I am delighted to have secured a debate on the subject of the gambling review report. This is the second one-and-a-half-hour debate on the issue, which shows the strength of feeling that people have on some of the recommendations made in the Budd report. Unfortunately, I was not able to be present for the previous Westminster Hall debate on 6 November 2001, but I have read Hansard and was pleased to see that it was a good, frank debate. I hope that today's debate will be of equal value.

Hansard records that hon. Members representing seaside resorts expressed understandably strong views in the previous debate about recommendations that could adversely affect their constituencies. I assure the House that there are also real concerns in constituencies such as mine, which are as far away from the sea as one can get. In my constituency, the town of Burton upon Trent is famous for its breweries. Indeed, it can justly be called the capital of brewing. Unsurprisingly, a number of industries have grown up around the production of beer. Perhaps the best known by-product is Marmite. It is said that people either love it or hate it, but I shall make no comment. It is produced in Burton, and I am pleased to say that the company is celebrating its centenary this year.

Another development from the town's brewing heritage has been the gaming machine industry. More than 500 people are employed in Burton in three businesses that service that industry. Leisure Link and Rank Leisure Machine Services supply, operate and distribute the machines, and Vivid Gaming designs gaming and amusement machine equipment. Obviously, anything that might adversely affect the industry is of direct concern to many of my constituents.

It is important to recognise the many positive proposals made in the Budd report. Many of its recommendations are sensible. It endeavours to modernise and to be libertarian yet, at the same time, it tries to crack down on illegalities. Since our previous debate, recommendation 72 has been implemented, which I welcome. It has increased the stake to 50p and the maximum prize to £25 on all cash machines. I visited two of the companies in my constituency in the new year, and they were pleased about that change.

We need to protect the vulnerable in society by ensuring, as far as possible, that problem gambling is limited, and that when it occurs, effective treatment is provided for people. I believe that the need for a voluntarily funded gambling trust is supported by all parts of the industry. However, one of the main concerns that has been expressed about the gambling review body's recommendations relates to ambient gambling. That misconceived concept particularly affects the gaming machine industry.

If the recommendations are carried through, every sector of the industry—pubs, clubs, the seaside and licensed gaming centres—will see a decline in demand and in the need for machines. That will affect manufacturers and suppliers of the product. The presumption is that ambient gambling, which the report describes as

"gambling opportunities that are available in locations which are not dedicated to gambling"

is more dangerous than gambling in premises where it is a primary function, such as in casinos or bingo halls. However, the report states:

"As with the Rothschild Commission, more than two decades ago, we were struck by how little is known about either normal or problem gambling. We had very little in the way of hard evidence to guide our discussions."

To help remedy that problem, the report recommends that

"research be carried out to understand the nature of normal, responsible, gambling behaviour and to understand the development of, and risk factors for, problem gambling".

In the report, there is also a presumption that gaming machines should be restricted in pubs because they are secondary to the consumption of alcohol, and yet the review body recommends that alcohol be permitted on the gaming floors of casinos.

I welcome the proposals for casinos and bingo halls. However, it is important to recognise that British manufacturers will not benefit from the potential introduction of thousands of casino slot machines with unlimited stakes and prizes. The expertise and technology for those machines lies with manufacturers in the United States that will export casino slot machines to the United Kingdom.

Bingo halls provide a valuable form of entertainment and a comfortable leisure activity for many people, especially women who want to go out and meet friends. For most people, visiting a casino is not an everyday activity. Indeed, those who are frequent visitors to such gaming establishments might be viewed as problem gamblers. It would be interesting to study whether most problem gamblers are found in casinos, where the primary function is gambling, or the local pub, where ambient gambling may take place.

In the debate initiated by my hon. Friend the Member for South Thanet (Dr. Ladyman) on 6 November, he and other hon. Members spoke eloquently about the impact of the recommendations on seaside arcades. The subject was well aired then and no doubt will be returned to today.

I congratulate the hon. Lady on securing the debate. She refers to seaside resorts and obviously will develop that point. The recommendations could be devastating for the traditional seaside resort as we know it. She has not yet mentioned rugby, football and other sporting and social clubs. The profitability of many rugby clubs in my constituency is based simply on one or two gaming machines.

The hon. Gentleman is right, and I shall come to members' clubs in a moment. I do not underestimate the impact of the proposals on seaside resorts or clubs. Those who represent seaside resorts may comment further today. Although I have enjoyed the odd hour or two in such arcades on a wet afternoon, I shall leave that aspect of the report to those who represent our sunny shores.

Strong representations have been made about members' clubs and the proposals to remove jackpot machines. My right hon. Friend the Minister for Sport has been lobbied close to home on the issue, and I am sure that he recognises the strength of the argument that many clubs would not survive if they could no longer rely on the income from the machines. In the previous debate, reference was made to the recommendations of the gambling review body to limit the number of all cash gaming machines allowed in public houses.

Does my hon. Friend agree that we all see problems caused by gambling and alcohol in our constituencies, but that those problems do not seem to be the driving force behind the review? Is her postbag like mine, in that owners of pubs and clubs write to point out the extra leisure facilities and community support that they provide? Given that, does she agree that we need to hear from the Minister about Government recognition of the importance of that sector and the need for stability in it?

Yes, I hope that we shall hear that today, as I am concerned about the pub sector. I represent the capital of brewing, and I am sure that my hon. Friend will understand that I want our pubs to remain viable so that they can sell the golden nectar—the beer—that so many of my constituents produce.

Can my hon. Friend recollect whether she has had representations from the Scottish clubs on this matter?

No, I cannot. Understandably, however, I have had many representations from constituents who work in the gaming machine industry. I want to speak out not only for those who are directly employed in the industry but for those who work in local businesses and who manage pub estates.

The argument for restricting pubs to up to two all-cash machines is not valid. I would go so far as to say that it is total nonsense to suggest that no account should be taken of the size of the pub. It is absurd to limit a 5,000 sq ft multi-bar pub to just two machines, while allowing a 400 sq ft pub with a single bar exactly the same entitlement.

Currently, local magistrates can approve up to five machines. The British Amusement Catering Trades Association—the trade organisation of the gaming machine industry—believes that it would be sensible to consider legislation to allow up to four all-cash machines as of right. That would reduce bureaucracy and free up valuable local authority time. Cases in which more machines were desired could, in exceptional circumstances, be considered individually.

The gambling review says that pubs have an average of 1.28 machines, so it appears that the report's recommendation is generous. It is, however, important to recognise that not all pubs have, or want, gaming machines, while others have five or more. All pubs are different, and 80 per cent. are independent small businesses. They are often the only source of entertainment in their local community, which they can also provide with other services.

I welcome the thrust of the hon. Lady's remarks. She makes a good point about the economic and social contribution made by pubs, and the same is true of arcades in coastal resorts. She may be aware of the Government's initiatives to revive such resorts, but it is not good joined-up government to threaten the future of traditional family arcades at the same time. Closing those arcades in the way outlined in the report will deal a devastating blow to the coastal resorts and seaside centres that, in another context, the Government say that they are trying to help.

I agree. In our last debate on this subject, a good case was made as regards the needs of the seaside. I would hate to see the demise of seaside arcades, which are a part of our history that, like Marmite, goes back 100 years. We must try to save them. I also agree about the need to regenerate our seaside resorts, and it would be wrong to put obstacles in the way of regeneration.

Our pubs and clubs provide pool and snooker tables, thereby making other leisure activities available to local people, but those activities may be lost if the number of gaming machines is reduced.

It may be said that the report does not propose to ban gaming machines from pubs. It is, however, important to remember that the gambling review body said that, if starting from scratch, it would

"recommend banning all-cash machines from pubs."

By saying that it would be "disproportionate and harsh" to follow through on that now, however, it leaves the door wide open to a ban in future.

Another reason that is offered for restricting the number of all-cash machines in pubs is their accessibility to children and young people. Most people would assume that there was already a restriction on those under 18 years of age; indeed, according to a recent MORI opinion survey, 92 per cent. of machine players in pubs believe that there is a legal age limit for playing. It is a credit to the industry that, in the absence of such a law, it operates a voluntary code restricting use of the machines to the over-18s. There is widespread support inside and outside the industry for legislation to prevent under-18s from playing fruit machines in pubs.

There should be no problem in enforcing such a measure, any more than in enforcing the current restrictions on the sale of alcohol to under-18s. Indeed, the report accepts that, when it states that

"by themselves, all-cash machines in limited numbers are an ancillary activity for pubs and we do not think that it is necessary to insist that a separate licence should be obtained for them. The checks that already exist in relation to the granting of liquor licences are adequate for this purpose."

The dispute therefore centres around the number of all-cash machines that should be allowed. Policing the use of machines to prevent young people from using them illegally would be no more onerous if up to four machines were permitted, as suggested by the industry, than it would if only two were allowed, as has been proposed.

Fruit machines are an accepted part of a pub's traditional leisure offering, enjoyed by millions of players. They enjoy a casual gamble while having a pint of beer or other beverage. Why should they be prevented from enjoying what for most people is harmless fun? I support the liberalisation of casinos, but I do not believe that people who want an occasional flutter on an all-cash machine should have to travel to a casino.

According to MORI, three out of four people surveyed are in favour of fruit machines in pubs. I hope that the Government will reject the recommendations that I have pointed out in the gambling review body report, as they will adversely affect pubs as well as clubs. Pubs are a vital part of the community, where people meet for a drink, food, entertainment and company. Many rural pubs are already at risk. We must not compound that situation. I look for any reassurance that my right hon. Friend the Minister can give to my constituents employed in the gaming machine, brewing and pub industries, and to the many hon. Members present who are concerned about this issue.

I congratulate the hon. Member for Burton (Mrs. Dean) on securing this debate on a subject that is important to many hon. Members and their constituents. I know that many hon. Members want to take part this morning, so I shall be brief.

The hon. Lady has already referred to the potential effects on pubs that implementation of the Budd report would have. That point must be true for every constituency in the country. She has referred to the clubs. Most constituencies have Royal British Legion clubs, constitutional clubs and similar venues, which depend for their survival on the proceeds from gaming machines. That ground has been well covered and will no doubt be covered again this morning, so I mean no disrespect to the people engaged in those concerns when I say that I shall concentrate my remarks on my constituents and the British seaside.

To put the issue in context, Thanet hosts several companies that manufacture or sell amusement-with-prizes machines and gaming machines. They employ significant numbers of people and export to the far east. Those sales have been valuable to this country. They employ significant numbers of my constituents and those of the hon. Member for South Thanet (Dr. Ladyman), who instigated an earlier debate on the subject. Those are real people in real jobs which are under threat. One of the oldest companies in the country, which has been one of the instigators and developers of much of the machinery that we are discussing, is at this moment fighting for survival. Whether Cromptons will survive, we do not know. Various rumours about its future are circulating.

I do not pretend that Cromptons' problems are entirely due to the Budd report. That is clearly not the case. Any company facing industrial problems must consider several contributory factors. However, the Budd report has destabilised what was a highly successful British industry, exporting British technology around the world. It is an absolute tragedy that that success story is now being placed in jeopardy as a result of a reaction to a threat that no longer exists.

I thank the hon. Gentleman, whose constituency adjoins my own, for giving way. I agree with him that the report is not the sole reason for Cromptons' problems, but does he agree that it makes it more difficult for it to find a solution to those problems?

The hon. Gentleman is absolutely right. The entire industry, not just Cromptons, is now operating in an atmosphere of uncertainty. What investor is likely to come forward in such an atmosphere, until we know the decision on the report's recommendations? I must say to the Minister, on behalf of the hon. Gentleman, his constituents and my own, that the sooner the matter is resolved satisfactorily, the better.

Does the hon. Gentleman agree that one of the worst aspects of the report is that, as the hon. Member for Burton (Mrs. Dean) mentioned, the research would be carried out over five years, causing uncertainty for constituencies such as mine, which provide the seaside machines? Firms will not invest during that period, and that will affect jobs in the constituency of the hon. Member for North Thanet (Mr. Gale.)

The hon. Gentleman is right. That is why I said to the Minister that the matter must be resolved quickly. We cannot wait for five years—the companies will not be there in five years. It is a moot point whether some of them will be there in five months, so the matter must be resolved quickly. I know that the Minister has heard these arguments before, and that he is not unsympathetic to many of our points. I hope that he will be able to send a clear signal that will stabilise and reassure the market, which is seriously under threat.

What does that threat stem from? I do not suppose that there is a Member present who is not conversant with the ill effects of gambling on young people and the potential for harm. However, the idea that amusement arcades, particularly in their seaside manifestation, are still dens of truants and rent boys and young gamblers stealing to feed a penny-in-the-slot machine habit is nonsense. I am not saying that it was not a problem at one time, but I speak for the arcades in my own constituency along the Margate seafront and in Herne Bay, in saying that it is no longer a problem.

As the Member of Parliament representing the people who run those arcades and those who use them, I am satisfied that in the main—there may be the odd error—they are well run and well managed. They do not provide the sort of haunt and haven that Professor Budd and his colleagues seem desirous of attacking. On the contrary, they are an integral part of British seaside life. It is an acknowledged fact that the sunshine in Margate is not always quite as hot or frequent—

Surely not.

Not always—there is the occasional cloud in the August sky. There is, from time to time, even a drop of rain. On those occasions, entire families seek solace in the amusement arcades.

I rise to speak up for my constituency, because in my experience the holidaymakers flock to our amusement arcades in the hot weather because of their good air-conditioning.

I do not want to labour the point. It has been well made.

Go on.

Do not excite me. Other hon. Members want to speak.

For much of the British seaside, the amusement arcades are a significant proportion of the all-weather facilities. It is a sad fact that there is a lack of investment in the kind of facilities that meet the needs of our climate.

If one removed the seaside arcade from the equation, it is not an exaggeration to say that one would go a long way towards killing what is left of the British seaside. We have suffered our hotels and guesthouses being taken over, first by dole-on-sea claimants and then by asylum seekers. We have seen the bucket and spade holidays go to the sunshine of the Mediterranean. Yet people are still running good reputable businesses—guest houses, pubs and fish and chip shops. People are still selling kiss-me-quick hats, candy floss and seaside rock from seaside bazaars. One cannot remove one bit of that equation without damaging the rest. Another element of uncertainty has been injected into the fate of seaside resorts, as well as into that of machine manufacturers.

Under human rights law, a sentence must be proportionate. Professor Budd has overreacted to a perceived but non-existent threat; the reaction is not proportionate, and the sentence that he proposes would not solve a problem but be a death sentence for the British seaside.

It is a pleasure to follow my parliamentary neighbour. There are few subjects on which he and I agree; in fact, I can think only of three off hand, and this subject is one of them.

I had a good stab at this subject on 6 November, when I was lucky enough to secure an Adjournment debate on it, so I shall be brief and let others contribute. I congratulate my hon. Friend the Member for Burton (Mrs. Dean) on winning further time to debate this important subject, which is, economically, a matter of life and death to many of my constituents who work in the industry.

Thanet is the world centre of the penny fall machine industry. Two leading companies in the world are based in Thanet, and they use their United Kingdom business as the bedrock of their business, because the revenue from it pays for their research and development work, which they apply to their machines to sell abroad. Without that United Kingdom business, there will be no exports abroad, the legs will be cut from under those businesses, and they will certainly collapse.

Since 6 November, I have had the pleasure of speaking at trade shows and conferences organised by the industry; I have met members of the industry in various forums and have debated the issue in various journals. Throughout that time, I have not heard anyone come up with an argument in support of the Budd recommendations. The only people whom I can find who think that the Budd recommendations about gaming machines and seaside amusement arcades have some merit are those who were involved with the Budd report themselves. No one else has any time for the recommendations, sees any merit in them or can provide evidence to support them; no one can understand what evidence Budd himself had to support them. Perhaps, however, we might find some clues in articles that Alan Budd has written and contributed to since he published his report.

Before I tell my right hon. Friend the Minister for Sport about those articles, let me tell him something that Alan Budd was heard to say on a visit to an amusement arcade in London. He stood in front of a fruit machine and said to the owner of the establishment, "I've never played on one of these before—how does it work?" And yet, in articles in the press, he has claimed to be an incipient gambler who used to get lost in seaside arcades as a child and, therefore, understands the problem of gambling from the inside. Only one of those two things can be true: he either knows the problems from the inside or he has never played on one of those machines before. Which is the real Alan Budd who wrote the report?

The one who worked for Thatcher.

I will not go down that route.

Alan Budd has said:

"When I enter a casino I almost fall over from the flood of adrenaline. It is only by immense self-control that I have not gambled away the house and everything in it."

If he had admitted to this problem earlier, does anyone seriously think that the Government would have put him at the head of a commission on gambling?

If limits were placed on the machines that could be put in pubs, clubs and arcades at seaside resorts such as those in my constituency on Canvey Island—across the Thames from the hon. Gentleman's—and on the prizes that they could offer, people would be driven towards casinos, where problem gambling can take hold. That would also result in the destruction of those pubs, clubs and arcades. They are the heart of our community, part of the fabric of our society. We should cherish them, not destroy them.

The hon. Gentleman is right. Nobody in their right mind can believe that the machines that we are discussing, located in seaside arcades, are part of a regime of hard gambling that creates a gambling problem in adult life. If people develop such a problem, it is not because they have spent a wet afternoon in Ramsgate, Broadstairs or Margate playing on a penny fall machine for tuppence a time. The use of such machines should not be treated as hard gambling, yet the Budd report recommends that penny fall machines, roulette machines and "Wheel'em ins"—harmless penny amusement machines—should be treated as coin-in, coin-out machines and their use restricted to people over the age of 18. Who, over the age of 18, wants to play on those machines? [HON MEMBERS: "Alan Budd."] Except that Sir Alan probably does not know how they work.

If that was not enough to convince the Minister that he should drop the recommendations, let me give some facts and figures from the Henley report that might convince either him or the Chancellor. The Henley centre believes that, in the short term, implementing the recommendations will result in the family amusement industry losing £20 million per year in revenue and 1,500 full time jobs. If the five-year ban goes ahead, there will be £117 million of revenue losses and 5,000 full-time jobs will be lost, while the Treasury will lose £14 million per year in licence duty, £51 million per year in VAT and £29 million per year in national insurance and PAYE. That is a loss to the Treasury alone of £94 million.

There will not only be a loss to the seaside amusement industry. You would immediately rule me out of order, Mr. Deputy Speaker, if I suggested that the Budd report would cost the national lottery's good causes hundreds of millions of pounds, but it will. There are some sensible recommendations in the report, as my hon. Friend the Member for Burton has said. Equally, there are some barmy ones. Overall, the Budd report could cost the Exchequer as much as £500 million and 15,000 jobs across the country. Surely we cannot countenance that. I ask my right hon. Friend the Minister, in making his report, to consider those matters carefully. If he comes up with the right recommendation, I can promise him from now on the premium space and the best deckchair on the beach whenever he comes to the seaside. Whatever he does, please will he make his recommendations as quickly as possible, because the uncertainty is already costing jobs and revenue to a vital industry and is adding to the problems of the British seaside.

rose—

Order. As hon. Members will see, there is a demand on time. We have some 30 minutes left because, traditionally, the final 30 minutes of a 90-minute debate are reserved for the Front-Bench spokesmen. Please, will all hon. Members whom I try to fit in be clear, concise and pertinent in their remarks, out of consideration for their colleagues?

I congratulate the hon. Member for Burton (Mrs. Dean) on having secured the debate. As its MP, I have an interest in the continuing success of Skegness as a traditional family resort. The town has not just relied on its heritage and excellent reputation, but has seen considerable investment, primarily from private individuals who run family businesses for the benefit of other families who come to Skegness to enjoy its facilities. It must be clearly understood that that investment has enabled Skegness to remain at the forefront of the United Kingdom tourist industry. I hope that hon. Members agree that there is a place in a responsible society for controlled gaming, but we must find a regulatory framework that allows companies to prosper and create employment and allows those who come to Skegness and other tourist destinations to find pleasure and enjoyment.

The Budd report does not strike the appropriate balance. It is an odd report in that it is contradictory and creates a paradox. It argues that the gambling industry should be liberalised while at the same time proposing to reduce competitiveness by adding unnecessary tiers of restrictions and regulations that will force many seaside arcades out of business. The British Amusement Catering Trades Association is right in saying that amusement arcades are one of the significant attractions of UK tourist resorts, second only to funfairs. They create family entertainment, enabling the family to stay together by providing entertainment for those of all ages, from children in playgroups to adults on gaming machines with large jackpot prizes, in restricted areas. The money from such machines produces the investment that allows the owners of arcades to provide a broader range of services, such as play areas for younger children.

The implementation of the Budd report would change all that. It would drive many adults who enjoy gaming machines away from regulated family arcades into bingo halls, betting offices and other buildings that have gambling licences where children would not be welcome or allowed. There is no evidence to support the suggestion that trivial gambling causes harm, whether it is on low-stake, low-pay-out machines, push machines, cranes or Derby races. Indeed, a recent survey detailed the issues affecting the lives of people under 18 that worried them most. Gambling came 12th. Only 0.6 per cent. of those asked felt that gambling was a significant concern. It might not be a surprise to find that drugs and alcohol were high on the list. Indeed, text messaging and eating junk food came higher up the list than gambling.

If children were banned from arcades, the traditional British family resort would be almost at an end. Where would the family go in Skegness on the rare occasions when the sun is not shining? Such a ban would also have a dramatic impact on the tangential businesses that support amusement arcades, such as electricians and plumbers. It would have serious implications for those employed directly in the amusement arcade business in both full-time and seasonal work. Those employed are often the least skilled and least well educated of our work force and deserve help from hon. Members of all parties. Those workers will be the hardest and first hit by the proposals contained in the Budd report. Many students subsidise their higher education by taking part-time jobs, especially in the summer months, in amusement arcades in Skegness. If the Budd report were implemented, many of those students might not be able to afford higher education and a bar might be created that would prevent those from the poorest backgrounds from having access to higher education.

Any resort must invest to move forward. A lack of investment means that a resort or a business stands still. The length of time that the consultation process is taking is creating a great deal of uncertainty, and the proposals to allow local authorities retrospectively to close arcades or impose a blanket ban on gaming in any particular area will not allow businesses to invest. Businesses need stability and certainty. I ask the Minister to confirm that that recommendation will not be implemented, or at least to say when he will announce the results of the consultation process. Otherwise, the disinvestment that will occur will further damage the already greatly challenged UK tourism market.

I will not repeat the arguments about the loss of revenue to the Exchequer, which have been made eloquently. I shall address recommendation 70, which seeks to reduce the potential jackpots in gaming machines in private clubs from £250 to £25. Many clubs survive solely on the profit generated by those machines.

Does the hon. Gentleman agree that one organisation most affected by that proposal is the Royal British Legion? Its clubs are hardly dens of iniquity and under-age gambling, and the average age of its members is over 40. They raise tens of thousands of pounds for their local communities every year, but many may be forced to close if recommendation 70 comes into force.

I am grateful for the hon. Gentleman's intervention, and agree with his point. Not only those of the Royal British Legion, but many other community clubs exist as meeting places. They often provide cheaper beer than is available in commercial pubs, which allows the retired generation in particular to get together. They are often the core of a rural community and provide money for charities. In one village in my constituency, Kirton, the profits from a jackpot machine in a private club support the only children's playground in the village. Sometimes money is used for educating members of clubs.

I would like to make further points, but I know that other hon. Members wish to speak. It was right to hold a gaming review, but it is wrong further to penalise the UK seaside resorts. It is right further to liberalise the UK gaming industry, but it is wrong to destroy family entertainment centres. I understand that the Minister's Department has been swamped by responses to the consultation process. I hope that he will recognise and react to the very strong feeling that has been expressed, and adhere to the points made.

I congratulate my hon. Friend the Member for Burton (Mrs. Dean) on securing this debate. Hers is an inland constituency, which, like all constituencies, will suffer if many aspects of the Budd report are implemented. However, I think that constituencies with seaside resorts will suffer the most. I notice that many Members of Parliament for such constituencies have taken part in today's debate.

Seaside resorts have suffered tremendously during the past 25 years. Other regions of the UK that have suffered, such as the steel, mining and agricultural communities, have had their heroic struggles well chronicled in books, films and newspaper articles. However, the struggle of seaside communities has not been chronicled, although it is an equally noble struggle. Perhaps that is because we are literally on the periphery of the country and do not have a union or united voice to represent us.

Local arcade operators in my constituency have informed me that the Budd report's recommendations would be the death knell of seaside towns such as Rhyl and Prestatyn. We have heard the statistics: 14,000 jobs will go and £550 million of Treasury income will be lost. Tim Batstone of HB Leisure, a very successful arcade operator in my constituency, estimates that he will lay off 130 workers in the short term and 300 in the long term. That will mainly be in the ward of Rhyl West, the most poverty-stricken of the 850 council wards in Wales.

The effect on my community will be devastating. There will be a human cost, in terms of job losses, and also an environmental cost. On the west parade in my home town of Rhyl, half the old Victorian buildings are now derelict. The other half are currently arcades, brightly lit and well maintained and presented. They, too, will soon fall into dereliction if the Budd report is implemented in full. The knock-on effect on the local economy could be considerable, with a loss in rates and a drastic reduction in the number of visitors to Rhyl.

The part of the Budd report that most concerns the arcade operators and me is its proposal to ban children from arcades, even with parental supervision, which smacks of Big Brother, and "we know best". There is a move by Alan Budd to stop the cheap tuppenny games. Sir Alan Budd believes that such games have a corrupting influence on young people. He recommends a five-year study, which we welcome, but he is prejudging its results and implementing his changes from the outset.

Research needs to take place, and we would all welcome it. Existing research from the British gambling prevalence study 2000 shows that, on the whole, British people are a nation of responsible gamblers. Perhaps that is so because, at an early age, we have spent our tuppences with parental support in a controlled environment, and have developed a responsible attitude to gambling.

My main concern is the effect on seaside towns, but a further worry is the effect on military clubs such as the Royal British Legion, Royal Air Forces Association and Royal Naval Association clubs, on political clubs—perhaps we should declare an interest—such as Conservative, Labour and constitutional clubs, and on social clubs. Many clubs in the poorest areas, especially in my constituency, will fold unless they can make money from gaming machines.

We have heard many opinions expressed. Aspects of Sir Alan Budd's report have united all political parties in one voice. That is unique in Parliament. However, although many aspects of the report are good and sensible, many of its proposals, particularly those that pertain to seaside resorts and registered members' clubs, should be extinguished at the earliest date. Uncertainty is undermining registered members' clubs and seaside resorts, which have suffered so terribly in the past. Those resorts need help, not a kick in the teeth, which is what Sir Alan Budd is offering. I ask the Minister to listen to pleas from all quarters and end the uncertainty as soon as possible.

I will be brief. I wish to reinforce the comments made by other hon. Members.

I declare an interest as an officer of the all-party group on non-profit-making members' clubs. I recognise, as I am sure do all hon. Members, that the gaming machine industry and non-profit-making clubs are irrevocably interlinked. The fortunes of the private clubs have a great effect on the fortunes of the gaming machine industry—clubs are a major customer of the industry. As the Minister knows, well over 20,000 private non-profit-making clubs in this country will be savagely affected should recommendation 70 come into play.

The Royal British Legion will be one of the biggest sufferers. The term "non-profit-making clubs" means that profits from machines go back to help members and local communities and provide comfort for those less well off or less well supported in the community. There are more than 20 non-profit-making clubs of all types and of different memberships in my constituency. They will be severely affected should recommendation 70 be introduced.

The Minister will remember that I asked him a parliamentary question in October about the number of representations that he had received from clubs and their members. He admitted that more than 1,500 clubs or members had written to him expressing concern about the effects of recommendation 70. He also knows that the organisations that represent such clubs nationally are desperately worried about the future of working men's clubs, social clubs, military clubs, the Royal British Legion, and, of course, political clubs. My local Conservative club in Eastleigh has written to me. It is desperately concerned that it will be forced to close if high-payment gaming machines are removed. I know that the Minister is a fair man. Given the average age of Conservative party members these days, he would hate to take away the old codgers' last bit of enjoyment.

The Minister has been gracious enough to listen to the views of the all-party group on non-profit-making members' clubs and the association that represents the clubs. He knows the issues well and I would like him to confirm that private, non-profit making clubs are an essential part of our community and social fabric. He has the chance to tell us that they will be exempted from a regulation that would destroy the very nature of an essential part of our society.

I congratulate my hon. Friend the Member for Burton (Mrs. Dean) on securing this important debate. It is also a pleasure to follow a fellow chartered civil engineer, the hon. Member for Eastleigh (Mr. Chidgey). We both know the importance of foundations and structures. In this debate, it is important to recognise the linkages between each facet of the industry.

I want to concentrate on the importance of the seaside, but I will not rehearse the weather forecasts that we have heard from such delightful places as Skegness, Margate, South Thanet, Great Yarmouth—

And Rhyl.

And Rhyl. The best place, and the place where the seaside industry was founded, is Scarborough. On behalf of my community, I thank my right hon. Friend the Minister for the tremendous work he did in laying key foundations to help the regeneration of the seaside while he was at the Department of Trade and Industry and the former Department of the Environment, Transport and the Regions. That important work led to my community being established as an objective 2 area.

An engineer's view of what confronts us would be simple. The Government are taking a long time to determine their response to the Budd report and, therefore, we face a blight on the industry at every level. I reiterate my previous invitations to the Minister to come to the front at Scarborough and do what Sir Alan Budd was not prepared to do: meet the many families who run businesses there. They cannot invest in their businesses because they are unsure of their direction.

The Budd report offers opportunities as well as challenges for the seaside community. The direction of the regeneration for which the Minister was responsible in seaside communities such as Scarborough and Whitby links to the possibilities for developing a casino-like culture in places such as Scarborough. I have a vision, which many of my constituents share, of turning Scarborough perhaps not into the Las Vegas of the north, but into something like the Monte Carlo of the north. I notice that my parliamentary neighbour, the hon. Member for Ryedale (Mr. Greenway), knows exactly what I mean. The beauty of the area is very similar to that of Monte Carlo. He represents the good people of Filey, so he will know that a casino in Scarborough, as well as suitable hotel development, could bring about the Minister's vision.

My simple message to the Minister from the many people who work in the seaside community in Scarborough is that he would be throwing the baby out with the bathwater by taking up the proposals on seaside gambling in the Budd report. The North sea is very grey and cold even at the best times of the year. Prosperity could be increased for many people in my community and I am here to try to bring that about. If it does not happen, my community will be blighted and things will be bleak.

At the earliest opportunity—today would be great—will the Minister please say that he is prepared to put to one side the proposals relating to the seaside community and gambling, which is the only way to go until we have some effective research? We must end the blight and bring about prosperity for the seaside, especially for my constituents in Scarborough and Whitby.

I shall be brief and try not to reiterate the excellent points that have been made both by hon. Members who represent seaside communities and by those whose constituencies are inland. I congratulate the hon. Member for Burton (Mrs. Dean) on securing the debate.

I should like to place on record my congratulations to the industry, which has completely changed its image in the past 20 years. Restricting access and improving policing have enhanced the quality of the environment in amusement arcades. I cannot remember the last time that I read in my local newspaper of a problem in an amusement arcade, whereas 20 years ago there were regular reports of incidents. The industry should be congratulated on getting its act together to provide true family entertainment and amusement.

One issue that has not been raised is that of piers. We talk a lot in this place about reforming peers, but I am talking about piers. Piers are run with amusements, and we want to retain the great British pier. Most of us who represent seaside resorts have a pier in our constituencies, and some constituencies contain two or more of them. I hope that the Minister will take it on board that piers are an integral part of the seaside and the traditional British holiday, and that they are threatened by the legislation. I know that he is no stranger to seaside resorts because he has visited my constituency in the past, and he is always welcome to come again. He would not need to bring an umbrella because my constituency is in the English riviera.

As others have said, if some of the recommendations in the report were accepted they would cost jobs. They would not kill the holiday industry in British seaside resorts because we have many other attractions, but we must offer a package, of which amusement arcades are a part. Amusement arcades are an integral part of the British seaside holiday experience, and we do not want to see them go.

I congratulate my hon. Friend the Member for Burton (Mrs. Dean) on securing today's debate. I shall speak briefly.

I want to impress on the Minister the effects that the five-year review is having on my constituency. Pavilion plc, one of the arcade owners in my area, intended to invest an extra £3 million in Pier avenue, but it has put that on hold because it cannot wait for five years. No one will give it investment and support because there is no certainty that there will be arcades in the area after five years. I stress the importance of the five-year review, and I, too, should like my right hon. Friend to make a statement as soon as possible on whether it is going ahead.

I remember hon. Members' campaigns for seaside resorts, and it was only in 2000 that we called on the Chancellor to help seaside resorts in his Budget. I shall read an extract from the Budget report 2002, in which we received a good response from him on the concerns raised about seaside resorts and arcades. The report says:

"The removal of the £645 annual licence charge on small-prize 'amusement with prizes' machines (AWPs), costing 10 pence per play or less, will provide a boost to seaside arcades, and will help to support the Government's 'Tomorrow's Tourism' initiative, aimed at reviving traditional seaside resorts."

The Chancellor is giving and Budd is taking away. We cannot afford some of the report's recommendations.

My hon. Friend the Member for South Thanet (Dr. Ladyman) mentioned an article. I wish to draw Members' attention to an article in Coinslot International, which is a publication for the traders who operate the arcades and machines. It says that Sir Alan Budd's problem is alleged to have stemmed from boyhood, specifically time spent in amusement arcades during holiday visits to the seaside. It says:

"The experience has clearly imprinted on Budd a protective attitude towards fruit machines, of which he is quoted: 'Machines are the most addictive form of gambling. The best way to trap someone is with machines. They are designed to be addictive."'

The banning of non-monetary prizes could be taken to an extreme. I am sure that we can all remember going into a shop and paying for a lucky dip, and how disappointed we were that we did not get what we wanted from it. One might take the ban even further. How many Members, when they were younger, paid to see Father Christmas, sat on his knee, asked for all sorts of things and did not get what they wanted at the end?

Is Budd saying that we should not play because we may get a prize at the end that we do not want, or because it may trap people in gambling? That is ridiculous. It is an idea that should be put to bed straight away so that we can safeguard the future of arcades. It is ridiculous to think that every time a young child spends a penny or two and gets a prize he will be trapped into a gambling habit.

For years, arcades in my constituency have regulated themselves. They do not allow under-18s into certain areas, and they have people on the doors who ensure that children do not go into arcades during school term and question them if they try to. Such regulation is already in place; the Budd report goes too far. We should ensure that our seaside resorts are maintained, and we should accept that arcades are part of their proud history.

The Government were right to conduct a review of the industry's regulations. It is an important industry, contributing some £42 billion a year to the UK economy and retaining a relatively modest £7 billion. Some of the proposals in the Budd report will find favour with the industry, punters and society generally. However, some parts of it contribute to an incoherent, contradictory and potentially damaging whole.

A main impetus for the review was that the Treasury was licking its lips about the prospects of regulating and taxing internet gambling. I have no objection to the Government doing that, but, as the hon. Member for South Thanet (Dr. Ladyman) said, there is a potential downside in terms of Government revenues. The perceived benefit to the Treasury could easily be wiped out if we were to accept the package as a whole.

Hon. Members have already made the point that the incidence of problem gambling in the UK is not very high, certainly in comparison with other countries. There is something rather perverse about the report. It attacks and undermines some traditional British forms of gambling, which we know do not create serious problems with social gambling. At the same time, it seeks to espouse and permit the growth of huge Las Vegas-style casinos. We know that America and Australia, where that is a far more typical part of gambling, have a far greater problem with dependent gambling. In Australia, for example, 2.5 per cent. of people have problems with gambling, and gambling addicts are estimated to cost the Australian community more than 5.5 billion Australian dollars a year.

The situation is extraordinary. Our industry does not give us problem gambling, and we may undermine all its essential and traditional characteristics. However, the same report proposes to allow the type of gambling that has contributed to problems in America and Australia.

The hon. Gentleman has not mentioned France, where a gaming machine regime has been instituted similar to that proposed by Budd. In France, the problem with gambling is people who are shot by gangsters for not buying their gaming machines from the right set of criminals.

The hon. Gentleman makes an important point, and it is another that the Minister will have to consider when he decides how to respond to the proposals.

When we debated the subject in this Chamber in November, most of the speeches were about the impact that the proposals would have on social clubs, a point that my hon. Friend the Member for Eastleigh (Mr. Chidgey) referred to this morning. Such clubs were quick off the mark with their lobbying, and it is clear that they made an impression on hon. Members from all parties. The Minister has acute political antennae, so he will have picked up on that. Were I a betting man, I would wager a small sum on his not accepting the burden of that recommendation.

Today, hon. Members from all parties have expressed loud and clear their belief that damage would be caused to seaside resorts if the Budd recommendations went through. Almost all those resorts are economically fragile. I know that myself, as north Devon has several seaside resorts that are in serious trouble. Amusement arcades are an integral part of the package of seaside resorts, so I urge the Government to think long and hard before going down the suggested route.

Similarly, the recommendations on pubs could be extremely damaging. It seems self-contradictory to offer local authorities, which are to be the licensing authorities, the prospect of draconian blanket bans on all forms of gambling yet not allow them to exercise common sense on how many machines should be allowed in different pubs. Pubs can come in different sizes, so a one-size-fits-all solution to the number of machines allowed in them does not seem logical.

If the Government decide to accept the Budd recommendations about allowing large-scale use of machines in casinos, they must be aware of what will happen. Most of the bingo clubs will turn into casinos overnight. The image that the public have of casinos—with smooth Roger Moore-type figures in black bow ties playing the roulette tables—will bear no resemblance to what will follow. I do not say that I am morally or implacably opposed to allowing larger-scale machine gaming halls—that is exactly what they will be—but I urge the Government not to allow them to operate in an uncontrolled way. They should leave in place certain brakes and controls to prevent them from getting out of hand.

Hon. Members from all over the country and all points on the political spectrum have spoken. Clearly, they have many serious worries and reservations. I am glad that the Government have taken the time to absorb the burden of the lobbying that has taken place and the representations that have been made. If they introduce a White Paper or Green Paper on the subject in the next few months, I hope that they will treat the Budd report in an à-la-carte fashion. They should pick the good bits from it and ignore the bad, because if they took it as a whole, the result would be complete disaster.

I congratulate the hon. Member for Burton (Mrs. Dean) on securing the debate, and on providing a further opportunity for the House to consider the implications of the Budd review for the future of the gaming machine industry and the importance of the income generated from gaming machines to several organisations. She set out clearly her constituency interest, as 500 local jobs depend on the gaming machine industry, and advanced a logical, coherent and powerful argument against a number of the Budd recommendations, which have caused such dismay and uncertainty throughout the industry.

The hon. Lady's thoughts were echoed by all the other speakers in the debate: my hon. Friend the Member for North Thanet (Mr. Gale), the hon. Members for South Thanet (Dr. Ladyman) and for Vale of Clwyd (Chris Ruane), my hon. Friend the Member for Boston and Skegness (Mr. Simmonds), and the hon. Members for Torbay (Mr. Sanders), for Scarborough and Whitby (Lawrie Quinn), for Harwich (Mr. Henderson), and for Eastleigh (Mr. Chidgey). Indeed, the hon. Member for Eastleigh gave the best example of how desperate people have become when he told us of the Conservative club that felt it necessary to write to a Liberal Democrat Member. One could not wish for greater evidence.

No one doubts that a review of gambling legislation was overdue. The regulation of casinos, internet gambling, the future of betting shops and the permitted mix of alcohol and gambling in various locations were all issues that needed to be addressed, and they needed to be considered against the background of a growth in leisure time and more relaxed attitudes generally. The Budd report, however, found difficulties in areas where no one had seen much of problem beforehand.

Sir Alan's thinking was so out of line with the industry view, and I shall quote again from the Coinslot interview. This comment says even more than those quoted by other hon. Members. He says of BACTA members,

"This will destroy us, they complain."

He continued:

"What they don't understand is that the alternative proposal is not to leave things as they are but to abolish it completely."

There we have it: we should abolish seaside arcades and jackpot machines in clubs and public houses. Many in the industry realise the scale of the threat. There is strong reason to doubt whether the existing regime for the availability and regulation of gaming machines was a matter of concern when the Budd report was commissioned. I do not recall it being so. If there was a problem, it was that the existing framework was too restrictive.

I was constantly lobbied as a member of the Home Affairs Committee, with my hon. Friend the Member for North Thanet, and when I had the gambling brief as Home Affairs spokesman when the Home Office had that responsibility. I was often told that the number of machines allowed in betting shops and bingo halls was too restrictive, and that the 100 local authorities that had banned all cash machines in a number of locations were being to restrictive.

There can be no doubt that the industry is deeply shocked by the Budd recommendations on clubs and seaside amusement arcades. We understand that the Minister will need time to respond in detail. I sympathise with him; it is a huge report with many recommendations. However, it is equally clear that the Budd report has generated huge uncertainty within the industry. Although it is not the only cause of decline in machine sales—I understand that sales of jackpot machines fell by about 27 per cent. between 1990 and 2000—it seems to have caused a major acceleration. In the quarter ending 30 June 2001, 1,509 machines were sold, but that number fell to only 1,235 in the quarter ending 31 December 2001. That is a further decline of 18 per cent. Yet, as many hon. Members said, the industry is one in which we have long led the world in ingenuity.

Some jackpot machines are too complex for some of the older members of clubs, which may be another reason for the decline in income in some clubs. That all impinges on the fact that if they lose that income altogether, they will be in real difficulty. I have considered the matter in considerable detail, and I would argue that the case has not been made for the Budd recommendations on jackpot machines or on how they might affect the seaside. Many hon. Members have said loud and clear that no one outside the review body has a good word to say for the recommendations, and I praise the views of the hon. Member for South Thanet.

At the BACTA conference in November, I made clear the Conservative view that we should leave alone the current regime of jackpot machines in clubs. Similarly, we believe that proposals to restrict machines in pubs to two are hard to fathom. Imposing such restrictions at the seaside is illogical given that there has been no research on their effect on tourism or on whether there is a problem with under-age gambling. It undermines the credibility of the recommendations. In our view, the solution—which Budd proposes—is a prohibition on under-18s playing jackpot or all-cash machines, regardless of their location. There must be a presumption that the proprietor will enforce that prohibition.

I concede that it is perhaps easy for the Opposition to take that view, but the strength of argument suggests that it is time to end the uncertainty. Every speaker has said loud and clear that businesses and jobs are at stake. I attend 90-minute debates in Westminster Hall with the Minister for Sport or his colleague the Minister for Tourism, Film and Broadcasting once a fortnight, but attendance has never been as good as it is now. That shows how concerned Members are about their constituency interests.

The general philosophy behind the Budd recommendations appears to be that ambient gambling should be discouraged and that gambling should be increasingly concentrated in premises that are dedicated to that purpose. It is, however, time to move the debate on and to ask whether that approach will create an industry and a gambling environment with which society feels more comfortable. Increasingly, I do not believe that it will, and I am becoming less and less convinced that the wholesale deregulation that Budd advocates is necessary.

Many in the industry who would benefit in the short term from Budd's proposed deregulation of casinos and amusement centres worry that we may see a massive expansion of casinos or so-called outlets—the hon. Member for North Devon (Mr. Harvey) stole my best line. Such outlets do not reflect the James Bond image of spending a luxury night out at a casino with—we can thank Budd for this recommendation, and there is nothing wrong with it—a glass of champagne in hand. Instead, we shall see wall-to-wall gaming machines in sheds that could be described only as gambling warehouses. It is a sad irony, however, that the machines in those premises will not benefit our manufacturers, because they will most likely be imported from the United States of America.

I want to give the Minister ample time to respond, so I shall conclude by advocating a cautious step-by-step approach to implementing those parts of the Budd report—I have alluded to some of them—that the Government support and for which there would be genuine all-party support. At the same time, when deciding the appropriate response to Budd's thinking on the gaming machine environment, the Government must keep in mind the old saying that if it ain't broke, don't fix it—I apologise that that is one of the most commonly used lousy cliches in our debates, but I could not think of a better one.

The debate has been a good opportunity to make it clear that the industry is convinced that the Budd report would wreak havoc on a range of legitimate businesses, and the Minister now has a good opportunity to respond.

Mr. Cook, I congratulate my hon. Friend the Member for Burton (Mrs. Dean) on initiating this very good debate, which, as she said, is our second debate on the Budd report. Both debates have homed in clearly on the significance of the review and of the gaming machine industry. I acknowledge that there is concern, which has also been reflected in the number of hon. Members from across the House who signed the early-day motion.

If I may, Mr. Cook, I shall—

Order. That is the second time the Minister has referred to me as Mr. Cook, although other hon. Members have done so, too. I would be failing in my duty if I did not call attention to the fact that the House—in its wisdom or otherwise—has decided that the four senior members of the Chairmen's Panel should be referred to as Deputy Speakers in this Chamber. As a senior member of the panel, I should point that out.

Please accept my humble apologies, Mr. Deputy Speaker. I am sorry if I have offended the House, or indeed the Chair.

In considering the reason for commissioning the Budd report, we need to look back to the mid-1960s when the last relevant legislation was put on the statute book. I remind hon. Members of the reason for that measure; it was driven, to a great extent, by criminality and the laundering of money through various gambling outlets, particularly casinos. The Budd report has originated from a different perspective—the acknowledgement of the fact that information is now passed around electronically. If we are to continue as a major centre of the gambling industry globally we shall need primary legislation. The law requires the person who places a bet to be in the place where the bet is made, so electronic gambling is illegal. The stimulus for the Budd report was to a large extent the internet and the electronic movement of information.

I want to make it clear to the House that we do not intend to damage an industry which, as has already been mentioned, has something like a £42 billion stake, and contributes marginally less than £2 billion to the Exchequer. The number of people employed in the industry, and the location of that employment, which tends to be seaside resorts, are important considerations for the Government.

If anything, we want modernisation along with deregulation to move gambling into mainstream leisure. In view of the restrictions under the Gaming Act 1968, which were introduced for the reasons I explained, we now believe that that is the right approach. There has been significant change. It is interesting that there has not been much opposition to gambling in this debate. A decade ago, the atmosphere would probably have been quite different. It is significant that about 70 per cent. of the population now gamble through the lottery.

That cultural change has led to the acceptance of gambling as part of leisure and there is now an opportunity to move gambling into mainstream leisure. There are several reasons to do so, including employment and inward investment. Also, I have been struck, as someone who was not an expert on gambling—people would probably say that I am still not; they might compare me to Alan Budd—by the integrity of the gambling industry in the United Kingdom. That is important when we consider global gambling and wonder where internet gambling will find its base in the future. We must take such issues into consideration in evaluating the Budd report.

Governments are criticised for consulting and for not consulting. On the present important issue, we wanted the Budd report and three months of consultation; about 3,000 representations have been made and the matter is being considered. I gave the House an assurance that we would respond by the end of March or the beginning of April. We are on course according to our timetable and will do that, assuming that my colleagues in other Departments do not raise other major issues. We have tried to bring certainty to the consultations in setting out a clear timetable. I am hopeful that we shall be able to adhere to it.

It is important to eliminate uncertainty. I have come to this House from industry, where uncertainty is an expensive commodity. Several hon. Members have pointed out the effect of uncertainty on the gambling machine industry. I give an assurance that we have kept to the timetable and will deliver on it.

Several hon. Members have raised the issue of the protection of children and vulnerable people with regard to gaming machines. One must acknowledge that in the UK, the incidence of abuse in gaming is very low indeed relative to other countries. Again, the integrity of the industry shines through—but it is right for Budd to raise the question of ambient gambling and vulnerability.

The industry has responded in an effective and responsible way to the Budd proposals on setting up a voluntary trust to consider how organisations such as GamCare can be funded and to conduct research. Just under £1 million has been raised by the industry on a voluntary basis, and that is to be welcomed. I met several people yesterday about the trust and I hope that it will develop.

It has also been interesting to find that it is an aspect of British culture that we allow our children to play slot machines. Almost every other country in the world forbids that. However, we have all been brought up with it and we acknowledge it. For the past 20 years I have spent my summer holidays in the UK. If I were to approach the report in the objective manner in which some Members have described the weather in our seaside resorts this morning, I would probably produce a rather perverse analysis of it. Nevertheless, Members or Parliament, particularly those who represent seaside constituencies, must promote their areas as strongly as possible.

We must give serious consideration to the five-year timetable that has been laid down for the further review of the industry. We have received strong representations on that. To return to my earlier point, I do not believe that such timetables should be left hanging over industry because they build in uncertainty. We must take on board the comments that have been made and factor them in clearly, trying wherever possible to remove those uncertainties.

The review resulted in a number of recommendations, the arguments around which have been well rehearsed here today. We have heard what the industry has to say and listened to Members' representations, and we will factor those into our final decision. We do not want to damage any of the resorts; we want to build them up. We want them to move gambling into mainstream leisure, and that will be our approach as we evaluate the Budd recommendations and Members' comments.

On jackpot machines and the proposal to reduce the maximum jackpot from £250 to £25, I can only repeat what I have said on previous occasions. I am president of a trades and labour club in Sheffield. I walked into the club at 9.30 one Sunday evening and found four secretaries of local working men's clubs. One of my colleagues said, "They've come to see you, Richard." They did not quite resort to the vernacular, but they made their position very clear indeed. I thanked them, and they did not buy me a drink. They spoke very forcefully, and we are taking that into consideration.

I have made a statement in the House to the effect that we are also factoring in the fact that many clubs play a major role in the social infrastructure of their communities. That has been forcefully expressed. I met the all-party group on non-profit-making clubs, and we will factor in all those considerations.

The overall industry response has been quite positive. We were right to take up the Budd report. Budd has done a good job in bringing several areas into the 21st century, which was necessary. The industry's response was quite predictable. It wants to see some recommendations implemented, but rejects others. Overall, the report gives us a firm foundation on which to build.

I understand the points made by the hon. Member for Ryedale (Mr. Greenway) about casinos, and I take them seriously. We must be careful as we proceed with the legislation. We want to deregulate, and to allow the industry to grow, but we do not want it to lose its integrity. We have seen how some countries have deregulated too fast, and it is difficult to pull back when that has happened.

We need to allow the creativity of the industry to flourish in a framework in which change can be managed. In respect of casinos, we must ensure that we do not deregulate at a pace that cannot be managed properly and would damage the industry.

I have heard what hon. Members have said. The debate has been a good one, and I take on board all the points that have been made. The main point is that we shall try to meet the timetable that I gave at the beginning, and I hope that that will remove the uncertainty from the future.

I am grateful for the opportunity to speak on this subject, which seems almost taboo in this country, both because it is hard to get any reliable statistics to measure the extent of the abuse and because many remain in denial about the existence of such abuse. However, the evidence that does exist suggests that elder abuse happens on a scale that requires a significant shift in Government thinking and a change in professional practice.

Let us start by defining our terms. Action on Elder Abuse, an organisation that campaigns on the issue, defines elder abuse as

"a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person."

The charity goes on to define five main types of abuse.

They are:

"Physical: for example, hitting, slapping, burning, pushing, restraining or giving too much medication or the wrong medication…Psychological: for example, shouting, swearing, frightening, blaming, ignoring or humiliating a person…Financial: for example, the illegal or unauthorised use of a person's property, money, pension book or other valuables…Sexual: for example, forcing a person to take part in any sexual activity without his or her consent—this can occur in any relationship…Neglect: for example, where a person is deprived of food, heat, clothing or comfort or essential medication."

Given those definitions, how widespread is elder abuse? Action on Elder Abuse offers evidence in its report entitled "Listening is not enough", which states that in the first two years of its national freephone service, more than one in four of the calls were about abuse in care homes. That figure should be set in context: just one in 20 older people live in care homes, and that pattern has continued beyond the first two years of the service. Research has also found that abuse increases with age.

Will the Minister tell us whether the Department has any plans to commission a national study of the level of elder abuse so that we can get a clear fix on the scale of the problem, not only in formal care settings but in the community at large? Such research is long overdue; research in the United States of America, commissioned by the US Congress, confirmed that the reported level of abuse in that country was merely the tip of the iceberg. I suspect that the findings would prove the same in this country, too.

I want to raise four concerns, of which I have given the Minister notice. The first relates to the resources available to the National Care Standards Commission to do its job properly. In 1983 there were eight nursing homes per inspector; in 1999 there were 20 homes per inspector.

The second issue is the low number of trained staff and the limited target set for raising the level of training. Currently, only two in 10 care staff have recognised qualifications. The Government have set the target that by 2005, half of care home staff should have NVQ2.

Thirdly, there is no offence of neglect of a vulnerable adult, and there is no legal means of dealing with informed consent when people no longer have the mental capacity to make decisions for themselves. Fourthly, standards of medication for older people are inadequate.

The resources available to the National Care Standards Commission are the subject of the first of my concerns. The British Medical Journal published a paper last year on the quality of care in the private sector and in national health service facilities for people with dementia. Using a system of evaluation based on dementia care mapping, researchers from the Institute for Ageing and Health came to the conclusion that the quality of care needed radical improvement or much improvement in all homes, and that

"no home showed even a fair standard of care."

Research revealed that in a six-hour daytime period, 60 per cent. of the time was spent asleep, socially withdrawn or not actively engaged in any form of basic or constructive activity. Only 50 minutes was spent talking or communicating in other ways with staff or residents, and less than than 12 minutes was spent actively engaged in everyday constructive activities. This is not about room sizes or the width of doorways; it is about the quality of the life experience of the residents in those care homes. As the researchers emphasised, inspection teams do not use direct observation, so how can they fully evaluate the care environment of older people?

In 1983 there were 28,000 nursing home beds. That increased sevenfold to 196,000 by 1999. In the same period, the number of inspectors increased from 100 to 300. The human resources available to carry out the meaningful inspection of care homes, and residential and nursing homes, is a serious cause for concern. I hope that the Minister can spell out in detail today some of the issues that I have raised in written parliamentary questions to which I have not yet received an answer, including details about the establishment of the National Care Standards Commission and the ratios that the Government hope to achieve for all care settings.

That is not the only concern. On 29 January the Minister wrote to the chair of the National Care Standards Commission, Anne Parker, with guidance on the implementation of regulations and national minimum standards. What message was the Minister trying to send? Certainly, the message received by groups such as the Coalition for Quality in Care was that the Minister condoned low standards, particularly in the physical environment, for an unacceptably long period. What message does that send to care home owners who already comply with or exceed the national minimum standards? What message does it send to care home residents? As the Institute for Ageing and Health demonstrated in its British Medical Journal paper, it is not good enough to limit the scope of the commission's work to the prevention of "dangerous and unsafe practice." As if to underline that point, Counsel and Care, another charity, published a report last month entitled "Showing Restraint", which makes depressing reading.

All restraints, used inappropriately, are an affront to the dignity of older people. They create barriers between the residents and the staff taking care of them. They undermine residents' confidence and autonomy. They emphasise the power of staff and the powerlessness of residents. They promote incontinence and dependency. In some cases they increase the risk of injury and death. Examples of restraint include removing a person's walking aid, setting a heavy table in front of a resident's chair to stop them getting up, and tightly tucking in blankets, which can immobilise a resident as effectively as straps.

A care home becomes abusive to its residents when the convenience of the staff is a greater priority than the dignity and well-being of the people in their care. Neither I nor Counsel and Care claim that elder abuse happens in every care home or care setting. There are many dedicated home owners and care home staff who do a challenging job, often in difficult circumstances, but that should not be an excuse for not turning the spotlight on this issue.

Far too prevalent is the insidious abuse experienced by residents because of poor standards and low expectations of the sort recorded by the Institute for Ageing and Health in its BMJ paper. I wrote to the institute to test whether it was confident about its findings and believed that they were representative of a wider problem. It confirmed that that was its strong view, but said that there was a need for further research to underpin the evidence produced by the original research.

Just as care home residents can become institutionalised, so too can the staff, accepting poor standards and tolerating bad practice. Will the Minister give a clear guarantee that the National Care Standards Commission has the necessary human resources to get to grips with the issues surrounding the quality of life in care homes and other care settings and to undertake even an abbreviated form of the recorded observation used by the Institute for Ageing and Health? If the commission is to focus on preventing dangerous and unsafe practice, how will the poor standards and low expectations reported by the BMJ be tackled?

That brings me to my second concern—the training of care staff and the status of elderly care. As long ago as 1997, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting said that it was concerned about the increasing number of cases that it saw involving abuse of older people. In the year 1999–2000, more than one in four cases of misconduct by nurses involved nurses in nursing homes. Action on Elder Abuse also found that as many as three out of four alleged abusers were care workers or nurses.

Those figures, set against the findings of a study by the university of Paisley, which examined the attitudes of nurses and health care professionals to nursing the elderly, paint a disturbing picture. That research found that the care of the elderly is given the lowest status among care professionals. Elderly care is seen by many of those surveyed by Paisley university as a place to put staff who cannot do anything else. That is not my view; those are not my words. That was the result of the research.

Poor quality is frequently, but not always, associated with low fee levels which lead, in turn, to reduced staff levels, higher staff turnover and poorly trained staff. Low levels of training and high staff turnover are a serious cause for concern. In a recent debate on the state of the care system, I referred to a statement by the Association for Residential Care. It said—and this time I shall complete the quote:

"With some supermarkets offering £8 per hour to stock shelves overnight it is hard to attract staff to a complex and often stressful job for much less money. In some parts of the country the only people applying for vacancies are those that Mcdonald's and Tesco have already rejected and, if employed, they come with high numeracy and literacy training needs, quite apart from any induction training and value based training needs."

Numeracy and literacy training needs are an issue for many care home providers. There are many thousands of dedicated people working in the sector, and their work is often overlooked and undervalued. Good staff really make a difference to the lives of the people they care for. Nevertheless, the economics of care are such that the pool of people willing to work in the care home sector is small and lacking in basic skills.

Inspections rely on good record keeping, so the skills gap must be closed, to ensure that the records can be relied on to give a true picture. Most hands-on care is provided by care assistants with limited or no formal training. It is disturbing to know that research in the United States has shown a strong and clear link between the level of abuse in a care home and the level of training. As Counsel and Care points out, the attitude of staff to residents can hugely affect the degree of freedom and choice that the residents enjoy. Standard 28 of the national minimum standards published last year for care homes sets the target of a minimum of 50 per cent. of members of care staff trained to NVQ2 level or equivalent, to be achieved by 2005. Can the Minister give us a categorical assurance that there will be no relaxation of that target, and that enforcement action will follow swiftly if it is not met? There can be no sliding on that standard.

My third area of concern is the legal protection of older people in care. The law continues to deny legal rights to people who are judged by others to lack the mental capacity to make decisions for themselves; they are not only denied proper legal status as autonomous individuals, but many areas of law simply ignore their existence. For example, under the Mental Health Act 1983, it is assumed that people who make no attempt to discharge themselves from hospital have consented to informal detention as patients. Who has authority? How is capacity defined? How can people with mental impairments, such as dementia, be enabled to participate in decisions affecting their lives?

The current "all or nothing" approach whereby authority is passed to those claiming power of attorney, or professionals giving health care and legal advice, will no longer do. Common law recognises that third parties must act in someone's best interests, but incapacitated people's best interests are about more than managing money or rationing services to meet their care needs. We must ensure that they have a decent quality of life, that they can express their needs and emotions, and that they are treated with respect as autonomous individuals.

The Government have shied away from reform in this area, despite promises of legislation year after year. The rights to life, privacy and family life under the Human Rights Act must be given real form; the legislation that has been lying around for too long in the Lord Chancellor's Department needs to be brought forward. In particular, it is time to introduce a new statutory offence to cover abuse of vulnerable adults. Why is there no such offence on the statute books?

My final area of concern is the inappropriate use of medication in care homes. Last December I published a report entitled "Keep taking the medicine?", which examined the evidence for over-medication and inappropriate medication of older people in care homes. The report drew on parliamentary answers and on an extensive review of both domestic and international research evidence. It concluded that antipsychotic medication was being used inappropriately to "chemically manage" some residents in care homes. The report called for action and set out seven recommendations, including more frequent reviews of medication in care homes, better documentation of prescribing, tougher requirements for the proportion of trained staff, and a change in the law governing informed consent.

Since its publication, the report has sparked considerable interest, and has resulted in a wide range of care professionals contacting me to express support for its findings and recommendations. When it was published I sent a copy to the Secretary of State for Health, and I look forward to receiving a letter setting out the Government's response.

The over-medication of elderly people is a form of abuse that can result in death, and denies them their dignity. The consequences of over-medication have been studied extensively and have been well reported. Despite that evidence, poor practice has persisted in the United Kingdom, and the prescription of antipsychotic medicine has continued to rise. Over the past 20 years concern has grown about the inappropriate use of antipsychotic medication in the care of the elderly, and drugs that were developed for one purpose have been switched to other purposes.

Although antipsychotic medication has beneficial effects in some cases, a succession of studies both in this country and abroad have demonstrated that the level of prescription greatly exceeds the number of elderly people exhibiting conditions that are treatable by such drugs. Research suggests that about 10 per cent. of residents in care homes have psychotic symptoms such as hallucinations and paranoid ideas, but about 30 per cent. of residents in care homes are regularly prescribed antipsychotic medication. If that pattern were repeated in England alone, more than 35,000 residents in nursing homes, and possibly as many as 53,500 elderly people in residential homes, would be kept in a state of sedation for no medical reason.

Elderly people with dementia are particularly at risk, and having to manage challenging behaviour without trained staff is no excuse for relying on chemical solutions. International evidence suggests that annual reviews of prescription for elderly people, as proposed in the national service framework, would be inadequate, and that harm can be done to people in far less than a year. Successive studies have consistently called for change. The chemical management of elderly people is an unacceptable scandal, because it denies them their dignity and their quality of life.

I hope that the Minister can tell us more about what the Government are going to do, not least about increasing the frequency of medication reviews. Will she undertake an awareness campaign targeted at care staff and GPs to ensure that over-medication is recognised and stamped out?

Elder abuse casts a sinister shadow over the care system and beyond. Elder abuse is more of a taboo than child abuse, and our attitude to it seems to be years behind our achievements in tackling child abuse. The national service framework for elderly people and the national minimum standards published last year are steps in the right direction, but more steps need to be taken. Without extra resources and law reform, elder abuse will remain hidden, and its victims will be dead and buried.

I congratulate the hon. Member for Sutton and Cheam (Mr. Burstow) on obtaining today's debate, and on his energetic, creative and intelligent campaigning; the House owes him a debt of gratitude.

The first thing that strikes one about this morning's debate is that it has attracted only one Back Bencher, although Front Benchers are present. The previous debate, which was about gambling, attracted at least 20 times as many Back Benchers, which illustrates the point of raising this issue. The ninth commandment of the Back Bencher's 10 commandments says, "Neglect the rich, the obsessed and the articulate, and seek out the silent voices." There are no voices quieter than those of people who are in residential homes for the elderly. Many of them have no relatives, or only relatives who are indifferent to their welfare. They are often broken and defensive and feel themselves to be weak, and their voices are rarely heard. The empty green leather Benches that surround us this morning are eloquent testimony to that.

As the hon. Gentleman rightly said, this campaign is enormously important. Sadly, it is not a new campaign, and although I wish him well in his plea, we have to look at the failures of the past decade. A number of early-day motions have been tabled in this Session of Parliament, the first of which was early-day motion 66, headed "Elder Abuse". There was also an early-day motion in 2000, and others in 1999, 1998, 1997, 1996, 1995 and 1994. I shall read out one of them to illustrate the fact that the position has hardly changed.

Early-day motion 1565, dated 1998, said:

"That this House is shocked by the evidence from the Alzheimers Disease Society and Age Concern on the dangers of the over-medication of the elderly; is alarmed by reports that up to one in five admissions to hospital of the elderly are caused by the misuse of medicines and by investigations in England and Scotland that found 54 per cent. and 88 per cent."—

the 54 per cent. was in Manchester and the 88 per cent. was in Glasgow—

"of prescriptions of powerful neuroleptic drugs"

to elderly residents in homes were not needed, so were "wrongly prescribed". The early-day motion calls for an improvement in care services, and

"calls on the Government to replicate the reviews nationally"—

that is, the reviews in Manchester.

There have been other parliamentary efforts, too. The Residential Care Homes and Nursing Homes (Medical Records) Bill 2000 sought to change the situation, and Adjournment debates in 1996, 1998 and 2000 made the same points—and those are not the whole story, but all the results of the activity of one MP. Others, too, have been pursuing the matter.

Whenever the issue is raised in Parliament, whenever I mention it in a question or in debate, hon. Members from both sides come up to me and say that what I have described also happened to their elderly mother-in-law, or to their father, or someone else in their family. The stories are very similar. The old people concerned went into homes, reluctantly, because they were physically frail but very alive and sharp mentally, but within a short time, they were turned into zombies. People in that condition are easy to manage. Many of us conclude that prescriptions of neuroleptic drugs are given not because of medical conditions but because it is much easier to run a home full of passive supine people who will take orders easily, than a home full of argumentative elderly people. The results for the elderly people are catastrophic.

Several studies have been carried out. One in Glasgow, which I have already mentioned, said that 88 per cent. of drugs were wrongly prescribed. As has been pointed out, that largely involves antipsychotic drugs, which are meant for people who are deeply psychotic. They are being used for an entirely different purpose—as a chemical cosh to induce lethargy in elderly people. Every study carried out by any independent body here, elsewhere in Europe or in the United States has found evidence of vast overuse of such drugs. Reactions from Governments of all colours have been discouraging and inappropriate.

The study carried out by Professor Alistair Burns, Sarah Kathryn Lloyd Craig and Lee Furniss in Manchester is probably the most celebrated. On my way to the debate this morning, I passed the Financial Secretary to the Treasury, who gave Professor Burns an award for that study when he was a Health Minister. It was a greatly encouraging study, and one assumed that the world would change after it. Professor Burns took into homes an independent group of doctors and pharmacists, who were not attached to the homes in any way, but, coming from outside, looked critically at the prescriptions being given out. Many of them were historic—people were getting prescriptions for illnesses that they had had 40 years earlier. Some of those were wholly inappropriate and clashed with other prescriptions.

The result of the study was to alter prescriptions, and greatly to reduce the number of prescriptions issued and medicines taken. The elderly people started to take milder medicines, often in lower doses. As a result, not only were their lives improved, but they made connections with members of staff and other residents. They were healthier and lived longer. Perhaps best of all—in the view of some people—there was a financial saving as well. That would have been irrelevant, because the aim was not to make financial savings, but every investigation has shown that savings result.

A similar exercise was carried out on a smaller scale in Ceredigion. The investigators did not find a significant amount of over-prescription, but they found that repeating prescriptions of appropriate medicines reduced the total amount of medication and resulted in a financial saving. Professor Alistair Burns and the others who took part demonstrated that large numbers of elderly people do not have to suffer from misery and confusion at the end of their days. We all applaud that priceless achievement.

Sadly, as suggested by the report referred to by the hon. Member for Sutton and Cheam, little progress has been made. The reasons are Government timidity and a reluctance to take on the medical establishment and challenge the opinions of doctors. A simple way to find out whether there is abuse would be to publish the percentages of residents in homes who are on dangerous drugs such as Largactil and the other neuroleptics. It would come out clearly that in some homes 100 per cent. of the residents are on neuroleptic drugs and in other homes none are. A health worker who was horrified by the drugs' effects set up his own home and decided not to allow them in. As a result, his home is successful, happy and profitable. Even that simple exercise, which would tell us where abuses are taking place, has not been undertaken.

Age Concern, Action on Elder Abuse and the Alzheimer's Disease Society have published details of heartbreaking cases. In some homes, all the residents are routinely given a pill at 6 o'clock at night. They are then put to bed and miss life, television and everything else that happens. When they wake up and wander around at 2 and 3 o'clock in the morning, they are given another pill. That is elder abuse on a large scale. There is a report in the papers this morning about the abuse of illegal drugs, but the greatest abuse of drugs takes place in this age group. We do not measure the numbers who have suffered from over-prescribing since 1993 to 1994, when the issue arose in this country, but they would be not in the hundreds or in the thousands but in the hundreds of thousands.

Is there a way out? There is in America, which, to its credit, went through this process a long time ago. Similar debates took place in the parliaments of countries such as Canada and America in previous decades. They concluded that it was necessary to institute a truly independent system of inspections, with powers attached.

The owners of care homes tell us that it is not they but the doctors who issue prescriptions, make decisions and have the power; one is quoted in the report referred to by the hon. Member for Sutton and Cheam. Of course that is right. However, there is often strong evidence of collusion; the two work together. The situation is similar to that of doctors in hospitals and prisons. There is a community of interest, and the parties close ranks.

A parallel situation exists in prisons, in which there is a routine knee-jerk reaction to women prisoners who mutilate themselves—a common action by young women who have been abused, perhaps by the care system, their family or their partner. In her book "Invisible Women", Angela Devlin described the almost universal reaction of prison officials. The doctors prescribe antipsychotic drugs, which turn the young women into what are called, in the cruel language of the prison, "muppets". Young women are given drugs that were meant for the deeply psychotic.

I am afraid that the cosy relationship between the doctors and the nursing homes is allowing the problem to continue. Often in such cases, those who are prescribed the drugs do not have an examination, or reexamination, by doctors; they are given them on the say-so of staff in homes. I join the hon. Gentleman in saying that many homes are run in an exemplary manner; the staff are dedicated, and they do jobs that most of us would be reluctant to do, and would, I suspect, be bad at doing. The tasks that they must perform are often heartbreaking, and the financial rewards are very small. They are an army of dedicated people, and I would not criticise such workers in homes for the elderly.

We look to the Government to react strongly. I have a copy of a letter that I sent to Ministers in the past, which contains terms similar to those used by the hon. Gentleman. Pleas have been made again and again, but progress is small, if there is any at all. We want to ensure that all homes are inspected. In America, prescriptions are checked monthly, then rechecked and improvements are made. If that does not happen here, the misery of a large number of unprotected and defenceless people will continue.

I seek to help hon. Members. In these 90-minute debates it is the common convention to start the winding-up speeches of the two Opposition spokespeople and the Minister 30 minutes before the end, but we are well ahead of that stage at present. In similar situations in the past—on two occasions, in my experience—a Member who spoke early has taken an inordinate length of time, which is not fair on other Members, nor on the replying Minister. I therefore earnestly appeal to hon. Members not to extend their contributions unduly, so that the time available is equitably shared.

Thank you, Mr. Deputy Speaker—but you have obviously never heard me speak before, because I do not tend to speak at length.

I thank my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) for securing the debate. This is an important subject, and I echo the thoughts of the hon. Member for Newport, West (Paul Flynn) that it is disappointing that so few hon. Members are in the Chamber. It has been a big disappointment for me on coming to Westminster to find that debates on health topics are frequently among the less well attended, and combining the subjects of health and the elderly seems to create a double problem.

I shall begin with some anecdotal evidence. I have taken a close interest in nursing homes since I was a mayor. One of the delights, or otherwise, of being a mayor is visiting all the nursing homes and care homes at Christmas, and it struck me powerfully that one could judge a home as one walked in. In some, residents are happy and lively and chat to each other—one can have an enjoyable visit, perhaps meeting old suffragettes, and all sorts. In others, residents sit in chairs and no effort is made to encourage people to communicate with one another. Often that is a result of the leadership of the owners. It is a subtle rather than a deliberate form of neglect. I found it upsetting to enter those homes, and I wondered who spoke to the residents all day.

The chemical cosh has been a problem for some years. Nearly 20 years ago—I was a pharmacist at the time—doctors were bulk prescribing for nursing homes. Prescriptions for packets of 500 tranquillisers at a time were common. Thankfully, that has changed and things have got a bit better over the years. GPs now have to take more care and pay more attention to their prescribing. They often officially endorsed whatever was going on in the nursing home—that has been hinted at already. They took the word of the nursing home owner at face value. Questions arose in my mind about that when one home that I regularly dispensed medication for changed hands. The prescriptions for antipsychotics dropped dramatically. As a pharmacy manager, I had a problem because they were left on my shelf, so I quizzed the new owners, who said that the drugs were not necessary. Since they had got over the hurdle of withdrawing them, they felt that the residents were healthier, happier and livelier—and they did not have a problem with that, because they thought that older people should be lively. Their view was certainly not that of the majority.

The research by my hon. Friend the Member for Sutton and Cheam has highlighted a 70 per cent. increase in the use of atypical antipsychotics among the over-60s in 1999–2000. We must be careful when we refer to percentages; it might be easier to use numbers, so I shall say that that means about 150,000 prescription items. There was a corresponding drop in prescribing traditional antipsychotics with more side effects, but only a drop of 2.9 per cent. There has been a big increase in the prescribing of chemical coshes.

Part of the problem—here it would be useful if the Minister could tell us what information has been given to GPs—is that when introducing such drugs one cannot treat older people in the same way as the rest of the population. Many older people are already taking various types of medication that may interact with each other, which is called polypharmacy. Because of failing kidneys or liver, they are less able to get rid of drugs when they are administered, so it is important that they begin with a low dose. If such good practice is not followed, the risk of side effects is considerable, including mental impairment, uncontrolled and involuntary movements, tremor, problems with blood pressure, sweating, incontinence, and dizziness. Those are all normal side effects of the drugs, but older people are less likely to be able to cope with them.

The side effects are very unpleasant, and could also exacerbate existing problems to a small degree. It is vital that we train staff, and GPs, in understanding the problems of older people, particularly dementia. Not enough work has been done to understand that problem and find ways to deal with people without resorting to chemical methods or some form of abuse. The poor wages in the sector have already been highlighted. Often there may be a very willing nursing home owner, but because of frequent changes of staff—working in a home is not a popular job—it is difficult to get that message across to the staff consistently.

GPs have many demands on their time, and probably do not have the time or the money to devote to this issue. Standard 9 of the national minimum standards is designed to protect people from inappropriate medication, through clear policies and procedure for dealing with medicines. However, many concerns have been raised about the fact that that the question of who will monitor that standard has not been adequately addressed. The Minister may respond to those concerns today.

Any form of restraint is a problem. I have highlighted the problems of incontinence and other side effects, and if people experience those, it can create a vicious circle. People simply sit there, not reacting to their surroundings, and the problem continues. Who will police the carers? I echo the concerns that have been expressed about the provision of adequate resources to protect people.

There is a case from close to home that, unfortunately, illustrates the point that I am trying to make. There is a nursing home whose owner has high standards, the home is kept very nicely and the residents are generally happy. However, the owner admits that he has problems from time to time, one being that he cannot be there every hour of the day. He arrived one morning to find a patient very distressed, which was unusual, because the lady in question was usually bubbly and happy. Something had obviously gone wrong. In talking to her and to the staff, who were keeping fairly quiet, he discovered that she had been taken to the toilet early in the night and forgotten, so she had been left there for hours getting cold, frightened and distressed.

The owners took that seriously, and promptly sacked the nurse in question. The nurse appealed and took them to an industrial tribunal, but they were on safe ground. I found it particularly appalling that the nurse was then able to enrol with an agency and earn a living filling in at nursing homes throughout the area. The story has a relatively happy ending, because the nurse eventually appeared before the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, which removed her from the register. However, for 18 months she had been able to subject other old people to neglect or abuse.

Sometimes the abuse is unthinking rather than deliberate, which is why we need to get the message across about positive ways of looking after our elderly people. A Counsel and Care publication, putting it very well, says:

"An act of omission rather than a deliberate act of tying a knot or turning a key can restrain residents, and staff may not be consciously aware that they are doing it."

The phrase "consciously aware" is the key. The problem is connected with education. The publication continues:

"Staff might think that, "He has had a good day today, he has been sitting quietly in his room." In fact, the resident might not have been given his walking stick, or he might still have his breakfast tray fastened across his lap. He might desperately want to get up to go to the toilet, go for a walk, or simply relieve the pressure on his lower back, but he can't. So he sits, having a quiet day."

There is a cultural perception with older people, as there is with children, that if they are quiet it must be good. That is not necessarily the case.

I would also like to echo the comments of the hon. Member for Newport, West about how residents feel that they cannot stand up for themselves, while their relatives, who perhaps do not visit as often as they should, do not want to make a fuss either. There is often an advocacy problem. Has that ever been considered or dealt with?

To sum up, I will list certain ideas or suggestions. First, does the Minister agree that it would be helpful to have an annual review of prescribing for elderly people? If that could not be done for all elderly people, perhaps a way of monitoring prescribing in care homes could be devised. If over-prescribing is a growing trend, that is a problem, particularly with an increasingly elderly population.

A comprehensive annual review would undoubtedly be a useful tool. As the hon. Member for Newport, West and I have said, medication reviews need to be much more frequent to prevent the damage and harm that can be done in a very short time. If the concentrations are wrong, the effects can quickly become devastating.

I agree with my hon. Friend, but much of that comes back to the fact that GPs do not necessarily have the time or the inclination to deal with what may seem a small part of their work load. We certainly have to address the problem from an educational viewpoint. Here I should put in a plug for my fellow professionals, the pharmacists, who are in an ideal position to monitor medication. Some already do so, and are paid for visiting homes, but not all homes are keen to take up that offer. Perhaps we should move in that direction.

Who can give real advice about antipsychotic drugs? One could accept guidance from the National Institute for Clinical Excellence if nothing else was available, but the trouble is that NICE considers only one drug at a time. It does not consider other drugs that could be prescribed for the same symptoms, and its prescribing recommendations can mean that other medications suffer. We need some helpful guidelines on when it is appropriate to prescribe particular types of antipsychotic.

The problem has been highlighted for a number of years, but the impression that I gained from listening to the hon. Member for Newport, West was that little has been done and that the problem is ignored—probably for the same reasons as there are so few of us here today. Have the Government any plans to study the abuse of the elderly, as suggested by my hon. Friend the Member for Sutton and Cheam? Will increased resources be made available to the National Care Standards Commission?

The other problem, at least in my locality, is that the local authority rate paid to nursing homes is low, and most relatives are forced to top up the nursing home fees. The problem about a low rate being paid is that inadequate attention is sometimes paid to providing the best possible service. However, some homes manage it, and we need to find a way of spreading that best practice. Increasing the grant from local authorities might help. We would then be assured that nursing homes would not have to resort to the measures that have been highlighted so eloquently today.

I add my congratulations to the hon. Member for Sutton and Cheam (Mr. Burstow) for giving us the opportunity to debate this important issue. As he said, it is a taboo subject to many people.

All too often, when considering abuse one thinks of child abuse. That emphasis can be seen in many social services budgets, because a significant proportion of their money each year is spent on the protection of children and their interests. I do not criticise that, but society concentrates on the problems of children and the horrendous problems of child abuse, with which we are far too familiar, to the exclusion of elder abuse. That is partly because many people do not realise that such a problem exists. It is either swept under the carpet or, because we are dealing with adults, people are unable to reconcile themselves to the fact that it occurs. As previous speakers have made clear, that fallacy needs to be addressed.

Sadly, far more elder abuse takes place than one realises, although as hon. Members have said, part of the problem is a general lack of understanding. There is also a lack of information, which, together with the fact that people do not understand the problem, means that one cannot realistically quantify the level of abuse that exists. There are various types of abuse. The obvious forms of abuse are physical, but far more insidious is psychological abuse. The latter is particularly cruel to the vulnerable and the weak, but it is also particularly difficult to prove and to combat.

There are also financial abuses. The Court of Protection can of course help, but all too often it does not play as sound and vigorous a role as one would hope in protecting the interests of those who can no longer look after their own financial and other affairs. Finally, there are the issues of sexual abuse—however distasteful that may be—and neglect, which, like psychological abuse, can be difficult to pinpoint and combat.

One difficultly is that abuse can happen anywhere—in the homes of the individual or of a carer, in residential or nursing homes, and even in hospitals. None of us should make the mistake of grossly generalising and tarring everyone with the same brush. The vast majority of privately owned and local authority owned residential and nursing homes, and the vast majority of medical staff in national health service and private hospitals, do a first-class job of looking after the elderly and other members of society. It would be unfortunate if carers and professionals in nursing were tarred with the same brush as the few who cause the elderly so much misery and suffering.

The scant evidence available suggests that, ironically, most abuse is carried out by individuals who are well known to the person who is being abused. We have a duty to ensure that elderly members of society have the right to a standard of living that is as high as possible—the standard that we would seek for ourselves. We also have a duty to ensure that they enjoy the dignity to which they are entitled.

The sad fact of life is, however, that changes that have occurred in society over the past 20 to 40 years are placing, a strain on the elderly. I have in mind greater mobility—younger family members sometimes need to leave the traditional home to search for work in other parts of the country—and the breakdown of the concept of family that existed 40 years ago. Family members often do not live close to each other, as they would have done 40 years ago. There is, therefore, no family support system, although the problem does not affect the elderly alone. Young families with children often do not have the stabilising influence of grandparents who can provide support. All too often, family members move away from the area in which they were born and brought up, and grandparents and elderly parents become isolated because there is no family support system. There is, therefore, an increasing reliance on agencies and on other forms of accommodation for the elderly, which can give rise to a greater propensity for abuse.

One comes to realise, from acquaintance with organisations such as Action on Elder Abuse, that there is great ignorance on this subject, and that abuse is carried out for a variety of reasons.

There are elderly people who are fortunate enough to be still living in their own homes, possibly with a carer or a domiciliary care package to help them to remain in those familiar surroundings, but abuse can arise from poor long-term relationships in the home, or a carer's inability to provide the required level of care. Sometimes the carer has mental or physical problems. There is a considerable and increasing burden on carers. The statistics, which reveal a worrying prospect for the future, show that people who care for elderly people are becoming older. Many of them are pensioners themselves. That causes a problem, not just because of the strains, frustrations and difficulties of caring for someone, but because the carers will have their own problems and hardships.

In other settings, such as residential or nursing homes, abuse is thought to be more often a symptom of staffing problems. Some staff may be poorly trained or supervised, or have little support from management in carrying out their duties. They may also work in isolation, which puts strains and pressures on them.

It is necessary to consider how to move forward. That does not involve the Government alone, although of course they have a role, which I am sure the Minister will fully accept. There are no differences of opinion among hon. Members about the problem, and I suspect that there will be little difference between our views about what we need to achieve. However, we should also pay tribute to the organisations that work with the elderly, providing support and back-up and playing a key role in enhancing elderly people's quality of life, as well as trying to minimise opportunities for abuse.

More needs to be done. Many hon. Members have talked about raising care standards, which is critical. As the hon. Member for Sutton and Cheam said, we are not talking about the size of rooms, or whether there is a lift. We are concerned about raising standards among people who look after elderly people in residential or nursing homes and people who provide domiciliary care for those able to remain in their homes. Of course the National Care Standards Commission has an important role to play. Similarly, more care and help is needed for carers, to reduce their feelings of isolation and frustration.

Ironically, it was only this morning that I was talking to someone who told me about the frustration felt by carers when, with all the other work that they do, they need to talk to someone from the authorities, such as a doctor or representative of the social services department. All too often they are told that the person in authority is not prepared to discuss the problem with them, but will speak only to the individual concerned. That is ludicrous in many cases, particularly if the elderly person is suffering from dementia or Alzheimer's disease. Such people cannot rationalise the problem that must be discussed with the agency, and there should be a more sympathetic and realistic approach.

The hon. Gentleman is making an important point. Many have experienced the practical difficulty that the system does not allow for another person to take decisions on health and welfare matters when someone has lost the mental capacity to make decisions on their own behalf. Would he agree that there is a need to examine and change the law in that regard?

I would agree that the matter must be reconsidered carefully, because the situation is unsatisfactory, but I hesitate to give a knee-jerk reaction in favour of new legislation, even after the hon. Gentleman's valid intervention, without seeing more evidence about the extent of the problem and hearing further suggestions about sensible improvements. It is dangerous to call automatically for legislation as a solution. If one has enough evidence to justify changes in the law, they should be considered, but I would not want to give a blanket call for a change in the law at this stage. I agree that something must be done to provide more co-operation and assistance for carers in that respect, as it is deeply frustrating for them to have to cope with the bureaucracy on top of everything else.

All the hon. Members who have spoken have talked about the use of medication. I do not think anyone would disagree that it is deeply distasteful and morally wrong to fill elderly people up with pills and keep them sedated and quiet simply to give those who look after them an easy life. It is not right to take the easy option of pill-popping for a quiet life. More must be done to solve that problem, and we must discover sensible ways of stopping that from happening.

More protection must be given to those vulnerable people, especially those who are senile or approaching senility and who do not have complete control over their lives. One hears stories of unscrupulous staff who, while in a position of responsibility looking after those people, plunder their assets.

I know of a case of an elderly lady, living in a residential home, who owned an original Lowry and kept it in her room. When she died, the picture had disappeared by the time her stepdaughter arrived at the home a few hours later. The nurse who had been looking after the lady was a locum who, as was established after a complaint to the police, had taken the picture upon her death. When the police tracked the nurse down, she said, "The picture is mine. The old lady said I could have it when she died." When the old lady had entered the nursing home, however, she was in no fit mental state to give anything to anyone. I have serious doubts that the picture was ever promised to the nurse—indeed, it could not have been, because the lady was not of sound mind. Yet in the light of that interview the police decided not to pursue the matter any further. Only when the stepdaughter decided to take out a private prosecution, because the picture had turned up for sale at an auction house in Sussex, did the nurse back off and return the picture. However, there was no prosecution and the family involved in the situation—which dragged on for about 18 months—felt let down by the police because it seemed clear that the lady concerned was in no fit mental state at any stage, from the moment she entered the residential home, to make a rational decision about giving her possessions to anyone.

I wonder how frequently elderly people are abused in that way by a small minority of unscrupulous people who prey on them in the hope that they will never be prosecuted, or even found out, because of the state of their victims? More attention should be given to the matter. The picture was sold at Christie's in London about two years later and reached the record price for the sale of a Lowry. This was an object worth not a few hundred pounds, but—from memory—almost six figures.

We have been fortunate in the success of the hon. Member for Sutton and Cheam in securing this debate. The issue is too often swept under the carpet; people either refuse to accept that there is a problem, or, because it is in many ways such a horrendous problem, they do not want to confront it. More must be done to eradicate this obscenity from our society.

Before I call the Minister to reply, may I indicate that as this is a critical debate—indeed, I am sorry that I was not in the Chair for the beginning of it—I hope that she will use the maximum time permitted for her reply if she needs it.

I begin by concurring with your comments, Mr. Deputy Speaker. This is an extremely important debate. I am delighted that the hon. Member for Sutton and Cheam (Mr. Burstow) has secured it and given us an opportunity to hear from other hon. Members. I am sorry that there are not more of our Back-Bench colleagues present, although the quality of the contributions has not been any the lower for that. I know that my hon. Friend the Member for Newport, West (Paul Flynn) has a long and proud record of having raised such issues, particularly in relation to medication, on which he is probably far more of an expert than I shall ever be. He has made a great contribution to the on-going debate and it is important for us to pursue it.

I am grateful to the hon. Member for Sutton and Cheam for having given me notice of the areas of concern that he wanted to highlight. I hope to cover them in some detail, and, perhaps, to offer him reassurance. The first is the overarching legal framework in which the issue of elder abuse can be addressed. Secondly, he mentioned training, qualifications and the standard of staff providing care for elderly people—a crucial issue. As he said, quality of care is not about the width of doorways, passenger lifts, and room dimensions—although those things are important; physical standards and the environment in which people are cared for are matters of great concern. The time taken to talk, to listen and to interact with elderly people is key to their sense of well-being, so I particularly want to talk about training.

The third issue is resources. We must look at the adequacy of the National Care Standards Commission, what its budget will be, whether it will be able to monitor not just physical standards but the quality of care given in residential settings, what the numbers of employees will be and how they will draw on the work of other professionals, not simply the commission, to ensure that the picture is fully rounded.

The final subject raised was the important issue of medication, which prompts several questions, such as how often medication should be reviewed, and what systems are being put in place to prevent inappropriate prescribing and over-prescribing of medication for elderly people, particularly, but not exclusively, in residential care settings. Many elderly people are now supported to live in their own homes by intensive domiciliary care packages, which will be regulated for the first time. We should not think that the care of elderly people is only about residential care. I hope that in the future, it will increasingly be about maintaining people's independence in their own homes, which is how most elderly people want to be cared for.

I hope to cover a great deal of ground in my response. The hon. Member for Romsey (Sandra Gidley) said that on her visits to care homes, she had seen dramatic variations in standards of care. I am sure that all hon. Members will have visited care homes, either to see family or friends or to see constituents, and many of us would echo the hon. Lady's comment that to lay people, standards of care seem to vary dramatically from one care setting to another. This is an issue involving leadership, and the ethos set for their staff by people who run care homes. That brings me back not only to training, but to the stability of the care home sector. Stability is important so that people can plan for the future and provide not just a business but a residential care establishment of high quality. Therefore, some issues go beyond care standards and relate to the stability of the whole sector. If we want a substantial well founded residential care sector that can meet the necessary standards, we must think ahead to where we will be in five or 10 years' time and consider the sort of care that can be provided.

The Government share hon. Members' concern about elder abuse. We are trying to ensure that there is a comprehensive framework to minimise the prospect of such incidents occurring. However, I want to put it on record at the outset that cases of deliberate elder abuse are very few, and I am thankful for that. Our real concern should be directed towards abuse that results from poor quality and inadequate care. Cases of deliberate neglect and abuse are in a tiny minority.

Would the Minister not describe the over-prescribing of neuroleptics as deliberate?

If a deliberate decision were taken that was not in the best interests of a patient who was receiving medication from their GP, that would be a matter of concern not only to the Government but to the authorities who regulate health care professionals. We are talking about the extent of prescribing and the effects of over-prescribing. A deliberate clinical decision to harm a patient would be abuse, but we are not talking about that. There are issues surrounding the over-prescribing of antipsychotic drugs, but I am certainly unaware of any widespread, deliberate clinical decisions to harm patients, so it would be wrong to consider the issue in those narrow and restricted terms.

I want to put on record my appreciation of the immense dedication of thousands of members of staff who work in sometimes intense, pressured situations, caring for elderly people in residential care settings. Many of them do a first-class job caring for people, so we should ensure that our debate remains in that context. One of the worst things that we can do is to drive down the morale of people who are working extremely hard, often on very low pay, at the sharp end of care in our communities.

I also want to thank the charities and other organisations that advocate for older people and try to push relevant issues up the agenda. Action on Elder Abuse has campaigned tirelessly to ensure that the issues are in the public domain. Local authorities such as Lewisham, Cornwall, Sheffield and Surrey have developed adult protection procedures through their social services departments to co-ordinate the response of relevant agencies to abuse. That mirrors the child protection multi-agency machinery that we are developing.

Such matters are not the responsibility of one agency. There are several statutory and voluntary organisations that must work together to ensure that incidents are minimised and that when they do occur, there is a proper, considered response.

My hon. Friend is rightly focusing on the positive aspects of the care of the elderly, which should be stressed. Perhaps we have neglected one area during the debate: the wonderful work done to expand the lives of elderly people through new technology. The infirm and those who are seriously handicapped can be liberated to roam across the vast prairies of the world wide web. That has greatly expanded the life experience of elderly people. We should commend organisations such as Hairnet, and the local authorities that have encouraged the development of fuller and richer lives for elderly people in residential homes and elsewhere.

My hon. Friend is right. I read a report about that from a community organisation in my constituency, where some elderly ladies in their late 80s have obtained their first new technology qualification. They are surfing the web with real enjoyment. That means that increasingly well armed and knowledgeable constituents will raise serious issues at our surgeries. New technology can allow interaction with the outside community even for people with physical infirmities.

The Government take the regulatory framework seriously. We began with the White Paper in 1998, and subsequently passed the Care Standards Act 2000, which put the aspirations of the White Paper into law. New regulatory frameworks are being introduced for residential care and nursing homes and agencies. Moreover, for the first time we will regulate domiciliary care agencies. The framework will be overseen by the National Care Standards Commission. Those are significant steps, and I am glad that the hon. Member for Sutton and Cheam welcomed the introduction of the commission, and the national service framework for older people. Those are recent significant steps in ensuring that we have a more coherent regulatory framework for the care of the elderly.

I would like to draw the attention of hon. Members to the creation of the protection of vulnerable adults list. In health and social care for vulnerable adults, the list will introduce a ban on workers who have harmed such individuals. The list will be similar to those in other public services: if it is proven that someone has harmed a vulnerable adult, they will not be re-employed. That is a significant step in providing real protection for older people.

The gateway to the system will be through the already established Criminal Records Bureau. A person included in the list must not be offered employment in a care worker position. If an employer has a reasonable belief that a care worker has abused a vulnerable adult, that worker must be referred to the Secretary of State for provisional inclusion on the protection of vulnerable adults list, even if the person is an ex-employee or retired. If the Secretary of State decides to include the person's name provisionally, inquiries will be undertaken to decide whether that inclusion should be permanent. Individuals may appeal to the tribunal if they have been put on the list. That is a significant step to ensure that we have a proper record. As in the case raised by the hon. Member for Romsey, if someone has harmed an older person, that individual should not be re-employed in the same service and allowed to continue such behaviour.

We also have the General Social Care Council, which will regulate the work force. Qualified social workers will be the first group to be registered, but we expect residential care home managers to be in the next group. In order to be registered with the GSCC, a person will have to demonstrate that they are of good character, physically and mentally fit to carry out the work for which they seek registration, and competent to do so, having attained a proper level of training.

Can the Minister tell us when she expects front-line care workers to be registered with the GSCC? Given that she has said that a small minority of staff go through due process and are reported for direct abuse, does she agree that although the list is a welcome addition, there is still a need for research that will give us a better picture of the entire iceberg, and not just its tip?

I will come later to research—an important matter, which the hon. Gentleman has already raised. I cannot give him a specific date on which front-line workers will be registered, because the process is on-going. We are starting with social workers and moving on to residential care home managers. We want to ensure that the whole of the work force who are in contact with elderly people are properly regulated and trained. Those are new measures, which are part of the new regulatory framework. Let us see how it settles down and beds in, and how we can begin to roll out a more extensive programme.

It is easy to call for overnight action on issues that have been outstanding for decades. Action is beginning to be taken, and we have to ensure that we set challenging targets that are also realistic. There are people out there who care for many elderly people. If our targets are not realistic and do not inspire confidence that they can be achieved, we will be in danger of setting our sights too high and setting people up to fail, which is the last thing we want. The most sensible way forward is the twin-track approach of setting new challenging targets and seeing how we can meet them.

In terms of training, we have set up a new fund specifically to ensure that we train people on induction standards when they first come into the sector. We should try to have a properly qualified social care work force, wherever people are working. Again, the record on that issue is poor. The National Training Organisation for Social Care published its training strategy—the first national strategy—in July 2000. That strategy includes details of the training and qualifications that care staff should have, starting with induction training for new staff.

In 2001–02, £2 million was set aside for induction training. Those standards cover essential elements such as understanding the principles of care and understanding the experiences and the particular needs of the service user group. The standards look at training from the point of view of the people who are being cared for, rather than from the point of view of the profession. That is a significant change that places patients and service users at the centre of the services that we are trying to set up. It will ensure that training is relevant to the needs of the people who are being cared for.

The National Care Standards Commission's national minimum standards include standards for training and qualifications for both care staff and managers. Those standards start with the induction training that new staff should undertake within six weeks of commencing their employment. They will move through foundation training to a competence-based qualification. In that way care staff will be more confident about their work, and I hope that they will take a more mature attitude to it.

There are about 1 million people in the social care work force, but only 20 per cent. of them have a relevant qualification. As I have said, we have to be realistic because we cannot expect to get everybody qualified overnight. We must ensure that services are still provided while staff are undertaking qualifications. We also have to know that there is sufficient capacity on the supply side with staff coming through. We must address the relatively low pay, and the fact that that kind of work has been undervalued.

The Minister is right that there is a question about capacity. Can she assure us that when we get to 2005 and half of all care staff have to be trained to NVQ2 level, capacity will not become a reason for allowing the standard not to be applied in full from that date?

We have set a target for 50 per cent. of care staff in residential care homes for older people to hold an NVQ2, and we aim to meet that target. There should be no excuses for having unqualified staff in a very important service. One way of raising the value of work in the sector, and thereby attracting more people to work in it, is to ensure that there is access to proper qualifications. We want to make faster progress if we can; that is why we have set that target.

The hon. Gentleman mentioned staff struggling with numeracy and literacy. There are some 10,000 people in the national health service as a whole who have such problems. We have a huge problem with access to basic skills in this country, so training in that area must also be considered.

We have care standards, the protection of vulnerable adults list, the qualifications required by the GSCC, the No Secrets guidance and the National Care Standards Commission. Let us see how that regulatory framework beds in and works. The overarching criminal law also provides for action to be taken when there are unfortunate incidents. We believe that that regulatory framework is an appropriate way forward.

Several hon. Members have mentioned overmedication and the over-prescription and inappropriate use of antipsychotic drugs for older people. The hon. Member for Sutton and Cheam has set out some of the research on that in his report, and I understand that he is awaiting a reply from the Minister of State, Department of Health, my hon. Friend the Member for Redditch (Jacqui Smith), which I am sure he will receive shortly.

We agree that excessive and inappropriate use of antipsychotics is a form of abuse. Because of our concern, we have tried to examine the available data on the change in prescribing rates of typical and atypical antipsychotics. The picture is complex and there is not one single explanation for the changes. The data that we have are captured from the Prescription Pricing Authority are about changes during the past year. The hon. Member for Romsey quoted the figures that show that prescribing of atypical antipsychotic drugs has increased. There is a reduction in the prescription of typical antipsychotic drugs, but that does not account for the whole difference in prescribing.

We are currently considering research on antipsychotic drugs in different care settings and the recommendation to ask the National Institute for Clinical Excellence to produce guidance on the use of such drugs for older people. That is an important field of research. It is difficult to drill down into what the data from the Prescription Pricing Authority really mean in residential care settings and in the community for older and younger people.

It is possible that the prescription of atypical antipsychotic drugs has increased because care for older people is catching up with trends in care for younger people, where there is an increasing use of modern drugs that have fewer side effects and are more beneficial. However, I do not think that that is the full explanation. The request for research is important.

On restraint, and the report from Counsel and Care, I reassure hon. Members that the care standards require that

"service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self-harm, inhumane or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies."

I believe that that standard is sufficiently wide to cover inappropriate restraint. That is important, and enforcing the standard will therefore be the key.

We have been asked how many inspectors the commission will have. I understand that the ratio of inspectors to homes will be approximately the same as at present—one inspector to 27 establishments—but because there will be a single and consistent regulatory regime, the arrangement is likely to be more efficient. At present, there are several different regimes, and people operate to different standards, which means that we do not make the best use of available resources. Increasingly, new technology will be used, which will give us an opportunity to do that.

I understand that inspectors will have access to 66 full-time equivalent pharmacist inspectors, who will help with the whole medicines management programme. Pharmacists play a key role in ensuring that medicines are managed properly and that there is regular review. We are beginning annual reviews for people over 75, and the prescriptions of people taking four or more medicines will be reviewed every six months. Let us see how the reviews work, because they represent significant steps forward in ensuring that medicines are managed properly.

In my 15 years' experience as a councillor and almost five years as an MP, it has become clear that planning issues are one of the most prominent vehicles for promoting interest and involvement in local democratic processes. Popular involvement is not just a product of NIMBYism or of a knee-jerk reaction against change, but of people's genuine concern for their community, their environment and future generations. Members of Parliament talk a great deal about the decline in democracy. We want to overcome apathy and answer the charge that we do not listen. If we are to rebuild our democracy from the ground up, what better place to start than with a review of planning?

There are some positive aspects to the planning Green Paper. For example, all councils will have to open up planning committee meetings to public participation. The Government are to expand the planning advice service. I stress that the details must be worked out soon and the resource commitments made, so that the Government can ensure that communities genuinely believe that their role is being enhanced and supported. Councils will be required to give reasons for decisions to approve planning applications, with reference to planning policies; that is already good practice among many local authorities, including Leeds city council. I understand that the Government are reviewing current enforcement arrangements and whether a deliberate breach of planning regulations should constitute an offence immediately pursuable through the courts; that would be welcome. I am also attracted by the idea floated in the Green Paper regarding mediation, which might help deal with some of the cases that come to Members' attention.

The accent on community involvement in local development frameworks and action plans is a welcome principle. However, the plans must be relevant to people, communities and their perceptions of problems and challenges; otherwise, they will appear to be abstract and bureaucratic exercises, and will attract little participation. The deficiencies of plans will come to the fore when they are tested and found wanting against specific planning applications that excite real community attention, anxiety and opposition.

The development frameworks and action plans must clearly and specifically address the concerns of our constituents on issues such as housing and other developments that place extra pressure on the local infrastructure of roads, public transport, school places and health care provision, such as GPs. They must also place mobile phone mast applications in a clear structure and move away from the current ad hoc approach.

Contrary to the Green Paper's assertion, compiling and keeping local development frameworks and action plans up to date will be labour-intensive, especially for large local authorities such as Leeds city council. Drawing up action plans in an area such as Leeds will be very time-consuming, and I cannot think of many communities in my constituency, or across the whole of the city, that will not want their own action plan in addition to the local development framework. Will the Minister explain who will decide where action plans are desirable or required?

The idea of developers engaging the community as a material consideration in the planning process is also a worthy principle. In practice, it is unfortunately more of a selling job than an attempt to find common ground. On two recent occasions, I have heard developers quote planning policy guidance 3—PPG3—to justify inappropriate and over-intensive proposals, and portray that as a simple wish to carry out the Government's will. Surely it is not the Government's intention that such cynical engagement with the community should count in developers' favour.

I am worried about what is contained in paragraph 4.26 of the Green Paper. It refers to representation at inquiries into local development frameworks and action plans. It implies that the Government are thinking about withdrawing the right to have objections to a local plan heard in front of an inspector at a public inquiry. The Green Paper states that such a system has proved to be "time consuming and adversarial".

I hate to be a cynical old student of humanity and human psychology, but relationships between communities and developers are often hostile and adversarial—that is inescapable. Communities regard the situation as a David and Goliath battle, and we have often seen headlines couched in such terms. However, as I read the Green Paper, it seems that the Government have taken pity on poor old Goliath against the upstart David. The Green Paper also suggests that the future system might be based on informal hearings or examinations in public. The Government seem to be proposing the removal of a tangible and defined statutory right of participation and replacing it with something vaguer that relates to public involvement.

To be effective, public participation must be founded on real, legally enforceable rights, not on a set of voluntary or discretionary opportunities. The system must cater for conflict and aggrieved parties, as well as promote consensus.

In paragraph 5.2, the Green Paper states that the present system of development control is not customer friendly. Who do we mean by customers in that context—the applicants? Are not individuals, neighbours, council tax payers and communities customers too? They certainly pay for the services and expect to have their interests protected. The paper provokes other fears that local community interests may not be adequately protected. For example, new business zones will be introduced in which developers will not have to apply for planning consent.

Under the previous, Conservative Government, we witnessed what can happen when areas are excluded from the normal democratic and accountable planning processes. We have some good examples in Leeds. The Green Paper tells us that important national policy, such as planning policy guidance notes on nature conservation, will be slimmed down. Can the Minister confirm that that is not a euphemism for diluted? It states that Parliament will be able to grant permission for a wide range of projects, including large-scale quarrying and opencast mining, chemical plants and roads over 30 km. However, Parliament is not best placed for dealing with major site-specific proposals. Lobbying an MP—no matter how brilliant we are—especially on whipped business, is not the same as having access to a public inquiry.

The Green Paper seeks to strip powers from directly elected county councils and unitary authorities, and to hand them to unelected regional planning bodies. The membership of those bodies is not made clear, but Lord Falconer confirmed in his evidence to the Select Committee that the Secretary of State would have the final veto on their membership. The Green Paper refers to local strategic partnerships and their importance. Those organisations may fulfil a useful economic regeneration function, but are not democratically accountable and should not be given influence in establishing the grounds for local public participation.

Finally, I turn to my hobbyhorse, on which I have tabled questions and an early-day motion: the third-party right of appeal on planning applications. In the Green Paper, the Government, quite wrongly, dismiss out of hand that right of appeal. They may have thought that dismissing the idea at the outset would make it go away; as always, the reverse it true. We have a system under which councils are held to be infallible when they grant planning applications, but fallible when they refuse them. In other words, developers can appeal if planning permission is refused, but communities cannot appeal when it is granted.

When I say that there are many reasons why we need at least a restricted right of appeal, I am talking not about Mrs. Scroggins appealing against the granting of planning permission for her next-door neighbour's conservatory, but about important major applications. I say that we need such a right, because, as a former council member, I am more than aware of the fact that councils are not perfect. Decisions can be finely balanced, and developers can be given the benefit of the doubt. Pressure from the district auditor can sometimes make councils sensitive about refusing too many applications, because those involved might appeal. Local authorities are also under pressure to meet housing quotas and—sometimes spuriously, as I shall show in a moment—to protect jobs. In some cases, they might even be the applicants. Finally, there are cases in which planning officers have recommended refusal, but local authority members have exercised their obvious prerogative to overturn that recommendation.

The case that the Government make in the Green Paper against a third-party right of appeal is intellectually and politically unsustainable. I hope that the Minister will not use her Department's intentions to improve the front-end community involvement aspects of the system as a pretext for preventing people from picking up controversial planning applications through a third-party right of appeal at the end of the process. I am sure that she will not suggest that calling in by the Secretary of State, judicial reviews or reference to the ombudsman will help to redress the balance as far as the community is concerned. Improving the pre-decision community involvement process is valuable and to be welcomed, but it is no good on its own. It is a bit like saying that someone can have the best defence lawyers that money can buy but that he will have no right of appeal if the jury convicts him, no matter how perversely.

Lord Falconer has impressed many people—including myself, I must say—with his grasp of the planning brief, his advocacy of the Green Paper, his willingness to debate and his huge charm. I should, however, tell him that one can be a friend of businesses without being its fall guy.

There are numerous examples in my constituency of sites that have been redesignated from employment to housing use. If the local development framework or the action plan can be ignored as easily as the unitary development plan is, we shall be back at square one. Again, that reinforces the need for a third-party right of appeal over major applications. What use is a unitary development plan, a local development framework or an action plan to the community—even where the community has been involved in drawing it up—if departures from it cannot be challenged on appeal? If there is a third-party right of appeal against such departures, the onus will surely be on the council to ensure that it gets its plans right in the first place.

Let me conclude with an example that best demonstrates why we need a third-party right of appeal. Silver Cross, the renowned pram maker, is based in Guiseley, in my constituency. Several years ago, the old family-owned company was in trouble. Consultants arrived on the scene, immediately cut the work force to 30 and came up with a recovery package that required the sale of half the site for housing. If that was not done, they threatened, the company and the remaining jobs would disappear.

The community was rightly up in arms, given the congestion that already existed on the A65 and the pressure on school places and facilities such as GP practices. The council, however, being only human, reluctantly succumbed to the threat contained in the planning application. Half the site was redesignated for housing, and planning permission was subsequently granted. The consultants then pocketed the £2 million proceeds from the sale of the site and sold the company on. The current owners, who are making a real go of the business and taking on 50 workers, are left bemoaning the loss of the rest of the site and the valuable warehousing that it contained. We are looking at massive community opposition, a reluctant council with a gun held to its head, a change in the designation of the site from employment to housing and the serious undermining of the viability of the remaining employment site. If ever a case called for a third-party right of appeal, this one does.

The Green Paper and the planning review teeter on the brink of enhancing community involvement and protecting the planning process. On behalf of the communities in my constituency, which are probably no different from those throughout the country, I do not ask for the earth; I ask only for some level ground.

I thank my hon. Friend the Member for Pudsey (Mr. Truswell) for raising this important matter. Issues relating to planning and development often generate intense community interest and scrutiny. It is often thought that planning is a dry subject, but his experience and mine do not support that view. People can be dramatically affected by the quality of their environment; they care deeply about what happens to it and about changes that take place around the areas in which they live and work.

The Government recognise the need for a planning system that engages people in shaping the future of their communities and gives them the chance to have a say. To be successful, the planning system must have the confidence of all parties. My hon. Friend asked who the consumers are. Anyone who is affected by plans and planning applications is a consumer—the term embraces the public, the business community, who have an interest in seeing successful results, and all who care about proposals for the development of their areas.

I shall deal partly with the existing system and partly with the Green Paper, on which we are still consulting. I assume that part of the point of today's debate is to ensure that the views of my hon. Friend are fed into that consultation.

It is right that people who are affected by a plan or who have an interest in the development of an area should have the opportunity to make their views known and to have them taken into account. The system already provides such opportunities. However, in the past, people either heard about planning proposals far too late or, although they theoretically had a right to be heard, were not able to exercise that right.

The planning Green Paper, published on 12 December, puts forward robust proposals to rectify that. They are designed to strengthen the opportunities for people to comment on and influence development proposals, even before a planning application has been submitted.

I shall explain some of those changes, including the third-party right of appeal, in which my hon. Friend is particularly interested. There is an issue about the local development frameworks. In recent years, the scope for communities to participate effectively in the planning process has been enhanced by the requirement that development plan policies be adopted only after widespread consultation, and the statutory requirement for all planning applications to be publicised. However, we must do more than merely consult. We intend to deliver a planning system that better engages communities and secures their effective involvement and ownership.

We propose real community participation in the preparation of our new local development frameworks, especially in drawing up action plans—I shall deal with my hon. Friend's question on those—which bear on local areas and may result in the regeneration or conservation of particular neighbourhoods. I am sure that my hon. Friend will recall development plans that ended up being 10 years out of date before they were even produced. One of the aims of the proposed changes is to ensure that we have documents that are current and relevant to a changing built and natural environment, and that are not out of date before they are completed.

The confusing complexity of the current system does little to promote public confidence or to encourage community engagement. We shall simplify the complex hierarchical system of plans and replace local plans with new local development frameworks. Those will connect with the local community strategy and help to put into practice the policies that it contains. The framework will include a clear set of criteria by which local authorities will be able to steer development and use growth to bring about the vision for their areas. Action plans will be drawn up for town centres, neighbourhoods and villages, and those will be the focus for local participation.

My hon. Friend asked whether local communities would be able to requisition, as it were, the plans. I appreciate his point, but we do not envisage that; however, we expect close working relations between a local authority and the community, and the local authority should be sensitive and responsive to the views of the community with respect to a range of activities.

The point that I was trying to make was that a framework that applies to a whole city will necessarily be somewhat vague and not relevant to particular communities. If those cannot, to use my hon. Friend's term, "requisition" a local action plan, I fear that the Government will fail to engage them any more than the current process does.

I take my hon. Friend's point, but we expect the local authority, through such mechanisms as a community strategy, to be alive to the concerns of communities and the areas in which action plans are needed. My hon. Friend was also concerned about local strategic partnerships and I want to go on to deal with them.

Under the present system, everyone has a right to make objections to draft local plans, and to have those heard, usually in a public inquiry. However, that approach can sometimes be time consuming and adversarial. We seek a better way to test the new local development frameworks. Under our proposal, we shall encourage all local authorities to work with local strategic partnerships to establish effective mechanisms for community involvement, building on their work preparing community strategies.

My hon. Friend questioned the democratic credentials of the local strategic partnership. They are being carefully developed around the country, but in particular in the most disadvantaged areas, with careful structuring to involve local businesses, residents, tenants and voluntary groups. We see them as extending, not replacing, the democratic credentials of the local authority and extending the effectiveness of the local authority's links with the community. The proposals on community advocacy in the Green Paper would support the ability of relevant groups to prepare and present their cases more effectively.

We propose that the local development framework should contain a statement of community involvement, setting out how the community should be involved in the continuing review of the framework and in commenting on significant planning applications. The statement will set the standard for good practice in engaging those with an interest in proposed developments. I hope that that provides some reassurance.

My hon. Friend mentioned large developments in particular. We propose that compliance with the terms of the statement, and its requirements for engaging the community, should be a "material consideration " supporting a planning application. As my hon. Friend probably knows, that term, used by planners, would denote that the amount and quality of public consultation would be a factor that could be taken into account in determining a planning application. That is in keeping with our view that there is mutual benefit to developers and communities in working together to plan developments that are likely to have a major impact on a locality.

My hon. Friend referred to the David and Goliath relationship that is usual between community and developer, and the fact that they are seldom in agreement. That is sometimes so, but equally in some cases the developer and the community work hand in glove and the developer is careful to ensure that the community is supportive. Some might cynically say that that sometimes happens if the proposed development would conflict with a PPG, but that is not necessarily so. Best practice would avoid conflict between the developer and the community.

I shall deal with some of the issues surrounding development control, so that I can deal with some of my hon. Friend's points. Master planning of major sites will help developers plan for higher quality development in partnership with local authorities. There will be clearer information for planning applicants and new requirements for openness and accountability within the planning process.

Master planning means that an overall vision or development brief for an area is set out so that people can understand clearly what the future may look like. It enables the community to be directly engaged with big development or redevelopment proposals.

We propose that local authorities should now give reasons for approving a planning application as well as for refusing it. By listening to people's concerns up front and ensuring that people can see why a particular decision has been reached, we aim to minimise the need for action after a decision has been made, which is often the least satisfactory route of all for local communities.

We recognise that elements in the planning system are a mystery to many in the community. Therefore, we are considering whether we can provide more support to Planning Aid, a voluntary network of planners who provide professional advice to the public. In collaboration with the Royal Town Planning Institute, we are investigating how that organisation might be expanded and better funded.

Before dealing with the third-party right of appeal, I would like to touch briefly on some of my hon. Friend's other points.

May I return to the question of Planning Aid? Does the Minister accept that it is pivotal to local communities, because structures are always regarded as bureaucratic and complicated, and the only way in which ordinary people and community groups can get round them is with the sort of advice provided by organisations such as Planning Aid? That, rather than the structure, is the key.

I certainly agree that it is essential that communities, particularly the more disadvantaged ones, be supported, so that the planning system is made to work for them.

I would like briefly to deal with three points before I go on to the third-party right of appeal. Making PPGs slimmer is designed not to weaken them but to make them more effective. Much of what is in the current PPGs consists of general statements of practice and does not represent the hard core of policy. Slimming them down is designed to make them more comprehensible, better tools in the development of planning policy. I assure my hon. Friend that it is not our intention that what he predicted should come about.

My hon. Friend also asked about debates in Parliament on general policy. It is essential that we have proper policies on major infrastructure issues, which are often among the most hotly contested in planning terms. For example, for the country not to have a proper policy on airports would be an abdication of our responsibility in that important area. It is essential that the Government propose policies on such issues and that Parliament debate them. That provides a framework for the way in which we approach the provision of that infrastructure.

We propose that counties retain their responsibility for minerals and waste. They will also retain an involvement in some other planning issues, but we envisage a slimmer planning structure. Retaining the strategic and local levels means that that tier disappears.

On the third-party right of appeal, the Government's view is that such a right would not be consistent with our democratically accountable system of planning. Elected councillors represent their communities—they must take account of the views of local people on planning matters before decisions are made and justify their decisions subsequently to their electorate.

Third parties do not have a right of appeal against planning decisions in the way that applicants do, because it is the responsibility of local planning authorities to act in the general public interest when determining planning applications. Local authorities must determine planning applications in accordance with the development plan for the area, unless material considerations indicate otherwise, which can include views expressed by local residents and other third parties.

The right way forward is to make the planning system more accessible and transparent and to strengthen the opportunities for community involvement, which we believe would be a major benefit of the proposals in our Green Paper.

Two hon. Members have sought my permission, and that of the proposer of the debate and the Minister, to participate in the debate very briefly, so that the Minister may reply in full.

I am pleased to have secured this debate and to see the Under-Secretary of State for Health, the hon. Member for Pontefract and Castleford (Yvette Cooper), in her seat. I thank her for coming to reply. I am also grateful to my hon. Friend the Member for Cotswold (Mr. Clifton-Brown) and the hon. Member for Stroud (Mr. Drew) for being present. They both have an interest in the debate as they represent constituencies in Gloucestershire.

I have been applying for this debate for some time but have been unlucky in the selection procedure. My desire to have the debate began on Christmas day, when I made my usual round of hospital visits, as I am sure all hon. Members do. My visit to my local hospital was unhappy: when I arrived, I discovered that a ward was closed due to a shortage of staff. Not even agency staff could be found on that occasion. I also found a great many patients who should not have been in hospital but were waiting for nursing home places. One poor chap had been waiting for six months for a place at a specialist spinal unit.

All hon. Members receive letters telling us of problems with the health service, but when we go to hospitals and meet such people, the problems become very real. When we see the problems at first hand, they have a great effect on us. For example, I am concerned about the oncology ward in Cheltenham general hospital, at which people who are in a very sickly state sometimes arrive first thing in the morning and have to wait all day for treatment. As all hon. Members will have done, I have spoken to doctors, nurses, scientists, therapists and carers in my area, who feel not only short-staffed but extremely stretched in their work. I do not want to paint too black a picture, but I have become aware of those problems over the past year, especially in the Christmas period.

I do not blame the doctors, nurses or other staff, or the health authority in that area. The health service has national problems, to which I do not want to refer too generally, given that the debate focuses on Gloucestershire. However, there are national problems with funding, despite the Government's claims that they are increasing funding and despite the previous, Conservative Government's increased spending. Without taking into account the private sector contributions, Government spending on the health service puts this country ahead of Luxembourg, Ireland, Finland, Spain, Portugal, Greece and Italy. However, we fall way behind Germany, Denmark, France, Belgium, Sweden, the Netherlands and Austria in that respect.

There are also problems with what is known as the postcode lottery, whereby drugs such as beta interferon, for the treatment of relapsing and remitting multiple sclerosis, are prescribed in some areas and not in others. People understandably find that unacceptable, given that the NHS is supposed to be a national service.

One reason why problems have been made worse for the health service is that it has been the victim of its own success. It has kept people relatively well and allowed them to live longer. Only 50 years ago, there were 4 million pensioners in the country, whereas now there are 11 million. Although I do not want it to appear as though I am blaming pensioners for the problems, hon. Members will recognise that their greater calling on health services presents the NHS with another problem. The fact that there are also new drugs, new treatments and new operations has created greater demand. There is also a greater public awareness, and a greater expectation of public servants. All those factors add to the problems of the health service. I fully recognise that the Gloucestershire health authority and the staff there are doing the best that they can in a difficult situation.

When I visited Tewkesbury hospital on Christmas day, I found that delayed discharges, which are unkindly known as bed blocking, are a big problem. I raised the matter with the Prime Minister and the Secretary of State for Health, The picture in Gloucestershire is bleak. There was a time when Gloucestershire had many nursing home places. I do not want to be party political, but in 1997 the county had 4,047 nursing home places; now it has only 3,064. Those figures were kindly provided by the Minister in a written answer, so I can only assume that the figure of 983 for the home care places that the county has lost is accurate. That is a significant fall.

What are the reasons for that fall? Again, I do not want to be party political, but people have told me that they have to work to the national standards, and say that other factors such as employment regulations and a shortage of staff have all added to the problem. We are all aware that the situation is unfair to those waiting to be discharged from hospital, their families, the hospital staff, and to those waiting for operations and for the beds that are unnecessarily occupied. It may be a bigger problem in Gloucestershire because the county has a slightly older population than some other counties. I draw that to the Minister's attention, although I am sure that she is aware of it. Unfortunately, over the past few weeks there has been another flurry of nursing home closures in the county, which will add to the problem.

As I say, I do not want to paint too bleak a picture, because many people are trying their best to make something of the situation. For instance, there is a sheltered housing scheme and a hospital home care discharge scheme, and the new trust will bid for development funds to provide further beds to be commissioned as and when they are wanted. Some initiatives are being taken, but the picture is not good.

I want to mention health service staffing in Gloucestershire. I mentioned the closed ward in Tewkesbury hospital; it was certainly needed. Staff could not be found, not even agency staff, to run the wards. When I spoke to nurses in other hospitals in Cheltenham and Gloucester, I was told how stretched the staff were and how short-staffed the service was. I was told that nurses are leaving the NHS to work for agencies, only to be employed by the NHS at a huge extra cost. No one can blame those who take advantage of that, but it benefits neither patients nor the NHS budget.

Scientific staff carry out a vital job behind the scenes. Most people never come across them, but they do important work. They, too, are stretched, as is the ambulance service. The rurality of Gloucestershire makes it difficult to provide an effective ambulance service, and it is a great tribute to those who work for it that they manage to provide such a good service. Therapists, too, are stretched, and we have far too few carers.

A great deal more is expected of public servants today, not only in the health service. However, it applies particularly to the health service, and we must consider the rewards that health service staff receive compared with what they could earn elsewhere. We must also consider their conditions of work. On a recent visit to the ambulance service in Gloucestershire, I was reminded that those who train as paramedics get very little more than those who do not. I am sure that the Minister will want to address that, as it is a big problem. If we want to provide the kind of immediate service that people want, we must ensure that we have the staff to do it.

I also want to talk about waiting times. I have been a little concerned by some letters that I have received—I am sure that my hon. Friend the Member for Cotswold and the hon. Member for Stroud share my concern—about people having to wait a long time for treatment. The national figures for people who wait 12 months or more are not impressive, and have increased during the past four years. That is reflected locally. I am worried about people who have to wait for heart bypass operations. They suffer from an extremely serious condition, and we all know of people who have waited far too long for such operations.

Several drugs have been developed to treat serious illnesses, and it is a tragedy when they are not prescribed. Gloucestershire was certainly not helped by the uncertainty created when the National Institute for Clinical Excellence seemed to point in different directions on beta interferon. To its credit, the health authority did its best to provide funding for some patients, but it was by no means enough. When a serious illness could be, but is not, treated by a drug, we have to ask what is going on and whether we have a national health service at all.

Another example that concerned me recently was brachytherapy, a treatment with which I am not familiar. I am sure that the Minister will correct me if I pronounced it wrongly. It is a treatment for prostate cancer that is considered to be far less traumatic and to have fewer side effects than others. Cheltenham has a machine for it, but I am told by the Gloucestershire prostate cancer brachytherapy unit trust that it needs to raise £50,000 a year itself during the next two years to pay for the machine to run. That concerns us, given that we are supposed to have a national health service. The service seems rather patchy, and I hope that the Minister will mention that in her reply.

Some arrangements are being introduced that I hope will improve the delivery of health services. I want to draw attention to two problems. One is the joint emergency services unit, which will be effective in Gloucestershire from next year when the three emergency teams will work together. The ambulance service has told me that it wants comparative pay levels introduced if the emergency services are to work together. The Minister might consider that with her colleagues.

New strategic health authorities and primary care trusts will also be developed. Tewkesbury and Cheltenham will form one of the smallest in the new strategic region. I am a little concerned about that and hope that the Minister will say a word or two on the subject. We are trying to be as positive as we can be about the changes, but we are concerned about the merging of hospital trusts. We hope that it will benefit patients, but we shall have to see how it works.

Gloucestershire is seen as an idyllic place to live—a wonderful place with beautiful countryside. It is a lovely place, and I am sure that all those who live there are proud to do so. However, it has pockets of deprivation and problems caused by rurality and poor health in some areas. That needs recognition. All too often, Gloucestershire is not given the funding or the treatment by Ministers that it deserves. The same may apply to other shire counties as well. I hope that, in future, simply because a county sounds beautiful to live in, it will not suffer through shortage of funding.

I thank the Minister for listening so intently, and look forward to hearing what my colleagues have to say before she replies to my points.

Order. Before I call the hon. Member for Stroud (Mr. Drew), I should tell him and the hon. Member for Cotswold (Mr. Clifton-Brown) that the Minister wants a full 10 minutes to reply. I hope that they will show self-discipline.

I hope that I shall take somewhat less than two minutes, and no more than my fair share.

I rise to make one point. There is a third acute hospital in the wonderful county of Gloucestershire: besides the Gloucestershire royal hospital and the Cheltenham general hospital, there is also Standish hospital. For some years, we have been waiting for the relocation of facilities to the main site at Gloucestershire royal hospital, but will the Minister reconfirm—if not today, perhaps later in writing—that before services are relocated, the medical uses of the Standish hospital site will be considered? That is only fair and reasonable, and it links up directly with what the hon. Member for Tewkesbury (Mr. Robertson) said. That site could be used to help with the provision of facilities and to overcome the problem of delayed discharge, and we might consider to what other uses the site could be put. Will the Minister consider that and ensure that the commitment given to me by the chief executive of the health authority is fulfilled? Obviously, such matters are not so easy in these days of changing structures. On the day when we saw the launch of Care and Repair England's document, "On the mend", which considers how housing can be combined with health and social services to ensure better care for older people, it is appropriate to consider how the facilities at Standish could be used to play a part in that process.

Thank you, Mr. Deputy Speaker, for allowing me to catch your eye. I congratulate my hon. Friend the Member for Tewkesbury (Mr. Robertson) on securing this important debate. As he said, Gloucestershire is a highly rural county. I have one of the top half dozen most rural constituencies, which also contains the third highest number of over-85-year-olds of any constituency in the country. I have made those points before in this Chamber, but the capitation formula for distributing money to the various health authorities does not adequately take into account either rurality or care of the elderly. The elderly and the very young are the most expensive categories to care for, and that should be taken into account.

I want to make one narrow point. Following a debate in this Chamber before Christmas about the future of Cirencester hospital, I went to see the Under-Secretary of State for Health, the hon. Member for Salford (Ms Blears), and we discussed the need for openness from the health authority and from the new Cotswold and Vale primary care trust. Having dragged out some information from that care trust this morning, I was disturbed to discover that what I understood at that meeting would take place will not now take place. The understanding at that meeting was that on 1 February junior doctor status would be withdrawn and locums would be put in place pending Cirencester doctors being trained to house officer status.

I now discover—I was not told this as Member of Parliament for the constituency, which is disgraceful—that that was not possible and that senior house officers will have to be seconded from Cheltenham general hospital. That hospital is already overstretched. If it has surplus capacity of senior house officers, what was it doing before? That arrangement is tenuous and bodes badly for the future of Cirencester hospital, but above all, it is not in keeping with the spirit of openness that formed part of my discussion with the Minister, who was only too keen that a discussion forum should be launched, and an inaugural meeting will take place on Friday. However, for the local Member of Parliament to have to find out about proposed changes at Cirencester hospital from the local press is unacceptable, and I ask the Minister to speak to her officials in Gloucestershire to ensure that I am kept fully in the picture in future.

I welcome the decision of the hon. Member for Tewkesbury (Mr. Robertson) to hold a debate on the national health service in Gloucestershire, and congratulate him on his success in securing the debate. Clearly, the NHS is vital to his constituents and to people throughout the country.

I shall start by briefly addressing the points made by other hon. Members. My hon. Friend the Member for Stroud (Mr. Drew) raised the question of Standish hospital, and I shall look into his remarks on the site's future medical role.

I was not aware of the issues raised by the hon. Member for Cotswold (Mr. Clifton-Brown) about Cirencester hospital. I shall discuss them with my hon. Friend the Member for Salford (Ms Blears), the Under- Secretary of State who has responsibility for the region, and we shall get back to him. We have discussed the capitation formula before, and although he pointed out the importance of considering the elderly in that context—I completely agree with him—he will be aware that other parts of the country make equally strong representations that they are penalised by a focus on the elderly. In areas where life expectancy is much lower, there is a lower elderly population, so people feel that health inequalities in their areas need to be addressed in the capitation formula. The hon. Gentleman will be aware that the capitation formula is under review, and that all those points are being taken into account.

The hon. Member for Tewkesbury raised a series of issues concerning the NHS in Gloucestershire, and I shall try to address some of them. Many of them were broad issues that apply both to Gloucestershire and to other areas across the country. We should be clear that there are pressures in Gloucestershire and elsewhere. Patients in many parts of the country wait too long for treatment, too many operations are cancelled at the last minute and too many patients who could be discharged are waiting in hospitals. Those problems result from years of underfunding and under-investment, which have reduced the NHS's capacity to respond. The Labour Government inherited a situation in which there were too few doctors and too few beds across the NHS.

We must also recognise the improvements that have already been made and that are being made. Such improvements are often a result of the hard work of health professionals both in Gloucestershire and across the country. The extra investment needs to be sustained into the future; we are working to provide improved care for patients in the NHS in Gloucestershire and elsewhere, but we need to go further.

Through the NHS plan, we have increased the number of doctors, nurses and other health professionals in training, we have reversed the decline in bed numbers for the first time in 30 years and we are increasing the amount of money invested in the NHS by record amounts. In Gloucestershire, as in the rest of England, that is starting to deliver changes to the services that people receive. Extra investment and extra capacity are extremely important. The hon. Member for Tewkesbury made many points concerning additional staffing, capacity and equipment, and about facilities for staff to use. I agree with him, but it is all about putting in extra investment.

The health authority has received a 5.7 per cent. real-terms increase in its budget in 2000–01 and this year. Next year, the health community's allocation will increase by 6.7 per cent. in real terms. Compared with a historical average across the country of some 3 per cent. in real terms, that is substantial additional investment in the health service. We need to look into the long-term needs of the NHS, which is what the Wanless report was about. That requires decisions about how we shall fund continued investment in the health service.

Although Westminster Hall is not a party political forum and I respect the tone in which the hon. Gentleman made his comments, he needs to debate the matter within his party, and not simply raise it with Ministers. I agree that the NHS needs greater capacity, and that we should find additional capacity. However, he may want to raise that issue with colleagues in his party.

More than £1 million has already been allocated from the modernisation fund to improve accident and emergency services at Cheltenham general hospital, where £413,000 was used to create a new surgical admissions lounge and improve security, and at the Gloucestershire royal hospital, where the accident and emergency department was refurbished. Additional investment has enabled the number of beds in the Gloucestershire health community to increase for the first time in more than 30 years of reductions. From 1999–2000 to 2000–01, the number of beds increased by 126, or 6.6 per cent.

From 1997 to 2001, the number of doctors employed in the hospital and community health service in Gloucestershire increased by 28 per cent. Additional investment has been targeted at critical care facilities—intensive care and high-dependence beds at Gloucestershire royal and Cheltenham general hospitals. Further investment will be made during the next few years. Gloucestershire royal hospital is developing a major £32 million capital scheme under the private finance initiative.

Extra investment has enabled the health community to tackle long waits. In the two years to September 2001, the number of outpatients waiting more than 13 weeks for a first outpatient appointment fell by 31.5 per cent. and the number waiting more than 26 weeks fell by more than 46 per cent. Plans are in place to ensure that no patients wait more than 26 weeks for a first outpatient appointment after the end of March this year.

Clearly, waits must be much shorter for cancer and other urgent referrals. The target for a GP referring someone with suspected cancer to a consultant is two weeks. The Gloucestershire health community has achieved that target for all patients covered by it since last July. In the three years to last September, the number of in-patients waiting for treatment fell by 12.6 per cent.

The Gloucestershire health community is making progress and plans to deliver the targets on waiting times set out in the NHS plan, which should make a considerable difference for patients in Gloucestershire and across the country. However, we must not only put in place the extra capacity, but introduce the right reforms and ensure that money is well spent. The hon. Member for Tewkesbury mentioned the postcode lottery. I agree that we need national standards in a national health service. For the first time, in the National Institute for Clinical Excellence, we have an authoritative body able to produce national standards for treatment and drug use that must be followed by health authorities and primary care trusts across the country.

The national service frameworks for coronary heart disease and cancer are providing national standards. New national service frameworks, for example, for children and for long-term conditions, will also come on stream. Many modernisation projects are already under way in Gloucestershire—"action on" and "collaborative" projects are leading the way in the modernisation of services and improved care for patients. They include the booked admissions project led by the Gloucestershire royal hospital, by which all surgical day cases, physiotherapy and routine radiography appointments are electronically booked.

"Action on" programmes are leading to shorter waiting times for patients. The ear, nose and throat programme at the Gloucestershire royal hospital is developing a GP specialist role to promote direct access for routine tonsillectomy. The action on cataracts programme at Cheltenham general hospital is improving efficiency and patient care so that patients can be treated more quickly. The orthopaedic collaboration, working across the acute hospitals, has reduced the length of hospital stays for routine hip replacements by improving pre-operative care, including physiotherapy to reduce recovery time. Discharge has now been reduced from 14 to seven to eight days.

The hon. Member for Tewkesbury raised concerns about delayed discharges. He is right that there are too many, not only in Gloucestershire but across the country. Gloucestershire social services received an additional £1,463,000 last October to tackle that problem. The average number of patients waiting to be discharged has declined by more than 60 per cent., from 109 in July to 48 in January. Progress must continue, but it is already under way.

Changes to the structures of the health service in Gloucestershire are already in place. Those will allow more decisions to be made locally, provide more resources to front-line clinicians making decisions about care, and provide a better structure and better reforms with which to use the considerable, additional investment already going into the NHS.

The lives of some 4,000 Plymouth, Sutton constituents have been blighted by potent "bad egg" sewage smells for more than four years. Cattedown and Prince Rock residents are those most affected. However, when the wind blows in a certain direction, residents of Oreston in the constituency of the hon. Member for South-West Devon (Mr. Streeter) are also affected.

Cattedown, Prince Rock and Coxside are part of the £18 million regeneration east end renewal project area. For several years, the residents have been working hard on their plans for regenerating the area, which focus around a healthy living project. It is ironic that the blight on the area, represented by the Cattedown pong, should be something that makes people feel sick. It is absolutely essential to the success of the project that a final solution is found to the Cattedown pong.

The residents and I know that South West Water has an action plan, but I am afraid we have heard this before. Plymouth city council had powers under the Environment Protection Act 1990 to issue an abatement notice, which could insist that a time scale be attached to such action. However, that reassurance seems, like the proverbial rug, to have been pulled from under our feet.

The plant was built in 1998, and 4 km of tunnels, 25 m beneath the streets of Plymouth, were constructed to carry sewage from more then 70,000 homes to the Cattedown treatment works. The project, which brought to an end decades of raw sewage being discharged into Plymouth Sound, was a key part of South West Water's on-going £1 billion clean-sweep programme to improve water quality standards around the south-west coast.

Residents raised many questions at the time of the proposal. After all, a sewage treatment works—or waste water treatment works, as it is more properly known—is not what one would choose in the neighbourhood. Reassurances were given that it was a state-of-the-art treatment works, so there would be none of the smells that people traditionally associate with such works. Assurances were given to residents and their representatives, including Councillor Jean Nelder. I am indebted to her for her helpful recollections, based on her diligent work in representing residents' interests.

In supporting residents in their battle to end the pong, I was approached by people operating businesses and leisure pursuits from the Cattedown wharf, including Ian Sleep, who operates a boat storage and maintenance business called Shore Store. The two problems are related, because they raise issues about the original design of the treatment works. I shall deal with each issue in turn.

Apart from the unpleasant nature of the pong, people worry that the smell is contaminating washing lines, decreasing property values and may result in ill health. As one of the residents told me,

"we were assured that there would be no smell from the new works but there is, to us it is a clean sweep under the carpet by South West Water."

The bad egg odour is, of course, hydrogen sulphide gas, which is a natural product of decay. While high levels of hydrogen sulphide can be harmful, even deadly, it can be detected by the nose at an extremely low level—at concentrations of one 400th of the threshold for harmful human health effects. Apparently, the levels of H₂S at Cattedown are lower, and I am advised that they do not represent a health risk per se. However, as anyone who has experienced the bad egg smell will know, the unpleasant, putrid odour can make people feel sick, to the extent, sometimes, that they become sick. It affects the quality of life in a way that could lead to or compound depression.

Plymouth city councillors and officers and I have received complaints from members of the public since 1998. They increased and became so frequent that the council officers met representatives of the water company in March 2001 and obtained commitments to a series of improvements. Following the initial meeting, complaints continued and the council officers, having experienced the odours on several occasions, concluded that a statutory nuisance existed. In July 2001, it served an abatement notice under section 80 of the Environmental Protection Act, which required South West Water to manage the waste water treatment works to ensure that any odours emanating beyond the boundary of the area did not amount to a statutory nuisance.

The company was given three months to comply. Subsequently, South West Water confirmed that urgent action was being taken at all three sites to secure improvements. There is also a problem at Camel's Head and Ernesettle in the neighbouring constituency of the Under-Secretary of State for Transport, Local Government and the Regions, my hon. Friend the Member for Plymouth, Devonport (Mr. Jamieson). The company asked for six months rather than three to do the work, and the council agreed to extend the notices, but not to the full six-month period. South West Water appealed against the notices and concurrently continued with the programme of works at each site.

Early last year, I had the first in a series of meetings with representatives of residents associations and learned that complaints made directly to the water company were not handled to the high standards that we expect of a modern utility. I could see that Plymouth city council were taking appropriate enforcement action, but I felt that residents deserved better information about what was happening. A polite response to my letter to the chief executive of South West Water informed me that the matter would be attended to. However, after a bad pong episode several months later, residents told me that things had not improved, and we decided to call a public meeting and invite all the parties to come and explain what was happening.

The meeting was held on 25 September 2001 in Prince Rock primary school. More than 60 people attended, as well as officers of the council, South West Water, the Environment Agency and the secretary of the Ofwat consumer committee. The company outlined its action plan in some detail. It is fair to say that, at long last, people felt that some commitment and resources would be applied to tackle the problem.

However, South West Water continued its appeal against the time scale attached to the abatement order. At a hearing on 29 November, the solicitors acting for South West Water requested an adjournment until 20 December 2001. At that point, people were still confident that the action plan would result in an end to the problem within a reasonable time. To that end, we have monthly meetings of the relevant parties to keep the spotlight on the issue and to ensure that residents have an opportunity to contact directly the company and the people who have the power to resolve the issue.

The appeal hearing on 20 December was adjourned, it having emerged that recent case law might have a bearing on the proceedings. To our dismay, that turned out to be the case: East Riding of Yorkshire council v. Yorkshire Water Services Ltd. in 2000 made it likely that a court would not regard the treatment works as premises under part 3 of the 1990 Act. Based on legal counsel's opinion, the local authority felt that it had no option but to withdraw the notices. Officers remain convinced that the 1990 Act was intended to include sewage treatment works among the premises that come under its control and are now considering alternative action, which may include common-law litigation.

How can local residents have confidence in a provider who is prepared to exploit legal loopholes to escape regulation? The Yorkshire case seems to have involved a sewer pipe to one cottage. It is regrettable that South West Water chose to seek its application to a whole treatment works that blights 4,000-plus households—a rather different kettle of fish. Residents received a slap in the face from that legal loophole. The company used it to avoid the notice, particularly the time scale attached. My constituents feel let down, and once again unsure that a light—or, more appropriately, fresh air—is at the end of the tunnel.

Our local paper, the Evening Herald, is fully behind the residents in their campaign. I ask, as did its recent editorial, whether the situation would be different if South West Water executives lived in the pong areas. Perhaps any review of enforcement powers should stipulate that after, say, three months of the uncontrolled nuisance, company executives should have an order placed on them to reside in the area.

Any court faced with the issue is likely to hold that the waste water treatment works are not premises on which an abatement notice may be served pursuant to section 79 of the Environmental Protection Act 1990. When the Act was introduced, water authorities, which took over from local authorities in 1972, were replaced by sewerage undertakers following privatisation. However, Parliament seems to have continued to use the word "premises" without redefining it to accommodate that change. The long title of the 1990 Act refers to the intention to

"restate the law defining statutory nuisances and improve the summary procedures for dealing with them",

but there is no material redefinition of the word "premises." Consideration can be given to the bringing of proceedings for an injunction to restrain common law public nuisance, but that is much less easy to prosecute than an offence defined in specific legislation. Local authorities the length and breadth of the country are left in a position far less clear than that envisaged by legislators and enforcement officers.

I turn now to problems that have been encountered, over which the Environment Agency has enforcement powers. In May 2001, Ian Sleep of Shore Store wrote to me:

"We have to complain about the South West Water sewage works in Finnigan Road Cattedown. We have complained to South West Water and the Environment Agency for more than 2 years now with no improvement at all. In fact the situation is getting worse. South West Water are using the River Plym as an open sewer, and their so called storm outlet is situated under the next wharf down, about 400 yards from us. It constantly empties raw macerated sewage, untreated into the river regularly without any logical reason. Whether the tide is flowing or ebbing the whole area is a massive cess tank which is full of sanitary towels, condoms, needles and even babies nappies. So much for cleaning up the environment."

The letter was accompanied by photos and a daily record of the sewage and the foul smell from the treatment works from April 2000 to May 2001. They showed that sewage was observed on 171 days, and the smell was present on 66. I visited the business with officers from the Environment Agency. A report from the agency following the meeting confirmed that the operation of the treatment works fell far short of the consents order. On 28 June 1998, the agency had granted a combined sewer overflow consent in respect of the treatment works to South West Water. It was granted for the Plymouth Hoe east and west bathing waters to achieve compliance with the mandatory bathing water standards, required under the European Community bathing water directives, and to address aesthetic impacts from the discharge. The consent specified an operation that should have been better than the agency's bathing water policy requirements, and a 6 mm screening requirement to remove sewage-related debris on the discharge.

In a letter of 31 August, the agency confirmed:

"It is now known that infiltration of groundwater gaining access to the sewerage system was significantly underestimated by South West Water (SWW) and this has resulted in far more frequent operation of the CSO than expected. This discharge should be weather related, although the large size of the catchment could cause overflow to continue to operate after rain has stopped falling. SWW are required to improve the performance of the CSO as part of the AMP3 (Asset Management Plan 3) investment…Regrettably, the scheme is behind schedule…SWW have asked for additional time before this work is commenced".

An action plan has been developed and should bring overflows from the treatment works back in line with the original consents order by the end of this year. The agency is monitoring the effect of recent works to increase capacity through new plant and engineering, although I understand that a combination of additional storage for storm flows and separation of infiltration water from the sewerage system will still be necessary.

The Department has many important environmental issues on its plate, and I have not lightly used the opportunity of my second debate on water-related matters in the past three months to bring the Minister to the Chamber. Will he let me have his observations on the legal powers available to local authorities to deal with odour problems around sewage treatment works, and will he review those powers? Will he take an interest in the work that local Environment Agency officers are doing to deal with the apparent breach of the combined sewer outflow consent? Will he also take an interest in my approaches to the director-general of Ofwat and the south-west customer service committee to ensure that the cost of this expensive nightmare is met by the shareholder, not the consumer?

Finally, does my right hon. Friend agree that the patient people of Prince Rock, Cattedown and the other affected areas merit special consideration by South West Water for the four years of pong, pollution and misery that they have endured? I ask that in particular because, as my right hon. Friend well knows, we have the highest water bills in the country, and charges for sewage treatment form the largest part of them.

I congratulate my hon. Friend the Member for Plymouth, Sutton (Linda Gilroy) on her success in securing a debate about the problems at the Cattedown sewage treatment works in Plymouth and on the succinct way in which she dealt with them. I have visited Plymouth several times, and I know how assiduously she tackles issues that affect her constituents and how connected she is with the local communities.

I have considerable sympathy with local residents who have had to endure the offensive odour problems around Cattedown and with those who have experienced similar problems around the works at Camel's Head and Ernesettle. In many ways, these are classic constituency problems, which most of us have encountered at one time or another. One of the strengths of this place is that we can bring our experience to bear on such matters, and when I first examined the problems at Cattedown I was reminded of problems that had arisen in my constituency when odours from a tip caused intense misery to many people in the area.

My hon. Friend is right to identify real and perceived problems and to ask whether issues are a nuisance or a threat to health. When an odour is offensive, however, the worry is genuine and palpable in the local community. I have great sympathy with my hon. Friend when she talks about the relationship with the healthy living centre. There are two such centres in my constituency, and I have seen the positive influence that they can bring to bear on the health and confidence of the local community. When problems arise, they can undermine the work of such centres.

I understand that the route for resolving statutory nuisances such as odour problems around sewage treatment works, through the Environmental Protection Act 1990, does not apply, and I shall return to that in a moment. Today, I read a letter dated yesterday from the chief executive of South West Water. It sets out the efforts that the company has made and intends to make to solve the problems to the satisfaction of local residents and businesses. I shall provide my hon. Friend with a copy of the letter after the debate, and she will see that the company expresses its commitment to solving the odour problems at Cattedown by April 2002. Furthermore, the letter sets out the action that the company will take to reduce the spill frequency of the storm water overflow from the works by the end of this year. Officials at the Environment Agency are working closely with South West Water to ensure that that deadline is met, and I have asked my officials to keep me informed of progress. I would be happy to join my hon. Friend in keeping in touch with those developments and keeping an eye on them, especially in view of her points about previous timetables. It is hoped that this and other improvement works will achieve more regular compliance with the standards of the bathing waters directive, and limit pollution of the River Plym.

My hon. Friend expressed concern about who would have to meet the costs of necessary measures. I can assure her that the people of Plymouth will not be asked to pay for putting right any mistakes made by South West Water. The price limits set by the Director-General of Water Services in 1999 and revised last December limit the bills that the company can charge its customers. Those price limits already provide for the standards and consents set by the Environment Agency, including the cost of Operation Clean Sweep. If the company finds that it costs it more, that is its risk, not that of its customers.

The water company would be able to ask the Office of Water Services—Ofwat—to look at its price limits only if it were asked to undertake measures that were not on the table in 1999 when its price limits were set. Both my Department and Ofwat have always made it clear that the control of odours and other nuisances is something that a sewerage company should be doing as a part of its day-to-day running costs, not something that requires extra funding.

I am told that the Ofwat customer services committee for the south-west, which is the statutory champion of water customers, has been energetic in pressing South West Water to solve the odour problem quickly.

It is interesting that none of my constituents approached Ofwat. The regulator's title causes problems. It relates to water and people do not perceive that consumer committee as being able to deal with sewage issues. We should draw further attention to Ofwat's powers in that area.

My hon. Friend makes an interesting point. The purposes for which that committee was established and its remit are clear, but I agree, from my own experience, that public knowledge and understanding of it are comparatively limited at local level. There are several issues surrounding the work of the committee that my hon. Friend may wish to explore further, along with the subject of price controls. I invite her to contact the Director-General of Water Services, Philip Fletcher, who would be happy to discuss those issues with her. We should investigate ways of making people more aware of what Ofwat is there to do on their behalf.

My hon. Friend raised the issue of statutory nuisance legislation. I am assured that there is no flaw in that legislation in terms of enabling local authorities to deal with odour nuisance from sewage treatment works. The definition of "premises" under the Environmental Protection Act 1990 and its predecessors clearly does not include sewers or sewage treatment works; nor did Parliament intend it to do so. If one examines the history of the definition, one finds that statutory nuisance provisions do not apply to public sewers and sewage treatment works and that that was established by 19th-century case law. It is not a recent development or the result of a lacuna in the recent legislation to which my hon. Friend referred. The courts held that Parliament could not have intended that magistrates, through enforcing local abatement notices, should direct how those constructing and operating such works should go about it. If that were the case, the establishment and running of a system for the benefit of a broader society could be undermined.

That is quite logical, but ensuring that there are ways of dealing with local nuisances is also important. There is no obstruction in the current situation. There is nothing to stop local authorities and water undertakings working closely together to identify problems and find solutions without having to resort to legal action. There is at the end of the day, as my hon. Friend said, the possibility of taking action through common law, although that may be more of a backstop than an approach that leads to immediate action. I would be happy to look at the history of this case to discover whether there are any lessons that should be learned. However, in the short term, we must deal with the matter.

We are committed to meeting our obligations under the urban waste water treatment and bathing water directives and, as a result, the Cattedown works have been built to treat sewage from Plymouth to the required standards of the directives. The provision of secondary treatment and ultra-violet disinfection since 1998 has had a positive effect on the quality of bathing waters at Plymouth Hoe east and west. For example, in 1999 and 2000, bathing waters in both areas passed the mandatory standard, and Plymouth west again passed in 2001. Unfortunately, Plymouth east was a marginal failure that year.

I commend my hon. Friend for the commitment and support that she has given her constituents in solving these problems. For example, she organised public meetings involving the relevant parties to ensure that everyone knew of the problems and of what was being done to solve them. I understand her concern that the problem appears to have taken longer to deal with than was desirable and than was suggested at an earlier stage. The letter that I received from South West Water, which I shall pass to her, gives assurances in that regard.

During the procedures that Plymouth city council has followed on behalf of the residents of Cattedown, it has taken legal advice and received legal counsel's opinion. I am surprised to hear the Minister say that no powers exist under the Environmental Protection Act 1990 with regard to serving abatement notices. Will he meet the environmental protection officer to discuss that further, as it is perceived to be an issue not only by the local environmental health officer but by others?

My hon. Friend goes slightly beyond what I said. I referred to the definition of "premises" under the Environmental Protection Act 1990, and the fact that that is clearly based on earlier case law. Rather than pretend that I am an expert on the law, I shall happily consider any advice provided to my hon. Friend, whether by the local authority or anyone else, and ask my officials and those in the Environment Agency to consider that advice and respond to any points that arise.

I shall share with her the letter that I received from Mr. Robert Baty, the chief executive of South West Water, which was written only yesterday and is probably the most up-to-date communication on these matters. In addition, I shall look into the matter with her, to ensure that the timetable that has been given is adhered to, so as to end the nuisance to her constituents. At the end of the day, it is most important to ensure that her constituents enjoy a pleasant environment.

I thank the Minister for that, and acknowledge that he is a frequent visitor to the far south-west. I hope that those visits will not cease and that he will visit the area—and, perhaps, our healthy living centre—without having to experience the pong. I am sure that his words will be greatly appreciated by my constituents.

I share my hon. Friend's desire that I should visit her area in safety, rather than find that it has a continuing problem. As I said, the important thing is that the problem should be overcome. Clearly, that cannot be done overnight and, clearly, it has gone on longer than was originally promised, and longer than is desirable.

I hope that what I have said today will give cause for optimism about ridding my hon. Friend's constituency of this nuisance. I hope, too, that everyone engaged in the matter—from the company to the Environment Agency, and to officials in my Department—will consider what can be done to accelerate the process and to learn lessons for the future, so that constituents elsewhere find that such matters are dealt with more speedily.