 and 1998. That is why the Government have put in place a broad strategy to cut deaths from smoking, including the banning of tobacco advertising, which has a significant impact on smoking among children and young people.

In the next 24 hours, 500 British teenagers will, on average, take a decade off their lives by taking up smoking. Is my hon Friend convinced that we can reduce that dreadful toll by hitting the targets set out in the 1998 White Paper, "Smoking Kills"? Will she introduce a national scheme to provide children with proof-of-age cards, which have been successful in parts of Leicestershire and elsewhere in reducing under-age tobacco sales? Will she read the Hansard record for 24 April, when my ten-minute Bill will be debated, and take the opportunity to review those topics?

My hon. Friend is right that smoking has a huge impact on health. We have already made progress on under-16s, but we have considerably more to do. He mentioned proof-of-age cards, which can play an important part in enforcement strategies to cut under-age sales. We are keen to encourage the sort of programme that has been initiated in Leicestershire, and we shall consider his proposals in detail.

Given the appalling increase since the Government came to power in the number of teenagers who smoke illegally imported tobacco, is not it one of the worst cases of Government mismanagement that they increase taxes on tobacco while failing to increase the services and Customs and Excise men to stop the smuggling? It is their fault that these teenagers are now smoking illegal cigarettes.

I must point out that smuggling is a serious problem not only in this country, but in Italy, which has low duty rates. Smuggling is a problem of organised crime and not of duty rates. That is exactly why the Government are investing more than £200 million over three years in tackling smuggling. The hon. Gentleman's party has not pledged to match that investment. The Conservatives may have made commitments in respect of investing in the health service, but I should point out that, unless they can match our investment in tackling smuggling, as well as in personal social services, they will not have the impact on health and on saving lives that is needed.

If he will make a statement on social inequalities in health. [156291]

Across the Government, there is a commitment to tackle health inequalities. For the first time, new national targets have been set to reduce the health gap among children and between geographical areas. We have backed that commitment with extra resources for the poorest parts of the country.

I am grateful to my right hon. Friend for that reply. Is he aware of the research published by Dr. Richard Mitchell and Professor Daniel Dorling of the university of Leeds, and Dr. Mary Shaw of the university of Bristol, which suggests that about 7,500 lives a year could be saved among people under the age of 65 if inequalities in wealth were to decrease? Does he therefore agree, unlike the previous Government, that reducing poverty has as big a part to play in reducing health inequalities as the improvements in primary health care to which he is committed?

I agree with my hon. Friend. As all hon. Members know from their constituencies, there is a direct relationship between poverty, deprivation and ill health. That is irrefutably the case. We also know from the statistics that a child born today into the poorest family in the land will, on average, live 10 years less than a child born into the richest family in the land, which, for most people, is an unacceptable state of affairs that must change. We know what the attitude of previous Governments has been. The hon. Member for Woodspring (Dr. Fox) summed it up neatly when he said:

"all we hear from the Opposition"

the Labour party

"is poverty, poverty, poverty, la, la, la & It is just boring for Conservative Members."—[Official Report, 22 October 1992; Vol. 212, c. 636.]

It might be boring for the hon. Gentleman, but it is a fact of life for millions of our fellow citizens, which we came into politics to change.

Is the right hon. Gentleman aware that many social inequalities are caused by variable waiting lists? Will he address the sort of problem that is faced by constituents of mine who have to wait significantly longer for their treatment at the New Cross hospital in Wolverhampton than those who live in Wolverhampton itself? That is a real social inequality, which needs addressing.

We must ensure that people, wherever they live, whatever their background and regardless of their ability to pay, receive the right treatment when they need it. Sadly, that is not a position to which the Conservative party is committed.

Nowhere are social inequalities in health more apparent than in my constituency, mainly as a result of historical underfunding under the previous Government. Even now, because of the difficulties in my area, my local health authority faces yet another deficit in its health budget of about £3 million. I plead once again with my right hon. Friend to reconsider the funding of Barnsley health authority, whose funding is one of the lowest in the country, to try to alleviate some of those problems.

As my hon. Friend is aware, not only Barnsley health authority but health authorities throughout the country will receive extra investment. He will also be aware that we are committed to changing the way in which cash is distributed within the NHS to ensure that it is much more geared to tackling such appalling health inequalities. In the meantime, we have made £130 million available to 50 or so health authorities with the highest incidence of early deaths and high morbidity from some of the diseases that we have been discussing today, including coronary heart disease and cancer.

We have a simple choice: we can either continue to do what has been done in the past and wring our hands at the dreadful facts around inequalities, regret those facts and say that, in the end, trickle-down economics will hit the poorest communities and the poorest people, or recognise, as the Government do, that we must learn from history that trickle-down economics have failed and have not benefited the poorest people in the poorest communities. We can then redouble our effort to do what Governments for many a generation should have done, which is to improve the nation's health overall and improve the health of the poorest people fastest.

Does the Minister share my worry about the social consequences in communities of CJD outbreaks? Is he aware that the national surveillance unit has just identified a number of clusters throughout the kingdom, including in my constituency, but its preliminary investigations have shown no strong links? I am anxious that there should be a detailed investigation into the causal links between the cases in my constituency. Does he agree that it is vital that such detailed investigations are carried out as quickly as possible, first to identify causal links and, secondly and most importantly, to allay the concerns of those in larger communities who are frightened by that terrifying disease?

The hon. Gentleman is right to say that it is a terrifying disease. The national variant CJD surveillance unit does a good job and, where there are outbreaks or clusters, we must try to find out why. The hon. Gentleman is aware that, in Queniborough in Leicestershire, research was carried out into the background factors that led to a cluster of deaths from variant CJD. If there are other clusters, we shall want to consider background causes. We must do that because we have to get to the bottom of why these things are happening and, hopefully, in the future, be in a better position to do something about them.

Does my right hon. Friend recognise the inequalities in health provision in rural areas such as my constituency? Will he confirm that, in future, hospitals such as Whitby community hospital will be a focal point for dealing with inequalities in dentistry provision and eyesight problems, and that they will form a key plank in our strategy for tackling inequalities in rural areas?

My hon. Friend makes a good point. All too often, we perceive health inequalities in terms of the concentration of poverty and deprivation in inner-city or urban areas such as those that my hon. Friend the Member for Barnsley, Central (Mr. Illsley) mentioned. However, as we all know from our constituencies, there are also large concentrations of poverty, deprivation and ill health in rural areas. I therefore give my hon. Friend the Member for Scarborough and Whitby (Mr. Quinn) a firm assurance that, when the new formula for distributing cash across the national health service is introduced in 2003, it will have a particular perspective on the way in which we recognise the needs of rural communities.

If he will make a statement on the national service framework for older people. [156292]

The Government are determined to improve the quality and range of NHS and social care services for older people. The national service framework, which was published last month, will ensure fair, high-quality, integrated health and social care services for older people. It sets new standards to help root out age discrimination and drive up the quality of care. Implementation of the new standards will be carefully monitored.

May I welcome the framework and ask the Minister how, and over what time scale, he envisages the removal of age discrimination from the NHS? How would the framework apply to my constituent, a 71-year-old lady who is marooned in Kingston hospital after a serious stroke? She cannot be moved because the nearest and most appropriate stroke rehabilitation unit, the Wolfson unit, operates a strict age bar and admits no one who is over 65.

I am grateful for the hon. Gentleman's support for the objective that we aim to achieve through the national service framework. I have been advised that the Wolfson unit does not set age-based criteria for admission as he suggests. I understand that it recently treated a 92-year-old in similar circumstances to his constituent. We have clearly set out in the national service framework that we want all age-based eligibility rules to be reviewed by October this year and the necessary action taken as soon as possible after that.

The hon. Gentleman is a man of good will, and he will understand that it will take time to put right the years of neglect and indifference that we inherited from the previous Administration. We are determined to do that. Older people are the largest users of NHS services and often the biggest supporters of the NHS. It is time for the Government and Parliament to pay proper attention to their needs in the NHS.

I thank my hon. Friend for taking such action. It is long overdue and it will make a genuine difference to older people, especially those who suffer strokes and from osteoporosis. Will he work closely with modernisation action in the NHS to ensure that there will be money to enable us to take advantage of the framework and implement it properly where need is greatest?

I certainly agree with my hon. Friend that we have a big task ahead of us in converting the aspirations of the national service framework into tangible improvements on the ground and in the front line. The national service framework has made some important declarations about improvements in stroke care services. They have been strongly welcomed by the Stroke Association, which has worked closely with us to develop the framework. It is a big job and we intend to work closely with all the key partners who have helped us to develop the standards and, of course, with the NHS and social services.

Does the Minister agree that the national service framework will be little more than fine-sounding words if we continue to lose intermediate care beds at the current rate? Why have we lost 50,000 such beds in the care home sector in the past 12 months? What will he do about it?

The hon. Gentleman is wrong; 50,000 beds have not been lost in the care home sector. Between 7,000 and 8,000 beds have been lost in that sector over the period that he mentioned. [Interruption.] Those are the figures. It is clear to Labour Members that Conservative Members hate being confronted with the truth about issues. However, we intend to deal with them. The number of intermediate care beds in the NHS is set to increase, and it is very important that it does so.

The hon. Gentleman will also want to reflect on the fact that an important part of the extra investment in intermediate care services will be local government investment through social services. I know that he does not like this, but let me remind him that his lectures on the subject are utterly bogus unless and until his hon. Friends can agree to match our spending on social services. They have been given numerous opportunities to do that, but they have never to this date said that they will match our spending

If he will take steps to ensure that children's hospices receive the same level of funding as adult hospices in future allocations. [156294]

What new resources are to be provided for existing children's hospices. [156295]

Children's hospices have the same access to health service funding as adult hospices. We are increasing funding for the provision of palliative care services and expect children's hospices to benefit thereby. In addition, funding will be available later this year from the new opportunities fund, specifically for services in support of children with life-threatening illnesses, including those provided by children's hospices.

It is an interesting answer. My hon. Friend may be aware of the excellent work done by Derian house in my constituency, which treats children not only from the north-west but from other regions. It is a very specialist children's hospice. Is she aware that children's hospices are the poor relations when it comes to funding, and that they received only £25,000, which is not acceptable? I put down a challenge to my hon. Friend: please will she personally look into the funding of children's hospices and ensure that there is a big improvement in what they receive? I know that we could work together for the benefit of children's hospices.

Not only am I happy to take up that challenge but I have in front of me details of Derian house, and I am aware of the good work that it does. We have to ensure that children's hospice provision is developed in a strategic way, and that is why we have set up a regional group. I urge my hon. Friend to encourage the hospice in his constituency to take part in that review. We have also made new funds available. The new opportunities funding that was announced recently by the Department for Culture. Media and Sport will make available about £300 million to spend on health initiatives. We envisage that about £48 million will be available over the next three years to provide palliative care for children with life-threatening and life-limiting illnesses. I hope that he will encourage the hospice to be part of that process to ensure that strategic care is provided in his area.

I am sure that the Minister will want to join me in paying tribute to the Shropshire and Mid Wales adult hospice and the Hope House children's hospice, which serves my community. They, and the hospice movement in general, welcomed the announcement of additional funding made by the Secretary of State last October, but six months later they are still seeking clarity. Will my hon. Friend confirm that the new resources will meet the needs not only of new initiatives in children's hospice provision but of existing hospices? Will she also confirm that a contribution will be made towards core funding, as well as new initiatives at those hospices? The hospices have been waiting a long time for the clarity that they seek, and they need some assurance from my hon. Friend the Minister so that they can plan for the future.

Of course; that is why the directions laid down for the bidding for new opportunities funding will provide exactly what my hon. Friend asks for. I have looked at the provisions for Hope House hospice and I note that the secretary of its association is a member of the children's taskforce and is playing a key role in the Association of Children's Hospices. I know from a meeting today that the association is satisfied that the current arrangements will allow hospices to plan for the future in the best interests of the children who need and deserve that care.

Will the Minister ensure that some of the extra money will go towards paying for the complementary therapists who do so much in hospices such as the Loros in Leicestershire? Now that the Government have helpfully published the response to the Lords report on complementary medicine, will she pledge perhaps £100,000 towards research?

Will the Minister have a word with a counterpart of hers? If homeopathy is good enough for humans, is it not good enough for animals in the foot and mouth disease crisis? Will she have a word with the Minister of Agriculture, Fisheries and Food?

I have long since stopped thinking of supplementary questions from the hon. Gentleman; I think of complementary questions. He is aware that homeopathy has played a significant role in palliative care. We shall continue to look at that and take it forward.

Is the Minister aware that, in Southend, where for many years we have had a wonderful hospice called Fair Havens and where, more recently, a children's hospice has opened, although we raise increasing sums every year to help the hospice, because the percentage of funding covered by public funds is being reduced, the burden is becoming greater every year? Does she not feel that there might be a case for a proper review by the Department of the percentage funding carried by the Government for both adult and children's hospices, because the percentage is genuinely going down and the burden on the community is continuing to increase?

I am aware that we need to increase the total amount of funding available for palliative care. That is why we made £50 million available for both adults and children. However, as I said earlier, children's hospices in particular have developed in a non-strategic way, so we need to ensure that each region has proper provision. Within that, children's hospices will bid for both health improvement money and new opportunities funding, so that we can strike the right balance between what is raised from the voluntary sector and what the NHS provides. That will vary from area to area.

I have to notify the House, in accordance with the Royal Assent Act 1967, that the Queen has signified her Royal Assent to the following Acts and a Measure:

Vehicles (Crime) Act 2001.

Criminal Defence Service (Advice and Assistance) Act 2001.

Election Publications Act 2001.

Regulatory Reform Act 2001.

Elections Act 2001.

Kent County Council Act 2001.

Medway Council Act 2001.

Churchwardens Measure 2001.

I beg to move,

That leave be given to bring in a Bill to amend the Consumer Credit Act 1974 to give the Director General of Fair Trading a duty to establish a Code of Practice for traders who offer consumers the services of debt management and credit repair; and for connected purposes.

I came into some money at the weekend, when I was one of the tiny number of those who won on the grand national. Unfortunately, my stake of £2 each way did not yield winnings sufficient to service adequately the huge debt that has been incurred by people across the United Kingdom. However, I believe that the largely unregulated way in which the current system works allows the most vulnerable sectors of society to be led slightly astray by some advertisements, particularly in tabloid newspapers.

If my Bill were to become law, traders would be obliged to comply with a code, and the Director General of Fair Trading would be given powers to enforce compliance with it by use of compliance orders, fines and compensation orders. The Bill would also ensure that, before publishing the code, the director general is required to consult representatives of consumers and those who are likely to be affected by it. The code would be published and widely disseminated.

The Bill would prescribe the issues to be addressed in the code of practice, including the advertising and marketing of personal debt services; the terms on which such services are provided; charges; the standards of services to be provided by the trader; arrangements in debt management services for the protection of client moneys; arrangements for ensuring the competence of the trader's staff; procedures for handling complaints from consumers; and any other such matters as the director general, having consulted, considers necessary and appropriate for the protection of consumers' interests.

I know that the Minister for Competition and Consumer Affairs is interested in the issue because I recently had the good fortune to attend a meeting that he hosted and at which I engaged in conversation with representatives of citizens advice bureaux. I decided to persuade the House of the Bill's merits largely because of those conversations.

The National Association of Citizens Advice Bureaux recently published a report, entitled "Daylight Robbery", that highlights the fact that consumer credit borrowing has increased dramatically in the past 20 years. In the past 21 years, there has been a revolution in the consumer credit industry. As of August 2000, outstanding unsecured consumer credit in the United Kingdom amounted to £122 billion. It is a huge sum, equivalent to £3,425 for every adult between 18 and 65 in the United Kingdom.

Consumers' enthusiasm—I do not criticize them for it—to buy now and pay later has been matched by credit companies' willingness to devise an ever greater range of credit products. In the past two years, citizens advice bureaux across the country have reported a 37 per cent. increase in the number of inquiries on consumer credit debts. In the past 10 years, citizens advice bureaux and other free advice agencies have seen an increase in the number of commercial companies offering services for a fee to those who are in debt. Undoubtedly the number of such companies has mushroomed.

Since deciding to promote this Bill, I have been inundated by letters from people describing their debt problems. However, as I said, although I came into money at the weekend, I am afraid that my £86.50 will not be sufficient to service all their debts. Nevertheless, I should like to share one example with the House. One person, whom I shall call "client A", has one dependent child. The client contacted a debt management company for help with debts of £25,000, and the company told the client that creditors would accept offers of £1 per month. However, when bailiffs began to call at the client's home, the client discovered that no agreement had been reached with creditors.

The client went to the CAB for advice. The CAB adviser discovered that the client's total debt was £51,000. When the CAB spoke to the client's creditors, it found that the debt management company had not made any arrangements with creditors. The creditors told the adviser that they would rather deal with the CAB than with a debt management company. I am delighted to say that, as a result, the CAB has the client's debt under control.

The National Consumer Council contacted me, saying:

"People are often at their most vulnerable when needing debt management services. To feel confident in using them, they need clear information about the choices available in the market place"—

this is what I am asking the Minister to consider—

"and also to know what to expect from both fee charging and free services."

The NCC believes:

"debt management services should be properly regulated".

I am also indebted to the Sunday Express. A journalist there called Rachel Baird has, for the last few weeks, written a series of articles headed "Debt 'Parasites' Spark Crusade", in which she has reported the experiences of all sorts of people who—sadly—have got into debt, panicked and gone to some of the companies that I am describing, with very unfortunate effects.

The company Direct Line has contacted me to say that it

"is concerned many consumers are using the services of these agencies without being fully aware of the potential consequences and costs. Often, it would be more effective for the consumer, and in their best long-term interests, to deal directly with the lender".

Direct Line is concerned about misleading advertising, hidden costs, the impact on credit rating, failure to take the full financial situation into account, and long-term costs.

Equidebt is another company that has contacted me. It speaks of a breed of cash flow managers targeting vulnerable people who want up-front payment of some sort. It says that such managers want to make money out of such people. The Finance and Leasing Association also contacted me.

As we all know, there are many advertisements for such services in the newspapers. They say, for instance, "Debt Problems? Money Worries?", offer "unsecured personal loans", and make such statements as

"We could arrange you a mortgage fast!"

Perhaps many of those companies are responsible; perhaps the majority give good advice. Unfortunately, according to the citizens advice bureaux, not all of them do.

Many of the advertisements suggest that, for a fee, companies advertising credit repair services can wipe the slate clean for those who have got into money difficulties in the past and had court judgments recorded against them. That is nonsense.

There is a real need for consumers to be protected from the services of debt management and credit repair companies. Those needing such protection are undoubtedly the poorest and most vulnerable members of society. I hope that the House will support the Bill.

Question put and agreed to.

Bill ordered to be brought in by Mr. David Amess, Mr. David Atkinson, Mr. Richard Burden, Mr. Simon Burns, Sir Sydney Chapman, Mr. Roger Gale, Mrs. Linda Gilroy, Mr. Mike Hancock, Ms Oona King, Mrs. Marion Roe, Mr. Alan Simpson and Mr. David Wilshire.

I beg to move,

That in the Order of 6th March (International Development Bill (Programme)) the following be substituted for paragraphs 4 and 5—

4. Proceedings on consideration and Third Reading shall be completed at today's sitting.

5. Proceedings on consideration shall (so far as not previously concluded) be brought to a conclusion at Three o'clock.

5A. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at Four o'clock.

The motion proposes that the remaining stages of the International Development Bill be completed in the House today. It is supplementary to the programme motion approved for the Committee stage, which finished on 15 March.

The Bill is important, but it is also short, simple and uncontroversial. We have already spent about 16 hours debating it—Seven on Second Reading and nine in Committee—and have covered a great deal of the ground. I hope that our debate today will be similarly constructive and that, to that end, we shall not spend too much time debating the programme motion. I commend the motion to the House and will set an example by sitting down.

I certainly do not want to detain the House for too long on the programme motion—frankly, there is precious little time this afternoon to discuss some important amendments to an important Bill. However, the Minister would not expect me to let him off the hook quite that lightly. It is important to record—Yet again—some important points of principle about the way that the Government whistle legislation through the House without proper scrutiny or consideration.

The Bill was printed on 15 February this year. Second Reading took place on 6 March. The Bill went into Committee on 12 March and was out again on 15 March. When it came out of Committee, several important new clauses—some of them drafted by me—had not been considered. In one sense, the Minister is right to say that the Bill is relatively uncontroversial. However, because it sets out the framework for international development—probably for many years to come; the previous Act of this type was in force for 21 years—it is essential that we get it right. The Conservatives and other hon. Members have raised important points that we want the Government to consider.

Today, we have two hours to consider 12 important amendments—one or two of which are fundamental to the essence of the Bill. That is not enough time. However, our main complaint about the programme motion, as you will know, Mr. Speaker—I suspect that you have heard this speech once or twice since Christmas—is one of principle. These newfangled programme motions are being imposed on the House of Commons by a heavy-handed Government using their massive majority. The result is that debate is stifled and insufficient scrutiny given to legislation. We all know that that means that legislation will be less good than it would otherwise be.

In this case, the community of non-governmental organisations has not had time to study the Bill properly, nor had an opportunity to make its comments on the Bill known to us. There has not been enough time during the Bill's consideration to tease out important points from the Government.

Does my hon. Friend agree that if the Government increased the allocation of time for Report, it would be possible to incorporate in the Bill the terms of the Organisation for Economic Co-operation and Development convention against bribery in international business dealings, thereby answering the consistent call of Her Majesty's Opposition and the recent request of the hon. Member for Putney (Mr. Colman)?

My hon. Friend makes an important point. It is one of the many failings of the Government in the last 12 months that they have failed to introduce important anti-bribery legislation, despite a commitment from a Minister in April 2000 to do so at the earliest opportunity. The earliest opportunity came in the Queen's Speech in the autumn; it came and it went. The legislation was not in the Queen's Speech and there is insufficient time to insert it into the Bill that we are considering today.

I ask the Government again to reconsider programme motions. They clearly are not a great success and there is no point in driving through legislation if it later turns out to be bad legislation because of insufficient time.

Members of Parliament are all in this place for a number of reasons. We are here to represent our constituents—that is important. We are here for some of us to become members of Governments and shadow Governments. But above all, we are here as Members of Parliament to make law. That is what our constituents think they send us here for. Perhaps we are becoming too much like glorified social workers now, but we are really here to make law.

It is important that there is consensus across the Chamber on the rules of procedure by which we seek to make and improve law. There are 659 of us in the House, all of us having the incredible privilege of being one of a small number of people in this country who can make legislation. What a great privilege and onerous responsibility that is. The onus therefore is on the Government to ensure that our rules of law making are fair, and that they give proper time for scrutiny, and proper time for Her Majesty's Opposition to consider things properly. That is not the case with this programme motion. For those reasons, I wish to register our firm opposition to it.

I shall speak briefly in opposition to the programme motion and to echo many of the points of the Conservative spokesman. The Minister is right that the Bill is simple, short and relatively uncontroversial, and it will remain uncontroversial if we do not get much opportunity to add anything to it.

As the Minister said, the Bill has had 16 hours of scrutiny, but I emphasise that Report is one of the few opportunities that ordinary Back Benchers, especially Back Benchers from minority parties, have to table amendments and hear them debated. I hope that we shall have the opportunity to do so this afternoon, but I believe that, in guaranteeing only an hour and a half for Report, the Government have done a disservice to their own Bill.

Would we not all have more time to debate important amendments to the Bill if we stopped talking about the programme motion and got on with it?

I do not accept that point at all. It is right and proper that we challenge the Government when they table programme motions such as this one. This is only the second time that I have spoken in a debate on a programme motion; I do not make it a habit. I do make it a habit, as I believe that the hon. Lady does, to oppose programme motions, because in drafting those motions the Government never allow sufficient time for debate.

I do not oppose programming on principle. If we allow enough time for Back Benchers to speak and for scrutiny of the different clauses, we should be able to reform the House, and should have a proper amount of time to go through every clause, but that does not mean that we should sit mute when the Government move an inappropriate programme motion. After Report and Third Reading, we shall have an Adjournment debate on matters to be considered before the Easter recess, which is a nice tradition in the House but less important than the vital job of legislation. We have got our priorities slightly wrong, and it is appropriate to take the opportunity to say so.

This is an important Bill, and there are some important issues that need scrutiny, especially in the first group of amendments on the Bill's objectives. For that reason, I did not intend to speak for more than a couple minutes but it was important to make our views known.

I was surprised by the comment made by the hon. Member for Richmond Park (Dr. Tonge), because she seemed to blame those hon. Members who want to make a couple of perfectly serious points on the programme motion. Under this procedure, every minute that we use to debate the programme motion comes out of the total debate, and that is unfair.

My hon. Friend the Member for South-West Devon (Mr. Streeter) said that we have about two hours to discuss all 10 amendments; but, of course, we will only have two hours if we have a very short programme motion debate. That puts us under intolerable pressure and is not a fair way to proceed.

The Minister defeated his own argument by saying that the Bill is non-controversial. It is non-controversial, but with such a Bill, it is right and proper for the Government to agree with the Opposition, through the usual channels, exactly how much time is needed. Perhaps two hours may be enough, or perhaps three hours would be right, but narrow time limits have been imposed without explanation. The Minister made no attempt to explain why we must finish this business by 4 o'clock, especially given that all that follows is the Easter Adjournment debate, so there is no rhyme or reason for doing so. The Government are simply determined to table programme motions on everything.

There are 10 amendments in four groups. If we debated each amendment for the same time, we would spend about 10 to 12 minutes on each. The Bill may not be controversial, but while a Bill may be non-controversial in a party political sense, people may still have serious points of view. International development is vital to many people outside the House. They are concerned about poverty in the third world and want Parliament to have a serious debate. They may well look askance at a Parliament that, on average, devotes only 12 minutes to each amendment.

Perhaps some of the amendments need no debate at all, but for the Government arbitrarily to lay down such a time limit on such a Bill damages the political process and the parliamentary process. The programme motion is unfair, and I regret and oppose it.

I had not planned to take part in this debate, but having been present during the whole debate on Second Reading and having served on the Standing Committee that considered the Bill, I thought that it might be appropriate to say a few words. I might even persuade the hon. Member for Gainsborough (Mr. Leigh) that he protests too much.

I refer the hon. Member for South-West Devon (Mr. Streeter), as well as his colleagues, to the Official Report of the proceedings of the Standing Committee. I genuinely invite them to consider whether the Committee's time, which they protested earlier was not enough, was used in the best interests of the Bill and the procedures of the House. I shall offer them a few examples of the kind of trivia that the Committee had to consider for two days, although I concede that everything that was said must have been in order or the Chairman would have ruled it out of order.

As reported in column 6, the hon. Member for Chesham and Amersham (Mrs. Gillan) thought it right to tell us the story, yet again, of David and Goliath—all very interesting. As reported in column 8, the hon. Member for Blaby (Mr. Robathan) lectured my hon. Friend the Member for Harrow, East (Mr. McNulty) on his girth. Later, as the discussions continued, the hon. Member for Faversham and Mid-Kent (Mr. Rowe), who normally makes constructive contributions, asked the Committee to focus on the need to export abroad, as he put it. Elizabeth Filkin. Those subjects are fascinating, but whether they help the Bill or international development is another matter entirely.

We then moved on to the bizarre events of the afternoon of Thursday 15 March. All the members of the Committee assembled for our fourth sitting at 2.30 pm, but the Chairman, the hon. Member for Bournemouth, West (Mr. Butterfill), was not there. He was half an hour late, and without the assistance of one of my hon. Friends, who started the Committee proceedings seven minutes late, we would have been delayed still further. The hon. Member for Chesham and Amersham then took another seven minutes to complain that we did not have enough time.

We are being told by the Opposition today that Parliament is being short-changed. However, if one reads columns 81 to 82 and 88 to 89 of the report of the Committee proceedings, one will find that we had an exchange on contact lenses, the work of opticians generally and the wonderful merits of hormone replacement therapy. I found that fascinating, but we were supposed to be making progress on the Bill and the important subjects that it covers, so was that a sensible use of our parliamentary time? I can tell the hon. Member for South-West Devon that I certainly did not think so.

At the heart of the Bill lies the need to challenge poverty internationally. The Bill is a move in the right direction, and I would do the House no further service if I did not sit down now and allow it to continue with its important business.

The right hon. Member for Coatbridge and Chryston (Mr. Clarke) was making the case of my hon. Friend the Member for South-West Devon (Mr. Streeter) when he spoke as he did about the Committee stage. It was perfectly possible for the Government and the Opposition to agree between them how much time the Bill needed. As I understand it, no consultation took place, and the result was that because the Opposition rightly oppose the whole concept of programming consideration of Bills, we had the kind of discussion about which the right hon. Gentleman complains. I have only read those exchanges—I did not participate.

My hon. Friend the Member for Gainsborough (Mr. Leigh) is right when he complains that we do not have sufficient time this afternoon properly to discuss the important questions on the Bill. It is a disgrace to Parliament; it is the wrong way to proceed, and we should not be in this position. The Bill deals with substantial matters of practical importance, not the party political issues between us. We need to understand and properly debate them. However, we have so organised Parliament that that will not happen. I only hope that in the time now left to us we can have an important, reasonable and sensible debate.

Question put:—

The House divided: Ayes 244, Noes 75.

rose—

Order. I do not think that the Minister should be moving the clause.

May I just say that the Minister would get away that lightly only in his dreams?

I beg to move, That the clause be read a Second time.

With this it will be convenient to discuss the following amendments: No. 2, in clause 1, page 1, line 10, at end insert—

'or the promotion of good governance'.

No. 5, in page 1, line 18, leave out from "that" to end of line 20 and insert—

'in the opinion of the Secretary of State, meets the needs of the present generation without compromising the ability of future generations to meet their own needs.'.

No. 6, in page 1, line 20, at end insert—

', but does not allow for any dilution of the developmental purpose to reflect commercial, political or other considerations.'.

No. 3, in clause 4, page 2, line 10, after "may", insert—

'provided he is satisfied that to do so is likely to contribute to a reduction in poverty or the promotion of good governance'.

No. 4, in clause 11, page 5, line 17, at end insert—

'(3A) No payment may be made under this section unless the Secretary of State is satisfied that to do so is likely to contribute to a reduction in poverty or the promotion of good governance.'.

This group of amendments is primarily about two vital issues. We are short of time in this important parliamentary debate so, if the House considers nothing else and if the Minister listens to nothing else this afternoon, may I urge him to listen to our arguments on good governance and all of the aid spending realised by the United Kingdom through third parties, including the European Union, the United Nations and other multilateral organisations? Will he consider extremely carefully the points that we seek to make?

I should like to talk about good governance. Obviously, our amendment addresses the issue of good governance, which we want included in the Bill. There was a long but curtailed discussion about good governance in Committee, and I must tell the Minister that it is fundamental for us. There is nothing new in people in international development talking about the subject. My distinguished predecessor Baroness Chalker—although I do not believe that she ever occupied my position in opposition—talked a lot about good governance and did many good things to establish a proper focus on good governance in British aid policy. I accept that the Minister and his boss, the Secretary of State, often talk about good governance and that it is part of the British aid programme. However, we are arguing that it is not just one factor to be considered in British aid; it is not an optional extra, but the very core of what British aid should be if it is to make a difference to the starving millions around the world.

The Opposition accept and embrace the poverty focus in the Bill but, from our experience and all that we read from commentators and experts, we believe passionately that if we are to deliver a reduction in poverty in the next few years for those living in abject misery and privation, we must put in place in the developing countries that we are seeking to help a much stronger framework for democracy, the rule of law, a strong civil service and burgeoning civil society. That is the essential framework for reducing poverty in those nations.

I have read carefully the Committee proceedings and disagree with the right hon. Member for Coatbridge and Chryston (Mr. Clarke), whose contributions I usually support, as I did not see any evidence of people being distracted or going off on a frolic of their own, as Lord Denning famously said. There were only two or three sentences suggesting such behaviour, but that happens in any Committee in which Members of opposing parties throw ideas at one another that may not be directly to the point. However, the Committee was focused and there was not enough time to deal with all of our important new clauses and amendments.

The hon. Member for Richmond Park (Dr. Tonge) asked why Conservative Members were focusing on good governance, not education, clean water or promoting the position of women. All those issues are important but, as I said, good governance is not just another factor. When building a house, one must have doors, windows and a roof; one cannot get anywhere without a foundation or framework. Good governance is the foundation and framework of any aid policy that this country must operate. It is not an optional extra—the doors and the windows—but the framework, the foundation, the absolute essence. It is because we are so passionately convinced of that that we want it reflected in the Bill.

We want good governance to be the focus for this Government, our next Government—who will come to office on 7 June—and future Governments of whatever political colour. We want it to be the framework of our aid policy for years to come. I hope that the Minister will consider amendment No. 2 carefully and agree that such an important foundation needs to be expressed in the Bill.

I know that the Minister greatly respects the things that I say—he looks bewildered and puzzled by that—but such comments are not just my thoughts and observations. Increasingly, international development experts and commentators around the world are concluding that good governance is an essential ingredient.

The excellent United Nations development programme poverty report 2000 states:

"Effective governance is often the missing link between anti-poverty efforts and poverty reduction.

A missing link between anti-poverty efforts and poverty reduction: governance. Even when a country tries to implement economic policies to foster pro-poor growth and mount targeted poverty programmes, inept or unresponsive governance … can nullify the impact.

When Governments are unaccountable or corrupt, poverty reduction programmes have little success in targeting benefits."

That emphasises that, if one is not careful to work with a Government of a developing country to build good governance into the system, so many of our aid and development programmes become merely a mechanism of pouring money into a black hole. We have seen that over many years.

The World Bank policy research report, "Assessing Aid", of November 1998, with which the Minister is no doubt familiar, states on page 4:

"First, financial assistance must be targeted more effectively on low-income countries with sound economic management. In a good policy environment financial assistance is a catalyst for faster growth, more rapid gains in social indicators, and higher private investment. In a poor policy environment, however, aid has much less impact. Clearly, poor countries with good policies should receive more financing than equally poor countries with weak economic management."

In order further to back up my arguments, the excellent report, "Aid and Reform in Africa", of 27 March 2001—a very recent report—also by the World Bank, states on page 33:

"Successful reform is undergirded by a strong commitment to good governance. This is essential for rebuilding business confidence".

Good governance is not an optional extra, but the very heart of the matter.

There is a second point that I wish to make to back up our arguments for the expression of good governance in the Bill. It is an important, practical point. All of us in this Chamber want to bear down on global poverty. There is not a single Member of Parliament who is not horrified and repulsed by the poverty that we see when we travel to some of the worst slums in the world. We want to make our own contribution to alleviating that. Most of us are also practical people, however, and we want to know that we are not merely wasting money and coming up with good-sounding language, but focusing on what works.

It is a truism that we have in this country a rich history of good governance. It does not always feel like that; when debating the programme motion, we could have persuaded ourselves that some of our good governance is under threat. However, with our stable democracy, our strong civil service, with which we look forward to working in just a few weeks, and our much respected independent judiciary, we have the history, knowledge and expertise in governance that we can share with developing countries, and which they are hungry to learn from us.

Who in this Chamber can doubt that we know how to collect tax? In many developing countries, they have no such expertise or systems of tax collection. We know all about Customs and Excise, security forces and civil society. I am not saying that we have it all sorted out or that we live in a perfect society—far from it.

Does my hon. Friend agree that one of the shadows on the picture is the cost of elections? There are many developing countries where the cost of getting elected is so high that it is wholly unrealistic to expect a Member of Parliament not to spend his time in office trying to reimburse himself. That, of course, sharply undermines good governance.

From his vast experience, my hon. Friend makes an important point. That is indeed the case. Some of the work that we have done in the Westminster Foundation for Democracy, about which I shall say a few words later, reinforces his point. It is not just the cost of getting elected; sometimes, in developing countries, the salary levels of people in important civil service positions are so low that although one can never condone corruption, there is almost an imperative for them to be open to such inducements in order to feed their families.

We have vast expertise in this country, and many in the developing world are hungry to learn from us about building good governance in their countries. There is a danger that the international development community is trying to do too much—its work is too scatter-gun. It would be far better to focus on a key issue, such as good governance, which will strengthen the framework, and to make sure that we can deliver on it.

From my experience with the Westminster Foundation for Democracy, which I strongly believe in and support—I am the vice-chairman of that excellent organisation—I know that democracy-building is long term, invisible, intangible and difficult to measure. However, I also know that it is essential for strong frameworks to grow and develop in developing countries, particularly those that have no recent history of democracy. We can be proud of the work of the British Council in supporting good governance abroad, and that work needs to be expanded.

I have set out two reasons why good governance should be written into the Bill, and there is a third reason. Focusing on strengthening the governance of a nation state is dealing with the world as it is. We know that globalisation is going on all around us, and we read books and articles and go to conferences about it. There are people out there protesting and trying to stop globalisation and the march of the multinational corporations. Sometimes they have a point, and sometimes they have a less strong point.

Most of us in the Chamber believe that there is no stopping globalisation: it is happening, and there is nothing much that we can do. In part, it is due to the success of the technological breakthroughs of recent times, increased mobility and the telecommunications revolution. Globalisation is here to stay. There are those who are trying to stop it, but others argue that it contains the answers to every problem faced by humankind. There are globalisation junkies who say that we should be thinking about global governance and allowing multilateral organisations to tackle the issues globally.

That is not yet the real world. Perhaps one day we will move towards global governance, although I have profound doubts about that. It does not seem to strike a chord with the reality of human nature, but there are those who think that that is the way to solve the problems confronting us, and there is an increasing fashion in international development to think along those lines.

However, we are still a world of nation states. The decisions of a national Government are still by far the most important decisions impacting, for example, on a child in Malawi. They are more important than anything that the World Bank or the International Monetary Fund may say or do. In trying to build good governance and working with the Government of Malawi to strengthen democracy, the civil service and civil society in that country will help them to make better decisions on behalf of the children of that country. By promoting good governance, we are cutting with the grain, not against it. We are not floating off into some philosophical nonsense about globalisation solving all our problems.

The world is made up of nation states, and this policy supports that important truth. I hope that the Minister will listen to these arguments.

I am grateful to my hon. Friend for giving way. Does he accept that the advanced western nations are sometimes good at intervening militarily to prevent or suppress tyranny, but are often not very good at following up to create sustainable democratic civil institutions—in other words, good governance? That is why it is essential that when we give aid to countries such as Bosnia-Herzegovina we should try to promote the sustainable civil institutions.

My hon. Friend is right. Such action is hard to take, but it is ultimately the only solution. When we visit Kosovo and the Balkans, as I have done in the past couple of years, we sense that the NGO community has moved in, is reluctant to move out and is making all the decisions. It is far better for us to be strengthening capacity in emerging nations and allowing them to have proper, strong institutions of government. My hon. Friend makes a powerful point. No one is saying that such help is easy to provide, but it should be the focus of our aid. Those are the reasons why I believe that good governance should be included in the Bill and why I urge the Government to accept amendment No. 2.

I want to speak now to new clause 2, which deals with a similar but unrelated point. We accept that UK aid should have a poverty focus, but the stark reality is that 50 per cent. of the Department for International Development's budget is spent not by the British Government, but by other multilateral organisations. Some 30 per cent. is spent through the European Union, and up to 20 per cent. is spent via the United Nations and other multilateral organisations. Thus, 50 per cent. of our aid will not be subject to the poverty focus. The new clause asks the Government, what is the point of introducing an important safeguard and framework for UK aid spend, when half the money that we spend will not be subject to the poverty focus?

I do not want to bore the House with the failings of the EU aid budget. Very few quotations suffice to make the point, which we have debated time and time again. To be fair to the Secretary of State, she has been as critical as anyone of the EU's scandalous and abysmal failure in promoting the interests of the poorest people in the world. On 17 May 2000, she said:

"Anyone who knows anything about development knows that the EU is the worst agency in the world, the most inefficient, the least poverty-focused, the slowest, flinging money around for political gestures rather than promoting real development."

I sometimes wish that she would more often say what she really means. In November 1999, she said:

"The EU's development efforts are very, very, very ineffective. There is poor management and then they get fraud".

In the Financial Times in July 2000, she said:

"The EU is running out of time to make concrete improvements in quality and effectiveness on the ground."

In the same article, the said:

"If there is no substantial progress in implementation during the next two years, the member states should think seriously about scaling back EU programmes and spending the money better elsewhere."

I could not have put it better myself. It is absolutely scandalous that the EU continues to misuse 30 per cent. of British taxpayers' money, because of lack of focus, fraud and misuse, and because it is getting it horribly wrong.

I am afraid that any hon. Members who think that the EU aid programme is getting better after the recent reforms are sadly mistaken. There is no evidence to suggest that that is happening. Two recent reports published by the European Parliament, that much-loved institution, state that the EU aid programme reached rock bottom in 1999. I should like to cite page 12/14—there does not seem to be a page 13—of one of those reports, which is dated 23 March 2001. In parliamentary terms, the report is hot off the press; indeed, in European parliamentary terms, it is extremely hot off the press.

My hon. Friend makes some effective points about the EU budget. When we take power on 7 June—I sincerely hope that we will do so—and he takes his richly deserved seat in the Secretary of State's chair, what can he do to start the process of withdrawing us from the scandalous waste of money that he describes, so that we can spend taxpayers' money to relieve third-world poverty?

My hon. Friend makes a telling point. In a moment, I shall spell out yet again our policy on ensuring that the abuse comes to an end and that we can scale back and claw back to member states the ability to spend the money bilaterally. We all know that that would ensure better value for money.

I shall return to that point shortly, but I want first to read my quotation from the important European Parliament report to which I referred. Of course, we enjoy reading these wonderful reports. The committee that produced the report

"regrets that in 1999 only one of the top 10 recipients of EC overseas development assistance was a least developed country"—

only one in 10—

"and that the percentage of EC ODA going to low income and least developed countries fell below fifty per cent. for the first time ever".

It sees that as

"contradictory to the Community's commitment to poverty reduction re-emphasised in the Council's and the Commission's Policy Statement."

The EU's aid programme is getting worse, and 30 per cent. of British taxpayers' aid money is spent via that aid programme.

Is my hon. Friend aware that US$850 million of the European development budget is being spent on Serbia and Kosovo, the same amount that is allocated for the whole of Latin America and Asia, where about 80 per cent. of the poorest people live? Is not that as much a scandal as what my hon. Friend describes?

My hon. Friend sums up the matter nicely, if grotesquely. It is a scandal which must come to an end. How much longer can we wait? The Conservative party is the only political party pressing for concrete action to bring the scandal to an end. The Government had an opportunity at the recent Nice summit to put the matter on the agenda and to start to build a portfolio of support for scaling back the EU aid programme and allowing member states to spend that money bilaterally.

Since I was the Conservative party's spokesman on Europe in 1997–98, I have become convinced that there is an appetite for such an approach. The Nice summit was an opportunity for the Government to put that issue on the agenda. I urged them several times to do so, but they failed to take that opportunity. As a result, the rather feeble agreement that has now been reached is to review the performance of the EU aid programme in 2006—five more years of waste and five more years of the poorest people in the world suffering in the way that we have described. The Government should have started work on that at the Nice summit and it is to be regretted that they did not.

Under the EU aid programme, 30 per cent. of our aid budget is without a poverty focus. Can the Minister honestly say that it is right that the Bill should have no reference to the fact that any money that we spend via multilateral organisations, whether the EU or the UN, should also have a poverty focus? That would place the Government under a legal obligation to ensure that every pound that is spent via the EU comes within the poverty focus and is properly spent, and would place them under a legal requirement not to sit back and allow the current situation to continue, but to sort the matter out. That is why that should be in the Bill.

As one reason the EU budget is so badly spent is that the EU is quite open about the fact that it has political rather than development imperatives, if the Government are prepared to go along with that, would it not be appropriate for the money that is being spent on our behalf by the EU to come from the Foreign and Commonwealth Office's budget?

That is an interesting suggestion, which I hope the Minister will take on board. It is wrong for development aid to be spent via the EU, either as a second tier of immigration policy for the southern European states, or as part of the wider Foreign Office or political diplomatic agenda.

New clause 2 and the amendments grouped with it contain two important points. We say that good governance should be the focus of the Bill and included in it, because without it the Bill will be less effective.

Secondly, the Bill should contain a legal obligation to ensure that any money spent by the British Government via the European Union or the United Nations is not be misused. I could have said much about the United Nations' effectiveness in spending our aid money, but I want to give other colleagues time to speak. The Government should be legally obliged by the measure not to sit back and allow such scandalous abuse and misuse to continue, but to build alliances, partnerships and support. I believe that they would be pushing against an open door, certainly with northern European and Scandinavian states, which are as fed up as we are. They should sort out the problem.

I hope that the Minister will take those substantive points into account. I believe that they have been fully argued and I am sure that my hon. Friends will speak in support of new clause 2. I hope that he will accept it and that we will not need to put it to the vote.

I want to make three points in support of my hon. Friend the Member for South-West Devon (Mr. Streeter) and the new clause and other amendments in the group. I shall speak about good governance and humanitarian aid. However, first, I want to consider whether the money allocated to international bodies such as the World Bank, the European Union, the development banks and other organisations such as the United Nations development programme and UNICEF could be subject to legal challenge under the Bill as currently drafted.

The Department for International Development spends more than 50 per cent. of its budget on multilateral institutions, which do not have a poverty focus as their only and single-minded purpose. The Bill enshrines that purpose. It is therefore clear that a citizen of this country or a non-governmental organisation could take the Department for International Development to court for allocating part of its budget to, for example, the European Union, which does not spend the money on poverty-focused purposes. That is a genuine danger. Those who drafted the Bill have recognised that, and I am sure that they will inform the Minister of the difficulty.

Clause 4 provides for the Secretary of State to support organisational funds that "wholly or partly" exist for the relevant purposes outlined in clause 1,

"if he is satisfied that to do so is likely to contribute to a reduction in poverty."

Clause 4 could be used as a defence in a court case against the Department for International Development on its use of international development money allocated by Parliament for relieving poverty. Is the Minister satisfied that the Department is adequately protected by the wording of clause 4? That is an important question if a lot of money and time is not to be wasted on court proceedings. I believe that the clause leaves the Department open to serious challenge in the courts. I should regret such a fruitless use of money and time, which could mean a reduction in the amount of money that the Department can spend on relieving abject poverty.

I want to reflect on what we mean by good governance. I presume that we do not mean the sort of time-wasting activity that we discussed when we considered the programme motion. I hope that we do not define good governance as imposing from above a Westminster-style parliamentary system on the people of other countries. However, good governance requires the maintenance of specific principles.

First, the Executive in any country should be accountable to the people through a representational body, however it is formed. I often argue that democracy is the traditional way in which African countries have ruled themselves. The previous Secretary-General of the Commonwealth, His Excellency Emeka Anyaoku, often used to refer in speeches to the way in which his chief ruled his area in south-west Africa. There, a meeting of all the people is held, as in a platonic Greek state. The chief is chief by tradition, not necessarily by inheritance. He is the senior man, but he is expected to listen to, take advice from and find the majority opinion within the meeting. Then, together with his elders, some of whom in some African tribes are and have always been—in living memory—elected, he takes the final executive decisions.

A similar process has been described to many of us on visits to Swaziland, which is a monarchy. That procedure is changing, but it is keeping to the principle that the Executive have to be accountable to their people and rule by consent. In essence, that is what our Parliament tries to achieve. If countries achieve it by a different route, we should not oppose it, but welcome and support it in any way that we can.

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The next thing that is essential is that we have a reliable and objective judiciary. That is not an easy thing to achieve. Even in this country, we are questioning whether we are right to leave the appointment of judges entirely in the hands of the Lord Chancellor, in view of his conduct in recent times in trying to raise money for political purposes from those who might be appointed to judgeships. Even we are not certain that we have got the right mechanism for appointing people to enforce with impartiality the laws passed by Parliament and the Executive.

A reliable and objective judiciary is essential if domestic savings are to be re-invested in a country and even more if we are to achieve the objective set out in the eliminating world poverty White Paper and the globalisation White Paper, both issued by the DFID during this Parliament, of bringing in the private sector to be the engine of growth, employment and opportunity in some of the poorest countries. Without that capacity to rely on an impartial judiciary, which will make objective decisions, the accumulation of domestic and overseas investment will not occur, and the abjectly poor will remain abjectly poor.

A survey entitled "Voices of the People" asked ordinary people in third-world countries what concerned them most about their Government and corruption. Their first concern was corruption in the judiciary and their second was corruption in the police force, to whom they always have to pay fees for one thing or another—to pass a police barrier on the road or to get a licence to do something or other.

Good governance requires a first-class impartial judiciary, an impartial police force and an objective and impartial civil service, which is essential to good administration. Those elements have to exist if we are to bring about development. The concept of good governance has come to the fore in development thinking as a result of failures of the past. Without such a framework in developing countries, it is close to impossible to get development to take place. So it is right to include the question of good governance in the Bill as it is essential to realising its objective, which is of course to eliminate abject poverty throughout the world.

Another thing that worries me about the proposals is whether we should allow regional development banks to invest in humanitarian aid. If we passed the new clause, we would exclude the possibility of regional banks providing such aid.

As I said on Second Reading, humanitarian aid is a problem because it is being thoroughly abused, which is undermining the whole concept of it. Such aid depends on the impartiality of its delivery. It should go to both or all sides of a conflict or violent event: to those who have been killed, maimed or injured who are working for the Government and those who have been killed, maimed or injured who are protesting or conducting a violent campaign against the Government. The Red Cross is trusted to go in on both sides and to provide humanitarian aid to them.

That principle has been established since the mid-19th century. If we throw it away, it will be at great expense: there will be much human suffering in those violent situations. That is why I am concerned that we make certain that humanitarian aid is delivered impartially.

In the post-cold war era, the concept of humanitarianism has been deepened and broadened in principle and in practice.

I hope that the hon. Gentleman will not mind if I echo what a number of people have already said. We shall miss him very much and we admire greatly the tremendous work that he has done on international development.

On the specific point that the hon. Gentleman raises, does he agree that, whoever is responsible for delivering humanitarian aid, it is crucial that they continue to work increasingly with non-governmental organisations, so that the aid is seen to be delivered to the people who should be benefiting?

I agree. We must be careful that we work with NGOs that are properly managed, organised and capable of delivering the aid to both sides impartially. If one NGO, for whatever reason, has adopted a particular position on the conflict in which it is working, I suggest that it be thereby excluded from delivering such humanitarian aid so as to maintain the impartial nature of the aid. That is essential if we are to be able to help, for example, in the distribution of food—we all saw the starvation conditions produced by conflict in Ethiopia many years ago.

One of the difficult questions that we face is whether we are feeding the two armies in a conflict as a primary result of the distribution of food, so that the fighting can continue for longer. By all admission, much food aid distributed in those circumstances does support the belligerents. In those circumstances we need to train NGOs to deliver impartially—they are the people to do so—because we cannot employ Government people to distribute the aid if they are in conflict with a large part of the civil population. The NGOs therefore play a crucial role.

As I have said, humanitarian assistance in the post-cold war period has been extended because it has begun to be used as a method by which to influence internal disputes within countries. As we all know, since the fall of the Berlin wall, we have predominantly dealt with conflicts within countries, not between countries. Although the type of conflict in which we were engaged in Kosovo and elsewhere in the Balkans is an example of that change, the examples of Sierra Leone and of Angola also stare us in the face. It is a very difficult issue

I am worried that humanitarian assistance is increasingly associated with politico-military intervention by the west. The obvious example of that is NATO's appointment of a "humanitarian general"—a general in charge of humanitarian assistance provided by NATO. The Select Committee on International Development met the general, the first to be appointed, who was very efficient and had organised most of Albania with the consent of its Government. He was given control of the ports, airports and all the roads leading to the border with Kosovo, all of which he ran with exemplary efficiency and discipline. Nevertheless, he called himself a humanitarian NATO general.

Let us consider that role for a moment. He was a humanitarian general on behalf of one side of a conflict. Was he offering those services to the Serbs in Kosovo? Was he also prepared to run their ports, airports and military logistics to assist them? It does not make any sense at all, but that is what we have started to slip into by using the word "humanitarian" for such purposes.

The relationship between humanitarian and political action has become very complex, and an international consensus is lacking on the political character and legitimacy of humanitarian assistance. I believe that that situation will become more acute if we continue down the same road. I also believe that clause 3 places us in danger of allowing the operation of humanitarian assistance to slip further. As hon. Members will have noticed, clause 3 exempts the Government from a requirement to ensure that money spent on humanitarian assistance is used for poverty reduction programmes. It requires that the money be spent not on pro-poor policies, but simply on humanitarian aid.

In its reply to the sixth report of the International Development Committee, on conflict prevention and reconstruction, which was published in 1999, the Department for International Development defined humanitarian aid as

"all measures in situations of conflicts, disasters and emergencies, which are intended to save lives, relieve suffering, hasten recovery, protect and rebuild livelihoods and community, and reduce vulnerability to future crises. This includes disaster relief, preparedness, prevention and mitigation, food aid and assistance to refugees and other displaced populations. It also includes essential measures to re-establish structures and systems to govern and administer services where these have broken down due to the crisis or disaster".

Currently, there is no statutory basis—the Bill does not provide one—for humanitarian assistance. The definition rests on an analysis of content and not on principle. Furthermore, it does not take into account the political distinction between relief and development assistance. I believe that we have to address ourselves to that issue and that, to protect itself, the Department also has to think about the issue.

I know that the Department does not wish to provide a definition because it is afraid that, if it does so, it will be taken to court in a judicial review. If the Government provided a definition, a decision to spend money on humanitarian assistance could be challenged in court. As we know, in court, definitions are manna for lawyers. I think that the risk of such legal action is a real danger. Conversely, leaving the definition as vague as it is in the Bill runs the equal danger of allowing humanitarian assistance to be used in a manner that is partial and that promotes conflict rather than the reverse.

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We must think about how we can achieve the objectives that we have set in regard to humanitarian assistance. I would define them as follows: to prevent and alleviate human suffering, to protect life and health, and to ensure respect for the human being. Arguably, that definition provides for the protection and re-establishment of livelihoods, not just the saving of lives. In other words, unlike development assistance or political intervention, humanitarian assistance is concerned with the preservation and dignity of individuals. It is based on their humanity, not on the development of particular political or economic systems or on political affiliation. That definition—probably refined—might fulfil the purposes that we all want to be maintained and sustained in respect of humanitarian assistance as defined in clause 3.

That is all that I wish to say at this stage, but I believe that there are important issues that should be reflected in the Bill.

I want to offer a few thoughts on good governance. In a few weeks, we are all likely to be touring the country telling the population that the other side is incapable of delivering good governance; yet here we are, discussing how other countries may deliver it.

1 was relieved to note that Opposition Members are not talking nowadays of trying to impose a west-approved system on other countries, but I feel that the hon. Member for Hertford and Stortford (Mr. Wells) is expecting a great deal in some instances. While representative democracy and an independent judiciary are ideals that we hope can be aspired to by every country—the sooner the better—in many cases we seem to be a long way from achieving those aims. In far too many countries, for example, women—despite constituting half the population—do not have a say in how their countries are run, let alone play a part in Government or judiciary. If we are calling for good governance, we should ensure that women have an equal right to run their own countries.

What the Secretary of State has done over the past four years is crucial. She has developed literacy and numeracy programmes, and that alone is a key element. Literacy and numeracy present populations with the opportunity to challenge, as they enable them to think for themselves, to argue, to campaign and to get things done. My right hon. Friend's concentration over those four years, and in the Bill, on promoting education—especially women's education—is what is required. We must begin where people are, not where they are likely to be.

I support new clause 2 and the amendments grouped with it.

Good governance is indeed crucial to the debate; we know that from our own experience. When this country suddenly leapt forward, it was because we started to pay High Court and other judges rates that ensured that they were incorruptible. From that moment we gave an enormous boost to good governance. The same applies to the civil service. Why did the country leap forward in the last century, in terms of good governance? Because corruption was cleared out of the civil service; civil servants were paid a decent salary, and were recruited through competitive examinations. The House should pay tribute to my hon. Friend the Member for South-West Devon (Mr. Streeter) for putting good governance on the agenda.

I want to concentrate on new clause 2, and its emphasis on a reduction of poverty. There is no doubt at all that EC assistance is too often influenced by political expediency rather than being concentrated on the reduction of poverty—I think that both sides of the House are convinced of that. As we have heard, that means that EU assistance, in the name of development aid, goes to relatively rich countries which are neighbours of the EU; such aid is thus unavailable for really poor countries.

I join the whole House in paying tribute to my hon. Friend the Member for Hertford and Stortford (Mr. Wells) for his chairmanship of the Select Committee on International Development and for the way in which he has developed the debate in a bipartisan spirit. He has contributed much to a greater understanding of the issues in the House and in the Conservative party. The Committee's ninth report is excellent; I very much hope that all Members will take a few moments to glance through it.

The report is fair. I do not want to be accused of EU bashing. I want to defend the EU—just for a moment—so that no one can say that we are trying to use new clause 2 merely to bash the EU. The report stated that the EU is perfectly entitled to take an interest in what is going on in Poland, in Bosnia or in Serbia. However, that is a political objective; it should not be part of the aid budget. As the report stated on page ix:

"EC external assistance policies are clearly determined more by political priorities than poverty alleviation. Pre-accession aid and the stability of the regions surrounding the EU are indeed important political objectives."

We all accept that. It is vital for all of us in this place that Poland, for instance, is ready to join the EU. However, we are in a ridiculous situation, as Chris Patten outlined in the report. He stated:

"A consequence of that is that today we spend twice as much in Poland preparing for accession as we spend in Latin America and Asia combined."

That cannot be right.

There must be a better way. We look forward to the comments of the Under-Secretary of State for International Development on this point. Can we not convince the Council of Ministers and our friends in the EU that we are entitled to pay our fair share in helping Serbia, Bosnia or Poland or other hot spots close to our borders, but that we need a ring-fenced budget? As the report states:

"All too often Category 4, initially envisaged as a source of finance for community development programmes, is 'raided' by the Council of Ministers to fund political initiatives that they do not wish to fund bilaterally, amounting to what Clare Short described as 'political gestures'."

The Committee asks for

"a budget for expenditure in all developing countries dedicated to its principles".

I agree.

I do not seek here to make a party political point or any point directed against the EU. I fully accept that everyone has their own priorities. However, when we are faced with dire poverty in the world, and when both sides of the House face enormous difficulties in the political debate trying to convince hon. Friends that we should devote more resources to the world's poorest populations, even though that may result in fewer hospitals, schools and roads—all the things that our voters actually want—how can we go to our electorates and argue for that aid when we see such waste, or at least misdirection, of resources? People think that those resources are going to help the world's poorest people, but they are in fact being diverted for political objectives. I hope that the whole House can agree with new clause 2 on that point.

The picture gets worse, however. Whatever one's opinion of the EU, one has to be critical of the way that it spends its money. On 6 August 2000, the Sunday Telegraph reported that

"nearly two years after Hurricane Mitch devastated Central America, leaving almost 7,000 people dead, the EU has failed to deliver a penny of the £170-million package pledged to help survivors of the disaster."

The article accuses the European Commission of

"'gesture politics' because they have a history of announcing grand aid packages to the Third World without having a clue how the money should be spent on the ground."

The report says, at page xvi:

"The Committee has heard of a number of examples of delays and inefficiencies in disbursement. Population Concern gave the Committee two examples of such delays: the first was a delay of thirteen months"—

13 months!—

"in the disbursement of funds for four mini-projects in Bolivia and Peru; in the second instance—a Community-based Distribution Programme in Karachi—The funding situation became so dire that the Director of a local NGO in Pakistan took out a personal loan to pay staff salaries".

The picture persists; it is not good enough. After all, we are talking about public money. It may be public money disbursed by an international organisation, a multinational organisation; there may not be very great political pressure—in fact, there is virtually no political pressure—on the way these moneys are disbursed. There may not even be much public interest. However, as a result of the lack of control and lack of concern, some poor person who is trying to do a decent job to help some of the world's poorest people, in some little office in Pakistan, has to pay salaries cut of her own pocket. That is simply not good enough.

My hon. Friend is probably aware that one of the pressures under which the EU operates is that whenever there is evidence of malfeasance there is a huge outburst of scandal and horror, and then, instead of reviewing all its procedures and ensuring that there is one accountable person, the EU simply increases the number of signatures that have to appear on each authorisation. Far from improving accountability, that requirement hugely diminishes it, and colossally increases the time that such an authorisation takes to go through the system.

My hon. Friend, who speaks with great knowledge on these subjects, makes a perfectly valid point. It is difficult to advise the EU on how to proceed, but I suppose that the problem boils down to a lack of political oversight, of national interest and of national concern—the equivalent of Ministers being brought back to the House to be brought to account. As a result there are scandals and bad publicity, and as my hon. Friend says, it is then necessary to add another layer of bureaucracy because people involved in the process get worried about their career and the way they will be reported in the press.

The Commission, in a statement on development policy, has analysed the problems that it faces in implementing commitments. Fair enough. It listed them as

"a complex and fragmented aid system: policies guided by instruments rather than by policy objectives; substandard monitoring and evaluation procedures; burdensome ex-ante financial controls; lack of human resources."

Let us consider the point about lack of human resources. Is the reason why the EU is unable to devote itself adequately to relieving poverty in the third world the fact that it does not have the right number of staff? The Commission has argued that there is a shortfall of 1,300 staff, and that therefore it simply cannot deliver the programme in the way it should. It says that the shortfall has the obvious effect of leaving a few staff to deal with an enormously increased amount of money to spend and makes it obvious that the efficiency of the programmes will be damaged, and that it will be less likely that they will be followed up and corruption detected.

Is it true that the reason why the EU is performing so badly is that there is a shortfall of 1,300 staff? I suspect not. My viewpoint is shared by the International Development Secretary, who declared her opposition to giving the Commission any more money for staff and has promised to "fight to the death" to prevent it unless the Commission improves the quality of what it is doing already.

The International Development Secretary, to whom I pay tribute, is being absolutely robust in this. She is saying that the problem is not due to lack of staff at all. Fair enough. If we therefore are all agreed—I see Labour Members nodding—why is she willing to continue to use the European Commission to distribute aid despite its being, in her words,

"the worst development agency in the world',

and despite the fact that, in her words.

"the poor quality and reputation of its aid bring Europe into disrepute"?

I have never heard a Minister, whether Conservative or Labour, use such strong language to describe any EU institution. This is not someone who has a reputation as a Eurosceptic trying to score political points, but the International Development Secretary, who describes the Commission as

"the worst development agency in the world'.

That is why the group of amendments before us is so apposite. It does not make sense for the International Development Secretary to continue to use and depend on the EU for aid distribution despite its being truly awful. Surely she and her junior Minister, who is here today, must agree with the Conservative new clause to propose that no aid be allowed to be distributed by a third party unless the Secretary of State is satisfied that it is likely to result in a reduction of poverty. That is all the new clause is about.

2.15 pm

If we place our hopes in the illusion of the EU's reforming itself and suddenly becoming, contrary to all the expectations of the International Development Secretary, an efficient organisation which works solely for the reduction of poverty in a holistic manner, I believe that we are fooling ourselves. The all-party International Development Committee, in producing the report, has been

"exasperated with the failure of the Commission to reform its development activity effectively."

That all-party Committee says that it would be foolishness to assume that the EU will now reform itself. The EU has far too many problems with its aid programme to reform itself effectively in the foreseeable future.

I believe that it would be better if the United Kingdom took the decision to spend this money itself, controlled by this Parliament, for the reduction in poverty in the world and to help the world's poorest people.

I rise to speak to amendment No. 6, but I hope that the House will allow me to make a few comments first on the other amendments and the new clause before us.

The hon. Member for South-West Devon (Mr. Streeter), as usual, said a great deal about good governance, and many people in the House would agree with what he says. It is indeed fundamental. It lies at the core of any development programme in an underdeveloped country. However, as the hon. Member for Hertford and Stortford (Mr. Wells) said, we must question what good governance is. It is sometimes extremely difficult to put a finger on what its ingredients are.

I was about to rise to ask the hon. Gentleman whether Uganda would be an example of good governance. I remember his having great doubts when we were out there, and yet Uganda seems to be doing quite well in development terms, and delivering the goods as far as the Department for International Development is concerned. If we intend to declare that people will get aid only to further good governance, and that that is at the very core of poverty alleviation, it is worth remembering that it is quite difficult to assess what good governance is.

The hon. Member for Hertford and Stortford mentioned the police and the judiciary. In doing so, he perfectly illustrated what I am always saying: that poverty can be alleviated only by addressing very many factors. One cannot give one factor a higher priority than another. How can one have a good police force, and above all a good judiciary, without education? Should not education therefore lie at the core of development? One cannot educate people or maintain good governance unless those people are relatively healthy and have a health care system—so should not health care be at the core? One cannot have good health without clean water, so should not clean water be at the very core? So is not clean water just as important as good governance? They all go together; it is thus absolutely right that the core powers are set out in the way that they are, and that they do not give one factor more importance than another. It is important that we go ahead on many fronts.

Certainly, it may sometimes feel, as the hon. Member for South-West Devon said, that this is a bit of a scatter-gun approach, but it has to be that way, because these aspects will improve and the countries involved will improve only if all those factors are addressed at the same time. I cannot therefore support the amendments tabled by the Conservative party.

We all have sympathy with what has been said about the inefficiency of European Union aid. I shall not bore the House again with my story of reading reports from the Court of Auditors. They contain absolutely horrific stories of projects not started, not completed or not reported on, and of money not even wasted but simply not used—just sitting there, not delivering the aid that was intended. Sadly, EU aid gives the Conservative party another opportunity for a bit of Europe bashing, and I wish that the EU would put its house in order because it provides such a wonderful excuse to attack Europe and all things European.

I remind Conservative Members that if they had played a more wholehearted part in setting up all those institutions, and if they had been there enthusiastically insisting that the European aid budgets were managed properly, instead of washing their hands, like Pontius Pilate, of all things European, we would be in a much better state today and they could not criticise what goes on in our name.

As the hon. Lady will know, because she was a member of the Select Committee when we drafted the report to which my hon. Friend the Member for Gainsborough (Mr. Leigh) referred, we recommended not that we should withdraw money from the European aid programme, but that we should make that programme perform better. Does she agree that Mr. Chris Patten and Mr. Nielsen—the two Commissioners principally concerned with European aid—have introduced many new measures which will come into force this year and promise to make European aid much more efficient and to deliver pro-poor policies in the third world?

Yes, I entirely agree with the hon. Gentleman, and I am hopeful that reform will take place. Conservative Members have quoted the Secretary of State on many occasions this afternoon. She is unhappy about the way things work, and she will ensure that we will not contribute more funds until they improve. I have a lot of faith in my constituent, Commissioner Patten—he is not all the Conservative party's; he is partly mine too. He and his colleague are sincerely trying to improve matters, but I repeat that it is very foolish of the Conservative Opposition continually to carp about the systems that they set up but now want nothing to do with.

I want to make one last point on European aid. It is rather strange that the Conservative party says that good governance and political considerations are of the very essence if we want to relieve poverty, and that good governance must be top of the aid agenda, since that is precisely what many European aid projects do. They are trying to deliver good governance, which will improve the countries where they operate and bring them into the first world and, eventually, the European Union. Conservative Members have been speaking on both sides of the argument.

I am reluctant to interrupt the hon. Lady's speech, which I am greatly enjoying, and I am keen to deal with the other groups of amendments, but I must make two points. First, the EU may well be building good governance in certain places, but our argument is that it is doing so in the wrong places; it is not doing it in the poorest countries, which are those most desperate for a measure of good governance.

Secondly, is the hon. Lady aware of a recent report—again, produced by the European Parliament—in which the Parliament expresses massive pessimism about whether the European aid reforms which Commissioner Patten has just introduced will work, because they do not deal with the EU culture, which is so bureaucratic, ineffective and unfocused? Is not that the problem? We all want those reforms to work, but I am afraid that, living in the real world, we profoundly believe they will not.

I thank the hon. Gentleman for that contribution. He reinforces what I say: much European aid is being used for the purposes that he suggests it should be used.

But in the wrong places.

Well, who is to say which are the wrong places, when talking about good governance? The Conservative party must sort out its argument; there is an element of confusion among some Opposition Members this afternoon.

I should like to deal with tied aid. In the White Paper on globalisation, we are told:

"The UK Government is totally committed to the multilateral untying of aid."

It also states that the Government will

"untie all UK development assistance from 1 April 2001."

The Government have already untied the knots and aid is now untied, so why have they not mentioned tied aid in the Bill? Would it not have been wonderful for all those of us who criticised the Pergau dam—the most famous example of all—to have seen the words "tied aid" in the Bill? That would have been a recognition, as the White Paper states, that the Government are legislating to stop the practice.

The White Paper states that more than a third of the total amount of aid to developing countries—about £13 billion—is given on the condition that it is tied to the purchase of products and services. According to the White Paper, tied aid

"reduces the value of that aid by about 25 per cent."

It states that "it is grossly inefficient" to supply developing countries with incompatible equipment from different development agencies.

Project objectives are skewed towards commercial considerations, and capital intensive projects are favoured more than smaller, more effective poverty-focused projects. Tied aid also

"encourages a donor driven approach to development. It signals that development agencies' major concern is not development, but their national contracts."

All that is stated in the White Paper.

I apologise for intervening on the hon. Lady and thank her for allowing me to do so. Does she not think that clause 1 would prohibit the retying of aid? Apart from being poverty focused, the Bill's objective is, under clause 1, to exclude any possibility of reintroducing tied aid.